| IDENTIFIER | DESCRIPTION | CATEGORY OF SERVICE | CHARGE AMOUNT |
|---|---|---|---|
| 2022451 | HC KIDNEY TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $410,628.00 |
| 2022453 | HC LIVER TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $425,524.00 |
| 2022457 | HC KIDNEY/PANCREAS TRANSPLANT CAD | Acquisition of Body Components - Cadaver Donor | $466,664.70 |
| 2025007 | HC OTHER TRANSPLANT | Acquisition of Body Components - Cadaver Donor | $323,171.99 |
| 2025900 | HC LUNG TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $410,628.00 |
| 2025937 | HC HEART TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $544,000.00 |
| 2026787 | HC HEART/LUNG TRANSPLANT CAD | Acquisition of Body Components - Cadaver Donor | $711,765.60 |
| 2022452 | HC KIDNEY TRANSPLANT (LIVE) | Acquisition of Body Components - Living Donor | $387,140.00 |
| 2022454 | HC LIVER TRANSPLANT (LIVE) | Acquisition of Body Components - Living Donor | $589,632.00 |
| 2026257 | HC BMT AUTOLOGOUS BY NYBC | Acquisition of Body Components - Stem Cells - Allogeneic (Effective 1/1/17) | $5,277.00 |
| 2026261 | HC BMT ALLOGENEIC UNRELATED CORD BLOOD | Acquisition of Body Components - Stem Cells - Allogeneic (Effective 1/1/17) | $275,358.00 |
| 2022434 | HC BLOOD SPLIT UNIT | Administration, Processing, and Storage for Blood and Blood Components | $3,300.00 |
| 2022435 | HC CRYOPRECIPITATE EACH UNIT | Administration, Processing, and Storage for Blood and Blood Components | $648.00 |
| 2022436 | HC RBC LEUKOCYTES REDUCED | Administration, Processing, and Storage for Blood and Blood Components | $2,126.70 |
| 2022438 | HC RED BLOOD CELLS UNIT | Administration, Processing, and Storage for Blood and Blood Components | $2,952.00 |
| 2022439 | HC WASHED RED BLOOD CELLS UNIT | Administration, Processing, and Storage for Blood and Blood Components | $10,110.72 |
| 2022441 | HC PLATELET PHERES LEUKOREDUCED | Administration, Processing, and Storage for Blood and Blood Components | $7,932.00 |
| 2022442 | HC PLATE PHERES LEUKOREDU IRRAD | Administration, Processing, and Storage for Blood and Blood Components | $7,409.49 |
| 2022443 | HC RBC DEGLYCEROLIZED | Administration, Processing, and Storage for Blood and Blood Components | $10,116.00 |
| 2022447 | HC PLATELETS, HLA-M, L/R, UNIT | Administration, Processing, and Storage for Blood and Blood Components | $16,368.00 |
| 2022448 | HC PLASMA, FRZ BETWEEN 8-24HOUR | Administration, Processing, and Storage for Blood and Blood Components | $780.00 |
| 2025244 | HC DETERGNT TX FROZ PLASMA EA UNIT | Administration, Processing, and Storage for Blood and Blood Components | $1,320.00 |
| 2020472 | HC BLOOD TRANSFUSION SERVICE | Administration, Processing, and Storage for Blood and Blood Components - Administration (e.g., Transfusion) | $3,003.05 |
| 2025454 | HC GROUND MILEAGE PER STATUTE MILE | Ambulance | $51.75 |
| 2025455 | HC ALS1-EMERGENCY | Ambulance | $2,875.00 |
| 2025456 | HC BLS - EMERGENCY | Ambulance | $1,725.00 |
| 2025490 | HC AMB EKG | Ambulance | $621.00 |
| 2025763 | HC ALS 2 | Ambulance | $4,025.00 |
| 2010000 | HC OPERATING ROOM FLAT FEE | Ambulatory Surgical Care | $4,303.53 |
| 2010001 | HC OPERATING ROOM PER MINUTE | Ambulatory Surgical Care | $143.45 |
| 2022677 | HC TERMINATED PROCEDURE | Ambulatory Surgical Care | $4,620.96 |
| 2022680 | HC ROBOTIC SURGERY | Ambulatory Surgical Care | $43,175.54 |
| 2026244 | HC ROBOTIC SURGERY - DAVINCI SINGLE PORT | Ambulatory Surgical Care | $43,175.54 |
| 2026538 | HC ROBOTIC SURGERY - INTUITIVE ION | Ambulatory Surgical Care | $43,175.54 |
| 2026567 | HC COMPUTER ASSISTED NAVIGATION IMAGE-LESS | Ambulatory Surgical Care | $29,342.60 |
| 2026568 | HC COMPUTER ASSISTED NAVIGATION CT/MRI | Ambulatory Surgical Care | $29,342.60 |
| 2022685 | HC ANESTHESIA BASE FEE | Anesthesia | $521.05 |
| 2022686 | HC ANESTHESIA PER MINUTE | Anesthesia | $4.83 |
| 2025794 | HC MOD SED SAME PHYS/QHP <5 YRS | Anesthesia | $392.44 |
| 2025796 | HC MOD SED SAME PHYS/QHP EA | Anesthesia | $130.81 |
| 2026163 | HC MOD SED SAME PHYS/QHP 5/>YRS | Anesthesia | $254.34 |
| 2021990 | HC EVOKED AUDITORY TEST | Audiology | $315.13 |
| 2022766 | HC NEWBORN AUDITORY EP | Audiology | $531.30 |
| 2023067 | HC NASOPHARYNGOSCOPY W ENDOSCOPE | Audiology | $3,313.38 |
| 2021986 | HC PURE TONE AUDIOMETRY, AIR | Audiology - Diagnostic | $269.27 |
| 2021987 | HC COMPREHENSIVE HEARING TEST | Audiology - Diagnostic | $305.50 |
| 2021989 | HC AUDITOR EVOKE POTENT, COMPRE | Audiology - Diagnostic | $856.12 |
| 2022763 | HC TYMPANOMETRY & REFL THR | Audiology - Diagnostic | $186.05 |
| 2022765 | HC VRA | Audiology - Diagnostic | $362.25 |
| 2022922 | HC BASIC VESTIBULAR EVAL | Audiology - Diagnostic | $315.13 |
| 2022989 | HC SCREEN TONE AIR ONLY | Audiology - Diagnostic | $231.58 |
| 2025549 | HC CALORIC VSTBLR TEST W/REC BITHERMAL | Audiology - Diagnostic | $798.22 |
| 2021969 | HC ELECTROCONVULSIVE THERAPY | Behavior Health Treatments/Services - Electroshock Treatment | $2,058.15 |
| 2021964 | HC FAMILY PSYTX W/O PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $833.32 |
| 2021965 | HC FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2021966 | HC MULTIPLE FAMILY GROUP PSYTX | Behavioral Health Treatment/Services - Family Therapy | $304.60 |
| 2025660 | HC FQHC FAMILY PSYTX W/O PATIENT 50 MIN - SMI | Behavioral Health Treatment/Services - Family Therapy | $833.24 |
| 2025661 | HC FQHC FAMILY PSYTX W/O PATIENT 50 MIN - SED | Behavioral Health Treatment/Services - Family Therapy | $833.24 |
| 2025662 | HC FQHC FAMILY PSYTX W/PATIENT 50 MIN - SMI | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2025663 | HC FQHC FAMILY PSYTX W/PATIENT 50 MIN - SED | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2025968 | HC TELEHEALTH FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $981.71 |
| 2026596 | HC HLTH BHV IVNTJ FAM 1ST 30 MIN | Behavioral Health Treatment/Services - Family Therapy | $105.25 |
| 2026597 | HC HLTH BHV IVNTJ FAM WO PT 1ST 30 MIN | Behavioral Health Treatment/Services - Family Therapy | $172.12 |
| 2026598 | HC HLTH BHV IVNTJ FAM W/O PT EA ADDL 15 MIN | Behavioral Health Treatment/Services - Family Therapy | $86.06 |
| 2026682 | HC HLTH BHV IVNTJ FAM EA ADDL | Behavioral Health Treatment/Services - Family Therapy | $52.62 |
| 2026890 | HC FHC TELE SBH FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2026891 | HC FHC TELE SBH PSYTX W/O PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $833.32 |
| 2026943 | HC SBHC/LCM AUDIO ONLY FAMILY PSYTX W/O PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $786.16 |
| 2026944 | HC SBHC/LCM AUDIO ONLY FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $925.80 |
| 2021967 | HC COG REMED SKILLS GRP 90MIN | Behavioral Health Treatment/Services - Group Therapy | $260.47 |
| 2023030 | HC ENVIR INTERV GRP 30MIN | Behavioral Health Treatment/Services - Group Therapy | $89.04 |
| 2024622 | HC COG REMED SKILLS GRP 120MIN | Behavioral Health Treatment/Services - Group Therapy | $521.52 |
| 2025664 | HC FQHC COG REMED SKILLS GRP - SMI | Behavioral Health Treatment/Services - Group Therapy | $261.10 |
| 2025665 | HC FQHC COG REMED SKILLS GRP - SED | Behavioral Health Treatment/Services - Group Therapy | $261.10 |
| 2026594 | HC HLTH BHV IVNTJ GRP 1ST 30 | Behavioral Health Treatment/Services - Group Therapy | $106.00 |
| 2026595 | HC HLTH BHV IVNTJ GRP EA ADDL 15 MIN | Behavioral Health Treatment/Services - Group Therapy | $79.50 |
| 2026899 | HC FHC TELE SBH COG REMED SKILLS GRP 90MIN | Behavioral Health Treatment/Services - Group Therapy | $260.47 |
| 2026945 | HC SBHC/LCM AUDIO ONLY COG REMED SKILLS GRP | Behavioral Health Treatment/Services - Group Therapy | $245.73 |
| 2021949 | HC PSYTX W PT 30 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2021951 | HC PSYTX W PT 45 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2021953 | HC PSYTX W PT 60 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2021958 | HC PSYTX W PT 30 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2022558 | HC CONSULTATION WITH FAMILY | Behavioral Health Treatment/Services - Individual Therapy | $189.43 |
| 2024316 | HC PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $685.67 |
| 2024317 | HC PSYCH DIAG EVAL W/MED SRVCS | Behavioral Health Treatment/Services - Individual Therapy | $760.04 |
| 2024318 | HC PSYTX W PT W E/M 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2024319 | HC PSYTX W PT W E/M 45 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,349.07 |
| 2024320 | HC PSYTX W PT W E/M 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,762.49 |
| 2024322 | HC PSYTX COMPLEX INTERACTIVE | Behavioral Health Treatment/Services - Individual Therapy | $60.54 |
| 2025668 | HC FQHC PSYTX PTW/E&M 45 MIN - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,349.07 |
| 2025672 | HC FQHC PSYTX PT 60 MINUTES - SMI | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2025673 | HC FQHC PSYTX PT 60 MINUTES - SED | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2025678 | HC FQHC PSYCH DIAGNOSTIC EVALUATION - SMI | Behavioral Health Treatment/Services - Individual Therapy | $686.05 |
| 2025679 | HC FQHC PSYCH DIAGNOSTIC EVALUATION - SED | Behavioral Health Treatment/Services - Individual Therapy | $686.05 |
| 2025680 | HC FQHC PSYCH DIAG EVAL W/MED SRVCS - SMI | Behavioral Health Treatment/Services - Individual Therapy | $760.29 |
| 2025681 | HC FQHC PSYCH DIAG EVAL W/MED SRVCS - SED | Behavioral Health Treatment/Services - Individual Therapy | $760.29 |
| 2025682 | HC FQHC PSYTX PT 30 MINUTES - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2025683 | HC FQHC PSYTX PT 30 MINUTES - SED | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2025684 | HC FQHC PSYTX PT W/E&M 30 MIN - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2025686 | HC FQHC PSYTX PT 45 MINUTES - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2025687 | HC FQHC PSYTX PT45 MINUTES - SED | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2025729 | HC FQHC PSYCH THRPY FOR CRISIS 1ST 60 MIN -SED | Behavioral Health Treatment/Services - Individual Therapy | $574.35 |
| 2025730 | HC FQHC PSYCH THRPY FOR CRISIS EA ADDL 30 MIN -SED | Behavioral Health Treatment/Services - Individual Therapy | $274.81 |
| 2025736 | HC FQHC PSYCH THRPY FOR CRISIS EA ADDL 30 MIN -SMI | Behavioral Health Treatment/Services - Individual Therapy | $274.81 |
| 2025760 | HC FQHC PSYCH THRPY FOR CRISIS 1ST 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $574.35 |
| 2025761 | HC FQHC PSYCH THRPY FOR CRISIS EA ADDL 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $274.81 |
| 2025965 | HC TELEHEALTH PSYTX W PT W E/M 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2025966 | HC TELEHEALTH PSYTX W PT W E/M 45 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,349.07 |
| 2025969 | HC TELEHEALTH PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $686.05 |
| 2025970 | HC TELEHEALTH PSYCH DIAG EVAL W/MED SRVCS | Behavioral Health Treatment/Services - Individual Therapy | $760.29 |
| 2026587 | HC HLTH BHV ASSMT/REASSESSMENT | Behavioral Health Treatment/Services - Individual Therapy | $242.04 |
| 2026588 | HC HLTH BHV IVNTJ INDIV 1ST 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $302.54 |
| 2026589 | HC HLTH BHV IVNTJ INDIV EA ADDL 15 MIN | Behavioral Health Treatment/Services - Individual Therapy | $75.64 |
| 2026889 | HC FHC TELE SBH CONSULTATION WITH FAMILY | Behavioral Health Treatment/Services - Individual Therapy | $189.43 |
| 2026892 | HC FHC TELE SBH PSYTX W PT 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2026893 | HC FHC TELE SBH PSYTX W PT 45 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2026894 | HC FHC TELE SBH PSYTX W PT 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2026895 | HC FHC TELE SBH PSYTX W PT W E/M 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2026898 | HC FHC TELE SBH PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $685.67 |
| 2026901 | HC FHC TELE SBH PSYCH THRPY FOR CRISIS 1ST 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $574.35 |
| 2026939 | HC SBHC/LCM AUDIO ONLY PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $646.86 |
| 2026940 | HC SBHC/LCM AUDIO ONLY PSYTX W PT 30 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $987.74 |
| 2026941 | HC SBHC/LCM AUDIO ONLY PSYTX W PT 45 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,299.27 |
| 2026942 | HC SBHC/LCM AUDIO ONLY PSYTX W PT 60 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,935.62 |
| 2026590 | HC PSY THER IVNTJ COG FUNC 1ST 15 MIN | Behavioral Health Treatment/Services - Rehabilitation | $243.19 |
| 2026591 | HC PSY THER IVNTJ COG FUNC EA ADDL 15 MIN | Behavioral Health Treatment/Services - Rehabilitation | $60.80 |
| 2022196 | HC NUBHVL XM PHYS/QHP 1ST HR | Behavioral Health Treatment/Services - Testing | $747.49 |
| 2026130 | HC BRIEF EMOTIONAL/BEHAV ASSMT | Behavioral Health Treatment/Services - Testing | $118.58 |
| 2026353 | HC NUBHVL XM PHY/QHP EA ADDL HR | Behavioral Health Treatment/Services - Testing | $498.32 |
| 2026361 | HC PSYCL TST EVAL PHYS/QHP 1ST | Behavioral Health Treatment/Services - Testing | $506.31 |
| 2026362 | HC PSYCL TST EVAL PHYS/QHP EA | Behavioral Health Treatment/Services - Testing | $337.54 |
| 2026363 | HC NRPSYC TST EVAL PHYS/QHP 1ST | Behavioral Health Treatment/Services - Testing | $506.31 |
| 2026364 | HC NRPSYC TST EACH 1HR | Behavioral Health Treatment/Services - Testing | $337.54 |
| 2026365 | HC PSYCL/NRPSYC TST PHY/QHP 1ST | Behavioral Health Treatment/Services - Testing | $63.94 |
| 2026366 | HC PSYCL/NRPSY EACH 30MIN | Behavioral Health Treatment/Services - Testing | $42.63 |
| 2026367 | HC PSYCL/NRPSYC TECH 1ST | Behavioral Health Treatment/Services - Testing | $63.94 |
| 2026368 | HC PSYCL/NRPSYC TST TECH EA | Behavioral Health Treatment/Services - Testing | $42.63 |
| 2022004 | HC HEART/LUNG RESUSCITATION CPR | Cardiology | $2,211.75 |
| 2022005 | HC CATH/EP CARDIOVERSION ELECTRIC, EXT | Cardiology | $7,308.51 |
| 2022033 | HC CATH/EP PM DEVICE PROGR EVAL, DUAL | Cardiology | $604.13 |
| 2022034 | HC CATH/EP PM DEVICE PROGR EVAL, MULTI | Cardiology | $682.21 |
| 2022035 | HC PRGRMG EVAL IMPLANTABLE DFB 1 SNGL | Cardiology | $1,458.76 |
| 2022036 | HC PRGRMG EVAL IMPLANTABLE DFB 1DUAL | Cardiology | $1,676.73 |
| 2022037 | HC PRGRMG EVAL IMPLANTABLE DFB MULT | Cardiology | $1,894.71 |
| 2022038 | HC PRGRMG DEV EVAL SCRMS IP | Cardiology | $2,041.51 |
| 2022039 | HC PERI-PX EVAL PM/LDLS PM IP | Cardiology | $2,041.51 |
| 2022040 | HC PERI-PX DEVICE EVAL & PRGR | Cardiology | $2,041.51 |
| 2022041 | HC INTERROG EVL PM/LDLS PM IP | Cardiology | $2,041.51 |
| 2022042 | HC INTERROG DEVICE EVAL HEART | Cardiology | $2,041.51 |
| 2022044 | HC INTERROG DEV EVAL SCRMS IP | Cardiology | $2,041.51 |
| 2022051 | HC DOPPLER ECHO EXAM, HEART | Cardiology | $1,614.01 |
| 2022080 | HC CATH/EP HEART FLOW RESERVE MEASURE | Cardiology | $6,674.93 |
| 2022083 | HC CATH/EP BUNDLE OF HIS RECORDING | Cardiology | $1,205.52 |
| 2022084 | HC CATH/EP INTRA-ATRIAL RECORDING | Cardiology | $3,612.53 |
| 2022085 | HC CATH/EP RIGHT VENTRICULAR RECORDING | Cardiology | $1,338.56 |
| 2022086 | HC CATH/EP MAP TACHYCARDIA, ADD-ON | Cardiology | $6,897.65 |
| 2022087 | HC CATH/EP INTRA-ATRIAL PACING | Cardiology | $3,612.53 |
| 2022088 | HC CATH/EP INTRAVENTRICULAR PACING | Cardiology | $3,041.35 |
| 2022089 | HC CATH/EP ELECTROPHYS MAP 3D, ADD-ON | Cardiology | $33,300.46 |
| 2022090 | HC CATH/EP ESOPHGL REC ATR EGRM +-VENTR EGRM | Cardiology | $1,205.71 |
| 2022092 | HC CATH/EP HEART RHYTHM PACING | Cardiology | $3,612.05 |
| 2022093 | HC CATH/EP COMPRE ELECTROPHYSIOLOGIC W/ ARRHYT HMIA INDUCT | Cardiology | $51,360.55 |
| 2022094 | HC CATH/EP COMPRE ELECTROPHYSIOLOGIC W/L ATR PAC/REC | Cardiology | $9,298.83 |
| 2022095 | HC CATH/EP COMPRE ELECTROPHYSIOLOGIC W/L VENTR PAC/REC | Cardiology | $13,626.35 |
| 2022096 | HC CATH/EP STIMULATION, PACING HEART | Cardiology | $12,374.55 |
| 2022100 | HC CATH/EP EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN | Cardiology | $10,633.82 |
| 2022101 | HC ELECTROPHYSIOLOGY EVALUATION | Cardiology | $14,460.88 |
| 2022102 | HC CATH/EP ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION | Cardiology | $16,931.17 |
| 2022105 | HC CATH/EP TILT TABLE EVALUATION | Cardiology | $8,949.41 |
| 2022106 | HC CATH/EP INTRACARDIAC ECG (ICE) | Cardiology | $7,718.10 |
| 2022107 | HC CATH/EP ANALYZE PACEMAKER SYSTEM | Cardiology | $446.70 |
| 2022770 | HC PRGRMG DEV EVAL PM/LDLS PM | Cardiology | $526.05 |
| 2022771 | HC PPM PROGRAM EVAL DUAL | Cardiology | $604.13 |
| 2022772 | HC PPM PROGRAM EVAL MULTI | Cardiology | $682.21 |
| 2022861 | HC CATH/EP EXER W/HEMODYNMIC MEAS | Cardiology | $1,727.93 |
| 2023066 | HC CATH/EP INTERROGATION VAD IN PERSON | Cardiology | $401.90 |
| 2024336 | HC EP & ABLATE SUPRAVENT ARRHYT | Cardiology | $23,703.39 |
| 2024337 | HC EP & ABLATE VENTRIC TACHY | Cardiology | $61,798.55 |
| 2024338 | HC ABLATE ARRHYTHMIA ADD ON | Cardiology | $23,237.48 |
| 2024339 | HC TX ATRIAL FIB PULM VEIN ISOL | Cardiology | $62,804.58 |
| 2024340 | HC TX L/R ATRIAL FIB ADDL | Cardiology | $23,865.95 |
| 2024811 | HC VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I | Cardiology | $33,327.21 |
| 2024812 | HC VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I | Cardiology | $33,327.21 |
| 2024844 | HC INTERROGATE SUBQ DEFIB | Cardiology | $158.98 |
| 2024982 | HC PERQ TRANSCATH CLOSURE PDA | Cardiology | $20,412.64 |
| 2025051 | HC AMBL BP MNTR W/SW REC ONLY | Cardiology | $320.05 |
| 2025986 | HC PAD REHAB PER SESSION | Cardiology | $204.02 |
| 2026133 | HC ELECTROPHYS EVAL COMP | Cardiology | $19,815.72 |
| 2020401 | HC CATH/EP INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR | Cardiology - Cardiac Cath Lab | $15,130.29 |
| 2020402 | HC CATH/EP INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD VENTR | Cardiology - Cardiac Cath Lab | $15,999.37 |
| 2020403 | HC CATH/EP INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR&VENTR | Cardiology - Cardiac Cath Lab | $17,390.67 |
| 2020404 | HC CATH/EP INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH | Cardiology - Cardiac Cath Lab | $7,347.35 |
| 2020408 | HC CATH/EP UPGRADE OF PACEMAKER SYSTEM | Cardiology - Cardiac Cath Lab | $16,902.83 |
| 2020409 | HC CATH/EP REPOSITION PACING-DEFIB LEAD | Cardiology - Cardiac Cath Lab | $3,407.91 |
| 2020410 | HC CATH/EP INSJ ELTRD 1CHMBR 1 ELTRD PRM PM/1CHMBR CVDFB | Cardiology - Cardiac Cath Lab | $7,347.35 |
| 2020411 | HC CATH/EP INSJ ELTRD 2CHMBR 2 ELTRDS PRM PM/2CHMBR CVDFB | Cardiology - Cardiac Cath Lab | $7,347.35 |
| 2020412 | HC CATH/EP REPAIR LEAD PACE-DEFIB, ONE | Cardiology - Cardiac Cath Lab | $3,761.00 |
| 2020413 | HC CATH/EP REVISE POCKET, PACEMAKER | Cardiology - Cardiac Cath Lab | $3,428.98 |
| 2020414 | HC CATH/EP REVISE POCKET, PACING-DEFIB | Cardiology - Cardiac Cath Lab | $4,114.78 |
| 2020415 | HC CATH/EP INSERT PACING LEAD & CONNECT | Cardiology - Cardiac Cath Lab | $16,902.83 |
| 2020416 | HC CATH/EP L VENTRIC PACING LEAD ADD-ON | Cardiology - Cardiac Cath Lab | $16,097.93 |
| 2020417 | HC CATH/EP REPOSITION L VENTRIC LEAD | Cardiology - Cardiac Cath Lab | $4,136.79 |
| 2020418 | HC CATH/EP REMOVAL PERMANENT PACEMAKER PULSE GENERATOR | Cardiology - Cardiac Cath Lab | $10,114.17 |
| 2020419 | HC CATH/EP RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR | Cardiology - Cardiac Cath Lab | $12,136.49 |
| 2020420 | HC CATH/EP REMOVAL PACEMAKER ELECTRODE | Cardiology - Cardiac Cath Lab | $15,171.25 |
| 2020422 | HC CATH/EP REMOVE PULSE GENERATOR | Cardiology - Cardiac Cath Lab | $5,720.09 |
| 2020423 | HC CATH/EP REMOVE ELTRD, TRANSVEN | Cardiology - Cardiac Cath Lab | $10,048.88 |
| 2020424 | HC CATH/EP ELTRD/INSERT PACE-DEFIB | Cardiology - Cardiac Cath Lab | $51,311.91 |
| 2020427 | HC CATH/EP INSERT IA PERCUT DEVICE | Cardiology - Cardiac Cath Lab | $2,454.94 |
| 2020441 | HC CATH/EP INJECTION EXT VENOGRAPHY | Cardiology - Cardiac Cath Lab | $13,017.09 |
| 2020445 | HC CATH/EP PLACE CATHETER IN VEIN | Cardiology - Cardiac Cath Lab | $1,679.29 |
| 2020450 | HC CATH/EP ESTABLISH ACCESS TO ARTERY | Cardiology - Cardiac Cath Lab | $1,442.50 |
| 2020452 | HC CATH/EP PLACE CATHETER IN AORTA | Cardiology - Cardiac Cath Lab | $2,154.15 |
| 2020456 | HC CATH/EP SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH | Cardiology - Cardiac Cath Lab | $2,882.44 |
| 2020457 | HC CATH/EP SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH | Cardiology - Cardiac Cath Lab | $3,458.93 |
| 2020462 | HC CATH/EP SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH | Cardiology - Cardiac Cath Lab | $5,618.98 |
| 2020464 | HC CATH/EP SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH | Cardiology - Cardiac Cath Lab | $9,414.02 |
| 2020466 | HC CATH/EP SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH | Cardiology - Cardiac Cath Lab | $11,202.12 |
| 2020482 | HC CATH/EP INSJ NON-TUN CTR CVC UNDER 5 YR | Cardiology - Cardiac Cath Lab | $3,875.68 |
| 2020497 | HC CATH/EP INSERTION CATHETER, ARTERY | Cardiology - Cardiac Cath Lab | $575.98 |
| 2020508 | HC CATH/EP TRANSCATH STENT, CCA W/EPS | Cardiology - Cardiac Cath Lab | $10,989.65 |
| 2022006 | HC CATH/EP CARDIOVERSION, ELECTRIC, INT | Cardiology - Cardiac Cath Lab | $2,005.67 |
| 2022007 | HC CATH/EP PERCUT CORONARY THROMBECTOMY | Cardiology - Cardiac Cath Lab | $7,212.51 |
| 2022009 | HC CATH/EP INTRAVASC US, HEART ADD-ON | Cardiology - Cardiac Cath Lab | $6,098.96 |
| 2022014 | HC CATH/EP REVISION OF AORTIC VALVE | Cardiology - Cardiac Cath Lab | $11,939.37 |
| 2022016 | HC CATH/EP REVISION OF PULMONARY VALVE | Cardiology - Cardiac Cath Lab | $14,483.91 |
| 2022017 | HC CATH/EP REVISION OF HEART CHAMBER | Cardiology - Cardiac Cath Lab | $8,191.68 |
| 2022021 | HC CATH/EP PRQ TRLUML P-ART BALO ANGIOP 1 VSL | Cardiology - Cardiac Cath Lab | $21,120.45 |
| 2022022 | HC CATH/EP PRQ TRLUML P-ART BALO ANGIOP EA VSL | Cardiology - Cardiac Cath Lab | $21,120.45 |
| 2022055 | HC CATH/EP INSERT/PLACE HEART CATHETER | Cardiology - Cardiac Cath Lab | $6,951.40 |
| 2022056 | HC CATH/EP BIOPSY OF HEART LINING | Cardiology - Cardiac Cath Lab | $4,881.73 |
| 2022063 | HC CATH/EP RT HEART CATH, CONGENITAL | Cardiology - Cardiac Cath Lab | $7,206.12 |
| 2022064 | HC CATH/EP CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMALY | Cardiology - Cardiac Cath Lab | $33,418.21 |
| 2022065 | HC CATH/EP CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN | Cardiology - Cardiac Cath Lab | $39,768.05 |
| 2022066 | HC CATH/EP CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN | Cardiology - Cardiac Cath Lab | $29,548.93 |
| 2022081 | HC CATH/EP TRANSCATH CLOSURE OF ASD | Cardiology - Cardiac Cath Lab | $32,494.08 |
| 2022082 | HC CATH/EP TRANSCATH CLOSURE OF VSD | Cardiology - Cardiac Cath Lab | $61,235.62 |
| 2022573 | HC CATH/EP SECONDY PERC THROMBECT | Cardiology - Cardiac Cath Lab | $5,510.18 |
| 2022699 | HC FEM/POPL REVSC STNT&ATHR | Cardiology - Cardiac Cath Lab | $24,758.07 |
| 2022826 | HC CATH/EP TRLUM PERIP ATHR ILC ART | Cardiology - Cardiac Cath Lab | $28,228.27 |
| 2022828 | HC CATH/EP P INSERTION CHEST TUBE | Cardiology - Cardiac Cath Lab | $1,507.78 |
| 2022832 | HC CATH/EP ILIAC REVASC | Cardiology - Cardiac Cath Lab | $11,936.81 |
| 2022833 | HC CATH/EP ILIAC REVASC W/STENT | Cardiology - Cardiac Cath Lab | $14,558.15 |
| 2022834 | HC CATH/EP ILIAC REVASC ADD-ON | Cardiology - Cardiac Cath Lab | $7,041.00 |
| 2022835 | HC CATH/EP ILIAC REVASC STENT ADDON | Cardiology - Cardiac Cath Lab | $21,120.45 |
| 2022836 | HC CATH/EP FEM/POPL REVAS W/TLA | Cardiology - Cardiac Cath Lab | $13,138.68 |
| 2022837 | HC CATH/EP FEM/POPL REVAS W/ATHER | Cardiology - Cardiac Cath Lab | $17,663.31 |
| 2022838 | HC CATH/EP FEM/POPL REVASC W/STENT | Cardiology - Cardiac Cath Lab | $14,597.83 |
| 2022839 | HC CATH/EP TIB/PER REVASC W/TLA | Cardiology - Cardiac Cath Lab | $15,926.41 |
| 2022840 | HC CATH/EP TIB/PER REVASC W/ATHER | Cardiology - Cardiac Cath Lab | $14,558.15 |
| 2022841 | HC CATH/EP TIB/PER REVASC W/STENT | Cardiology - Cardiac Cath Lab | $14,558.15 |
| 2022842 | HC CATH/EP TIB/PER REVSC STNT&ATHER | Cardiology - Cardiac Cath Lab | $74,271.65 |
| 2022843 | HC CATH/EP TIB/PER REVASC ADD-ON | Cardiology - Cardiac Cath Lab | $7,041.00 |
| 2022848 | HC CATH/EP RIGHT HEART CATH | Cardiology - Cardiac Cath Lab | $26,108.42 |
| 2022849 | HC CATH/EP L HRT CATH W/VENTGRPHY | Cardiology - Cardiac Cath Lab | $28,719.52 |
| 2022850 | HC CATH/EP R&L HRT CATH W/VENTGRPHY | Cardiology - Cardiac Cath Lab | $37,595.97 |
| 2022851 | HC CATH/EP CORONARY ART ANGIO S&I | Cardiology - Cardiac Cath Lab | $20,815.06 |
| 2022852 | HC CATH/EP CORO ART/GRFT ANGIO S&I | Cardiology - Cardiac Cath Lab | $24,246.62 |
| 2022853 | HC CATH/EP R HRT CORONARY ART ANGIO | Cardiology - Cardiac Cath Lab | $27,152.86 |
| 2022854 | HC CATH/EP R HRT ART/GRFT ANGIO | Cardiology - Cardiac Cath Lab | $30,808.40 |
| 2022855 | HC CATH/EP L HRT ART/VENTRCLE ANGIO | Cardiology - Cardiac Cath Lab | $26,108.42 |
| 2022856 | HC CATH/EP L HRT ART/GRFT ANGIO | Cardiology - Cardiac Cath Lab | $28,719.52 |
| 2022857 | HC CATH/EP R&L HRT ART/VENT ANGIO | Cardiology - Cardiac Cath Lab | $30,808.40 |
| 2022858 | HC CATH/EP R&L HRT ART/VENT ANGIO | Cardiology - Cardiac Cath Lab | $34,984.87 |
| 2022859 | HC CATH/EP L HRT CATH TRNSPTL PUNC | Cardiology - Cardiac Cath Lab | $9,036.44 |
| 2022860 | HC CATH/EP DRUG ADMN&HEMODYMIC MEAS | Cardiology - Cardiac Cath Lab | $4,246.87 |
| 2022862 | HC CATH/EP P INJ CONG CARD CATH | Cardiology - Cardiac Cath Lab | $9,108.12 |
| 2022864 | HC CATH/EP INJ L VENT/ATRIAL ANG | Cardiology - Cardiac Cath Lab | $7,157.48 |
| 2022865 | HC CATH/EP INJ R VENT/ATRIAL ANG | Cardiology - Cardiac Cath Lab | $7,157.48 |
| 2022866 | HC CATH/EP INJ SUPRVLV AORTGRAPY | Cardiology - Cardiac Cath Lab | $8,132.80 |
| 2022867 | HC CATH/EP INJ PULM ART HRT CATH | Cardiology - Cardiac Cath Lab | $7,320.03 |
| 2022909 | HC CATH/EP INSERT VENTRIC ASSIS DEV | Cardiology - Cardiac Cath Lab | $11,417.15 |
| 2022910 | HC CATH/EP PRIM ART MECH THROMBCTMY | Cardiology - Cardiac Cath Lab | $14,920.37 |
| 2023027 | HC CATH/EP IVUS ADDITIONAL VESSEL | Cardiology - Cardiac Cath Lab | $4,879.16 |
| 2023033 | HC CATH/EP IV DOPPLER; EA ADDTL VESSEL | Cardiology - Cardiac Cath Lab | $5,339.95 |
| 2023084 | HC TRANSCATH OCCLUSION CNS | Cardiology - Cardiac Cath Lab | $9,758.40 |
| 2023096 | HC INS CATH REN ART 1ST UNILAT | Cardiology - Cardiac Cath Lab | $13,488.30 |
| 2023097 | HC INS CATH REN ART 1ST BILAT | Cardiology - Cardiac Cath Lab | $17,747.79 |
| 2023410 | HC REMV&REPLC PM GEN DUAL LEAD | Cardiology - Cardiac Cath Lab | $19,302.92 |
| 2023411 | HC RMVL& REPLC PULSE GEN 1 LEAD | Cardiology - Cardiac Cath Lab | $20,029.94 |
| 2023420 | HC REMOVE&REPLACE PM GEN SINGL | Cardiology - Cardiac Cath Lab | $18,531.12 |
| 2023421 | HC REMV&REPLC PM GEN MULT LEADS | Cardiology - Cardiac Cath Lab | $20,268.00 |
| 2023422 | HC INSRT PULSE GEN W/DUAL LEADS | Cardiology - Cardiac Cath Lab | $15,350.57 |
| 2023423 | HC INSRT PULSE GEN W/MULT LEADS | Cardiology - Cardiac Cath Lab | $15,350.57 |
| 2023424 | HC RMVL & RPLCMT DFB GEN 2 LEAD | Cardiology - Cardiac Cath Lab | $20,273.12 |
| 2023425 | HC RMVL & RPLCMT DFB GEN MLT LD | Cardiology - Cardiac Cath Lab | $22,070.17 |
| 2023589 | HC REM IAB ASSIST DEVICE PERCUTANEOUS | Cardiology - Cardiac Cath Lab | $287.99 |
| 2023590 | HC PRIM ART M-THROMBECT ADD-ON | Cardiology - Cardiac Cath Lab | $5,520.53 |
| 2024310 | HC CATH/EP PLACE CATH THORACIC AORTA | Cardiology - Cardiac Cath Lab | $6,692.86 |
| 2024311 | HC CATH/EP PLACE CATH CAROTID/INOM ART | Cardiology - Cardiac Cath Lab | $9,168.27 |
| 2024313 | HC CATH/EP PLACE CATH CAROTD ART | Cardiology - Cardiac Cath Lab | $11,276.36 |
| 2024314 | HC CATH/EP PLACE CATH SUBCLAVIAN ART | Cardiology - Cardiac Cath Lab | $9,993.84 |
| 2024323 | HC PRQ CARD STENT W/ANGIO 1 VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024324 | HC PRQ CARD STENT/ATH/ANGIO | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024325 | HC PRQ REVASC BYP GRAFT 1 VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024326 | HC PRQ CARD REVASC MI 1 VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024327 | HC PRQ CARD REVASC CHRONIC 1VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024328 | HC PRQ CARD STENT W/ANGIO ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024329 | HC PRQ CARD STENT/ATH/ANGIO ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024330 | HC PRQ REVASC BYP GRAFT ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024331 | HC PRQ CARD REVASC CHRONIC ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024332 | HC PRQ CARDIAC ANGIOPLAST 1 ART | Cardiology - Cardiac Cath Lab | $15,411.88 |
| 2024333 | HC PRQ CARD ANGIO/ATHRECT 1 ART | Cardiology - Cardiac Cath Lab | $31,047.74 |
| 2024334 | HC PRQ CARDIAC ANGIO ADDL ART | Cardiology - Cardiac Cath Lab | $15,411.88 |
| 2024335 | HC PRQ CARD ANGIO/ATHRECT ADDL | Cardiology - Cardiac Cath Lab | $31,047.74 |
| 2024353 | HC PERC DRUG-EL COR STENT SING | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024354 | HC PERC DRUG-EL COR STENT BRAN | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024355 | HC PERC D-E COR STENT ATHER S | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024356 | HC PERC D-E COR STENT ATHER BR | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024357 | HC PERC D-E COR REVASC T CABG S | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024359 | HC PERC D-E COR REVASC W AMI S | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024360 | HC PERC D-E COR REVASC CHRO SIN | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024361 | HC PERC D-E COR REVASC CHRO ADD | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024623 | HC PERQ CLSR TCAT L ATR APNDGE | Cardiology - Cardiac Cath Lab | $28,777.11 |
| 2024807 | HC OPEN/PERQ PLACE STENT 1ST | Cardiology - Cardiac Cath Lab | $38,668.56 |
| 2024809 | HC OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST | Cardiology - Cardiac Cath Lab | $34,371.45 |
| 2024836 | HC INS/REP SUBQ DEFIBRILLATOR | Cardiology - Cardiac Cath Lab | $146,352.54 |
| 2024841 | HC RMVL OF SUBQ DEFIBRILLATOR | Cardiology - Cardiac Cath Lab | $10,615.92 |
| 2024869 | HC REPAIR TCAT MITRAL VALVE | Cardiology - Cardiac Cath Lab | $2,986.12 |
| 2024870 | HC REPAIR TCAT MITRAL VALVE | Cardiology - Cardiac Cath Lab | $302.06 |
| 2025017 | HC IMPLANTING PA SENSOR | Cardiology - Cardiac Cath Lab | $20,114.41 |
| 2025075 | HC ECMO/ECLS INITIATION VENOUS | Cardiology - Cardiac Cath Lab | $10,605.67 |
| 2025076 | HC ECMO/ECLS INITIATION ARTERY | Cardiology - Cardiac Cath Lab | $10,605.67 |
| 2025077 | HC ECMO/ECLS DAILY MGMT-VENOUS | Cardiology - Cardiac Cath Lab | $10,817.77 |
| 2025078 | HC ECMO/ECLS DAILY MGMT ARTERY | Cardiology - Cardiac Cath Lab | $10,817.77 |
| 2025080 | HC ECMO/ECLS INSJ PRPH CANNULA; PERCUTANEOUS 6 YRS & OLDER | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025081 | HC ECMO/ECLS INSJ PRPH CANNULA; OPEN BIRTH - 5 YRS OLD | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025082 | HC ECMO/ECLS INSJ PRPH CANNULA; OPEN 6 YRS & OLDER | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025083 | HC ECMO/ECLS INSJ PRPH CANNULA; STERNOTOMY OR THORACOTOMY BIRTH - 5 YRS OLD | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025084 | HC ECMO/ECLS INSJ PRPH CANNULA; STERNOTOMY OR THORACOTOMY 6 YRS & OLDER | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025158 | HC ECMO/ECLS REPOS PERPH CNULA >6 YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025163 | HC ECMO/ECLS RMVL PERPH CANNULA BIRTH - 5YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025164 | HC ECMO/ECLS RMVL PERPH CANNULA > 6YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025165 | HC TCAT IMPL WRLS P-ART PRS SNR | Cardiology - Cardiac Cath Lab | $50,470.84 |
| 2025182 | HC ECMO/ECLS RMVL PERPH CANNULA BIRTH - 5YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025183 | HC ECMO/ECLS RMVL PERPH CANNULA >6 YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025184 | HC ECMO/ECLS RMVL CTR CANNULA BIRTH - 5YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025185 | HC ECMO/ECLS RMVL CTR CANNULA >6 YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025255 | HC INSERT VAD ARTERY ACCESS | Cardiology - Cardiac Cath Lab | $25,740.05 |
| 2025256 | HC REMOVE VAD DIFFERENT SESSION | Cardiology - Cardiac Cath Lab | $25,740.05 |
| 2025257 | HC REPOSITION VAD DIFF SESSION | Cardiology - Cardiac Cath Lab | $25,740.05 |
| 2026279 | HC TCAT INSJ/RPL PERM LDLS PM | Cardiology - Cardiac Cath Lab | $57,185.55 |
| 2026280 | HC TCAT RMVL PERM LDLS PM | Cardiology - Cardiac Cath Lab | $9,837.96 |
| 2026281 | HC INSJ SUBQ CAR RHYTHM MNTR | Cardiology - Cardiac Cath Lab | $27,575.52 |
| 2026282 | HC RMVL SUBQ CAR RHYTHM MNTR | Cardiology - Cardiac Cath Lab | $2,265.54 |
| 2026390 | HC PERQ TRANSCATH SEPTAL REDUXN | Cardiology - Cardiac Cath Lab | $16,287.16 |
| 2026564 | HC PERQ TRANSCATH CLS AORTIC | Cardiology - Cardiac Cath Lab | $57,185.55 |
| 2026625 | HC PERICARDIOCENTESIS W/IMAGING | Cardiology - Cardiac Cath Lab | $6,280.50 |
| 2026626 | HC PRCRD DRG 6YR+ W/O CGEN CAR | Cardiology - Cardiac Cath Lab | $742.00 |
| 2026627 | HC PRCRD DRG 0-5YR OR W/ANOMLY | Cardiology - Cardiac Cath Lab | $742.00 |
| 2026965 | HC REVASC INTRAVASC LITHOTRIPSY | Cardiology - Cardiac Cath Lab | $18,004.98 |
| 2026966 | HC REVASC INTRA LITHOTRIP-STENT | Cardiology - Cardiac Cath Lab | $36,012.36 |
| 2026967 | HC REVASC INTRA LITHOTRIP-ATHER | Cardiology - Cardiac Cath Lab | $36,012.36 |
| 2022046 | HC TTE W/DOPPLER, COMPLETE | Cardiology - Echocardiology | $3,309.95 |
| 2022048 | HC CATH/EP TTE, F-UP OR LMTD | Cardiology - Echocardiology | $911.32 |
| 2022049 | HC TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R | Cardiology - Echocardiology | $4,219.99 |
| 2022052 | HC DOPPLER COLOR FLOW ADD-ON | Cardiology - Echocardiology | $774.37 |
| 2022053 | HC STRESS TTE ONLY | Cardiology - Echocardiology | $2,680.22 |
| 2022409 | HC TTE W OR WO FOL WCON,DOPPLER | Cardiology - Echocardiology | $3,309.95 |
| 2022731 | HC FETAL CARDIOVASC 2-D FOLLOWUP US | Cardiology - Echocardiology | $1,777.85 |
| 2022732 | HC COMP FETAL DOPPLER ECHO | Cardiology - Echocardiology | $746.20 |
| 2022733 | HC LIMIT FETAL DOPPLER ECHOCARDIOGRAM | Cardiology - Echocardiology | $522.21 |
| 2022773 | HC TTE CONG ABN; COMPLETE | Cardiology - Echocardiology | $2,666.13 |
| 2022774 | HC TTE CONG ABN; LIMITED/F-UP | Cardiology - Echocardiology | $1,893.04 |
| 2022775 | HC TTE F-UP OR LMTD | Cardiology - Echocardiology | $911.32 |
| 2022776 | HC DOPPLER ECHO;LMITED F/UP | Cardiology - Echocardiology | $807.64 |
| 2022777 | HC STRESS TTE COMPLETE | Cardiology - Echocardiology | $2,680.22 |
| 2022888 | HC 2D TTE W OR W/O FOL W/CON FU | Cardiology - Echocardiology | $911.32 |
| 2025133 | HC ECHO TRANSESOPHAGEAL (TEE) | Cardiology - Echocardiology | $2,622.62 |
| 2025700 | HC TEE CONGENITAL; INT & REP | Cardiology - Echocardiology | $464.81 |
| 2026424 | HC ECHO TRANSESOPHAGEAL IMAGE I&R ONLY | Cardiology - Echocardiology | $3,602.38 |
| 2026783 | HC MYOCRD STRAIN IMG SPCKL TRCK | Cardiology - Echocardiology | $455.66 |
| 2022026 | HC CARDIOVASCULAR STRESS TEST | Cardiology - Stress Test | $1,718.97 |
| 2022687 | HC CARD REHAB STRESS TEST | Cardiology - Stress Test | $1,718.97 |
| 2020015 | HC DEBRIDE SKIN, FULL | Clinic | $3,003.05 |
| 2022153 | HC RAPID DESENSITIZATION, EA HR | Clinic | $928.57 |
| 2022304 | HC WOUND(S) CARE NON-SELECTIVE | Clinic | $280.64 |
| 2022305 | HC NEG PRESS WOUND TX <=50 CM | Clinic | $241.50 |
| 2022306 | HC NEG PRESS WOUND TX >50 CM | Clinic | $425.04 |
| 2022330 | HC OFFICE OUTPT NEW 10 MIN | Clinic | $458.70 |
| 2022331 | HC OFFICE OUTPT NEW 10 MIN 25 | Clinic | $458.70 |
| 2022332 | HC OFFICE OUTPT NEW 20 MINUTES | Clinic | $462.98 |
| 2022333 | HC OFFICE OUTPT NEW 20 MINUTES 25 | Clinic | $462.98 |
| 2022334 | HC OFFICE OUTPT NEW 30 MIN | Clinic | $688.06 |
| 2022335 | HC OFFICE OUTPT NEW 30 MIN 25 | Clinic | $688.06 |
| 2022336 | HC OFFICE OUTPT NEW 45 MIN | Clinic | $736.48 |
| 2022337 | HC OFFICE OUTPT NEW 45 MIN 25 | Clinic | $736.48 |
| 2022338 | HC OFFICE OUTPT NEW 60 MIN | Clinic | $1,236.50 |
| 2022339 | HC OFFICE OUTPT NEW 60 MIN 25 | Clinic | $1,236.50 |
| 2022340 | HC OFFICE O/P EST 5 MIN 25 | Clinic | $406.00 |
| 2022341 | HC OFFICE O/P EST 5 MIN | Clinic | $406.00 |
| 2022342 | HC OFFICE OUTPT EST 10 MIN | Clinic | $418.82 |
| 2022343 | HC OFFICE OUTPT EST 10 MIN 25 | Clinic | $418.82 |
| 2022344 | HC OFFICE OUTPT EST15 MIN | Clinic | $502.87 |
| 2022345 | HC OFFICE OUTPT EST15 MIN 25 | Clinic | $502.87 |
| 2022346 | HC OFFICE OUTPT EST 25 MIN | Clinic | $733.64 |
| 2022347 | HC OFFICE OUTPT EST 25 MIN 25 | Clinic | $733.64 |
| 2022348 | HC OFFICE OUTPT EST 40 MIN | Clinic | $1,115.42 |
| 2022349 | HC OFFICE OUTPT EST 40 MIN 25 | Clinic | $1,115.42 |
| 2022350 | HC PREV VISIT, NEW, AGE 18-39 | Clinic | $183.90 |
| 2022351 | HC PREV VISIT, NEW, AGE 40-64 | Clinic | $183.39 |
| 2022352 | HC PREV VISIT, EST, AGE 18-39 | Clinic | $624.28 |
| 2022353 | HC PREV VISIT, EST, AGE 40-64 | Clinic | $624.28 |
| 2022657 | HC PT FOLLOWUP EVAL FOOT PT LOP | Clinic | $218.89 |
| 2022787 | HC INIT PM E/M, NEW PT INF | Clinic | $183.39 |
| 2022788 | HC INIT PM E/M NEW PT 1-4YR | Clinic | $183.39 |
| 2022789 | HC PREV VISIT NEW AGE 5-11 | Clinic | $183.39 |
| 2022790 | HC PREV VISIT NEW AGE 12-17 | Clinic | $183.39 |
| 2022791 | HC PER PM REEVAL EST PT INF | Clinic | $624.28 |
| 2022792 | HC PREV VISIT EST AGE 1-4 | Clinic | $624.28 |
| 2022793 | HC PREV VISIT EST AGE 5-11 | Clinic | $624.28 |
| 2022794 | HC PREV VISIT EST AGE 12-17 | Clinic | $624.28 |
| 2022796 | HC PREVENTIVE CONSLT IND 30 MIN | Clinic | $206.01 |
| 2023132 | HC GENETIC COUNSEL NEW PATIENT 30MIN | Clinic | $688.06 |
| 2023133 | HC GENETIC COUNSEL EST PATIENT 30MIN | Clinic | $733.64 |
| 2023134 | HC GENETIC COUNSEL NEW PATIENT 60MIN | Clinic | $1,236.50 |
| 2023238 | HC PROLONGED SERVICE OFFICE | Clinic | $710.01 |
| 2023239 | HC PER PM REEVAL EST PAT 65+ YR | Clinic | $624.28 |
| 2025194 | HC PREV VISIT, NEW, AGE 65+ | Clinic | $183.39 |
| 2025441 | HC VISUAL FIELD EXAMINATION(S) | Clinic | $177.50 |
| 2025443 | HC INTERM EYE EXAM NEW PT | Clinic | $332.00 |
| 2025444 | HC EYE EXAM NEW PATIENT 1+ VISITS | Clinic | $332.06 |
| 2025445 | HC INTERM EYE EXAM EST PT | Clinic | $265.65 |
| 2025446 | HC EYE EXAM & TREATMENT 1+VISITS | Clinic | $265.65 |
| 2025451 | HC GONIOSCOPY | Clinic | $132.08 |
| 2025475 | HC DETERMINE REFRACTION | Clinic | $126.79 |
| 2025478 | HC VISUAL ACUITY SCREEN BILAT - QUAN | Clinic | $76.07 |
| 2025656 | HC FQHC MONITORING VST - ASYMPTOMATIC HIV DISEASE | Clinic | $265.65 |
| 2025657 | HC FQHC HIV COUNSELING VISIT (NO TESTING) | Clinic | $265.65 |
| 2025658 | HC FQHC HIV COUNSELING AND TESTING VISIT | Clinic | $265.65 |
| 2025659 | HC FQHC POST-TEST HIV COUNSELING VISIT - POSITIVE RESULTS | Clinic | $265.65 |
| 2025688 | HC FQHC OFFSITE BILLING | Clinic | $253.00 |
| 2025724 | HC TRANS CARE MGMT 14 DAY DISCH | Clinic | $436.33 |
| 2025725 | HC TRANS CARE MGMT 7 DAY DISCH | Clinic | $436.33 |
| 2025770 | HC OFFICE CONSULTATION 60 MIN | Clinic | $733.64 |
| 2025785 | HC CAREGIVER HEALTH RISK ASSMT | Clinic | $93.45 |
| 2025859 | HC ADVNCD CARE PLAN 30 MIN | Clinic | $629.31 |
| 2025860 | HC ADVNCD CARE PLAN ADDL 30 MIN | Clinic | $590.75 |
| 2025872 | HC NEG PRESS WND TX <=50 SQ CM | Clinic | $1,149.18 |
| 2025907 | HC FUNDUS PHOTOGRAPHY | Clinic | $370.57 |
| 2025961 | HC TELEHEALTH OFFICE OUTPT EST 10 MIN | Clinic | $418.82 |
| 2025962 | HC TELEHEALTH OFFICE OUTPT EST 15 MIN | Clinic | $502.87 |
| 2025963 | HC TELEHEALTH OFFICE OUTPT EST 25 MIN | Clinic | $733.64 |
| 2025964 | HC TELEHEALTH OFFICE OUTPT EST 40 MIN | Clinic | $1,115.42 |
| 2026013 | HC SLIT LAMP PHOTOGRAPHY (EXT) | Clinic | $196.86 |
| 2026128 | HC OCULAR INSTRUMNT SCREEN BIL | Clinic | $69.00 |
| 2026172 | HC FIT GLASSES; MONOFOCAL | Clinic | $396.30 |
| 2026174 | HC FIT GLASSES; MULTIFOCAL | Clinic | $562.14 |
| 2026179 | HC INIT PM E/M NEW PAT INF <1 YR 25 | Clinic | $183.39 |
| 2026180 | HC INIT PM E/M NEW PAT 1-4 YRS 25 | Clinic | $183.39 |
| 2026181 | HC PREV VISIT NEW AGE 5-11 25 | Clinic | $183.39 |
| 2026182 | HC PREV VISIT NEW AGE 12-17 25 | Clinic | $183.39 |
| 2026183 | HC PREV VISIT NEW AGE 18-39 25 | Clinic | $183.39 |
| 2026184 | HC PREV VISIT NEW AGE 40-64 25 | Clinic | $183.39 |
| 2026185 | HC INIT PM E/M NEW PAT 65+ YRS 25 | Clinic | $183.39 |
| 2026186 | HC PER PM REEVAL EST PAT INF <1 YR 25 | Clinic | $624.28 |
| 2026187 | HC PREV VISIT EST AGE 1-4 25 | Clinic | $624.28 |
| 2026188 | HC PREV VISIT EST AGE 5-11 25 | Clinic | $624.28 |
| 2026189 | HC PREV VISIT EST AGE 12-17 25 | Clinic | $624.28 |
| 2026190 | HC PREV VISIT EST AGE 18-39 25 | Clinic | $624.28 |
| 2026191 | HC PREV VISIT EST AGE 40-64 25 | Clinic | $624.28 |
| 2026192 | HC PER PM REEVAL EST PAT 65+ YR 25 | Clinic | $624.28 |
| 2026231 | HC SUBSEQUENT HOSPITAL CARE 15 | Clinic | $133.77 |
| 2026249 | HC OCULAR INSTRUMNT SCREEN BIL | Clinic | $69.00 |
| 2026356 | HC OFFICE CONSULTATION 30 MIN | Clinic | $418.82 |
| 2026357 | HC OFFICE CONSULTATION 40 MIN | Clinic | $502.87 |
| 2026489 | HC PHARMACY (ONLY) - CDTM AMBULATORY SERVICES | Clinic | $165.00 |
| 2026798 | HC FQHC PHONE E/M PHYS/QHP 5-10 MIN | Clinic | $406.00 |
| 2026799 | HC FQHC PHONE E/M PHYS/QHP 11-20 MIN | Clinic | $406.00 |
| 2026800 | HC FQHC PHONE E/M PHYS/QHP 21-30 MIN | Clinic | $406.00 |
| 2026938 | HC CLINIC VISIT SPEC COLLEC COVID-19, ANY SPEC SOURCE | Clinic | $83.55 |
| 2022330IOC | HC OFFICE OUTPT NEW 10 MIN | Clinic | $1,236.00 |
| 2022331IOC | HC OFFICE OUTPT NEW 10 MIN 25 | Clinic | $1,236.00 |
| 2022332IOC | HC OFFICE OUTPT NEW 20 MINUTES | Clinic | $1,236.00 |
| 2022333IOC | HC OFFICE OUTPT NEW 20 MINUTES 25 | Clinic | $1,236.00 |
| 2022334IOC | HC OFFICE OUTPT NEW 30 MIN | Clinic | $1,236.00 |
| 2022335IOC | HC OFFICE OUTPT NEW 30 MIN 25 | Clinic | $1,236.00 |
| 2022336IOC | HC OFFICE OUTPT NEW 45 MIN | Clinic | $1,236.00 |
| 2022337IOC | HC OFFICE OUTPT NEW 45 MIN 25 | Clinic | $1,236.00 |
| 2022338IOC | HC OFFICE OUTPT NEW 60 MIN | Clinic | $1,236.00 |
| 2022339IOC | HC OFFICE OUTPT NEW 60 MIN 25 | Clinic | $1,236.00 |
| 2022340IOC | HC OFFICE O/P EST 5 MIN 25 | Clinic | $1,236.00 |
| 2022341IOC | HC OFFICE O/P EST 5 MIN | Clinic | $1,236.00 |
| 2022342IOC | HC OFFICE OUTPT EST 10 MIN | Clinic | $1,236.00 |
| 2022343IOC | HC OFFICE OUTPT EST 10 MIN 25 | Clinic | $1,236.00 |
| 2022344IOC | HC OFFICE OUTPT EST15 MIN | Clinic | $1,236.00 |
| 2022345IOC | HC OFFICE OUTPT EST15 MIN 25 | Clinic | $1,236.00 |
| 2022346IOC | HC OFFICE OUTPT EST 25 MIN | Clinic | $1,236.00 |
| 2022347IOC | HC OFFICE OUTPT EST 25 MIN 25 | Clinic | $1,236.00 |
| 2022348IOC | HC OFFICE OUTPT EST 40 MIN | Clinic | $1,236.00 |
| 2022349IOC | HC OFFICE OUTPT EST 40 MIN 25 | Clinic | $1,236.00 |
| D000120 | HC PERIODIC ORAL EVALUATION - ESTABL | Clinic - Dental | $220.00 |
| D000140 | HC LIMITED ORAL EVALUATION - PROBLEM | Clinic - Dental | $220.00 |
| D000145 | HC ORAL EVALUATION FOR A PATIENT UND | Clinic - Dental | $220.00 |
| D000150 | HC COMPREHENSIVE ORAL EVALUATION - N | Clinic - Dental | $220.00 |
| D000160 | HC DETAILED AND EXTENSIVE ORAL EVALU | Clinic - Dental | $220.00 |
| D000170 | HC RE-EVALUATION - LIMITED, PROBLEM | Clinic - Dental | $220.00 |
| D000171 | HC RE-EVALUATION ? POST-OPERATIVE OFFICE VISIT | Clinic - Dental | $150.00 |
| D000180 | HC COMPREHENSIVE PERIODONTAL EVALUAT | Clinic - Dental | $129.00 |
| D000190 | HC SCREENING OF A PATIENT | Clinic - Dental | $75.00 |
| D000191 | HC DENTAL ASSESSMENT OF A PATIENT | Clinic - Dental | $75.00 |
| D000210 | HC INTRAORAL - COMPLETE SERIES (INCL | Clinic - Dental | $161.00 |
| D000220 | HC INTRAORAL - PERIAPICAL FIRST FILM | Clinic - Dental | $36.00 |
| D000230 | HC INTRAORAL - PERIAPICAL EACH ADDIT | Clinic - Dental | $30.00 |
| D000240 | HC INTRAORAL - OCCLUSAL FILM | Clinic - Dental | $56.00 |
| D000250 | HC EXTRAORAL - FIRST FILM | Clinic - Dental | $99.00 |
| D000251 | HC EXTRA-ORAL POSTERIOR DENTAL RADIOGRAPHIC IMAGE | Clinic - Dental | $103.00 |
| D000270 | HC BITEWING - SINGLE FILM | Clinic - Dental | $36.00 |
| D000272 | HC BITEWINGS - TWO FILMS | Clinic - Dental | $56.00 |
| D000273 | HC BITEWINGS - THREE FILMS | Clinic - Dental | $69.00 |
| D000274 | HC BITEWINGS - FOUR FILMS | Clinic - Dental | $80.00 |
| D000321 | HC OTHER TEMPOROMANDIBULAR JOINT FIL | Clinic - Dental | $264.00 |
| D000330 | HC PANORAMIC FILM | Clinic - Dental | $136.00 |
| D000340 | HC CEPHALOMETRIC FILM | Clinic - Dental | $159.00 |
| D000350 | HC ORAL/FACIAL PHOTOGRAPHIC IMAGES | Clinic - Dental | $110.00 |
| D000364 | HC CONE BEAM INTERP LIMITED VIEW | Clinic - Dental | $243.00 |
| D000365 | HC CONE BEAM INTERP FULL ARCH MAND | Clinic - Dental | $400.00 |
| D000366 | HC CONE BEAM INTERP FULL ARCH MAX | Clinic - Dental | $400.00 |
| D000367 | HC CONE BEAM INTERP BOTH JAWS | Clinic - Dental | $558.00 |
| D000368 | HC CONE BEAM INTERP TMJ SERIES | Clinic - Dental | $400.00 |
| D000380 | HC CONE BEAM CT IMAG-LIMITED FIEL | Clinic - Dental | $325.00 |
| D000381 | HC CONE BEAM FULL ARCH MAND | Clinic - Dental | $400.00 |
| D000382 | HC CONE BEAM FULL ARCH MAX | Clinic - Dental | $400.00 |
| D000384 | HC CONE BEAM TMJ SERIES | Clinic - Dental | $550.00 |
| D000415 | HC COLLECTION OF MICROORGANISMS FOR | Clinic - Dental | $256.00 |
| D000422 | HC COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORATORY ANALYSIS AND REPORT | Clinic - Dental | $270.00 |
| D000460 | HC PULP VITALITY TESTS | Clinic - Dental | $74.00 |
| D000470 | HC DIAGNOSTIC CASTS | Clinic - Dental | $154.00 |
| D000601 | HC CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF LOW RISK | Clinic - Dental | $5.00 |
| D000602 | HC CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF MODERATE RISK | Clinic - Dental | $30.00 |
| D000603 | HC CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF HIGH RISK | Clinic - Dental | $50.00 |
| D001000 | HC DENTAL CLINIC VISIT | Clinic - Dental | $196.00 |
| D001110 | HC PROPHYLAXIS - ADULT | Clinic - Dental | $117.00 |
| D001120 | HC PROPHYLAXIS - CHILD | Clinic - Dental | $85.00 |
| D001206 | HC TOPICAL FLUORIDE VARNISH, THERAPE | Clinic - Dental | $65.00 |
| D001208 | HC TOPICAL APPLICATION OF FLUORIDE | Clinic - Dental | $51.00 |
| D001310 | HC NUTRITIONAL COUNSELING FOR CONTRO | Clinic - Dental | $95.00 |
| D001330 | HC ORAL HYGIENE INSTRUCTIONS | Clinic - Dental | $74.00 |
| D001351 | HC SEALANT - PER TOOTH | Clinic - Dental | $68.00 |
| D001352 | HC PREVENTIVE RESIN RESTORATION | Clinic - Dental | $68.00 |
| D001353 | HC SEALANT REPAIR ? PER TOOTH | Clinic - Dental | $54.00 |
| D001354 | HC INTERIM CARIES ARRESTING MEDICAMENT APPLICATION | Clinic - Dental | $108.00 |
| D001510 | HC SPACE MAINTAINER - FIXED - UNILAT | Clinic - Dental | $402.00 |
| D001516 | HC FIXED BILAT SPACE MAINT, MAX | Clinic - Dental | $551.00 |
| D001517 | HC FIXED BILAT SPACE MAINT, MAN | Clinic - Dental | $551.00 |
| D001520 | HC SPACE MAINTAINER - REMOVABLE - UN | Clinic - Dental | $489.00 |
| D001526 | HC REMOVE BILAT SPACE MAIN, MAX | Clinic - Dental | $612.00 |
| D001527 | HC REMOVE BILAT SPACE MAIN, MAN | Clinic - Dental | $612.00 |
| D001999 | HC UNSPECIFIED PREVENTIVE PROCEDURE, BY REPORT | Clinic - Dental | $250.00 |
| D002140 | HC AMALGAM - ONE SURFACE, PRIMARY OR | Clinic - Dental | $175.00 |
| D002150 | HC AMALGAM - TWO SURFACES, PRIMARY O | Clinic - Dental | $227.00 |
| D002160 | HC AMALGAM - THREE SURFACES, PRIMARY | Clinic - Dental | $276.00 |
| D002161 | HC AMALGAM - FOUR OR MORE SURFACES, | Clinic - Dental | $325.00 |
| D002330 | HC RESIN-BASED COMPOSITE - ONE SURFA | Clinic - Dental | $198.00 |
| D002331 | HC RESIN-BASED COMPOSITE - TWO SURFA | Clinic - Dental | $258.00 |
| D002332 | HC RESIN-BASED COMPOSITE - THREE SUR | Clinic - Dental | $320.00 |
| D002335 | HC RESIN-BASED COMPOSITE - FOUR OR M | Clinic - Dental | $388.00 |
| D002390 | HC RESIN-BASED COMPOSITE CROWN, ANTE | Clinic - Dental | $612.00 |
| D002391 | HC RESIN-BASED COMPOSITE-ONE SUR2391 | Clinic - Dental | $229.00 |
| D002392 | HC RESIN-BASED COMPOSITE-TWO SUR2392 | Clinic - Dental | $292.00 |
| D002393 | HC RESIN-BASED COMPOSITE-THREE 2393 | Clinic - Dental | $365.00 |
| D002394 | HC RESIN-BASED COMPOSITE-FOUR OR2394 | Clinic - Dental | $432.00 |
| D002630 | HC INLAY - PORCELAIN/CERAMIC - THREE | Clinic - Dental | $1,247.00 |
| D002740 | HC CROWN - PORCELAIN/CERAMIC SUBSTRA | Clinic - Dental | $1,433.00 |
| D002750 | HC CROWN - PORCELAIN FUSED TO HIGH N | Clinic - Dental | $1,404.00 |
| D002751 | HC CROWN - PORCELAIN FUSED TO PR2751 | Clinic - Dental | $1,297.00 |
| D002752 | HC CROWN-PORCELAIN FUSED TO NOBLE | Clinic - Dental | $1,328.00 |
| D002790 | HC CROWN - FULL CAST HIGH NOBLE META | Clinic - Dental | $1,620.00 |
| D002791 | HC CROWN - FULL CAST PREDOMINANTLY B | Clinic - Dental | $1,262.00 |
| D002792 | HC CROWN - FULL CAST NOBLE METAL | Clinic - Dental | $1,297.00 |
| D002799 | HC PROVISIONAL CROWN | Clinic - Dental | $612.00 |
| D002910 | HC RECEMENT INLAY, ONLAY, OR PARTIAL | Clinic - Dental | $136.00 |
| D002915 | HC RECEMENT CAST OR PREFABRICATED PO | Clinic - Dental | $154.00 |
| D002920 | HC RECEMENT CROWN | Clinic - Dental | $143.00 |
| D002929 | HC PREFAB PORC/CERAM CROWN-PRIMARY | Clinic - Dental | $164.00 |
| D002930 | HC PREFABRICATED STAINLESS STEEL CRO | Clinic - Dental | $362.00 |
| D002931 | HC PREFABRICATED STAINLESS STEEL2931 | Clinic - Dental | $419.00 |
| D002932 | HC PREFABRICATED RESIN CROWN | Clinic - Dental | $491.00 |
| D002933 | HC PREFABRICATED STAINLESS STEEL2933 | Clinic - Dental | $477.00 |
| D002940 | HC PROTECTIVE RESTORATION | Clinic - Dental | $154.00 |
| D002941 | HC INTERIM THERAPEUTIC RESTORATION ? PRIMARY DENTITION | Clinic - Dental | $198.00 |
| D002950 | HC CORE BUILDUP, INCLUDING ANY PINS | Clinic - Dental | $355.00 |
| D002952 | HC POST AND CORE IN ADDITION TO CROW | Clinic - Dental | $556.00 |
| D002954 | HC PREFABRICATED POST AND CORE IN AD | Clinic - Dental | $440.00 |
| D002957 | HC EACH ADDITIONAL PREFABRICATED POS | Clinic - Dental | $285.00 |
| D002962 | HC LABIAL VENEER (PORCELAIN LAMINATE | Clinic - Dental | $1,728.00 |
| D002980 | HC CROWN REPAIR, BY REPORT | Clinic - Dental | $1,000.00 |
| D002990 | HC RESIN INFILTRATION INCIPIENT | Clinic - Dental | $75.00 |
| D002999 | HC UNSPECIFIED RESTORATIVE PROCEDURE | Clinic - Dental | $250.00 |
| D003110 | HC PULP CAP - DIRECT (EXCLUDING FINA | Clinic - Dental | $111.00 |
| D003120 | HC PULP CAP - INDIRECT (EXCLUDING FI | Clinic - Dental | $117.00 |
| D003220 | HC THERAPEUTIC PULPOTOMY (EXCLUDING | Clinic - Dental | $266.00 |
| D003221 | HC PULPAL DEBRIDEMENT, PRIMARY AND P | Clinic - Dental | $314.00 |
| D003222 | HC PARTIAL PULPOTOTOMY APEXOGEN | Clinic - Dental | $403.65 |
| D003240 | HC PULPAL THERAPY (RESORBABLE FI3240 | Clinic - Dental | $446.00 |
| D003310 | HC ANTERIOR (EXCLUDING FINAL RESTORA | Clinic - Dental | $966.60 |
| D003320 | HC BICUSPID (EXCLUDING FINAL RESTORA | Clinic - Dental | $1,080.00 |
| D003330 | HC MOLAR (EXCLUDING FINAL RESTORATIO | Clinic - Dental | $1,267.92 |
| D003332 | HC INCOMPLETE ENDODONTIC THERAPY, IN | Clinic - Dental | $586.00 |
| D003333 | HC INTERNAL ROOT REPAIR OF PERFORATI | Clinic - Dental | $465.00 |
| D003346 | HC RETREATMENT OF PREVIOUS ROOT CANA | Clinic - Dental | $1,091.00 |
| D003347 | HC RETREATMENT OF PREVIOUS ROOT 3347 | Clinic - Dental | $1,205.00 |
| D003348 | HC RETREATMENT OF PREVIOUS ROOT 3348 | Clinic - Dental | $1,424.00 |
| D003353 | HC APEXIFICATION/RECALCIFICATION - F | Clinic - Dental | $741.00 |
| D003355 | HC PULPAL REGENERATION - INITIAL VISIT | Clinic - Dental | $786.00 |
| D003357 | HC PULPAL REGENERATION - COMPLETION OF TREATMENT | Clinic - Dental | $371.00 |
| D003410 | HC APICOECTOMY/PERIRADICULAR SUR3410 | Clinic - Dental | $893.00 |
| D003421 | HC APICOECTOMY/PERIRADICULAR SUR3421 | Clinic - Dental | $984.00 |
| D003425 | HC APICOECTOMY/PERIRADICULAR SUR3425 | Clinic - Dental | $1,132.00 |
| D003426 | HC APICOECTOMY/PERIRADICULAR SURGERY | Clinic - Dental | $562.00 |
| D003428 | HC BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? PER TOOTH, SINGLE SITE | Clinic - Dental | $513.00 |
| D003429 | HC BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? EACH ADDITIONAL CONTIGUOUS TOOTH IN THE SA | Clinic - Dental | $1,959.00 |
| D003430 | HC RETROGRADE FILLING - PER ROOT | Clinic - Dental | $393.00 |
| D003431 | HC BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATION IN CONJUNCTION WITH PERIRADICUL | Clinic - Dental | $529.20 |
| D003432 | HC GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CONJUNCTION WITH PERIRADICULAR SURGE | Clinic - Dental | $450.00 |
| D003450 | HC ROOT AMPUTATION - PER ROOT | Clinic - Dental | $652.00 |
| D003470 | HC INTENTIONAL REIMPLANTATION (INCLU | Clinic - Dental | $997.00 |
| D004211 | HC GINGIVECTOMY OR GINGIVOPLASTY - O | Clinic - Dental | $419.00 |
| D004240 | HC GINGIVAL FLAP PROCEDURE, INCL4240 | Clinic - Dental | $989.00 |
| D004241 | HC GINGIVAL FLAP PROCEDURE, INCLUDIN | Clinic - Dental | $863.00 |
| D004245 | HC APICALLY POSITIONED FLAP | Clinic - Dental | $1,045.00 |
| D004249 | HC CLINICAL CROWN LENGTHENING - HARD | Clinic - Dental | $989.00 |
| D004260 | HC OSSEOUS SURGERY (INCLUDING FL4260 | Clinic - Dental | $1,369.00 |
| D004261 | HC OSSEOUS SURGERY (INCLUDING FLAP E | Clinic - Dental | $1,134.00 |
| D004263 | HC BONE REPLACEMENT GRAFT - FIRST SI | Clinic - Dental | $1,037.00 |
| D004264 | HC BONE REPLACEMENT GRAFT - EACH ADD | Clinic - Dental | $760.00 |
| D004266 | HC GUIDED TISSUE REGENERATION - RESO | Clinic - Dental | $1,124.00 |
| D004275 | HC SOFT TISSUE ALLOGRAFT | Clinic - Dental | $1,309.00 |
| D004277 | HC FREE SOFT TISSUE GRAFT,FIRST TTH | Clinic - Dental | $1,400.00 |
| D004278 | HC FREE SOFT TISSUE GRAFT,EACH ADD | Clinic - Dental | $432.00 |
| D004321 | HC PROVISIONAL SPLINTING - EXTRACORO | Clinic - Dental | $680.00 |
| D004341 | HC PERIODONTAL SCALING AND ROOT 4341 | Clinic - Dental | $320.00 |
| D004342 | HC PERIODONTAL SCALING AND ROOT PLAN | Clinic - Dental | $241.00 |
| D004346 | HC SCALING GINGIV INFLAMMATION | Clinic - Dental | $325.00 |
| D004355 | HC FULL MOUTH DEBRIDEMENT TO ENABLE | Clinic - Dental | $246.00 |
| D004910 | HC PERIODONTAL MAINTENANCE | Clinic - Dental | $179.00 |
| D005110 | HC COMPLETE DENTURE - MAXILLARY | Clinic - Dental | $2,140.00 |
| D005120 | HC COMPLETE DENTURE - MANDIBULAR | Clinic - Dental | $2,101.00 |
| D005130 | HC IMMEDIATE DENTURE - MAXILLARY | Clinic - Dental | $2,344.00 |
| D005140 | HC IMMEDIATE DENTURE - MANDIBULAR | Clinic - Dental | $2,348.00 |
| D005211 | HC MAXILLARY PARTIAL DENTURE - RESIN | Clinic - Dental | $1,731.00 |
| D005212 | HC MANDIBULAR PARTIAL DENTURE - RESI | Clinic - Dental | $1,713.00 |
| D005213 | HC DENTURES MAXILL PART METAL | Clinic - Dental | $2,279.00 |
| D005214 | HC DENTURES MANDIBL PART METAL | Clinic - Dental | $2,286.00 |
| D005221 | HC IMMEDIATE MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TE | Clinic - Dental | $2,214.88 |
| D005223 | HC IMMEDIATE MAXILLARY PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING AN | Clinic - Dental | $2,897.56 |
| D005224 | HC IMMEDIATE MANDIBULAR PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING A | Clinic - Dental | $2,897.56 |
| D005225 | HC MAXILLARY PARTIAL DENTURE - FLEXI | Clinic - Dental | $2,592.00 |
| D005226 | HC MANDIBULAR PARTIAL DENTURE - FLEX | Clinic - Dental | $2,592.00 |
| D005283 | HC REMOVE UNIL PART DENTURE,MAN | Clinic - Dental | $1,359.00 |
| D005410 | HC ADJUST COMPLETE DENTURE - MAXILLA | Clinic - Dental | $117.00 |
| D005411 | HC ADJUST COMPLETE DENTURE - MANDIBU | Clinic - Dental | $115.00 |
| D005421 | HC DJUST PARTIAL DENTURE - MAXILLAR | Clinic - Dental | $116.00 |
| D005422 | HC ADJUST PARTIAL DENTURE - MANDIBUL | Clinic - Dental | $115.00 |
| D005511 | HC REPAIR BROKEN COMPLETE DENTRURE BASE, MANDIBULAR | Clinic - Dental | $279.00 |
| D005512 | HC REPAIR BROKEN COMPLETE DENTRURE BASE, MAXILLARY | Clinic - Dental | $350.00 |
| D005520 | HC REPLACE MISSING OR BROKEN TEETH - | Clinic - Dental | $241.00 |
| D005611 | HC REPAIR RESIN PARTIAL DENTRUE BASE, MANDIBULAR | Clinic - Dental | $486.00 |
| D005612 | HC REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY | Clinic - Dental | $486.00 |
| D005621 | HC REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR | Clinic - Dental | $468.00 |
| D005622 | HC REPAIR CAST PARTIAL FRAMEWORK, MAXILLARY | Clinic - Dental | $468.00 |
| D005630 | HC REPAIR OR REPLACE BROKEN CLASP | Clinic - Dental | $405.00 |
| D005640 | HC REPLACE BROKEN TEETH - PER TOOTH | Clinic - Dental | $405.00 |
| D005650 | HC ADD TOOTH TO EXISTING PARTIAL DEN | Clinic - Dental | $405.00 |
| D005660 | HC ADD CLASP TO EXISTING PARTIAL DEN | Clinic - Dental | $405.00 |
| D005710 | HC REBASE COMPLETE MAXILLARY DENTURE | Clinic - Dental | $754.00 |
| D005711 | HC REBASE COMPLETE MANDIBULAR DENTUR | Clinic - Dental | $754.00 |
| D005730 | HC RELINE COMPLETE MAXILLARY DENTURE | Clinic - Dental | $492.00 |
| D005731 | HC RELINE COMPLETE MANDIBULAR DENTUR | Clinic - Dental | $492.00 |
| D005741 | HC RELINE MANDIBULAR PARTIAL DENTURE | Clinic - Dental | $491.00 |
| D005750 | HC RELINE COMPLETE MAXILLARY DEN5750 | Clinic - Dental | $810.00 |
| D005751 | HC RELINE COMPLETE MANDIBULAR DE5751 | Clinic - Dental | $810.00 |
| D005760 | HC RELINE MAXILLARY PARTIAL DEN 5760 | Clinic - Dental | $810.00 |
| D005810 | HC INTERIM COMPLETE DENTURE (MAXILLA | Clinic - Dental | $1,221.00 |
| D005820 | HC INTERIM PARTIAL DENTURE (MAXILLAR | Clinic - Dental | $932.00 |
| D005821 | HC INTERIM PARTIAL DENTURE (MANDIBUL | Clinic - Dental | $958.00 |
| D005865 | HC OVERDENTURE - COMPLETE MANDIBULAR | Clinic - Dental | $6,480.00 |
| D005867 | HC REPLACEMENT OF REPLACEABLE PART O | Clinic - Dental | $563.00 |
| D005986 | HC FLUORIDE GEL CARRIER | Clinic - Dental | $345.00 |
| D006010 | HC SURGICAL PLACEMENT OF IMPLANT BOD | Clinic - Dental | $2,471.00 |
| D006011 | HC SECOND STAGE IMPLANT SURGERY | Clinic - Dental | $200.00 |
| D006052 | HC SEMI-PRECISION ATTACHMENT ABUTMENT | Clinic - Dental | $2,500.00 |
| D006056 | HC PREFABRICATED ABUTMENT - INCLUDES | Clinic - Dental | $1,204.00 |
| D006057 | HC CUSTOM ABUTMENT - INCLUDES PLACEM | Clinic - Dental | $1,348.00 |
| D006058 | HC ABUTMENT SUPPORTED PORCELAIN/CERA | Clinic - Dental | $1,977.00 |
| D006059 | HC ABUTMENT SUPPORTED PORCELAIN 6059 | Clinic - Dental | $1,977.00 |
| D006060 | HC ABUTMENT SUPPORTED PORCELAIN 6060 | Clinic - Dental | $1,850.00 |
| D006065 | HC IMPLANT SUPPORTED PORCELAIN/CERAM | Clinic - Dental | $2,145.00 |
| D006066 | HC IMPLANT SUPPORTED MTL CROWN | Clinic - Dental | $2,070.00 |
| D006069 | HC ABUTMENT SUPPORTED RETAINER 6069 | Clinic - Dental | $2,000.00 |
| D006072 | HC ABUTMENT SUPPORTED RETAINER 6072 | Clinic - Dental | $1,945.00 |
| D006076 | HC IMPLANT SUPPORTED RETAINER FOR PO | Clinic - Dental | $2,067.00 |
| D006080 | HC IMPLANT MAINTENANCE PROCEDURES, I | Clinic - Dental | $476.00 |
| D006081 | HC SCALE & DEBRIDE, SINGLE IMP | Clinic - Dental | $250.00 |
| D006090 | HC REPAIR IMPLANT SUPPORTED PROSTHES | Clinic - Dental | $977.00 |
| D006091 | HC REPLACEMENT OF SEMI-PRECISION OR | Clinic - Dental | $879.00 |
| D006093 | HC RECEMENT IMPLANT/ABUTMENT SUP6093 | Clinic - Dental | $227.00 |
| D006100 | HC IMPLANT REMOVAL, BY REPORT | Clinic - Dental | $1,012.00 |
| D006104 | HC BONE GRAFT AT IMPLANT PLACEMENT | Clinic - Dental | $600.00 |
| D006111 | HC IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARCH ? MANDIBULAR | Clinic - Dental | $6,480.00 |
| D006119 | HC IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTRURE FOR EDENTULOUS ARCH - MAXILLARY | Clinic - Dental | $3,060.00 |
| D006190 | HC RADIOGRAPHIC/SURGICAL IMPLANT IND | Clinic - Dental | $1,400.00 |
| D006199 | HC UNSPECIFIED IMPLANT PROCEDURE, BY | Clinic - Dental | $250.00 |
| D006205 | HC PONTIC - INDIRECT RESIN BASED COM | Clinic - Dental | $1,253.00 |
| D006210 | HC PONTIC - CAST HIGH NOBLE METAL | Clinic - Dental | $1,359.00 |
| D006212 | HC PONTIC - CAST NOBLE METAL | Clinic - Dental | $1,297.00 |
| D006240 | HC PONTIC - PORCELAIN FUSED TO HIGH | Clinic - Dental | $1,404.00 |
| D006241 | HC PONTIC - PORCELAIN FUSED TO PREDO | Clinic - Dental | $1,300.00 |
| D006242 | HC PONTIC - PORCELAIN FUSED TO NOBLE | Clinic - Dental | $1,404.00 |
| D006245 | HC PONTIC - PORCELAIN/CERAMIC | Clinic - Dental | $1,404.00 |
| D006251 | HC PONTIC - RESIN WITH PREDOMINANTLY | Clinic - Dental | $1,359.00 |
| D006253 | HC PROVISIONAL PONTIC | Clinic - Dental | $1,031.00 |
| D006545 | HC RETAINER - CAST METAL FOR RESIN B | Clinic - Dental | $1,113.00 |
| D006548 | HC RETAINER - PORCELAIN/CERAMIC FOR | Clinic - Dental | $1,337.00 |
| D006740 | HC CROWN - PORCELAIN/CERAMIC | Clinic - Dental | $1,421.00 |
| D006750 | HC CROWN-PORCELAIN FUSED TO HIGH6750 | Clinic - Dental | $1,404.00 |
| D006751 | HC CROWN - PORCELAIN FUSED TO PREDOM | Clinic - Dental | $1,295.00 |
| D006752 | HC CROWN-PORCELAIN FUSED TO NOBL6752 | Clinic - Dental | $1,404.00 |
| D006791 | HC CROWN - FULL CAST PREDOMINANT6791 | Clinic - Dental | $1,288.00 |
| D006792 | HC CROWN - FULL CAST NOBLE METAL6792 | Clinic - Dental | $1,318.00 |
| D006930 | HC RECEMENT FIXED PARTIAL DENTURE | Clinic - Dental | $229.00 |
| D006950 | HC PRECISION ATTACHMENT | Clinic - Dental | $1,574.64 |
| D007111 | HC EXTRACTION, CORONAL REMNANTS - DE | Clinic - Dental | $183.00 |
| D007140 | HC EXTRACTION, ERUPTED TOOTH OR EXPO | Clinic - Dental | $229.00 |
| D007210 | HC SURGICAL REMOVAL OF ERUPTED TOOTH | Clinic - Dental | $357.00 |
| D007220 | HC REMOVAL OF IMPACTED TOOTH - SOFT | Clinic - Dental | $418.00 |
| D007230 | HC REMOVAL OF IMPACTED TOOTH - PARTI | Clinic - Dental | $521.00 |
| D007240 | HC REMOVAL OF IMPACTED TOOTH - COMPL | Clinic - Dental | $639.00 |
| D007241 | HC REMOVAL OF IMPACTED TOOTH - 7241 | Clinic - Dental | $745.00 |
| D007250 | HC SURGICAL REMOVAL OF RESIDUAL TOOT | Clinic - Dental | $402.00 |
| D007251 | HC CORONECTOMY | Clinic - Dental | $639.00 |
| D007270 | HC TOOTH REIMPLANTATION AND/OR STABI | Clinic - Dental | $736.00 |
| D007280 | HC SURGICAL ACCESS OF AN UNERUPTED T | Clinic - Dental | $665.00 |
| D007283 | HC PLACEMENT OF DEVICE TO FACILITATE | Clinic - Dental | $698.00 |
| D007285 | HC BIOPSY OF ORAL TISSUE - HARD (BON | Clinic - Dental | $624.00 |
| D007286 | HC BIOPSY OF ORAL TISSUE - SOFT | Clinic - Dental | $432.00 |
| D007311 | HC ALVEOLOPLASTY IN CONJUNCTION 7311 | Clinic - Dental | $446.00 |
| D007320 | HC ALVEOLOPLASTY NOT IN CONJUNCTION | Clinic - Dental | $647.00 |
| D007321 | HC ALVEOLOPLASTY NOT IN CONJUNC 7321 | Clinic - Dental | $655.00 |
| D007410 | HC EXCISION OF BENIGN LESION UP TO 1 | Clinic - Dental | $618.00 |
| D007411 | HC EXCISION OF BENIGN LESION GREATER | Clinic - Dental | $924.00 |
| D007451 | HC REMOVAL OF BENIGN ODONTOGENIC7451 | Clinic - Dental | $1,175.00 |
| D007473 | HC REMOVAL OF TORUS MANDIBULARIS | Clinic - Dental | $1,039.00 |
| D007510 | HC INCISION AND DRAINAGE OF ABSCESS | Clinic - Dental | $309.00 |
| D007511 | HC INCISION AND DRAINAGE OF ABS 7511 | Clinic - Dental | $507.00 |
| D007520 | HC INCISION AND DRAINAGE OF ABS 7520 | Clinic - Dental | $704.00 |
| D007670 | HC ALVEOLUS CLOSED REDUCTION MAY IN | Clinic - Dental | $2,961.00 |
| D007820 | HC CLOSED REDUCTION OF DISLOCATION | Clinic - Dental | $890.00 |
| D007870 | HC ARTHROCENTESIS | Clinic - Dental | $803.00 |
| D007880 | HC OCCLUSAL ORTHOTIC DEVICE, BY REPO | Clinic - Dental | $1,641.00 |
| D007951 | HC SINUS AUGMENTATION WITH BONE OR B | Clinic - Dental | $4,771.00 |
| D007952 | HC SINUS AUGMENTATION-VERTICAL APP | Clinic - Dental | $1,500.00 |
| D007953 | HC BONE REPLACEMENT GRAFT FOR RIDGE | Clinic - Dental | $4,561.00 |
| D007960 | HC FRENULECTOMY (FRENECTOMY OR FRENO | Clinic - Dental | $610.00 |
| D007963 | HC FRENULOPLASTY | Clinic - Dental | $676.00 |
| D007997 | HC APPLIANCE REMOVAL (NOT BY DENTIST | Clinic - Dental | $524.00 |
| D008020 | HC LIMITED ORTHODONTIC TREATMENT8020 | Clinic - Dental | $3,398.00 |
| D008060 | HC INTERCEPTIVE ORTHODONTIC TREA8060 | Clinic - Dental | $3,944.00 |
| D008090 | HC COMPREHENSIVE ORTHODONTIC TRE8090 | Clinic - Dental | $7,358.00 |
| D008210 | HC REMOVABLE APPLIANCE THERAPY | Clinic - Dental | $1,297.00 |
| D008220 | HC FIXED APPLIANCE THERAPY | Clinic - Dental | $1,489.00 |
| D008660 | HC PRE-ORTHODONTIC TREATMENT VISIT | Clinic - Dental | $628.00 |
| D008670 | HC PERIODIC ORTHODONTIC TREATMENT VI | Clinic - Dental | $376.00 |
| D008681 | HC REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT | Clinic - Dental | $216.00 |
| D008695 | HC REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN COMPLETION OF TREATMENT | Clinic - Dental | $250.00 |
| D008999 | HC UNSPECIFIED ORTHODONTIC PROCEDURE | Clinic - Dental | $250.00 |
| D009110 | HC PALLIATIVE (EMERGENCY) TREATMENT | Clinic - Dental | $172.00 |
| D009120 | HC FIXED PARTIAL DENTURE SECTIONING | Clinic - Dental | $367.00 |
| D009211 | HC REGIONAL BLOCK ANESTHESIA | Clinic - Dental | $130.00 |
| D009215 | HC LOCAL ANESTHESIA | Clinic - Dental | $86.00 |
| D009219 | HC EVALUATION FOR DEEP SEDATION OR GENERAL ANESTHESIA | Clinic - Dental | $216.00 |
| D009222 | HC DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MINS | Clinic - Dental | $350.00 |
| D009223 | HC DEEP SEDATION/GENERAL ANESTHESIA ? EACH 15 MINUTE INCREMENT | Clinic - Dental | $350.00 |
| D009230 | HC INHAL NITR OXIDE/ANXIOLYS,ANALGES | Clinic - Dental | $117.00 |
| D009239 | HC INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA - FIRST 15 MINS | Clinic - Dental | $300.00 |
| D009243 | HC INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA ? EACH 15 MINUTE INCREMENT | Clinic - Dental | $296.15 |
| D009248 | HC NON-INTRAVENOUS CONSCIOUS SEDATIO | Clinic - Dental | $482.00 |
| D009310 | HC CONSULTATION - DIAGNOSTIC SERVICE | Clinic - Dental | $203.00 |
| D009420 | HC HOSPITAL OR AMB SURG CTR CALL | Clinic - Dental | $411.00 |
| D009430 | HC OFFICE VISIT FOR OBSERVATION (DUR | Clinic - Dental | $220.00 |
| D009440 | HC OFFICE VISIT - AFTER REGULARLY SC | Clinic - Dental | $247.00 |
| D009610 | HC THERAPEUTIC PARENTERAL DRUG, SING | Clinic - Dental | $163.00 |
| D009910 | HC APPLICATION OF DESENSITIZING MEDI | Clinic - Dental | $93.00 |
| D009911 | HC APPLICATION OF DESENSITIZING RESI | Clinic - Dental | $117.00 |
| D009920 | HC BEHAVIOR MANAGEMENT, BY REPORT | Clinic - Dental | $247.00 |
| D009930 | HC TREATMENT OF COMPLICATIONS (POST- | Clinic - Dental | $204.00 |
| D009943 | HC OCCLUSAL GUARD ADJUSTMENT | Clinic - Dental | $161.54 |
| D009944 | HC OCC GUARD, HARD, FULL ARCH | Clinic - Dental | $839.00 |
| D009945 | HC OCC GUARD, SOFT, FULL ARCH | Clinic - Dental | $839.00 |
| D009946 | HC OCC GUARD, HARD, PART ARCH | Clinic - Dental | $839.00 |
| D009951 | HC OCCLUSAL ADJUSTMENT - LIMITED | Clinic - Dental | $267.00 |
| D009971 | HC ODONTOPLASTY 1 - 2 TEETH, INCLUDE | Clinic - Dental | $295.00 |
| D009972 | HC EXTERNAL BLEACHING - PER ARCH | Clinic - Dental | $518.00 |
| D009974 | HC INTERNAL BLEACHING - PER TOOTH | Clinic - Dental | $409.00 |
| D009975 | HC EXTERNAL BLEACHING-HOME,PER ARCH | Clinic - Dental | $300.00 |
| D009990 | HC TRANS OR SIGN LANGUAGE SVCS | Clinic - Dental | $110.00 |
| D009991 | HC CASE MGMT, APPT BARRIERS | Clinic - Dental | $106.00 |
| D009994 | HC CASE MGMT, PT EDUCATION | Clinic - Dental | $145.00 |
| D009995 | HC TELEDENTRISTRY - SYNCHRONOUS; REAL-TIME ENCOUNTER | Clinic - Dental | $483.00 |
| D009999 | HC UNSPECIFIED ADJUNCTIVE PROCEDURE, | Clinic - Dental | $250.00 |
| D011552 | HC RECEMENT SPACE MAINT - MAN BILAT | Clinic - Dental | $109.00 |
| D011553 | HC RECEMENT UNILAT SPACE MAINT | Clinic - Dental | $109.00 |
| D011556 | HC REMOVE FIXED UNILAT SPACE MAINT | Clinic - Dental | $98.00 |
| D011557 | HC REMOVE FIXED BILAT SPACE MAINT MAX | Clinic - Dental | $98.00 |
| D011558 | HC REMOVE FIXED BILAT MAN | Clinic - Dental | $98.00 |
| D019975 | HC EXTERNAL BLEACHING-HOME, NON-CUSTOM TRAY | Clinic - Dental | $540.00 |
| 2026235 | HC HOME VISIT NEW PATIENT 30 | Clinic - Other | $270.90 |
| 2026239 | HC HOME VISIT EST PATIENT 15 | Clinic - Other | $188.28 |
| 2026240 | HC HOME VISIT EST PATIENT 25 | Clinic - Other | $286.92 |
| 2026241 | HC HOME VISIT EST PATIENT 40 | Clinic - Other | $439.17 |
| 2026242 | HC HOME VISIT EST PATIENT 60 | Clinic - Other | $610.29 |
| 2026502 | HC DIALYSIS ONE EVALUATION (CAPD) | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate | $1,127.81 |
| 2026505 | HC DIALYSIS TRAINING INCOMPLETE (CAPD) | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate | $2,330.00 |
| 2026503 | HC DIALYSIS ONE EVALUATION (CCPD) | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate | $1,127.81 |
| 2026506 | HC DIALYSIS TRAINING INCOMPLETE (CCPD) | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate | $2,330.00 |
| 1010031 | HC RB SPECIAL CARE EPILEPSY | Coronary Care Unit - Other | $11,753.20 |
| 2020001 | HC CCTA W/WO, STRXR | CT Scan | $4,923.96 |
| 2020645 | HC CT HEAD/BRAIN W/O DYE | CT Scan | $2,997.64 |
| 2020646 | HC CT HEAD/BRAIN W/DYE | CT Scan | $4,196.95 |
| 2020647 | HC CT HEAD/BRAIN W/O & W/DYE | CT Scan | $4,945.72 |
| 2020648 | HC CT ORBIT/EAR/FOSSA W/O DYE | CT Scan | $3,530.10 |
| 2020649 | HC CT ORBIT/EAR/FOSSA W/DYE | CT Scan | $4,164.96 |
| 2020650 | HC CT ORBIT/EAR/FOSSA W/O&W/DYE | CT Scan | $4,554.06 |
| 2020651 | HC CT MAXILLOFACIAL W/O CONTRAST | CT Scan | $3,710.57 |
| 2020652 | HC CT MAXILLOFACIAL W/CONTRAST | CT Scan | $4,490.06 |
| 2020653 | HC CT MAXILLOFACIAL W/O & W/CONTRAST | CT Scan | $5,455.15 |
| 2020654 | HC CT SOFT TISSUE NECK W/O DYE | CT Scan | $3,871.85 |
| 2020655 | HC CT SOFT TISSUE NECK W/DYE | CT Scan | $4,721.73 |
| 2020656 | HC CT SFT TSUE NCK W/O & W/DYE | CT Scan | $5,571.62 |
| 2020695 | HC CT THORAX W/O DYE | CT Scan | $3,842.41 |
| 2020696 | HC CT THORAX W/DYE | CT Scan | $7,723.22 |
| 2020697 | HC CT THORAX W/O & W/DYE | CT Scan | $8,646.05 |
| 2020698 | HC CT ANGIOGRAPHY, CHEST | CT Scan | $6,056.72 |
| 2020719 | HC CT NECK SPINE W/O DYE | CT Scan | $3,517.30 |
| 2020720 | HC CT NECK SPINE W/DYE | CT Scan | $7,069.16 |
| 2020721 | HC CT NECK SPINE W/O & W/DYE | CT Scan | $7,913.92 |
| 2020722 | HC CT CHEST SPINE W/O DYE | CT Scan | $3,517.30 |
| 2020723 | HC CT CHEST SPINE W/DYE | CT Scan | $7,069.16 |
| 2020724 | HC CT CHEST SPINE W/O & W/DYE | CT Scan | $7,913.92 |
| 2020725 | HC CT LUMBAR SPINE W/O DYE | CT Scan | $3,623.53 |
| 2020728 | HC CT LUMBAR SPINE W/DYE | CT Scan | $7,282.92 |
| 2020729 | HC CT LUMBAR SPINE W/O & W/DYE | CT Scan | $8,153.28 |
| 2020744 | HC CT ANGIOGRAPH PELV W/O&W/DYE | CT Scan | $4,185.44 |
| 2020745 | HC CT PELVIS W/O DYE | CT Scan | $2,461.34 |
| 2020746 | HC CT PELVIS W/O DYE 52 | CT Scan | $2,461.34 |
| 2020747 | HC CT PELVIS W/DYE | CT Scan | $4,922.69 |
| 2020750 | HC CT PELVIS W/O & W/DYE | CT Scan | $5,514.02 |
| 2020967 | HC CT LOWER EXTREMITY W/CONTRAST | CT Scan | $3,896.16 |
| 2020971 | HC CT ANGIO LWR EXTR W/O&W/DYE | CT Scan | $3,764.33 |
| 2020992 | HC CT ABDOMEN W/O DYE | CT Scan | $3,600.50 |
| 2020993 | HC CT ABDOMEN W/DYE | CT Scan | $5,551.14 |
| 2020994 | HC CT ABDOMEN W/O & W/DYE | CT Scan | $6,301.19 |
| 2020995 | HC CT ANGIO ABDOM W/O & W/DYE | CT Scan | $7,499.22 |
| 2021039 | HC CT ANGIO ABDOMINAL ARTERIES | CT Scan | $3,115.40 |
| 2021131 | HC 3D RENDER W/O POSTPROCESS | CT Scan | $651.49 |
| 2021132 | HC 3D RENDERING W/POSTPROCESS | CT Scan | $1,808.57 |
| 2021172 | HC CT SCAN FOR NEEDLE BIOPSY | CT Scan | $3,463.55 |
| 2021173 | HC CT GUIDE FOR TISSUE ABLATION | CT Scan | $7,025.64 |
| 2021174 | HC CT SCAN FOR THERAPY GUIDE | CT Scan | $1,971.12 |
| 2022720 | HC CT HRT W/O DYE W/CA TEST | CT Scan | $4,185.44 |
| 2022721 | HC CT HRT W/3D IMAGE | CT Scan | $4,923.96 |
| 2022917 | HC CT ABD & PEL W/O CONT | CT Scan | $4,801.08 |
| 2022918 | HC CT ABD & PEL W/CONT | CT Scan | $7,501.78 |
| 2022919 | HC CT ABD & PEL W & W/O CON | CT Scan | $8,477.10 |
| 2023501 | HC CT; U EXTR WO CONTRAST | CT Scan | $3,523.70 |
| 2023502 | HC CT; U EXTR W CONTRAST | CT Scan | $4,369.75 |
| 2023503 | HC CT: U EXTR W AND WO CONTRAST | CT Scan | $5,461.54 |
| 2023504 | HC CT ANGIO UPR EXTRM W/O&W/DYE | CT Scan | $2,551.84 |
| 2023524 | HC CT L EXTR W AND WO CONTRAST | CT Scan | $4,730.69 |
| 2023570 | HC CT ANGIO ABD&PELV W/O&W/DYE | CT Scan | $9,493.39 |
| 2023571 | HC CT COLONOGRAPHY DX | CT Scan | $1,624.25 |
| 2023781 | HC CT LIMITED OR FOLLOW-UP STUDY | CT Scan | $1,105.87 |
| 2025033 | HC CT PERFUSION W/CONTRAST CBF | CT Scan | $1,002.19 |
| 2025722 | HC LDCT FOR LUNG CA SCREEN | CT Scan | $509.47 |
| 2026138 | HC CT COLONOGRAPHY SCREEN | CT Scan | $1,752.18 |
| 2026733 | HC CT CDSM NDSC | CT Scan | $1.06 |
| 2022884 | HC CT LOWER EXTREMITY W/O CONTR | CT Scan - Body Scan | $3,092.35 |
| 2020657 | HC CT ANGIOGRAPHY, HEAD | CT Scan - Head Scan | $6,554.62 |
| 2020658 | HC CT ANGIOGRAPHY, NECK | CT Scan - Head Scan | $6,723.58 |
| 2022154 | HC EEG EXTND MNTR 61-119 MIN | EEG (Electroencephalogram) | $4,159.37 |
| 2022155 | HC EEG, AWAKE AND ASLEEP | EEG (Electroencephalogram) | $3,678.46 |
| 2022665 | HC WADA ACTIVATION TEST | EEG (Electroencephalogram) | $3,147.39 |
| 2024302 | HC EEG EXTEND MONIT 41-60 MINUTES | EEG (Electroencephalogram) | $3,493.73 |
| 2024303 | HC EEG AWAKE & DROWSY | EEG (Electroencephalogram) | $3,214.65 |
| 2024468 | HC EEG COMA OR SLEEP ONLY | EEG (Electroencephalogram) | $3,276.67 |
| 2024593 | HC POLYSOM <6 YRS 4> PARAMTRS | EEG (Electroencephalogram) | $6,488.06 |
| 2024594 | HC POLYSOM <6 YRS CPAP/BILVL | EEG (Electroencephalogram) | $8,823.98 |
| 2024597 | HC POLYSOM 6/> YRS 4/> PARAM | EEG (Electroencephalogram) | $4,642.51 |
| 2024598 | HC POLYSOM 6/>YRS CPAP 4/> PARM | EEG (Electroencephalogram) | $4,886.85 |
| 2026444 | HC ACTIGRAPHY TESTING 73 HRS-14 CONS DAYS | EEG (Electroencephalogram) | $208.19 |
| 2026605 | HC EEG CONT REC W/VID EEG TECH 8 CH | EEG (Electroencephalogram) | $919.89 |
| 2026606 | HC EEG W/O VID 2-12 HR UNMNTR | EEG (Electroencephalogram) | $950.90 |
| 2026608 | HC EEG W/O VID 2-12HR CONT MNTR | EEG (Electroencephalogram) | $1,692.90 |
| 2026609 | HC EEG WO VID EA 12-26HR UNMNTR | EEG (Electroencephalogram) | $2,821.80 |
| 2026611 | HC EEG W/O VID EA 12-26HR CONT | EEG (Electroencephalogram) | $4,305.80 |
| 2026612 | HC VEEG 2-12 HR UNMONITORED | EEG (Electroencephalogram) | $11,206.51 |
| 2026614 | HC VEEG 2-12 HR CONT MNTR | EEG (Electroencephalogram) | $12,194.51 |
| 2026615 | HC VEEG EA 12-26 HR UNMNTR | EEG (Electroencephalogram) | $22,908.91 |
| 2026616 | HC VEEG EA 12-26HR INTMT MNTR | EEG (Electroencephalogram) | $23,402.91 |
| 2022023 | HC ELECTROCARDIOGRAM, TRACING | EKG/ECG (Electrocardiogram) | $515.81 |
| 2022024 | HC ELECTROCARDIOGRAM, TRACING 76 | EKG/ECG (Electrocardiogram) | $515.81 |
| 2022030 | HC ECG MONITOR/RECORD, 48 HRS | EKG/ECG (Electrocardiogram) - Holter Monitor | $629.73 |
| 2022031 | HC ECG MONITOR/REPORT, 48 HRS | EKG/ECG (Electrocardiogram) - Holter Monitor | $940.76 |
| 2023746 | HC EMERGENCY DEPT VISIT LVL 1 | Emergency Room | $2,624.30 |
| 2023747 | HC EMERGENCY DEPT VISIT LVL 2 | Emergency Room | $3,017.60 |
| 2023748 | HC EMERGENCY DEPT VISIT LVL 3 | Emergency Room | $4,364.25 |
| 2023749 | HC EMERGENCY DEPT VISIT LVL 4 | Emergency Room | $4,985.25 |
| 2023750 | HC EMERGENCY DEPT VISIT LVL 5 | Emergency Room | $5,904.10 |
| 2023751 | HC CRITICAL CARE 1ST HOUR | Emergency Room | $6,369.28 |
| 2023752 | HC CRITICAL CARE ADDL 30 MIN | Emergency Room | $3,185.25 |
| 2023783 | HC EMERG DEPT F/U VISIT LVL 1 | Emergency Room | $1,312.15 |
| 2023784 | HC EMERG DEPT F/U VISIT LVL 2 | Emergency Room | $1,508.80 |
| 2023785 | HC EMERG DEPT F/U VISIT LVL 3 | Emergency Room | $2,182.13 |
| 2023786 | HC EMERG DEPT F/U VISIT LVL 4 | Emergency Room | $2,492.63 |
| 2023787 | HC EMERG DEPT F/U VISIT LVL 5 | Emergency Room | $2,952.05 |
| 2023789 | HC ED TRIAGE VISIT | Emergency Room | $430.92 |
| 2025615 | HC ED SUTURE REMOVAL VISIT LVL 1 | Emergency Room | $430.92 |
| 2026978 | HC HOSP NOTIF TRAUMA RESPONS W OR W/O CC | Emergency Room | $7,511.03 |
| 2024430 | HC URGENT CARE NEW LVL 1 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024431 | HC URGENT CARE NEW LVL 1 | Emergency Room - Urgent Care | $1,495.00 |
| 2024434 | HC URGENT CARE NEW LVL 3 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024435 | HC URGENT CARE NEW LVL 3 | Emergency Room - Urgent Care | $1,495.00 |
| 2024436 | HC URGENT CARE NEW LVL 4 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024438 | HC URGENT CARE NEW LVL 5 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024440 | HC URGENT CARE EST LVL 1 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024441 | HC URGENT CARE EST LVL 1 | Emergency Room - Urgent Care | $1,495.00 |
| 2024444 | HC URGENT CARE EST LVL 3 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024445 | HC URGENT CARE EST LVL 3 | Emergency Room - Urgent Care | $1,495.00 |
| 2024446 | HC URGENT CARE EST LVL 4 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024447 | HC URGENT CARE EST LVL 4 | Emergency Room - Urgent Care | $1,495.00 |
| 2024448 | HC URGENT CARE EST LVL 5 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024449 | HC URGENT CARE EST LVL 5 | Emergency Room - Urgent Care | $1,495.00 |
| 2022762 | HC BREATH HYDROGEN TEST | Gastro-Intestinal (GI) Services | $1,317.38 |
| 2023730 | HC PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX | Gastro-Intestinal (GI) Services | $925.44 |
| 2025006 | HC GI TRACT CAPSULE ENDOSCOPY | Gastro-Intestinal (GI) Services | $5,212.35 |
| 0230001 | HH SOC | Health Insurance Prospective Payment System (HIPPS) - Home Health | $420.00 |
| 0230002 | HH F/U | Health Insurance Prospective Payment System (HIPPS) - Home Health | $420.00 |
| 0230004 | HH ROC | Health Insurance Prospective Payment System (HIPPS) - Home Health | $420.00 |
| 2026113 | HC DIALYSIS TRAINING INCOMPLETE | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $2,330.00 |
| 2026114 | HC ESRD SVC HOME DIALYSIS FULL MONTH 20+YRS | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $1,415.00 |
| 2026115 | HC UNLISTED DIALYSIS PROCEDURE | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $1,209.00 |
| 2026116 | HC DIALYSIS ACU KIDNEY NO ESRD | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $945.00 |
| 2026504 | HC HEMODIALYSIS REPEAT EVAL | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $2,470.00 |
| 2021974 | HC HEMODIALYSIS, ONE EVALUATION | Hemodialysis - Outpatient or Home - Other OP Hemodialysis | $2,887.13 |
| 2024613 | HC EMERG DIALYSIS ESRD PT | Hemodialysis - Outpatient or Home - Other OP Hemodialysis | $1,524.81 |
| 2026573 | HC HH SVS OF CSW EA 15 MIN | Home Health (HH) - Medical Social Services - Visit Charge | $420.00 |
| 2026569 | HC HH RN TELEHEALTH PER DIEM GT | Home Health (HH) - Other Visits | $420.00 |
| 2026578 | HC HH NUTRITION COUNSELING DIETITIAN | Home Health (HH) - Other Visits - Other | $420.00 |
| 2026574 | HC HH SVS OF AIDE EA 15 MIN | Home Health (HH) Aide - Visit Charge | $420.00 |
| 2026200 | HC IP CAPD DIALYSIS 90945 | Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (CAPD) | $1,500.00 |
| 2026199 | HC IP DIALYSIS CVVH | Inpatient Renal Dialysis - Hemodialysis | $2,469.00 |
| 2026204 | HC IP CVVHD | Inpatient Renal Dialysis - Hemodialysis | $2,469.00 |
| 2024850 | HC DIALYSIS ONE EVALUATION | Inpatient Renal Dialysis - Peritoneal Dialysis (Non-CAPD) | $1,127.81 |
| 1010025 | HC RB POST OP/STEPDOWN ICU | Intensive Care Unit - Intermediate ICU | $13,173.22 |
| 1010028 | HC RB SPECIAL CARE ICU/INTERMEDIATE | Intensive Care Unit - Intermediate ICU | $12,545.93 |
| 1010018 | HC RB ICU MEDICAL | Intensive Care Unit - Medical | $14,000.00 |
| 1010029 | HC RB SPECIAL CARE OTHER | Intensive Care Unit - Other | $11,753.20 |
| 1010020 | HC RB ICU PEDIATRICS | Intensive Care Unit - Pediatric | $11,753.20 |
| 1010019 | HC RB ICU SURGICAL | Intensive Care Unit - Surgical | $14,000.00 |
| 1010035 | HC RB ICU/TRAUMA | Intensive Care Unit - Trauma | $14,079.45 |
| 2021945 | HC NON CHEMO INFUSION, CONCURRENT | IV Therapy | $412.34 |
| 2021946 | HC NON CHEMO IV PUSH, SAME DRUG, REPEAT | IV Therapy | $289.38 |
| 2022190 | HC RFL&MAIN IMPLT PMP/RSVR RX DLVR SPI/BRN BY PHYS | IV Therapy | $3,780.11 |
| 2022202 | HC HYDRATION IV INFUSION, 1ST HOUR | IV Therapy | $2,718.90 |
| 2022203 | HC HYDRATION IV INFUSION, ADDITIONAL HOUR | IV Therapy | $921.14 |
| 2022204 | HC NON CHEMO INFUSION, 1ST HOUR | IV Therapy | $2,718.90 |
| 2022205 | HC NON CHEMO INFUSION, ADDITIONAL HOUR | IV Therapy | $921.14 |
| 2022206 | HC NON CHEMO INFUSION, SEQ 1ST HOUR | IV Therapy | $1,081.20 |
| 2022207 | HC INJECTION - SC/IM | IV Therapy | $1,246.56 |
| 2022209 | HC NON CHEMO IV PUSH 0-15 MINUTES, INITIAL | IV Therapy | $1,221.12 |
| 2022210 | HC NON CHEMO IV PUSH 0-15 MINUTES, SEQ | IV Therapy | $455.80 |
| 2022222 | HC REFILL/MAINT PUMP/RESVR SYST | IV Therapy | $1,402.38 |
| 2022223 | HC IRRIG DRUG DELIVERY DEVICE | IV Therapy | $429.30 |
| 2022427 | HC THER/PROPH/DIAG INJ, IV PUSH | IV Therapy | $1,221.12 |
| 2024829 | HC PROLONG IV INFUSION, REQ PUMP | IV Therapy | $798.68 |
| 2025836 | HC APPLICATON ON-BODY INJECTOR | IV Therapy | $286.20 |
| 2027040 | HC BAMLANIVIMAB-XXXX INFUSION | IV Therapy | $928.80 |
| 2020556 | HC FETAL MONITOR W/REPORT | Labor Room/Delivery | $120.75 |
| 2024288 | HC L&D OPERATING ROOM FLAT FEE | Labor Room/Delivery | $4,303.53 |
| 2024289 | HC L&D OPERATING ROOM PER MINUTE | Labor Room/Delivery | $143.45 |
| 2022469 | HC CIRCUMCISION | Labor Room/Delivery - Circumcision | $698.41 |
| 2022468 | HC LDR DELIVERY ROOM | Labor Room/Delivery - Delivery Room | $7,195.00 |
| 2022481 | HC MULTPLE BIRTH RESOURCES | Labor Room/Delivery - Delivery Room | $5,318.82 |
| 2025459 | HC ATTENDANCE AT DELIVERY | Labor Room/Delivery - Delivery Room | $289.80 |
| 2020470 | HC ROUTINE VENIPUNCTURE | Laboratory | $87.49 |
| 2020471 | HC CAPILLARY BLOOD DRAW | Laboratory | $308.09 |
| 2021286 | HC LIPID PANEL | Laboratory | $282.56 |
| 2021287 | HC RENAL FUNCTION PANEL | Laboratory | $176.30 |
| 2021289 | HC HEPATIC FUNCTION PANEL | Laboratory | $141.28 |
| 2021292 | HC ASSAY OF AMIKACIN | Laboratory | $211.31 |
| 2021295 | HC ASSAY, CARBAMAZEPINE, TOTAL | Laboratory | $220.97 |
| 2021298 | HC ASSAY OF DIGOXIN | Laboratory | $195.62 |
| 2021300 | HC ASSAY, DIPROPYLACETIC ACID | Laboratory | $179.92 |
| 2021302 | HC ASSAY OF GENTAMICIN | Laboratory | $206.48 |
| 2021306 | HC ASSAY OF LIDOCAINE | Laboratory | $106.26 |
| 2021307 | HC ASSAY OF LITHIUM | Laboratory | $159.39 |
| 2021309 | HC ASSAY OF PHENOBARBITAL | Laboratory | $169.05 |
| 2021310 | HC ASSAY OF PHENYTOIN, TOTAL | Laboratory | $184.75 |
| 2021311 | HC ASSAY OF PHENYTOIN, FREE | Laboratory | $67.62 |
| 2021312 | HC ASSAY OF PRIMIDONE | Laboratory | $149.73 |
| 2021315 | HC ASSAY OF QUINIDINE | Laboratory | $82.11 |
| 2021316 | HC ASSAY OF SIROLIMUS | Laboratory | $282.56 |
| 2021318 | HC ASSAY OF TACROLIMUS | Laboratory | $350.18 |
| 2021320 | HC ASSAY OF THEOPHYLLINE | Laboratory | $231.84 |
| 2021321 | HC ASSAY OF TOBRAMYCIN | Laboratory | $224.60 |
| 2021322 | HC ASSAY OF TOPIRAMATE | Laboratory | $158.18 |
| 2021323 | HC ASSAY OF VANCOMYCIN | Laboratory | $208.90 |
| 2021324 | HC QUANTITATIVE ASSAY, DRUG | Laboratory | $237.88 |
| 2021326 | HC URINALYSIS, AUTO, W/O SCOPE | Laboratory | $199.06 |
| 2021332 | HC TEST FOR ACETONE/KETONES | Laboratory | $54.34 |
| 2021333 | HC ACYLCARNITINES, QUANT | Laboratory | $235.46 |
| 2021334 | HC ASSAY OF ACTH | Laboratory | $567.53 |
| 2021335 | HC ASSAY OF SERUM ALBUMIN | Laboratory | $79.87 |
| 2021336 | HC ASSAY OF ALBUMIN | Laboratory | $62.79 |
| 2021339 | HC ASSAY OF ALDOLASE | Laboratory | $443.76 |
| 2021340 | HC ASSAY OF ALDOSTERONE | Laboratory | $710.01 |
| 2021341 | HC ALPHA-1-ANTITRYPSIN, TOTAL | Laboratory | $248.75 |
| 2021343 | HC ALPHA-FETOPROTEIN, SERUM | Laboratory | $315.16 |
| 2021349 | HC AMINO ACIDS, QUAN, 6 OR MORE | Laboratory | $1,127.81 |
| 2021350 | HC ASSAY OF AMMONIA | Laboratory | $202.86 |
| 2021351 | HC ASSAY OF AMYLASE | Laboratory | $143.69 |
| 2021353 | HC ASSAY OF ANDROSTENEDIONE | Laboratory | $476.96 |
| 2021354 | HC ANGIOTENSIN I ENZYME TEST | Laboratory | $322.40 |
| 2021355 | HC ASSAY OF APOLIPOPROTEIN | Laboratory | $206.48 |
| 2021356 | HC ASSAY OF ARSENIC | Laboratory | $313.95 |
| 2021357 | HC ASSAY OF ASCORBIC ACID | Laboratory | $147.32 |
| 2021359 | HC ASSAY OF BETA-2 PROTEIN | Laboratory | $321.20 |
| 2021361 | HC BILIRUBIN, TOTAL | Laboratory | $143.27 |
| 2021362 | HC BILIRUBIN, DIRECT | Laboratory | $86.94 |
| 2021363 | HC OCCULT BLOOD, FECES | Laboratory | $131.62 |
| 2021364 | HC OCCULT BLOOD, OTHER SOURCES | Laboratory | $57.96 |
| 2021367 | HC ASSAY OF CALCITONIN | Laboratory | $393.65 |
| 2021368 | HC CALCIUM TOT | Laboratory | $73.54 |
| 2021369 | HC CALCIUM IONIZED | Laboratory | $230.63 |
| 2021370 | HC CALCIUM URINE QUAN TMD SPEC | Laboratory | $117.13 |
| 2021371 | HC CALCULUS ASSAY, QUANT | Laboratory | $72.45 |
| 2021374 | HC ASSAY, BLOOD CARBON DIOXIDE | Laboratory | $56.75 |
| 2021380 | HC ASSAY, THREE CATECHOLAMINES | Laboratory | $456.44 |
| 2021381 | HC ASSAY OF CERULOPLASMIN | Laboratory | $191.45 |
| 2021382 | HC ASSAY OF BLOOD CHLORIDE | Laboratory | $103.85 |
| 2021383 | HC ASSAY OF URINE CHLORIDE | Laboratory | $42.26 |
| 2021384 | HC ASSAY, OTHER FLUID CHLORIDES | Laboratory | $42.26 |
| 2021385 | HC ASSAY, BLD/SERUM CHOLESTEROL | Laboratory | $78.49 |
| 2021391 | HC ASSAY OF CHROMIUM | Laboratory | $254.78 |
| 2021394 | HC ASSAY OF COPPER | Laboratory | $364.67 |
| 2021395 | HC CORTISOL, FREE | Laboratory | $313.95 |
| 2021396 | HC TOTAL CORTISOL | Laboratory | $251.16 |
| 2021397 | HC ASSAY OF CREATINE | Laboratory | $72.45 |
| 2021399 | HC ASSAY OF CK (CPK) | Laboratory | $107.57 |
| 2021400 | HC ASSAY OF CPK IN BLOOD | Laboratory | $138.86 |
| 2021401 | HC ASSAY OF CREATININE | Laboratory | $137.66 |
| 2021402 | HC ASSAY OF URINE CREATININE | Laboratory | $146.11 |
| 2021403 | HC CREATININE CLEARANCE TEST | Laboratory | $154.56 |
| 2021404 | HC ASSAY OF CRYOGLOBULIN | Laboratory | $128.00 |
| 2021406 | HC VITAMIN B-12 | Laboratory | $254.25 |
| 2021409 | HC DEHYDROEPIANDROSTERONE | Laboratory | $531.24 |
| 2021412 | HC DEOXYCORTISOL | Laboratory | $297.05 |
| 2021415 | HC ASSAY OF DIHYDROXYVITAMIN D | Laboratory | $677.41 |
| 2021416 | HC ASSAY OF ERYTHROPOIETIN | Laboratory | $334.48 |
| 2021417 | HC ASSAY OF ESTRADIOL | Laboratory | $469.38 |
| 2021418 | HC ASSAY OF ESTROGENS | Laboratory | $449.19 |
| 2021422 | HC ASSAY OF BLOOD FATTY ACIDS | Laboratory | $120.75 |
| 2021423 | HC LONG CHAIN FATTY ACIDS | Laboratory | $294.63 |
| 2021424 | HC ASSAY OF FERRITIN | Laboratory | $271.69 |
| 2021425 | HC ASSAY OF FETAL FIBRONECTIN | Laboratory | $920.48 |
| 2021429 | HC GG IGA IGD IGG IGM EA | Laboratory | $286.18 |
| 2021430 | HC GG IGE | Laboratory | $315.16 |
| 2021431 | HC IGG 1, 2, 3 OR 4, EACH | Laboratory | $450.40 |
| 2021435 | HC ASSAY OF GLUCAGON | Laboratory | $80.90 |
| 2021436 | HC GLUCOSE OTHER FLUID | Laboratory | $67.62 |
| 2021437 | HC ASSAY, GLUCOSE, BLOOD QUANT | Laboratory | $62.79 |
| 2021438 | HC GLUCOSE TEST | Laboratory | $73.66 |
| 2021439 | HC GLUCOSE TOLERANCE TEST (GTT) | Laboratory | $227.01 |
| 2021441 | HC ASSAY OF G6PD ENZYME | Laboratory | $245.97 |
| 2021443 | HC ASSAY OF GGT | Laboratory | $178.77 |
| 2021445 | HC GONADOTROPIN (FSH) | Laboratory | $370.70 |
| 2021448 | HC ASSAY OF HAPTOGLOBIN, QUANT | Laboratory | $170.26 |
| 2021457 | HC ASSAY OF HEMOSIDERIN, QUAL | Laboratory | $45.89 |
| 2021462 | HC ASSAY OF 5-HIAA | Laboratory | $207.69 |
| 2021463 | HC HYDROXYPROGST 17-D | Laboratory | $451.61 |
| 2021465 | HC IA ANAL OTH/THN NFCT AGT MLT STEP METH | Laboratory | $365.87 |
| 2021466 | HC RIA NONANTIBODY | Laboratory | $450.40 |
| 2021467 | HC IMMUNOASSAY QUANT NOS NONAB | Laboratory | $652.95 |
| 2021468 | HC ASSAY OF INSULIN | Laboratory | $240.29 |
| 2021469 | HC ASSAY OF IRON | Laboratory | $115.92 |
| 2021470 | HC IRON BINDING TEST | Laboratory | $201.06 |
| 2021472 | HC ASSAY OF LACTIC ACID | Laboratory | $231.84 |
| 2021473 | HC LACTATE (LD) (LDH) ENZYME | Laboratory | $125.93 |
| 2021474 | HC ASSAY OF LDH ENZYMES | Laboratory | $72.45 |
| 2021475 | HC LACTOFERRIN, FECAL (QUAL) | Laboratory | $287.81 |
| 2021476 | HC ASSAY OF LEAD | Laboratory | $218.07 |
| 2021478 | HC ASSAY OF LIPASE | Laboratory | $243.92 |
| 2021481 | HC ASSAY OF LIPOPROTEIN | Laboratory | $111.09 |
| 2021483 | HC ASSAY OF MAGNESIUM | Laboratory | $120.75 |
| 2021485 | HC ASSAY OF MERCURY | Laboratory | $282.73 |
| 2021486 | HC ASSAY OF METANEPHRINES | Laboratory | $537.34 |
| 2021489 | HC MUCOPOLYSACCHARIDES | Laboratory | $90.56 |
| 2021490 | HC ASSAY OF MYOGLOBIN | Laboratory | $271.33 |
| 2021492 | HC ASSAY, NEPHELOMETRY NOT SPEC | Laboratory | $229.80 |
| 2021512 | HC OLIGOCLONAL BANDS | Laboratory | $294.63 |
| 2021513 | HC ORGANIC ACIDS, TOTAL, QUANT | Laboratory | $311.54 |
| 2021515 | HC ASSAY OF BLOOD OSMOLALITY | Laboratory | $165.43 |
| 2021516 | HC ASSAY OF URINE OSMOLALITY | Laboratory | $86.94 |
| 2021519 | HC ASSAY OF PARATHORMONE | Laboratory | $590.47 |
| 2021522 | HC ASSAY ACID PHOSPHATASE | Laboratory | $51.92 |
| 2021523 | HC PHOSPHATASE ALKALINE | Laboratory | $145.80 |
| 2021525 | HC PHOSPHATASE ALKALINE ISOENZYMES | Laboratory | $194.41 |
| 2021526 | HC ASSAY OF PHOSPHORUS | Laboratory | $80.90 |
| 2021529 | HC ASSAY OF URINE PORPHYRINS | Laboratory | $196.52 |
| 2021530 | HC ASSAY OF SERUM POTASSIUM | Laboratory | $61.58 |
| 2021531 | HC ASSAY OF URINE POTASSIUM | Laboratory | $60.38 |
| 2021532 | HC ASSAY OF PREALBUMIN | Laboratory | $135.24 |
| 2021536 | HC PROGST | Laboratory | $340.52 |
| 2021537 | HC ASSAY OF PROLACTIN | Laboratory | $410.55 |
| 2021539 | HC ASSAY OF PSA, FREE | Laboratory | $308.03 |
| 2021540 | HC ASSAY OF PROTEIN, SERUM | Laboratory | $147.07 |
| 2021541 | HC ASSAY OF PROTEIN, URINE | Laboratory | $113.51 |
| 2021542 | HC ASSAY OF PROTEIN, OTHER | Laboratory | $67.20 |
| 2021543 | HC PROTEIN E-PHORESIS, SERUM | Laboratory | $249.95 |
| 2021546 | HC ASSAY OF PROINSULIN | Laboratory | $126.79 |
| 2021548 | HC ASSAY OF PYRUVATE | Laboratory | $177.50 |
| 2021549 | HC ASSAY OF ENDOCRINE HORMONE | Laboratory | $476.96 |
| 2021550 | HC ASSAY, NONENDOCRINE RECEPTOR | Laboratory | $333.27 |
| 2021555 | HC ASSAY OF SERUM SODIUM | Laboratory | $65.21 |
| 2021556 | HC ASSAY OF URINE SODIUM | Laboratory | $67.62 |
| 2021558 | HC ASSAY OF SOMATOMEDIN | Laboratory | $470.93 |
| 2021560 | HC BODY FLUID SPECIFIC GRAVITY | Laboratory | $13.28 |
| 2021564 | HC ASSAY OF THYROGLOBULIN | Laboratory | $363.46 |
| 2021565 | HC ASSAY OF TOTAL THYROXINE | Laboratory | $187.16 |
| 2021566 | HC ASSAY OF FREE THYROXINE | Laboratory | $283.62 |
| 2021567 | HC ASSAY OF THYROID ACTIVITY | Laboratory | $202.86 |
| 2021568 | HC ASSAY THYROID STIM HORMONE | Laboratory | $306.71 |
| 2021571 | HC TRANSFERASE (AST) (SGOT) | Laboratory | $92.98 |
| 2021572 | HC ALANINE AMINO (ALT) (SGPT) | Laboratory | $91.77 |
| 2021573 | HC ASSAY OF TRANSFERRIN | Laboratory | $326.03 |
| 2021574 | HC ASSAY OF TRIGLYCERIDES | Laboratory | $94.19 |
| 2021575 | HC ASSAY OF THYROID (T3 OR T4) | Laboratory | $96.60 |
| 2021576 | HC ASSAY, TRIIODOTHYRONINE (T3) | Laboratory | $255.99 |
| 2021577 | HC FREE ASSAY (FT-3) | Laboratory | $469.72 |
| 2021578 | HC T3 REVERSE | Laboratory | $305.50 |
| 2021579 | HC ASSAY OF TROPONIN, QUANT | Laboratory | $249.74 |
| 2021580 | HC UREA NITROGEN; QUAN | Laboratory | $68.83 |
| 2021581 | HC ASSAY OF URINE/UREA-N | Laboratory | $126.79 |
| 2021583 | HC ASSAY OF BLOOD/URIC ACID | Laboratory | $106.26 |
| 2021584 | HC ASSAY OF URINE/URIC ACID | Laboratory | $81.14 |
| 2021587 | HC ASSAY OF VASOPRESSIN | Laboratory | $472.13 |
| 2021590 | HC ASSAY OF ZINC | Laboratory | $190.19 |
| 2021592 | HC CHORIONIC GONADOTROPIN TEST | Laboratory | $335.69 |
| 2021593 | HC CHORIONIC GONADOTROPIN ASSAY | Laboratory | $223.15 |
| 2021643 | HC BLOOD PLATELET AGGREGATION | Laboratory | $387.61 |
| 2021654 | HC BLOOD VISCOSITY EXAMINATION | Laboratory | $96.60 |
| 2021666 | HC C-REACTIVE PROTEIN, HS | Laboratory | $262.03 |
| 2021672 | HC COMPLEMENT, TOTAL (CHBI) | Laboratory | $367.08 |
| 2021687 | HC IMMUNE COMPLEX ASSAY | Laboratory | $538.55 |
| 2021688 | HC IMMUNOFIX E-PHORESIS, SERUM | Laboratory | $353.80 |
| 2021689 | HC IMMUNFIX E-PHORSIS/URINE/CSF | Laboratory | $387.61 |
| 2021690 | HC INSULIN ANTIBODIES | Laboratory | $275.31 |
| 2021710 | HC BARTONELLA ANTIBODY | Laboratory | $114.71 |
| 2021714 | HC BRUCELLA ANTIBODY | Laboratory | $118.34 |
| 2021742 | HC HEP B SURFACE ANTIBODY | Laboratory | $205.28 |
| 2021745 | HC HEP A ANTIBODY, IGM | Laboratory | $229.43 |
| 2021746 | HC INFLUENZA VIRUS ANTIBODY | Laboratory | $207.69 |
| 2021753 | HC PROTOZOA ANTIBODY NOS | Laboratory | $178.71 |
| 2021762 | HC WEST NILE VIRUS AB, IGM | Laboratory | $136.45 |
| 2021771 | HC RBC ANTIBODY SCREEN | Laboratory | $376.56 |
| 2021773 | HC RBC ANTIBODY IDENTIFICATION | Laboratory | $815.06 |
| 2021774 | HC COOMBS TEST, DIRECT | Laboratory | $169.05 |
| 2021776 | HC COOMBS TEST, INDIRECT, TITER | Laboratory | $248.75 |
| 2021777 | HC AUTOLOGOUS BLOOD PROCESS | Laboratory | $1,078.96 |
| 2021782 | HC COMPATIBILITY TEST, SPIN | Laboratory | $213.73 |
| 2021785 | HC COMPATIBILITY TEST, ELECTRIC | Laboratory | $173.88 |
| 2021789 | HC BLOOD PRODUCT/IRRADIATION | Laboratory | $117.13 |
| 2021792 | HC POOLING BLOOD PLATELETS | Laboratory | $177.95 |
| 2021799 | HC CULTURE ANAEROBE IDENT, EACH | Laboratory | $44.68 |
| 2021812 | HC MICROBE SUSCEPTIBLE, MIC | Laboratory | $173.88 |
| 2021830 | HC GIARDIA AG, EIA | Laboratory | $191.45 |
| 2021831 | HC ENTAMOEB HIST GROUP, AG, EIA | Laboratory | $228.22 |
| 2021844 | HC CYTOMEG, DNA, QUANT | Laboratory | $781.25 |
| 2021848 | HC HEPATITIS C, RNA, QUANT | Laboratory | $879.06 |
| 2021857 | HC DETECT AGENT NOS, DNA, AMP | Laboratory | $698.60 |
| 2021860 | HC INFLUENZA ASSAY W/OPTIC | Laboratory | $51.92 |
| 2021862 | HC AGENT NOS ASSAY W/OPTIC | Laboratory | $146.11 |
| 2021863 | HC GENOTYPE, DNA, HIV REVERSE T | Laboratory | $1,877.66 |
| 2021864 | HC GENOTYPE, DNA, HEPATITIS C | Laboratory | $3,587.48 |
| 2021937 | HC C-CNT MISC BDY FLUS XCPT BLD DIFFIAL CNT | Laboratory | $237.09 |
| 2021938 | HC EXAM,SYNOVIAL FLUID CRYSTALS | Laboratory | $210.11 |
| 2022410 | HC PSA SCREENING | Laboratory | $363.46 |
| 2022528 | HC MISC SEND OUT / CHEM LAB TEST | Laboratory | $0.00 |
| 2022737 | HC ENZYME ACTIVITY BC NO RA | Laboratory | $403.08 |
| 2022738 | HC HEAVY METAL QUANTITATIVE | Laboratory | $291.01 |
| 2022739 | HC NMR LIPO PRFL | Laboratory | $315.16 |
| 2022743 | HC RIBOFLAVIN | Laboratory | $181.30 |
| 2022748 | HC INHIBIN A | Laboratory | $254.85 |
| 2022749 | HC CELL FUNCTION ASSAY STIM | Laboratory | $929.78 |
| 2022757 | HC SPUTUM SPEC INDUCTION | Laboratory | $248.75 |
| 2023022 | HC HEPARIN ASSAY | Laboratory | $561.49 |
| 2023301 | HC DRAW BLOOD OFF VENOUS DEVICE | Laboratory | $379.16 |
| 2023333 | HC URINALYSIS AUTO W/ MICROSCOPY | Laboratory | $57.96 |
| 2023651 | HC MONONUCLEAR CELL ANTIGEN QUANT NOS EA ANTG | Laboratory | $348.97 |
| 2023653 | HC FIBRINOGEN; ANTIGEN | Laboratory | $47.09 |
| 2025036 | HC AB; ENCEPHALITIS CALIF | Laboratory | $65.21 |
| 2025037 | HC AB; ENCEPHALITIS E EQUINE | Laboratory | $65.21 |
| 2025038 | HC AB; ENCEPHALITIS ST. LOUIS | Laboratory | $65.21 |
| 2025039 | HC AB; ENCEPHALITIS W EQUINE | Laboratory | $65.21 |
| 2025040 | HC AB; NEISSERIA MENINGITIDIS | Laboratory | $65.21 |
| 2025041 | HC CRYPTOCOCCUS NEOFORM AG EIA | Laboratory | $59.26 |
| 2025042 | HC GENOTYPE DNA HIV OTHER REGION | Laboratory | $636.18 |
| 2025204 | HC TRANSCUTANEOUS CARBOXYHB | Laboratory | $24.74 |
| 2025205 | HC TRANSCUTANEOUS METHB | Laboratory | $3,296.48 |
| 2025221 | HC DIPROPYLACETIC ACID FREE | Laboratory | $179.92 |
| 2025260 | HC IADNA-DNA/RNA PROBE TQ 12-25 | Laboratory | $2,157.34 |
| 2025310 | HC SECRETIONS FAT STAIN | Laboratory | $50.72 |
| 2025518 | HC MGMT GENE PRMTR MTHYLTN ALYS | Laboratory | $1,046.00 |
| 2025941 | HC TRICHOMONAS VAGINALIS AMPLIF | Laboratory | $586.73 |
| 2026042 | HC BILIRUBIN TOTAL TRANSCUT | Laboratory | $18.57 |
| 2026169 | HC ONCOLOGY PROSTATE PROB SCORE | Laboratory | $2,280.00 |
| 2026555 | HC FERN TEST | Laboratory | $78.20 |
| 2026904 | HC IA NFCT AB COVID19; MULTI STEP | Laboratory | $207.69 |
| 2026905 | HC IA NFCT AB COVID19; SGL STEP | Laboratory | $155.77 |
| 2026906 | HC IA INFECTIOUS AGENT SGL STEP | Laboratory | $155.77 |
| 2026937 | HC DRUG ASSAY VEDOLIZUMAB | Laboratory | $185.12 |
| 2026963 | HC NFCT DS 22 TRGT SARS-COV-2 | Laboratory | $2,000.54 |
| 2026972 | HC CORONAVIRUS AG IA | Laboratory | $53.13 |
| 2026973 | HC NFCT DS 22 TRGT SARS-COV-2 | Laboratory | $2,000.54 |
| 2026974 | HC ANTIBODY SARSCOV-2 TITER(S) | Laboratory | $207.69 |
| 2026984 | HC NEUTRLZG ANTB SARSCOV2 SCR | Laboratory | $410.55 |
| 2026985 | HC NEUTRLZG ANTB SARSCOV2 TITER | Laboratory | $410.55 |
| 2026987 | HC SVNT SARSCOV2 ELISA PLSM SRM | Laboratory | $2,000.54 |
| 2027006 | HC SARS-COV-2 ANTB QUANTITATIVE | Laboratory | $207.69 |
| 2027030 | HC NFCT DS VIR RESP RNA 4 TRGT | Laboratory | $427.89 |
| 2027031 | HC NFCT DS VIR RESP RNA 3 TRGT | Laboratory | $427.89 |
| 2027035 | HC SARSCOV & INF VIR A&B AG IA | Laboratory | $53.13 |
| 2021795 | HC BLOOD CULTURE FOR BACTERIA | Laboratory - Bacteriology & Microbiology | $186.25 |
| 2021796 | HC FECES CULTURE, BACTERIA | Laboratory - Bacteriology & Microbiology | $149.73 |
| 2021797 | HC CULTURE, BACTERIA, OTHER | Laboratory - Bacteriology & Microbiology | $338.91 |
| 2021798 | HC CULTR BACTERIA, EXCEPT BLOOD | Laboratory - Bacteriology & Microbiology | $166.64 |
| 2021800 | HC CULTURE SCREEN ONLY | Laboratory - Bacteriology & Microbiology | $214.94 |
| 2021801 | HC URINE CULTURE/COLONY COUNT | Laboratory - Bacteriology & Microbiology | $248.69 |
| 2021803 | HC SKIN FUNGI CULTURE | Laboratory - Bacteriology & Microbiology | $43.47 |
| 2021804 | HC FUNGUS ISOLATION CULTURE | Laboratory - Bacteriology & Microbiology | $263.24 |
| 2021806 | HC MYCOPLASMA | Laboratory - Bacteriology & Microbiology | $242.71 |
| 2021807 | HC CHLAMYDIA CULTURE | Laboratory - Bacteriology & Microbiology | $160.60 |
| 2021808 | HC MYCOBACTERIA CULTURE | Laboratory - Bacteriology & Microbiology | $248.75 |
| 2021810 | HC OVA AND PARASITES SMEARS | Laboratory - Bacteriology & Microbiology | $216.80 |
| 2021811 | HC MICROBE SUSCEPTIBLE, DISK | Laboratory - Bacteriology & Microbiology | $121.96 |
| 2021814 | HC SMEAR, GRAM STAIN | Laboratory - Bacteriology & Microbiology | $112.22 |
| 2021815 | HC SMEAR, FLUORESCENT/ACID STAI | Laboratory - Bacteriology & Microbiology | $97.81 |
| 2021816 | HC SMEAR, SPECIAL STAIN | Laboratory - Bacteriology & Microbiology | $187.16 |
| 2021817 | HC SMEAR, COMPLEX STAIN | Laboratory - Bacteriology & Microbiology | $277.66 |
| 2021818 | HC SMEAR, WET MOUNT, SALINE/INK | Laboratory - Bacteriology & Microbiology | $84.53 |
| 2021819 | HC TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT | Laboratory - Bacteriology & Microbiology | $65.21 |
| 2021820 | HC ASSAY, TOXIN OR ANTITOXIN | Laboratory - Bacteriology & Microbiology | $48.30 |
| 2021821 | HC VIRUS INOCULATION, TISSUE | Laboratory - Bacteriology & Microbiology | $582.02 |
| 2021822 | HC VIRUS INOCULATION, SHELL VIA | Laboratory - Bacteriology & Microbiology | $260.82 |
| 2021824 | HC INFLUENZA B, AG, IF | Laboratory - Bacteriology & Microbiology | $96.60 |
| 2021826 | HC LEGION PNEUMOPHILIA AG, IF | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2021828 | HC ASPERGILLUS AG, EIA | Laboratory - Bacteriology & Microbiology | $315.16 |
| 2021829 | HC CRYPTOSPORIDIUM AG, EIA | Laboratory - Bacteriology & Microbiology | $243.43 |
| 2021832 | HC HPYLORI, STOOL, EIA | Laboratory - Bacteriology & Microbiology | $217.35 |
| 2021834 | HC HEPATITIS B SURFACE AG, EIA | Laboratory - Bacteriology & Microbiology | $220.62 |
| 2021835 | HC HEPATITIS BE AG, EIA | Laboratory - Bacteriology & Microbiology | $214.94 |
| 2021839 | HC STREP A AG, EIA | Laboratory - Bacteriology & Microbiology | $111.09 |
| 2021840 | HC AG DETECT NOS, EIA, MULT | Laboratory - Bacteriology & Microbiology | $206.48 |
| 2021841 | HC LYME DIS, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $897.17 |
| 2021842 | HC CHYLMD TRACH, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2021843 | HC CYTOMEG, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $530.09 |
| 2021845 | HC ENTEROVIRUS, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $478.17 |
| 2021846 | HC HEPATITIS B, DNA, QUANT | Laboratory - Bacteriology & Microbiology | $747.44 |
| 2021849 | HC HSV, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $555.45 |
| 2021851 | HC HIV-1, DNA, QUANT | Laboratory - Bacteriology & Microbiology | $1,247.35 |
| 2021852 | HC M.PNEUMON, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $543.38 |
| 2021853 | HC N.GONORRHOEAE, DNA, AMP PROB | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2021855 | HC TRICHOMONAS VAGIN, DIR PROBE | Laboratory - Bacteriology & Microbiology | $294.15 |
| 2021858 | HC DETECT AGENT NOS, DNA, QUANT | Laboratory - Bacteriology & Microbiology | $607.31 |
| 2021861 | HC RSV ASSAY W/OPTIC | Laboratory - Bacteriology & Microbiology | $62.79 |
| 2021865 | HC MICROBIOLOGY PROCEDURE | Laboratory - Bacteriology & Microbiology | $130.41 |
| 2022648 | HC C DIFF AMPLIFIED PROBE | Laboratory - Bacteriology & Microbiology | $293.42 |
| 2022659 | HC SC STD ANTMCRB AGT AGAR DIL METH PR AGT | Laboratory - Bacteriology & Microbiology | $43.47 |
| 2022752 | HC CANDIDA NA DIRECT PROBE | Laboratory - Bacteriology & Microbiology | $280.14 |
| 2022753 | HC GARDNERELLA DIR NA PROBE | Laboratory - Bacteriology & Microbiology | $280.14 |
| 2023021 | HC STAPH A DNA AMP PROBE | Laboratory - Bacteriology & Microbiology | $543.38 |
| 2023034 | HC DNA/RNA; MULTI ORG - AMP PR | Laboratory - Bacteriology & Microbiology | $1,028.79 |
| 2023035 | HC HC INFLUENZA DNA AMP PROBE | Laboratory - Bacteriology & Microbiology | $2,862.98 |
| 2023039 | HC HISTOPLASMA CAPSUL AG EIA | Laboratory - Bacteriology & Microbiology | $144.90 |
| 2023061 | HC HIV-1 AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $660.50 |
| 2023064 | HC BARTONELLA AMPLIF NAP | Laboratory - Bacteriology & Microbiology | $248.75 |
| 2023068 | HC MYCOBACTERIA T AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $333.27 |
| 2023069 | HC CHLAMYDIA P AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $543.38 |
| 2023075 | HC HERPES 6 NA QUAN | Laboratory - Bacteriology & Microbiology | $647.22 |
| 2023631 | HC AEROBIC STOOL CULTR ADDTL PATHOG EA PLATE | Laboratory - Bacteriology & Microbiology | $53.13 |
| 2024459 | HC GENOTYPE DNA HEPATITIS B | Laboratory - Bacteriology & Microbiology | $2,466.92 |
| 2024605 | HC RESP VIRUS 3-5 TARGETS | Laboratory - Bacteriology & Microbiology | $637.56 |
| 2024607 | HC RESP VIRUS 12-25 TARGETS | Laboratory - Bacteriology & Microbiology | $2,056.37 |
| 2024653 | HC STREP A ASSAY W/OPTIC | Laboratory - Bacteriology & Microbiology | $224.91 |
| 2024654 | HC GENOTYPE CYTOMEGALOVIRUS | Laboratory - Bacteriology & Microbiology | $2,466.92 |
| 2024868 | HC HIV-1 AG W/HIV-1 & HIV-2 AB | Laboratory - Bacteriology & Microbiology | $405.82 |
| 2024992 | HC CANDIDA NA AMPLIFIED PROBE | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2025070 | HC GENOTYPE DNA HIV | Laboratory - Bacteriology & Microbiology | $636.18 |
| 2025118 | HC HPV HIGH-RISK TYPES | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2025119 | HC HPV TYPES 16 & 18 ONLY | Laboratory - Bacteriology & Microbiology | $490.25 |
| 2025322 | HC CLOSTRIDIUM AG EIA | Laboratory - Bacteriology & Microbiology | $83.97 |
| 2025852 | HC CNS DNA AMP PROBE TYPE 12-25 | Laboratory - Bacteriology & Microbiology | $1,800.92 |
| 2025942 | HC MACROSCOPIC EXAM PARASITE | Laboratory - Bacteriology & Microbiology | $53.94 |
| 2026039 | HC STREP A AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $129.99 |
| 2026178 | HC IADNA-DNA/RNA PROBE TQ 6-11 | Laboratory - Bacteriology & Microbiology | $790.47 |
| 2026438 | HC VIRUS INOCULATE TISSUE ADDL | Laboratory - Bacteriology & Microbiology | $67.35 |
| 2026789 | HC COVID-19 LAB TEST NON-CDC | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026794 | HC 2019-NCOV DIAGNOSTIC P | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026802 | HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026907 | HC COVID-19 LAB TEST NON-CDC; HIGH THROUGHPUT TECH | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026908 | HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ; HIGH THROUGHPUT TECH | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2027007 | HC NFCT AGENT DETECTION GI | Laboratory - Bacteriology & Microbiology | $384.87 |
| 2027009 | HC SARSCOV2 & INF A&B AMP PRB | Laboratory - Bacteriology & Microbiology | $244.53 |
| 2027010 | HC SARSCOV2&INF A&B&RSV AMP PRB | Laboratory - Bacteriology & Microbiology | $293.43 |
| 2027027 | HC SARS-COV-2 COVID19 W/OPTIC | Laboratory - Bacteriology & Microbiology | $53.13 |
| 2027028 | HC COV-19 AMP PRB HGH THRUPUT WITHIN 2 DAYS COLLECT | Laboratory - Bacteriology & Microbiology | $1.00 |
| 2021282 | HC METABOLIC PANEL TOTAL CA | Laboratory - Chemistry | $170.37 |
| 2021283 | HC ELECTROLYTE PANEL | Laboratory - Chemistry | $117.13 |
| 2021284 | HC COMPREHEN METABOLIC PANEL | Laboratory - Chemistry | $310.01 |
| 2021296 | HC ASSAY OF CYCLOSPORINE | Laboratory - Chemistry | $399.38 |
| 2021303 | HC DRUG/SUBSTANCE NOS 1-3 | Laboratory - Chemistry | $96.36 |
| 2021314 | HC PROCAINAMIDE METABOLITES | Laboratory - Chemistry | $94.19 |
| 2021337 | HC URINE ALBUMIN, QUANTITATIVE | Laboratory - Chemistry | $154.56 |
| 2021342 | HC ALPHA-1-ANTITRYPSIN, PHENO | Laboratory - Chemistry | $381.63 |
| 2021345 | HC ALPHA-FETOPROTEIN L3 | Laboratory - Chemistry | $876.65 |
| 2021365 | HC ASSAY OF CADMIUM | Laboratory - Chemistry | $206.48 |
| 2021366 | HC ASSAY OF VITAMIN D | Laboratory - Chemistry | $498.72 |
| 2021372 | HC CALCULUS SPECTROSCOPY | Laboratory - Chemistry | $189.58 |
| 2021375 | HC CARCINOEMBRYONIC ANTIGEN | Laboratory - Chemistry | $313.95 |
| 2021376 | HC ASSAY OF CARNITINE | Laboratory - Chemistry | $297.05 |
| 2021377 | HC ASSAY OF CAROTENE | Laboratory - Chemistry | $86.94 |
| 2021392 | HC ASSAY OF CITRATE | Laboratory - Chemistry | $156.98 |
| 2021393 | HC COLLAGEN CROSSLINKS | Laboratory - Chemistry | $268.07 |
| 2021405 | HC ASSAY OF CYANIDE | Laboratory - Chemistry | $109.88 |
| 2021407 | HC B-12 BINDING CAPACITY | Laboratory - Chemistry | $211.31 |
| 2021408 | HC CYSTATIN C | Laboratory - Chemistry | $156.98 |
| 2021410 | HC DEHYDROEPIANDROSTERONE-SULFATE | Laboratory - Chemistry | $392.44 |
| 2021411 | HC DESOXYCORTICOSTERONE | Laboratory - Chemistry | $175.09 |
| 2021420 | HC FATS/LIPIDS, FECES, QUAL | Laboratory - Chemistry | $121.96 |
| 2021426 | HC BLOOD FOLIC ACID SERUM | Laboratory - Chemistry | $249.95 |
| 2021427 | HC ASSAY OF FOLIC ACID, RBC | Laboratory - Chemistry | $323.61 |
| 2021428 | HC ASSAY GALACTOSE TRANSFERASE | Laboratory - Chemistry | $118.34 |
| 2021432 | HC BLOOD PH | Laboratory - Chemistry | $47.09 |
| 2021433 | HC BLOOD GASES: PH, PO2 & PCO2 | Laboratory - Chemistry | $387.61 |
| 2021434 | HC ASSAY OF GASTRIN | Laboratory - Chemistry | $259.61 |
| 2021444 | HC GLYCATED PROTEIN | Laboratory - Chemistry | $200.45 |
| 2021446 | HC GONADOTROPIN (LH) | Laboratory - Chemistry | $355.01 |
| 2021447 | HC ASSAY, GROWTH HORMONE (HGH) | Laboratory - Chemistry | $245.12 |
| 2021450 | HC HEMOGLOBIN ELECTROPHORESIS | Laboratory - Chemistry | $115.92 |
| 2021451 | HC HEMOGLOBIN CHROMOTOGRAPHY | Laboratory - Chemistry | $239.09 |
| 2021453 | HC FETAL HEMOGLOBIN ASSAY, QUAL | Laboratory - Chemistry | $19.32 |
| 2021454 | HC GLYCOSYLATED HEMOGLOBIN TEST | Laboratory - Chemistry | $190.19 |
| 2021459 | HC ASSAY OF HOMOCYSTINE | Laboratory - Chemistry | $431.08 |
| 2021460 | HC ASSAY OF FOR HVA | Laboratory - Chemistry | $96.60 |
| 2021479 | HC ASSAY OF LIPOPROTEIN(A) | Laboratory - Chemistry | $172.67 |
| 2021480 | HC LIPOPRO BLD, ELECTROPHORETIC | Laboratory - Chemistry | $62.79 |
| 2021482 | HC ASSAY OF BLOOD LIPOPROTEIN | Laboratory - Chemistry | $132.83 |
| 2021484 | HC MASS SPECTROMETRY QUAL/QUAN | Laboratory - Chemistry | $514.40 |
| 2021487 | HC DRUG SCREENING METHADONE | Laboratory - Chemistry | $66.41 |
| 2021491 | HC NATRIURETIC PEPTIDE | Laboratory - Chemistry | $472.13 |
| 2021494 | HC ALKALOIDS NOS | Laboratory - Chemistry | $218.56 |
| 2021514 | HC ORGANIC ACID, SINGLE, QUANT | Laboratory - Chemistry | $422.63 |
| 2021517 | HC ASSAY OF OSTEOCALCIN | Laboratory - Chemistry | $438.32 |
| 2021518 | HC ASSAY OF OXALATE | Laboratory - Chemistry | $65.93 |
| 2021520 | HC ASSAY OF BODY FLUID ACIDITY | Laboratory - Chemistry | $115.37 |
| 2021521 | HC ASSAY FOR CALPROTECTIN FECAL | Laboratory - Chemistry | $408.14 |
| 2021527 | HC ASSAY OF URINE PHOSPHORUS | Laboratory - Chemistry | $72.45 |
| 2021528 | HC ASSAY OF PORPHOBILINOGEN | Laboratory - Chemistry | $120.75 |
| 2021534 | HC ASSAY OF PREGNENOLONE | Laboratory - Chemistry | $301.76 |
| 2021535 | HC ASSAY OF 17-HYDROXYPREGNENO | Laboratory - Chemistry | $334.48 |
| 2021538 | HC ASSAY OF PSA, TOTAL | Laboratory - Chemistry | $363.46 |
| 2021544 | HC PROTEIN E-PHORESIS/URINE/CSF | Laboratory - Chemistry | $236.67 |
| 2021545 | HC ASSAY RBC PROTOPORPHYRIN | Laboratory - Chemistry | $55.55 |
| 2021547 | HC ASSAY OF VITAMIN B-6 | Laboratory - Chemistry | $444.36 |
| 2021551 | HC ASSAY OF RENIN | Laboratory - Chemistry | $335.69 |
| 2021552 | HC ASSAY OF SELENIUM | Laboratory - Chemistry | $356.21 |
| 2021553 | HC ASSAY OF SEROTONIN | Laboratory - Chemistry | $469.72 |
| 2021554 | HC ASSAY OF SEX HORMONE GLOBUL | Laboratory - Chemistry | $366.70 |
| 2021557 | HC ASSAY OF SWEAT SODIUM | Laboratory - Chemistry | $28.98 |
| 2021559 | HC SPECTROPHOTOMETRY | Laboratory - Chemistry | $400.22 |
| 2021561 | HC ASSAY OF TESTOSTERONE | Laboratory - Chemistry | $231.84 |
| 2021562 | HC ASSAY OF TOTAL TESTOSTERONE | Laboratory - Chemistry | $518.02 |
| 2021563 | HC ASSAY OF VITAMIN B-1 | Laboratory - Chemistry | $341.72 |
| 2021569 | HC ASSAY OF TSI | Laboratory - Chemistry | $731.75 |
| 2021570 | HC ASSAY OF VITAMIN E | Laboratory - Chemistry | $216.14 |
| 2021585 | HC ASSAY OF URINE VMA | Laboratory - Chemistry | $239.09 |
| 2021586 | HC ASSAY OF VIP | Laboratory - Chemistry | $275.31 |
| 2021588 | HC ASSAY OF VITAMIN A | Laboratory - Chemistry | $171.47 |
| 2021591 | HC ASSAY OF C-PEPTIDE | Laboratory - Chemistry | $448.83 |
| 2022645 | HC HPYLORI BRTH NON-RADACT ISOTOPE | Laboratory - Chemistry | $585.64 |
| 2023009 | HC BLOODGASES W/02 SATURATN | Laboratory - Chemistry | $160.60 |
| 2023020 | HC PLASMA HEMOGLOBIN | Laboratory - Chemistry | $47.09 |
| 2023031 | HC ONCOPROTEIN DCP | Laboratory - Chemistry | $885.10 |
| 2023045 | HC PROTEIN WB; IM ID FOR BANDS | Laboratory - Chemistry | $496.28 |
| 2023046 | HC SUGARS; SINGLE QUAL EA SPECIMEN | Laboratory - Chemistry | $30.19 |
| 2023047 | HC SUGARS; SINGLE QUAN EA SPECIMEN | Laboratory - Chemistry | $105.05 |
| 2023056 | HC QUANT SERUM ACETONES/KETONES | Laboratory - Chemistry | $76.07 |
| 2023062 | HC ASSAY OF VOLATILES | Laboratory - Chemistry | $141.28 |
| 2023063 | HC ETHYLENE GLYCOL | Laboratory - Chemistry | $135.24 |
| 2023070 | HC ETHOSUXIMIDE | Laboratory - Chemistry | $184.75 |
| 2023072 | HC DELTA ALA | Laboratory - Chemistry | $91.77 |
| 2023073 | HC CC/MS; QUAL/QUAN SS & MP | Laboratory - Chemistry | $371.91 |
| 2023076 | HC SOMATOSTATIN | Laboratory - Chemistry | $102.64 |
| 2023079 | HC PROCALCITONIN (PCT) | Laboratory - Chemistry | $387.61 |
| 2023130 | HC DRUG SCREENING COCAINE | Laboratory - Chemistry | $81.14 |
| 2023302 | HC COLLECT BLOOD FROM PICC | Laboratory - Chemistry | $421.42 |
| 2023334 | HC STAT GLUCOSE/REAGENT STRIP II | Laboratory - Chemistry | $71.96 |
| 2023398 | HC ASSAY CARBOXYHB QUANT | Laboratory - Chemistry | $68.83 |
| 2023403 | HC MYELIN BASIC PROTEIN CSF | Laboratory - Chemistry | $159.39 |
| 2023561 | HC CARB DEFICIENT TRANSFERRIN | Laboratory - Chemistry | $164.22 |
| 2023563 | HC CHEMILUMINESCENT ASSAY | Laboratory - Chemistry | $421.42 |
| 2023626 | HC UNLISTED CHEMISTRY PROCEDURE | Laboratory - Chemistry | $91.77 |
| 2024425 | HC VITAMIN NOS | Laboratory - Chemistry | $163.01 |
| 2024428 | HC PHENOTYPE INFECT AGENT DRUG | Laboratory - Chemistry | $646.01 |
| 2024603 | HC HOMOGENIZ TISS FOR CULTURE | Laboratory - Chemistry | $119.54 |
| 2024698 | HC ACTH STIM; ADRENAL INSUFF | Laboratory - Chemistry | $122.49 |
| 2024710 | HC HLA I & II TYPE VERIFY LR | Laboratory - Chemistry | $839.82 |
| 2024720 | HC UR ALBUMIN SEMIQUANTITATIVE | Laboratory - Chemistry | $72.45 |
| 2024724 | HC OCCULT BLD FECES 1-3 TESTS | Laboratory - Chemistry | $50.72 |
| 2024730 | HC ELECTROPHORESIS NES | Laboratory - Chemistry | $123.00 |
| 2024739 | HC GLUCOSIDASE BETA | Laboratory - Chemistry | $137.66 |
| 2024741 | HC B-HEXOSAMINIDASE EA ASSAY | Laboratory - Chemistry | $330.86 |
| 2024854 | HC DRUG SCREEN QUAN LAMOTRIGINE | Laboratory - Chemistry | $66.41 |
| 2024855 | HC DRUG SCREEN QUANT EVEROLIMUS | Laboratory - Chemistry | $68.83 |
| 2024856 | HC DRUG SCREEN QUANT ZONISAMIDE | Laboratory - Chemistry | $66.41 |
| 2024857 | HC DRUG SCRN QUAN LEVETIRACETAM | Laboratory - Chemistry | $66.41 |
| 2024858 | HC DRUG SCRN QUANT OXCARBAZEPIN | Laboratory - Chemistry | $66.41 |
| 2024859 | HC AB; FRANCISELLA TULARENSIS | Laboratory - Chemistry | $52.50 |
| 2024864 | HC CLOZAPINE | Laboratory - Chemistry | $92.39 |
| 2024865 | HC MYCOPHENOLATE (MYCOPHENOLIC ACID) | Laboratory - Chemistry | $89.36 |
| 2024866 | HC TIAGABINE | Laboratory - Chemistry | $89.04 |
| 2024986 | HC HLA II TYPING 1 LOCUS LR | Laboratory - Chemistry | $684.65 |
| 2025094 | HC DRUG SCREEN QUANTALCOHOLS | Laboratory - Chemistry | $272.90 |
| 2025095 | HC ALCOHOLS BIOMARKERS 1OR 2 | Laboratory - Chemistry | $247.54 |
| 2025102 | HC ANALGESICS NON-OPIOID 1 OR 2 | Laboratory - Chemistry | $297.05 |
| 2025105 | HC ANTIDEPRESSANT TRICYCLIC 1/2 | Laboratory - Chemistry | $101.43 |
| 2025108 | HC ANTIEPILEPTICS NOS 1-3 | Laboratory - Chemistry | $173.70 |
| 2025111 | HC BENZODIAZEPINES1-12 | Laboratory - Chemistry | $258.41 |
| 2025112 | HC BENZODIAZEPINES 13 OR MORE | Laboratory - Chemistry | $271.33 |
| 2025113 | HC OPIATES 1 OR MORE | Laboratory - Chemistry | $177.50 |
| 2025116 | HC OPIOID &OPIATE ANALOG 5/MORE | Laboratory - Chemistry | $195.62 |
| 2025559 | HC DRUG TEST(S), DEFINITIVE, QUAL/QUANT 1-7 | Laboratory - Chemistry | $464.92 |
| 2025560 | HC DRUG TEST(S), DEFINITIVE, QUAL/QUANT 8-14 | Laboratory - Chemistry | $715.31 |
| 2025562 | HC DRUG TEST(S), DEFINITIVE, QUAL/QUANT 22+ | Laboratory - Chemistry | $1,251.77 |
| 2025704 | HC DRUG SCREENING FENTANYL | Laboratory - Chemistry | $77.28 |
| 2025790 | HC DRUG TEST PRSMV DIR OPT OBS | Laboratory - Chemistry | $179.92 |
| 2025798 | HC DRUG TEST PRSMV CHEM ANLYZR | Laboratory - Chemistry | $241.50 |
| 2025855 | HC DRUG/SUBSTANCE NOS 7/MORE | Laboratory - Chemistry | $370.60 |
| 2025890 | HC AORTIC DYSFUNCTION/DILATION | Laboratory - Chemistry | $5,094.75 |
| 2025891 | HC AORTIC DYSFUNCTION/DILATION | Laboratory - Chemistry | $3,299.25 |
| 2025958 | HC EVAL AMNIOTIC FLUID PROTEIN | Laboratory - Chemistry | $278.33 |
| 2026035 | HC VKORC1 GENE | Laboratory - Chemistry | $264.60 |
| 2026056 | HC BLOOD GASES O2 SAT ONLY | Laboratory - Chemistry | $32.31 |
| 2026059 | HC TPMT GENE COM VARIANTS | Laboratory - Chemistry | $524.43 |
| 2026061 | HC MLH1 GENE | Laboratory - Chemistry | $576.96 |
| 2026062 | HC FLT3 GENE ANALYSIS | Laboratory - Chemistry | $249.00 |
| 2026063 | HC ASXL1 GENE TARGET SEQ ALYS | Laboratory - Chemistry | $895.92 |
| 2026064 | HC IDH2 COMMON VARIANTS | Laboratory - Chemistry | $887.37 |
| 2026065 | HC DH1 COMMON VARIANTS | Laboratory - Chemistry | $579.75 |
| 2026256 | HC GENERAL HEALTH PANEL | Laboratory - Chemistry | $645.40 |
| 2026343 | HC DIHYDROTESTOSTERONE | Laboratory - Chemistry | $297.05 |
| 2026696 | HC DRUG SCREENING OXYCODONE | Laboratory - Chemistry | $464.92 |
| 2021597 | HC HEMATOCRIT | Laboratory - Hematology | $36.23 |
| 2021598 | HC HEMOGLOBIN | Laboratory - Hematology | $39.85 |
| 2021599 | HC COMPLETE CBC W/AUTO DIFF WBC | Laboratory - Hematology | $132.01 |
| 2021600 | HC COMPLETE CBC, AUTOMATED | Laboratory - Hematology | $128.90 |
| 2021602 | HC AUTOMATED RETICULOCYTE COUNT | Laboratory - Hematology | $72.45 |
| 2021603 | HC AUTOMATED LEUKOCYTE COUNT | Laboratory - Hematology | $100.16 |
| 2021604 | HC AUTOMATED PLATELET COUNT | Laboratory - Hematology | $48.18 |
| 2021605 | HC BLOOD SMEAR INTERPRETATION | Laboratory - Hematology | $101.18 |
| 2021608 | HC BLOOD CLOT FACTOR II TEST | Laboratory - Hematology | $301.88 |
| 2021609 | HC BLOOD CLOT FACTOR V TEST | Laboratory - Hematology | $309.12 |
| 2021610 | HC BLOOD CLOT FACTOR VII TEST | Laboratory - Hematology | $412.97 |
| 2021611 | HC CLTNG FACTOR VIII AHG 1 STG | Laboratory - Hematology | $563.90 |
| 2021612 | HC CLTNG FACTOR VIII VW FACTOR RISTOCETIN COFACTOR | Laboratory - Hematology | $547.00 |
| 2021613 | HC CLTNG FACTOR VIII VW FACTOR AG | Laboratory - Hematology | $615.83 |
| 2021614 | HC CLTNG FACTOR VIII MULTMTRIC ALYS | Laboratory - Hematology | $422.63 |
| 2021615 | HC BLOOD CLOT FACTOR IX TEST | Laboratory - Hematology | $443.76 |
| 2021616 | HC BLOOD CLOT FACTOR X TEST | Laboratory - Hematology | $332.06 |
| 2021617 | HC BLOOD CLOT FACTOR XI TEST | Laboratory - Hematology | $491.45 |
| 2021618 | HC BLOOD CLOT FACTOR XII TEST | Laboratory - Hematology | $305.56 |
| 2021619 | HC CLTNG FACTOR XIII FIBRIN STABILIZING | Laboratory - Hematology | $363.46 |
| 2021620 | HC CLTNG FACTOR XIII FIBRIN STABILIZING SCR SOLUB | Laboratory - Hematology | $220.97 |
| 2021622 | HC ANTITHROMBIN III TEST | Laboratory - Hematology | $392.44 |
| 2021625 | HC CLTNG NHBTORS PROTEIN C ACTV | Laboratory - Hematology | $480.59 |
| 2021627 | HC CLTNG NHBTORS PROTEIN S FR | Laboratory - Hematology | $438.32 |
| 2021628 | HC ASSAY ACTIVATED PROTEIN C | Laboratory - Hematology | $358.63 |
| 2021630 | HC FIBRIN DEGRADE, SEMIQUANT | Laboratory - Hematology | $125.52 |
| 2021632 | HC FIBRINOGEN | Laboratory - Hematology | $223.39 |
| 2021633 | HC FBRNLYC FACTORS&NHBTORS PLSMNG ACTIVATOR | Laboratory - Hematology | $121.96 |
| 2021634 | HC FBRNLYC FACTORS&NHBTORS PLSMNG XCPT AGIC ASSAY | Laboratory - Hematology | $201.65 |
| 2021636 | HC HGB/RBCS FTL F&MAT HEMRRG DIFFIAL LSS | Laboratory - Hematology | $136.45 |
| 2021637 | HC HGB/RBCS FTL F&MAT HEMRRG ROSETTE | Laboratory - Hematology | $114.71 |
| 2021641 | HC MURAMIDASE | Laboratory - Hematology | $276.52 |
| 2021644 | HC PROTHROMBIN TIME | Laboratory - Hematology | $164.22 |
| 2021646 | HC RUSSELL VIPER VENOM, DILUTED | Laboratory - Hematology | $393.65 |
| 2021649 | HC RBC SED RATE, AUTOMATED | Laboratory - Hematology | $76.07 |
| 2021650 | HC RBC SICKLE CELL TEST | Laboratory - Hematology | $97.81 |
| 2021651 | HC THROMBIN TIME, PLASMA | Laboratory - Hematology | $111.09 |
| 2021652 | HC THROMBOPLASTIN TM PRTL PLSM/WHL BLD | Laboratory - Hematology | $118.52 |
| 2021653 | HC THROMBOPLASTIN TM PRTL SUBJ PLSM FXJS EA | Laboratory - Hematology | $260.82 |
| 2021663 | HC BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REPRT | Laboratory - Hematology | $553.04 |
| 2021664 | HC BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT | Laboratory - Hematology | $386.40 |
| 2021778 | HC BLOOD TYPING, ABO | Laboratory - Hematology | $280.20 |
| 2021779 | HC BLOOD TYPING, RH (D) | Laboratory - Hematology | $280.20 |
| 2021781 | HC BLOOD TYPING, RBC ANTIGENS | Laboratory - Hematology | $343.35 |
| 2022646 | HC BLD# RETICULOCYTES AUTO 1+ CELL MEAS | Laboratory - Hematology | $50.72 |
| 2022745 | HC COAG TIME ACTIVATED | Laboratory - Hematology | $82.11 |
| 2022746 | HC FIBRINOLYS OR/COAG SCRN | Laboratory - Hematology | $79.70 |
| 2023048 | HC OSMOTIC FRAGILITY RBC; UNINCUBATED | Laboratory - Hematology | $37.43 |
| 2023404 | HC CLOTTING FUNCT ACTIVITY | Laboratory - Hematology | $211.31 |
| 2023550 | HC FACTOR INHIBITOR TEST | Laboratory - Hematology | $94.19 |
| 2025921 | HC UNLISTED HEMAT & COAG PROCED | Laboratory - Hematology | $125.69 |
| 2021656 | HC ALLERGEN SPECIFIC IGE | Laboratory - Immunology | $141.28 |
| 2021657 | HC WBC ANTIBODY IDENTIFICATION | Laboratory - Immunology | $410.55 |
| 2021658 | HC PLATELET ANTIBODIES | Laboratory - Immunology | $352.59 |
| 2021659 | HC IMMUNOGLOBULIN ASSAY | Laboratory - Immunology | $403.31 |
| 2021660 | HC ANA | Laboratory - Immunology | $301.88 |
| 2021661 | HC ANA TITER | Laboratory - Immunology | $185.80 |
| 2021662 | HC ANTISTREPTOLYSIN O, TITER | Laboratory - Immunology | $187.16 |
| 2021665 | HC C-REACTIVE PROTEIN | Laboratory - Immunology | $239.09 |
| 2021667 | HC GLYCOPROTEIN ANTIBODY | Laboratory - Immunology | $328.44 |
| 2021668 | HC CARDIOLIPIN ANTIBODY | Laboratory - Immunology | $425.38 |
| 2021669 | HC COLD AGGLUTININ, TITER | Laboratory - Immunology | $71.24 |
| 2021670 | HC COMPLEMENT, ANTIGEN | Laboratory - Immunology | $229.43 |
| 2021671 | HC COMPLEMENT/FUNCTION ACTIVITY | Laboratory - Immunology | $234.26 |
| 2021673 | HC CCP ANTIBODY | Laboratory - Immunology | $339.31 |
| 2021674 | HC DNA ANTIBODY | Laboratory - Immunology | $304.29 |
| 2021675 | HC NUCLEAR ANTIGEN ANTIBODY | Laboratory - Immunology | $356.21 |
| 2021676 | HC FLUORESCENT ANTIBODY, SCREEN | Laboratory - Immunology | $463.68 |
| 2021677 | HC FLUORESCENT ANTIBODY, TITER | Laboratory - Immunology | $390.02 |
| 2021678 | HC HEMAGGLUTINATION INHIBITION | Laboratory - Immunology | $57.96 |
| 2021679 | HC IMMUNOASSAY, TUMOR, CA 15-3 | Laboratory - Immunology | $408.14 |
| 2021680 | HC IMMUNOASSAY, TUMOR, CA 19-9 | Laboratory - Immunology | $288.59 |
| 2021681 | HC IMMUNOASSAY, TUMOR, CA 125 | Laboratory - Immunology | $450.40 |
| 2021682 | HC HTROPHL ANTIBODIES SCR | Laboratory - Immunology | $186.38 |
| 2021684 | HC IMMUNOASSAY, TUMOR OTHER | Laboratory - Immunology | $304.29 |
| 2021685 | HC IMMUNOASSAY,INFECTIOUS AGENT | Laboratory - Immunology | $315.16 |
| 2021686 | HC IMMUNODIFFUSION OUCHTERLONY | Laboratory - Immunology | $176.30 |
| 2021691 | HC INTRINSIC FACTOR ANTIBODY | Laboratory - Immunology | $233.29 |
| 2021692 | HC LYMPHOCYTE TRANSFORMATION | Laboratory - Immunology | $479.38 |
| 2021693 | HC B CELLS, TOTAL COUNT | Laboratory - Immunology | $555.45 |
| 2021694 | HC NK CELLS, TOTAL COUNT | Laboratory - Immunology | $562.70 |
| 2021695 | HC T CELLS, TOTAL COUNT | Laboratory - Immunology | $525.26 |
| 2021696 | HC T CELL, ABSOLUTE COUNT/RATIO | Laboratory - Immunology | $765.56 |
| 2021697 | HC T CELL, ABSOLUTE COUNT | Laboratory - Immunology | $243.92 |
| 2021698 | HC STEM CELLS, TOTAL COUNT | Laboratory - Immunology | $321.20 |
| 2021699 | HC MICROSOMAL ANTIBODY | Laboratory - Immunology | $419.00 |
| 2021701 | HC PART AGGLUJ SCR EA ANTB | Laboratory - Immunology | $199.24 |
| 2021704 | HC RHEUMATOID FACTOR, QUANT | Laboratory - Immunology | $135.24 |
| 2021705 | HC TB INTRADERMAL TEST | Laboratory - Immunology | $106.50 |
| 2021706 | HC BLOOD SEROLOGY, QUALITATIVE | Laboratory - Immunology | $112.30 |
| 2021708 | HC ASPERGILLUS ANTIBODY | Laboratory - Immunology | $126.79 |
| 2021709 | HC BACTERIUM ANTIBODY | Laboratory - Immunology | $71.24 |
| 2021711 | HC BLASTOMYCES ANTIBODY | Laboratory - Immunology | $49.51 |
| 2021712 | HC ANTB BORRELIA BURGDORFERI CONFIRMATORY TST | Laboratory - Immunology | $385.19 |
| 2021713 | HC ANTB BORRELIA BURGDORFERI LYME DISEASE | Laboratory - Immunology | $434.70 |
| 2021715 | HC CAMPYLOBACTER ANTIBODY | Laboratory - Immunology | $65.21 |
| 2021716 | HC CHLAMYDIA ANTIBODY | Laboratory - Immunology | $182.33 |
| 2021717 | HC CHLAMYDIA IGM ANTIBODY | Laboratory - Immunology | $95.39 |
| 2021718 | HC COCCIDIOIDES ANTIBODY | Laboratory - Immunology | $62.79 |
| 2021720 | HC CMV ANTIBODY | Laboratory - Immunology | $234.26 |
| 2021721 | HC CMV ANTIBODY, IGM | Laboratory - Immunology | $195.62 |
| 2021722 | HC ENTEROVIRUS ANTIBODY | Laboratory - Immunology | $293.42 |
| 2021723 | HC ANTB EPSTEIN-BARR EB VIRUS EARLY AG EA | Laboratory - Immunology | $274.10 |
| 2021724 | HC ANTB EPSTEIN-BARR EB VIRUS NUC AG EBNA | Laboratory - Immunology | $306.71 |
| 2021725 | HC ANTB EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA | Laboratory - Immunology | $294.63 |
| 2021726 | HC EHRLICHIA ANTIBODY | Laboratory - Immunology | $188.37 |
| 2021727 | HC FUNGUS ANTIBODY | Laboratory - Immunology | $254.78 |
| 2021732 | HC HTLV/HIV CONFIRMATORY TEST | Laboratory - Immunology | $361.35 |
| 2021733 | HC ANTB HERPES SMPLX NON-SPEC TYP TST | Laboratory - Immunology | $199.24 |
| 2021734 | HC ANTB HERPES SMPLX TYP 1 | Laboratory - Immunology | $240.29 |
| 2021735 | HC HERPES SIMPLEX TYPE 2 | Laboratory - Immunology | $322.70 |
| 2021736 | HC HISTOPLASMA | Laboratory - Immunology | $128.00 |
| 2021737 | HC HIV-1 | Laboratory - Immunology | $72.45 |
| 2021738 | HC HIV-2 | Laboratory - Immunology | $225.80 |
| 2021739 | HC HIV-1/HIV-2, SINGLE ASSAY | Laboratory - Immunology | $287.81 |
| 2021740 | HC HEP B CORE ANTIBODY, TOTAL | Laboratory - Immunology | $200.47 |
| 2021741 | HC HEP B CORE ANTIBODY, IGM | Laboratory - Immunology | $231.84 |
| 2021743 | HC HEP BE ANTIBODY | Laboratory - Immunology | $248.75 |
| 2021747 | HC LEGIONELLA ANTIBODY | Laboratory - Immunology | $213.73 |
| 2021748 | HC LEPTOSPIRA ANTIBODY | Laboratory - Immunology | $62.79 |
| 2021749 | HC MUMPS ANTIBODY | Laboratory - Immunology | $263.72 |
| 2021750 | HC MYCOPLASMA ANTIBODY | Laboratory - Immunology | $195.62 |
| 2021751 | HC PARVOVIRUS ANTIBODY | Laboratory - Immunology | $345.35 |
| 2021754 | HC RICKETTSIA ANTIBODY | Laboratory - Immunology | $199.24 |
| 2021755 | HC RUBELLA ANTIBODY | Laboratory - Immunology | $191.99 |
| 2021756 | HC RUBEOLA ANTIBODY | Laboratory - Immunology | $240.29 |
| 2021757 | HC TOXOPLASMA ANTIBODY | Laboratory - Immunology | $191.99 |
| 2021758 | HC TOXOPLASMA ANTIBODY, IGM | Laboratory - Immunology | $189.58 |
| 2021759 | HC TREPONEMA PALLIDUM, CONFIRM | Laboratory - Immunology | $220.02 |
| 2021760 | HC TRICHINELLA ANTIBODY | Laboratory - Immunology | $32.60 |
| 2021761 | HC VARICELLA-ZOSTER ANTIBODY | Laboratory - Immunology | $255.99 |
| 2021763 | HC VIRUS ANTIBODY NOS | Laboratory - Immunology | $249.95 |
| 2021764 | HC THYROGLOBULIN ANTIBODY | Laboratory - Immunology | $335.99 |
| 2021765 | HC HEPATITIS C AB TEST | Laboratory - Immunology | $310.33 |
| 2021767 | HC HLA TYPING B/C 1 AG | Laboratory - Immunology | $547.00 |
| 2021772 | HC RBC ANTIBODY ELUTION | Laboratory - Immunology | $173.85 |
| 2021780 | HC BLOOD TYPING, ANTIGEN SCREEN | Laboratory - Immunology | $343.35 |
| 2021783 | HC COMPATIBILITY TEST, INCUBATE | Laboratory - Immunology | $173.85 |
| 2021784 | HC COMPATIBILITY TEST, ANTIGLOB | Laboratory - Immunology | $219.77 |
| 2021836 | HC HEPATITIS DELTA AG, EIA | Laboratory - Immunology | $166.64 |
| 2022650 | HC TUBERCULOSIS TST CELL MEDIATED IMMUNITY | Laboratory - Immunology | $1,041.44 |
| 2022747 | HC ANTI-PHOSPHATIDYLSER AB | Laboratory - Immunology | $144.90 |
| 2022750 | HC ANTIBODY SALMONELLA | Laboratory - Immunology | $44.68 |
| 2022751 | HC WEST NILE VIRUS ANTIBODY | Laboratory - Immunology | $225.80 |
| 2023038 | HC ISLET CELL AB | Laboratory - Immunology | $224.60 |
| 2023040 | HC AB HELMINTH NES | Laboratory - Immunology | $131.62 |
| 2023049 | HC ALLERG SP IGG QUAN OR SEMIQUAN | Laboratory - Immunology | $44.68 |
| 2023050 | HC DNA AB | Laboratory - Immunology | $259.92 |
| 2023051 | HC IEP; NOT SERUM | Laboratory - Immunology | $202.86 |
| 2023052 | HC AB; BORDETELLA | Laboratory - Immunology | $184.75 |
| 2023053 | HC AB; HEPATITIS D | Laboratory - Immunology | $195.62 |
| 2023058 | HC AB; COXIELLA BRUNETII | Laboratory - Immunology | $50.72 |
| 2023560 | HC HUMAN EPIDIDYMIS PROTEIN 4 | Laboratory - Immunology | $217.35 |
| 2024641 | HC JOHN CUNNINGHAM ANTIBODY | Laboratory - Immunology | $70.93 |
| 2024643 | HC HLA CLASS1 & 2 ANTIBODY QUALITATIVE | Laboratory - Immunology | $128.38 |
| 2024749 | HC SYPHILIS TEST NON-TREP QUANT | Laboratory - Immunology | $21.70 |
| 2024752 | HC CULTURE AEROBIC IDENTIFY | Laboratory - Immunology | $136.90 |
| 2024756 | HC CULTURE TYPE IMMUNOFLUORESC | Laboratory - Immunology | $28.71 |
| 2024758 | HC DNA/RNA SEQUENCING | Laboratory - Immunology | $569.87 |
| 2024759 | HC MICROBE SUSCEPTIBLE ENZYME | Laboratory - Immunology | $23.40 |
| 2024763 | HC VANOMYCIN DNA AMP PROBE | Laboratory - Immunology | $187.16 |
| 2024774 | HC M.AVIUM-INTRA DNA AMP PROB | Laboratory - Immunology | $173.01 |
| 2024851 | HC ALLERGEN SPECIFIC IGE | Laboratory - Immunology | $40.51 |
| 2025984 | HC TB AG RESPONSE T-CELL SUSP | Laboratory - Immunology | $308.37 |
| 2024453 | HC GLUCOSE; BLD BY MONITOR DEVICE | Laboratory - Other | $22.83 |
| 2021329 | HC MICROSCOPIC EXAM OF URINE | Laboratory - Urology | $16.49 |
| 2023222 | HC N-AUTOM URINALYS WO MICRO | Laboratory - Urology | $40.57 |
| 2024638 | HC URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS | Laboratory - Urology | $87.49 |
| 2021606 | HC BONE MARROW INTERPRETATION | Laboratory Pathology | $761.06 |
| 2021879 | HC CELL MARKER STUDY | Laboratory Pathology | $418.51 |
| 2021883 | HC TISSUE CULTURE, LYMPHOCYTE | Laboratory Pathology | $916.49 |
| 2021884 | HC TISSUE CULTURE, SKIN/BIOPSY | Laboratory Pathology | $1,312.55 |
| 2021885 | HC TISSUE CULTURE, PLACENTA | Laboratory Pathology | $629.11 |
| 2021886 | HC TISSUE CULTURE, BONE MARROW | Laboratory Pathology | $1,052.94 |
| 2021887 | HC TISSUE CULTURE, TUMOR | Laboratory Pathology | $699.14 |
| 2021890 | HC CHROMOSOME ANALYSIS, BI-100 | Laboratory Pathology | $1,234.07 |
| 2021892 | HC CHROMOSOME ANALYSIS, 5 | Laboratory Pathology | $2,463.30 |
| 2021893 | HC CHROMOSOME ANALYSIS, 15-20 | Laboratory Pathology | $1,828.16 |
| 2021894 | HC CHROMOSOME ANALYSIS, 45 | Laboratory Pathology | $2,448.81 |
| 2021896 | HC CHROMOSOME ANALYS, PLACENTA | Laboratory Pathology | $2,783.29 |
| 2021902 | HC CHROMOSOME KARYOTYPE STUDY | Laboratory Pathology | $536.13 |
| 2021904 | HC CHROMOSOME COUNT, ADDITIONAL | Laboratory Pathology | $414.17 |
| 2021905 | HC CHROMOSOME STUDY, ADDITIONAL | Laboratory Pathology | $350.18 |
| 2021907 | HC SURGICAL PATH, GROSS | Laboratory Pathology | $1,047.99 |
| 2021908 | HC LVL II-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,204.41 |
| 2021909 | HC LEVEL III-SURG PATH GROSS&MICROSCOPIC XM | Laboratory Pathology | $1,360.83 |
| 2021910 | HC LVL IV-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,564.17 |
| 2021911 | HC LVL V-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,742.94 |
| 2021912 | HC LVL VI-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,981.29 |
| 2021913 | HC DECALCIFY TISSUE | Laboratory Pathology | $150.87 |
| 2021914 | HC SPEC STAINS GRP I MICROORGANISMS EA | Laboratory Pathology | $981.70 |
| 2021915 | HC SPEC STAINS GRP II STAINS EA | Laboratory Pathology | $603.51 |
| 2021916 | HC HISTOCHEMICAL STAIN | Laboratory Pathology | $524.06 |
| 2021917 | HC ENZYME HISTOCHEMISTRY | Laboratory Pathology | $1,365.68 |
| 2021918 | HC CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE | Laboratory Pathology | $548.21 |
| 2021919 | HC CONSLTJ&REPRT MATRL REQ PREPJ SLIDES | Laboratory Pathology | $486.62 |
| 2021920 | HC PATH CONSULT INTROP | Laboratory Pathology | $231.84 |
| 2021921 | HC PATH CONSULT INTRAOP, 1 BLOC | Laboratory Pathology | $536.13 |
| 2021922 | HC PATH CONSULT INTRAOP, ADD'L | Laboratory Pathology | $202.86 |
| 2021925 | HC IMMUNOHISTOCHEMISTRY | Laboratory Pathology | $770.41 |
| 2021926 | HC IMFLUOR STD DIR METH 1ST STAIN | Laboratory Pathology | $1,115.73 |
| 2021928 | HC ELECTRON MICROSCOPY | Laboratory Pathology | $6,724.57 |
| 2021930 | HC ANALYSIS, TUMOR | Laboratory Pathology | $418.51 |
| 2021931 | HC TUMOR IMMUNOHISTOCHEM/MANUAL | Laboratory Pathology | $886.24 |
| 2021932 | HC TUMOR IMMUNOHISTOCHEM/COMPUT | Laboratory Pathology | $467.21 |
| 2021933 | HC INSITU HYBRIDIZATION (FISH) | Laboratory Pathology | $477.99 |
| 2021934 | HC INSITU HYBRIDIZATION, MANUAL | Laboratory Pathology | $725.71 |
| 2022423 | HC PROSTATE BIOPSY, ANY MTHD | Laboratory Pathology | $5,756.15 |
| 2022653 | HC TISS EXAM MOLECULAR STUDY | Laboratory Pathology | $66.41 |
| 2022920 | HC INSITU HYBRIDIZATION AUTO | Laboratory Pathology | $2,277.10 |
| 2023013 | HC CYT FNA EVAL SPEC EA ADD | Laboratory Pathology | $78.61 |
| 2023014 | HC CYT URINE 3-5 PROBE COMP | Laboratory Pathology | $3,420.85 |
| 2023015 | HC XM ARCHIVE TISSUE MOL AN | Laboratory Pathology | $177.32 |
| 2023444 | HC NERVE TEASING PREP | Laboratory Pathology | $783.84 |
| 2023568 | HC HBA1/HBA2 GENE | Laboratory Pathology | $1,391.04 |
| 2024487 | HC NPM1 | Laboratory Pathology | $874.23 |
| 2024488 | HC JAK2 | Laboratory Pathology | $1,396.69 |
| 2024489 | HC IGH GENE REARRANGE AMP METH | Laboratory Pathology | $1,754.39 |
| 2024490 | HC TRG GENE REARRANGEMENT ANAL | Laboratory Pathology | $1,783.37 |
| 2024491 | HC MOPATH PROCEDURE LEVEL 2 | Laboratory Pathology | $1,839.17 |
| 2024492 | HC FLT3 GENE | Laboratory Pathology | $645.98 |
| 2024493 | HC UNLISTED MOLECULAR PATHOLOGY | Laboratory Pathology | $645.98 |
| 2024495 | HC BCR-ABL (CML) | Laboratory Pathology | $1,643.70 |
| 2024496 | HC BCR-ABL (ALL) | Laboratory Pathology | $1,643.70 |
| 2024497 | HC MOPATH PROCEDURE LEVEL 6 | Laboratory Pathology | $3,509.13 |
| 2024498 | HC PML-RARA | Laboratory Pathology | $2,864.52 |
| 2024504 | HC IGK REARRANGEABN CLONAL POP | Laboratory Pathology | $1,754.39 |
| 2024505 | HC KRAS GENE | Laboratory Pathology | $5,416.06 |
| 2024506 | HC BRAF GENE | Laboratory Pathology | $1,893.29 |
| 2024525 | HC CFTR GENE COM VARIANTS | Laboratory Pathology | $1,113.20 |
| 2024528 | HC CFTR GENE FULL SEQUENCE | Laboratory Pathology | $8,690.52 |
| 2024532 | HC CYP2C9 GENE COM VARIANTS | Laboratory Pathology | $1,719.99 |
| 2024534 | HC CYTOGEN M ARRAY COPY NO&SNP | Laboratory Pathology | $5,137.37 |
| 2024535 | HC F2 GENE | Laboratory Pathology | $1,012.05 |
| 2024536 | HC F5 GENE | Laboratory Pathology | $314.41 |
| 2024538 | HC FMR1 GENE DETECTION | Laboratory Pathology | $588.43 |
| 2024545 | HC HFE GENE | Laboratory Pathology | $748.57 |
| 2024546 | HC IKBKAP GENE | Laboratory Pathology | $2,070.79 |
| 2024547 | HC IGH GENE REARRANG DIR PROBE | Laboratory Pathology | $2,263.16 |
| 2024548 | HC IGH VARI REGIONAL MUTATION | Laboratory Pathology | $2,828.95 |
| 2024550 | HC CHIMERISM ANAL NO CELL SELEC | Laboratory Pathology | $796.64 |
| 2024554 | HC MTHFR GENE | Laboratory Pathology | $434.53 |
| 2024567 | HC UGT1A1 GENE COMMON VARIANTS | Laboratory Pathology | $1,348.84 |
| 2024570 | HC HLA I TYPING COMPLETE HR | Laboratory Pathology | $5,584.75 |
| 2024571 | HC HLA I TYPING 1 LOCUS HR | Laboratory Pathology | $2,480.43 |
| 2024572 | HC HLA I TYPING 1 ALLELE HR | Laboratory Pathology | $724.21 |
| 2024573 | HC HLA II TYPING 1 LOC HR | Laboratory Pathology | $1,701.90 |
| 2024574 | HC HLA II TYPING 1 ALLELE HR | Laboratory Pathology | $1,378.27 |
| 2024575 | HC MOPATH PROCEDURE LEVEL 1 | Laboratory Pathology | $1,267.01 |
| 2024576 | HC MOPATH PROCEDURE LVL 3 | Laboratory Pathology | $1,976.85 |
| 2024577 | HC MOPATH PROCEDURE LEVEL 4 | Laboratory Pathology | $1,916.47 |
| 2024578 | HC MOPATH PROCEDURE LEVEL 5 | Laboratory Pathology | $2,862.95 |
| 2024579 | HC MOPATH PROCEDURE LEVEL 7 | Laboratory Pathology | $6,782.82 |
| 2024580 | HC MOPATH PROCEDURE LEVEL 8 | Laboratory Pathology | $6,056.19 |
| 2024581 | HC MOPATH PROCEDURE LEVEL 9 | Laboratory Pathology | $6,351.88 |
| 2024582 | HC MICRODISSECTION MANUAL | Laboratory Pathology | $2,160.69 |
| 2024663 | HC EGFR GENE COM VARIANTS | Laboratory Pathology | $891.19 |
| 2025120 | HC IMMUNOHISTO ANTIBODY ADDL SLIDE | Laboratory Pathology | $654.84 |
| 2025150 | HC ISH, ADDTL SINGLE PROBE STAIN/SPECIMEN | Laboratory Pathology | $314.43 |
| 2025151 | HC ISH, MULTIPLEX PROBE STAIN/SPECIMEN | Laboratory Pathology | $728.12 |
| 2025152 | HC ISH, COMPUTER ASSISTED, ADDT?L SINGLE PROBE STAIN/SPECIMEN | Laboratory Pathology | $1,259.00 |
| 2025153 | HC ISH, COMPUTER ASSISTED, MULTIPLEX PROBE STAIN/SPECIMEN | Laboratory Pathology | $823.52 |
| 2025220 | HC TARGETED GENOMIC SEQ ANALYS 5-50 | Laboratory Pathology | $3,622.50 |
| 2025548 | HC IIMMUNOFLUOR ANTB ADDL STAIN | Laboratory Pathology | $532.51 |
| 2025644 | HC ABL1 GENE | Laboratory Pathology | $1,916.47 |
| 2025645 | HC CEBPA GENE FULL SEQUENCE | Laboratory Pathology | $1,916.47 |
| 2025646 | HC CALR GENE COM VARIANTS | Laboratory Pathology | $963.59 |
| 2025647 | HC KIT GENE TARGETED SEQ ANALYS | Laboratory Pathology | $1,916.47 |
| 2025648 | HC KIT GENE ANALYS D816 VARIANT | Laboratory Pathology | $726.29 |
| 2025649 | HC KRAS GENE ADDL VARIANTS | Laboratory Pathology | $1,146.86 |
| 2025650 | HC NRAS GENE VARIANTS EXON 2&3 | Laboratory Pathology | $1,720.33 |
| 2025651 | HC PDGFRA GENE | Laboratory Pathology | $1,916.47 |
| 2026022 | HC TARGETED GENOMIC SEQ ANALYS > 50 | Laboratory Pathology | $8,759.00 |
| 2026029 | HC ONC BREAST MRNA 58 GENES | Laboratory Pathology | $9,297.06 |
| 2026030 | HC MICROSATELLITE INSTABILITY | Laboratory Pathology | $1,072.44 |
| 2026043 | HC MICRODISSECTION LASER | Laboratory Pathology | $132.40 |
| 2026317 | HC AR GENE CHARAC ALLELES | Laboratory Pathology | $1,839.17 |
| 2026318 | HC BTK GENE COMMON VARIANTS | Laboratory Pathology | $1,893.29 |
| 2026329 | HC MYD88 GENE P.LEU265PRO VRNT | Laboratory Pathology | $1,893.29 |
| 2026330 | HC NUDT15 GENE COMMON VARIANTS | Laboratory Pathology | $2,263.16 |
| 2026333 | HC SMN1 GENE DOS/DELETION ALYS | Laboratory Pathology | $1,839.17 |
| 2026936 | HC DPYD GENE COMMON VARIANTS | Laboratory Pathology | $839.08 |
| 2021866 | HC CYTOPATH FL NONGYN, SMEARS | Laboratory Pathology - Cytology | $382.78 |
| 2021867 | HC CYTOPATH, CONCENTRATE TECH | Laboratory Pathology - Cytology | $514.40 |
| 2021869 | HC CYTOPATH, C/V, THIN LAYER | Laboratory Pathology - Cytology | $269.27 |
| 2021872 | HC CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ | Laboratory Pathology - Cytology | $151.00 |
| 2021877 | HC CYTOPATHOLOGY EVAL OF FNA | Laboratory Pathology - Cytology | $391.78 |
| 2021878 | HC CYTOPATH EVAL, FNA, REPORT | Laboratory Pathology - Cytology | $897.66 |
| 2021880 | HC FLOWCYTOMETRY/ TC, 1 MARKER | Laboratory Pathology - Cytology | $548.21 |
| 2021881 | HC FLOWCYTOMETRY/TC, ADD-ON | Laboratory Pathology - Cytology | $467.74 |
| 2021891 | HC CHROMOSOME ANALYSIS, 100 | Laboratory Pathology - Cytology | $1,234.07 |
| 2021895 | HC CHROMOSOME ANALYSIS, 20-25 | Laboratory Pathology - Cytology | $710.01 |
| 2021897 | HC CYTOGENETICS, DNA PROBE | Laboratory Pathology - Cytology | $414.17 |
| 2021899 | HC CYTOGENETICS, 10-30 | Laboratory Pathology - Cytology | $376.74 |
| 2021900 | HC CYTOGENETICS, 25-99 | Laboratory Pathology - Cytology | $528.89 |
| 2021901 | HC CYTOGENETICS, 100-300 | Laboratory Pathology - Cytology | $638.77 |
| 2021923 | HC INTRAOP CYTO PATH CONSULT, 1 | Laboratory Pathology - Cytology | $761.06 |
| 2021924 | HC INTRAOP CYTO PATH CONSULT, 2 | Laboratory Pathology - Cytology | $172.67 |
| 2023648 | HC CYTOGENETICS AND MOLEC CYTOGENETICS, INTERP & RPT | Laboratory Pathology - Cytology | $164.83 |
| 2024629 | HC CYTOPATH C/V AUTO FLUID REDO | Laboratory Pathology - Cytology | $444.93 |
| 2024661 | HC OBTAINING SCREEN PAP SMEAR | Laboratory Pathology - Cytology | $142.73 |
| 2024682 | HC CYTOPATH CELL ENHANCE TECH | Laboratory Pathology - Cytology | $554.30 |
| 2025329 | HC CHROM ANALY; SITU AF CELLS FROM 6-12 COL | Laboratory Pathology - Cytology | $647.22 |
| 2024867 | HC IMMUNOHISTO ANTIBODY SLIDE | Laboratory Pathology - Histology | $1,248.05 |
| 2025582 | HC M/PHMTRC ALYS ISH QUANT/SEMIQ EACH | Laboratory Pathology - Histology | $894.76 |
| 2020643 | HC MAGNETIC IMAGE, JAW JOINT | Magnetic Resonance Technology (MRT) | $2,646.18 |
| 2020659 | HC MRI ORBIT/FACE/NECK W/O DYE | Magnetic Resonance Technology (MRT) | $5,762.34 |
| 2020660 | HC MRI ORBIT/FACE/NECK W/DYE | Magnetic Resonance Technology (MRT) | $8,594.86 |
| 2020661 | HC MRI ORBT/FAC/NCK W/O & W/DYE | Magnetic Resonance Technology (MRT) | $9,767.29 |
| 2020662 | HC MR ANGIOGRAPHY HEAD W/O DYE | Magnetic Resonance Technology (MRT) | $6,644.21 |
| 2020663 | HC MR ANGIOGRAPH HEAD W/O&W/DYE | Magnetic Resonance Technology (MRT) | $11,229.00 |
| 2020664 | HC MR ANGIOGRAPHY NECK W/O DYE | Magnetic Resonance Technology (MRT) | $5,780.25 |
| 2020665 | HC MR ANGIOGRAPH NECK W/O&W/DYE | Magnetic Resonance Technology (MRT) | $9,798.01 |
| 2020667 | HC MRI BRAIN W/DYE | Magnetic Resonance Technology (MRT) | $8,185.27 |
| 2020668 | HC MRI BRAIN W/O & W/DYE | Magnetic Resonance Technology (MRT) | $9,301.39 |
| 2020700 | HC MRI CHEST W/O DYE | Magnetic Resonance Technology (MRT) | $5,775.13 |
| 2020701 | HC MRI CHEST W/DYE | Magnetic Resonance Technology (MRT) | $8,614.06 |
| 2020702 | HC MRI CHEST W/O & W/DYE | Magnetic Resonance Technology (MRT) | $9,789.05 |
| 2020703 | HC MRA W/O FOL W/CONT, CHEST | Magnetic Resonance Technology (MRT) | $6,637.82 |
| 2020730 | HC MRI NECK SPINE W/O DYE | Magnetic Resonance Technology (MRT) | $5,043.00 |
| 2020731 | HC MRI NECK SPINE W/DYE | Magnetic Resonance Technology (MRT) | $7,514.58 |
| 2020732 | HC MRI CHEST SPINE W/O DYE | Magnetic Resonance Technology (MRT) | $4,696.13 |
| 2020751 | HC MRI PELVIS W/O DYE | Magnetic Resonance Technology (MRT) | $4,058.71 |
| 2020752 | HC MRI PELVIS W/DYE | Magnetic Resonance Technology (MRT) | $6,052.88 |
| 2020753 | HC MRI PELVIS W/O & W/DYE | Magnetic Resonance Technology (MRT) | $6,878.45 |
| 2020871 | HC MR ANGIO UPR EXTR W/O&W/DYE | Magnetic Resonance Technology (MRT) | $3,584.01 |
| 2020996 | HC MRI ABDOMEN W/O DYE | Magnetic Resonance Technology (MRT) | $5,758.49 |
| 2020997 | HC MRI ABDOMEN W/DYE | Magnetic Resonance Technology (MRT) | $8,589.74 |
| 2020998 | HC MRI ABDOMEN W/O & W/DYE | Magnetic Resonance Technology (MRT) | $9,760.90 |
| 2021030 | HC CARDIAC MRI FOR MORPH W/DYE | Magnetic Resonance Technology (MRT) | $10,879.57 |
| 2022396 | HC MRA W/O FOL W/CONT, ABD | Magnetic Resonance Technology (MRT) | $5,433.39 |
| 2022399 | HC MRI W/O FOL W/CONT, BRST, UN | Magnetic Resonance Technology (MRT) | $7,922.44 |
| 2022402 | HC MRI W/O FOL W/CONT, BRST, BI | Magnetic Resonance Technology (MRT) | $11,861.40 |
| 2023505 | HC MRI U EXT NOT JOINT WO CONTRAST | Magnetic Resonance Technology (MRT) | $5,009.72 |
| 2023506 | HC MRI U EXT NOT JOINT W CONTRAST | Magnetic Resonance Technology (MRT) | $7,464.66 |
| 2023507 | HC MRI U EXTR; NOT JOINT W&WO CONTR | Magnetic Resonance Technology (MRT) | $8,466.86 |
| 2023508 | HC MRI U EXTR; ANY JOINT WO CONTRAST | Magnetic Resonance Technology (MRT) | $6,325.51 |
| 2023509 | HC MRI U EXTR; ANY JOINT W CONTRAST | Magnetic Resonance Technology (MRT) | $9,425.55 |
| 2023510 | HC MRI UE ANY JOINT W & WO CONTRAST | Magnetic Resonance Technology (MRT) | $10,690.14 |
| 2023525 | HC MRI - LEXTREM WO CONTR | Magnetic Resonance Technology (MRT) | $6,464.38 |
| 2023526 | HC MRI - LEXTREM W CONTR | Magnetic Resonance Technology (MRT) | $9,632.07 |
| 2023527 | HC MRI LEXTREM W&WO CONTR | Magnetic Resonance Technology (MRT) | $10,924.82 |
| 2023528 | HC MRI - LE JNT WO CONTR | Magnetic Resonance Technology (MRT) | $6,325.51 |
| 2023529 | HC MRI LE JNT W CONTR | Magnetic Resonance Technology (MRT) | $9,425.55 |
| 2023530 | HC MRI LE JNT W&WO CONTR | Magnetic Resonance Technology (MRT) | $10,690.14 |
| 2023572 | HC CARDIAC MRI FOR MORPH | Magnetic Resonance Technology (MRT) | $9,465.22 |
| 2023574 | HC UNLISTED MAGNETIC RESONANCE PROCED | Magnetic Resonance Technology (MRT) | $2,858.37 |
| 2025616 | HC MRA ABD W/WO CONTR | Magnetic Resonance Technology (MRT) | $5,274.67 |
| 2025617 | HC MR ANGIO PELVIS W/WO CONTRAST | Magnetic Resonance Technology (MRT) | $6,468.87 |
| 2026012 | HC CARD MRI VEL FLW MAP ADD-ON | Magnetic Resonance Technology (MRT) | $587.24 |
| 2026384 | HC CAD BREAST MRI | Magnetic Resonance Technology (MRT) | $433.90 |
| 2026735 | HC MRT GEN CDSM NDSC | Magnetic Resonance Technology (MRT) | $1.06 |
| 2020666 | HC MRI BRAIN W/O DYE | Magnetic Resonance Technology (MRT) - Brain/Brainstem | $5,488.42 |
| 2020669 | HC FMRI BRAIN BY TECH | Magnetic Resonance Technology (MRT) - Brain/Brainstem | $3,535.32 |
| 2022407 | HC MRA W/O FOL W/CONT, LWR EXT | Magnetic Resonance Technology (MRT) - MRA - Lower Extremities | $6,557.18 |
| 2025630 | HC MRA LEXTREM W/WO CONTR | Magnetic Resonance Technology (MRT) - MRA - Lower Extremities | $6,366.47 |
| 2022408 | HC MRA W/O FOL W/CONT, PELVIS | Magnetic Resonance Technology (MRT) - MRA - Other | $4,336.47 |
| 2026737 | HC MRA CDSM NDSC | Magnetic Resonance Technology (MRT) - MRA - Other | $1.06 |
| 2026779 | HC MRA CDSM QUALIFIED NOS | Magnetic Resonance Technology (MRT) - MRA - Other | $1.06 |
| 2022401 | HC MRI BREAST C- BILATERAL | Magnetic Resonance Technology (MRT) - MRI - Other | $7,675.75 |
| 2025720 | HC MRI FETAL SNGL/1ST GESTATION | Magnetic Resonance Technology (MRT) - MRI - Other | $1,238.84 |
| 2025721 | HC MRI FETAL EA ADDL GESTATION | Magnetic Resonance Technology (MRT) - MRI - Other | $389.28 |
| 2026736 | HC MRI CDSM NDSC | Magnetic Resonance Technology (MRT) - MRI - Other | $1.06 |
| 2020733 | HC MRI CHEST SPINE W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $7,003.88 |
| 2020734 | HC MRI LUMBAR SPINE W/O DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $5,967.13 |
| 2020735 | HC MRI LUMBAR SPINE W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $8,890.53 |
| 2020736 | HC MRI NECK SPINE W/O & W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $8,523.18 |
| 2020737 | HC MRI THORAC SPINE W & WO CONTR | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $7,958.73 |
| 2020738 | HC MRI LUMBAR SPINE W/O & W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $10,084.72 |
| 2021975 | HC DIALYSIS PROCEDURE | Miscellaneous Dialysis | $4,087.03 |
| 2026112 | HC ULTRAFILTRATION ONLY | Miscellaneous Dialysis - Ultrafiltration | $2,470.00 |
| 2026201 | HC IP ULTRAFILTRATION | Miscellaneous Dialysis - Ultrafiltration | $2,469.00 |
| 2020517 | HC IDENTIFY SENTINEL NODE | Nuclear Medicine | $3,470.36 |
| 2021207 | HC THYROID MET IMAGING, BODY | Nuclear Medicine | $4,774.46 |
| 2026732 | HC NUC MED CDSM NDSC | Nuclear Medicine | $1.00 |
| 2021201 | HC THYROID, SINGLE UPTAKE | Nuclear Medicine - Diagnostic Procedures | $1,420.02 |
| 2021204 | HC THYROID IMAGING WITH UPTAKE | Nuclear Medicine - Diagnostic Procedures | $2,840.04 |
| 2021211 | HC THYROID MET UPTAKE | Nuclear Medicine - Diagnostic Procedures | $1,289.61 |
| 2021213 | HC BONE MARROW IMAGING, BODY | Nuclear Medicine - Diagnostic Procedures | $2,559.90 |
| 2021214 | HC BLOOD VOLUME | Nuclear Medicine - Diagnostic Procedures | $1,732.76 |
| 2021215 | HC RED CELL SEQUESTRATION | Nuclear Medicine - Diagnostic Procedures | $1,616.84 |
| 2021216 | HC SPLEEN IMAGING | Nuclear Medicine - Diagnostic Procedures | $1,588.71 |
| 2021217 | HC LYMPH SYSTEM IMAGING | Nuclear Medicine - Diagnostic Procedures | $4,502.77 |
| 2021221 | HC SERIAL SALIVARY IMAGING | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2021222 | HC ESOPHAGEAL MOTILITY STUDY | Nuclear Medicine - Diagnostic Procedures | $3,537.98 |
| 2021223 | HC GASTROESOPHAGEAL REFLUX EXAM | Nuclear Medicine - Diagnostic Procedures | $1,802.83 |
| 2021224 | HC GASTRIC EMPTYING IMAG STUDY | Nuclear Medicine - Diagnostic Procedures | $3,934.04 |
| 2021226 | HC ACUTE GI BLOOD LOSS IMAGING | Nuclear Medicine - Diagnostic Procedures | $2,044.97 |
| 2021227 | HC MECKEL'S DIVERT EXAM | Nuclear Medicine - Diagnostic Procedures | $3,051.35 |
| 2021228 | HC BONE IMAGING, LIMITED AREA | Nuclear Medicine - Diagnostic Procedures | $2,346.17 |
| 2021230 | HC BONE IMAGING, WHOLE BODY | Nuclear Medicine - Diagnostic Procedures | $3,257.84 |
| 2021231 | HC BONE IMAGING, 3 PHASE | Nuclear Medicine - Diagnostic Procedures | $4,495.52 |
| 2021238 | HC HEART IMAGE (3D), SINGLE | Nuclear Medicine - Diagnostic Procedures | $4,598.16 |
| 2021239 | HC HEART IMAGE (3D), MULTIPLE | Nuclear Medicine - Diagnostic Procedures | $5,540.01 |
| 2021240 | HC HEART INFARCT IMAGE (3D) | Nuclear Medicine - Diagnostic Procedures | $1,510.16 |
| 2021241 | HC GATED HEART, PLANAR, SINGLE | Nuclear Medicine - Diagnostic Procedures | $2,789.33 |
| 2021242 | HC GATED HEART, MULTIPLE | Nuclear Medicine - Diagnostic Procedures | $3,486.05 |
| 2021246 | HC LUNG PERFUSION IMAGING | Nuclear Medicine - Diagnostic Procedures | $2,276.14 |
| 2021253 | HC BRAIN IMAGE W/FLOW 4 + VIEWS | Nuclear Medicine - Diagnostic Procedures | $5,024.41 |
| 2021255 | HC CEREBSP FLU FLO IMG X INTRO MATRL CISTRNG | Nuclear Medicine - Diagnostic Procedures | $3,143.12 |
| 2021256 | HC CSF SHUNT EVALUATION | Nuclear Medicine - Diagnostic Procedures | $3,556.09 |
| 2021260 | HC K FLOW/FUNCT IMAGE W/O DRUG | Nuclear Medicine - Diagnostic Procedures | $3,007.88 |
| 2021261 | HC K FLOW/FUNCT IMAGE W/DRUG | Nuclear Medicine - Diagnostic Procedures | $2,255.61 |
| 2021262 | HC K FLOW/FUNCT IMAGE, MULTIPLE | Nuclear Medicine - Diagnostic Procedures | $4,699.59 |
| 2021264 | HC KIDNEY FUNCTION STUDY | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2021265 | HC URINARY BLADDER RETENTION | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2021269 | HC RP LOCLZJ TUM 1 AREA 1 D IMG | Nuclear Medicine - Diagnostic Procedures | $2,206.10 |
| 2021270 | HC RP LOCLZJ TUM 2+AREA 1+D IMG | Nuclear Medicine - Diagnostic Procedures | $3,022.37 |
| 2021271 | HC RP LOCLZJ TUM/DSTRBJ AGT WHBDY 1 D IMG | Nuclear Medicine - Diagnostic Procedures | $3,750.50 |
| 2021273 | HC RP LOCLZJ TUM SPECT 1 AREA | Nuclear Medicine - Diagnostic Procedures | $4,623.27 |
| 2021274 | HC RP LOCLZJ TUM/DSTRBJ AGT WHBDY REQ 2/> D IMG | Nuclear Medicine - Diagnostic Procedures | $6,618.31 |
| 2022966 | HC BRAIN VASCULAR FLOW ONLY | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2023109 | HC HEPATOBILIARY SYSTEM IMAGING | Nuclear Medicine - Diagnostic Procedures | $4,456.88 |
| 2023110 | HC HEPATOBIL SYST IMAGE W/DRUG | Nuclear Medicine - Diagnostic Procedures | $6,105.12 |
| 2023113 | HC LUNG VENTILAT&PERFUS IMAGING | Nuclear Medicine - Diagnostic Procedures | $3,205.91 |
| 2023114 | HC LUNG PERFUSION DIFFERENTIAL | Nuclear Medicine - Diagnostic Procedures | $5,141.54 |
| 2023575 | HC LIVER IMAGE; W VASC FLOW | Nuclear Medicine - Diagnostic Procedures | $2,375.15 |
| 2023576 | HC VT VENOGRAM; UNIL | Nuclear Medicine - Diagnostic Procedures | $1,702.58 |
| 2024467 | HC PARATHYRD PLANAR W/WO SUBTRJ | Nuclear Medicine - Diagnostic Procedures | $2,586.47 |
| 2025340 | HC HEART FIRST PASS SINGLE | Nuclear Medicine - Diagnostic Procedures | $1,407.95 |
| 2026034 | HC PARATHYRD PLANAR W/SPECT&CT | Nuclear Medicine - Diagnostic Procedures | $2,832.80 |
| 2026473 | HC MUGA SGL W RV EF BY 1ST PASS | Nuclear Medicine - Diagnostic Procedures | $2,283.88 |
| 2026622 | HC RP LOCLZJ TUM SPECT W/CT 1 | Nuclear Medicine - Diagnostic Procedures | $4,623.27 |
| 2026623 | HC RP LOCLZJ TUM SPECT 2 AREAS | Nuclear Medicine - Diagnostic Procedures | $5,085.60 |
| 2022358 | HC TC99M SESTAMIBI | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $945.00 |
| 2022359 | HC TC99M MEDRONATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $494.04 |
| 2022361 | HC TL201 THALLIUM PER 1 MCI | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $203.11 |
| 2022365 | HC TC99M PERTECHNETATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $11.35 |
| 2022366 | HC IODINE I-123 SOD IODIDE MIC | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $780.57 |
| 2022369 | HC I131 SERUM ALBUMIN, DX | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $819.00 |
| 2022373 | HC TC99M MEBROFENIN | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $420.21 |
| 2022374 | HC TC99M PYROPHOSPHATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $967.68 |
| 2022375 | HC TC99M PENTETATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $2,770.99 |
| 2022377 | HC TC99M FILT SULFUR COLLOID | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $11,740.68 |
| 2022386 | HC TC99M MERTIATIDE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $4,953.31 |
| 2023753 | HC AMYVID FLORBETAPIR F 18 INJ | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $56,485.80 |
| 2026553 | HC TC99M UNFILT SULFUR COLLOID | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $1,153.02 |
| 5020037 | HC TC99M TETROFOSMIN | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $548.10 |
| 5020042 | HC F18 FDG =< 45 MCI | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $1,877.40 |
| 5020046 | HC TECHNETIUM TC-99M AEROSOL | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $3,425.62 |
| 5020053 | HC NEURACEQ RADIOPHARM DX BETA AMYLOID PET | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $35,280.00 |
| 5020058 | HC FLUCICLOVINE F-18 | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $5,351.22 |
| 5020059 | HC GALLIUM GA-68 | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $816.66 |
| 2021279 | HC NUCLEAR RX, ORAL ADMIN | Nuclear Medicine - Therapeutic Procedures | $2,673.41 |
| 2021280 | HC NUCLEAR RX, IV ADMIN | Nuclear Medicine - Therapeutic Procedures | $2,056.37 |
| 2021281 | HC HEMATOPOIETIC NUCLEAR TX | Nuclear Medicine - Therapeutic Procedures | $1,938.04 |
| 2023124 | HC INTRA-ARTERIAL RPHARM RX | Nuclear Medicine - Therapeutic Procedures | $1,347.57 |
| 2023328 | HC HDR RDNCL NTRSTL/ICAV BRCHTX 1 CHAN | Nuclear Medicine - Therapeutic Procedures | $6,078.56 |
| 2023329 | HC HDR RDNCL NTRSTL/ICAV BRCHTX 2-12 CHAN | Nuclear Medicine - Therapeutic Procedures | $6,685.93 |
| 2023620 | HC HDR RDNCL NTRSTL/ICAV BRCHTX 12+ CHAN | Nuclear Medicine - Therapeutic Procedures | $7,294.51 |
| 2022367 | HC I131 IODIDE CAP, RX | Nuclear Medicine - Therapeutic Radiopharmaceuticals | $198.45 |
| 2025134 | HC RADIUM RA223 DICHLORIDE THER PER MICROCURIE | Nuclear Medicine - Therapeutic Radiopharmaceuticals | $1,725.95 |
| 1010022 | HC RB NURSERY/NEWBORN LEVEL I | Nursery - Newborn - Level I | $10,660.50 |
| 1010034 | HC RB NURSERY/NEWBORN LEVEL II | Nursery - Newborn - Level II | $11,311.97 |
| 1010024 | HC RB NURSERY/NEWBORN LEVEL IV | Nursery - Newborn - Level IV | $13,500.00 |
| 2020292 | HC OT APPLICATION OF LONG ARM CAST GO | Occupational Therapy | $297.05 |
| 2022236 | HC OT HOT OR COLD PACKS THERAPY GO | Occupational Therapy | $77.28 |
| 2022242 | HC OT PARAFFIN BATH THERAPY GO | Occupational Therapy | $102.64 |
| 2022255 | HC OT ULTRASOUND THERAPY GO | Occupational Therapy | $140.07 |
| 2022257 | HC OT THERAPEUTIC EXERCISES GO | Occupational Therapy | $397.27 |
| 2022260 | HC THERAPEUTIC EXERCISES | Occupational Therapy | $397.27 |
| 2022262 | HC OT NEUROMUSCULAR REEDUCATION GO | Occupational Therapy | $431.08 |
| 2022264 | HC OT AQUATIC THERAPY/EXERCISES GO | Occupational Therapy | $379.16 |
| 2022271 | HC OT MASSAGE THERAPY EA 15 MINS - GO | Occupational Therapy | $272.90 |
| 2022277 | HC OT MANUAL THERAPY EA 15 MINS - GO | Occupational Therapy | $365.87 |
| 2022278 | HC OT GROUP THERAPEUTIC PROCEDURES GO | Occupational Therapy | $216.14 |
| 2022281 | HC OT THERAPEUTIC ACTIVITIES GO EA 15 MINS | Occupational Therapy | $363.46 |
| 2022291 | HC OT SENSORY INTEGRATION GO EA 15 MINS | Occupational Therapy | $385.19 |
| 2022293 | HC OT SELF CARE MNGMENT TRAINING GO EA 15 MINS | Occupational Therapy | $420.21 |
| 2022296 | HC OT COMMUNITY/WORK REINTEGRATION GO EA 15 MINS | Occupational Therapy | $324.82 |
| 2022299 | HC OT WHEELCHAIR MNGMENT TRAINING GO EA 15 MINS | Occupational Therapy | $276.52 |
| 2022300 | HC WORK HARDENING | Occupational Therapy | $1,100.03 |
| 2022311 | HC OT INI ORTH MGMT/TRAINING GO | Occupational Therapy | $458.85 |
| 2022318 | HC OT C/O FOR ORTHOTIC/PROSTH USE 15 MIN GO | Occupational Therapy | $310.33 |
| 2022421 | HC OT ELEC STIM OTHER THAN WOUND GO | Occupational Therapy | $188.37 |
| 2022913 | HC CANALITH REPOSITIONING PROC GO | Occupational Therapy | $350.18 |
| 2026250 | HC OT GAIT TRAINING THERAPY EA 15 MINS GO | Occupational Therapy | $345.35 |
| 2026592 | HC OT THER IVNTJ COG FUNC 1ST 15 MIN GO | Occupational Therapy | $243.19 |
| 2026593 | HC OT THER IVNTJ COG FUNC EA ADDL 15 MIN GO | Occupational Therapy | $60.80 |
| 2026633 | HC OT OTA WHEELCHAIR MNGMENT TRAINING EA 15 MINS GOCO | Occupational Therapy | $276.52 |
| 2026635 | HC OT OTA THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN GOCO | Occupational Therapy | $363.46 |
| 2026637 | HC OT OTA ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS GOCO | Occupational Therapy | $458.85 |
| 2026643 | HC OT OTA SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES GOCO | Occupational Therapy | $420.21 |
| 2026645 | HC OT OTA NEUROMUSCULAR REEDUCATION EA 15 MINS GOCO | Occupational Therapy | $431.08 |
| 2026647 | HC OT OTA THERAPEUTIC EXERCISES EA 15 MINS GOCO | Occupational Therapy | $397.27 |
| 2026650 | HC OT OTA COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN GOCO | Occupational Therapy | $324.82 |
| 2026653 | HC OT OTA MANUAL THERAPY EA 15 MINS GOCO | Occupational Therapy | $365.87 |
| 2026659 | HC OT OTA MASSAGE THERAPY EA 15 MINS GOCO | Occupational Therapy | $272.90 |
| 2026948 | HC OT HCPRO PHONE CALL 5-10MIN GO | Occupational Therapy | $19.29 |
| 2026951 | HC OT HCPRO PHONE CALL 11-20MIN GO | Occupational Therapy | $38.09 |
| 2026954 | HC OT HCPRO PHONE CALL 21-30MIN GO | Occupational Therapy | $55.00 |
| 2026960 | HC OTA THER IVNTJ COG FUNC 1ST 15 MIN GO CO | Occupational Therapy | $243.19 |
| 2026961 | HC OTA THER IVNTJ COG FUNC EA ADDL 15 MIN GO CO | Occupational Therapy | $60.80 |
| 2022235 | HC OT RE-EVAL EST PLAN CARE GO | Occupational Therapy - Evaluation or Reevaluation | $559.07 |
| 2025788 | HC OT EVAL MOD COMPLEX GO | Occupational Therapy - Evaluation or Reevaluation | $1,351.37 |
| 2025789 | HC OT EVAL HIGH COMPLEX GO | Occupational Therapy - Evaluation or Reevaluation | $1,801.59 |
| 2025793 | HC OT EVAL LOW COMPLEX GO | Occupational Therapy - Evaluation or Reevaluation | $900.80 |
| 2022248 | HC OT ELECTRICAL STIMULATION GO | Occupational Therapy - Visit Charge | $144.90 |
| 2026571 | HC HH SERV OF OT EA 15 MIN | Occupational Therapy - Visit Charge | $420.00 |
| 2026412 | HC REPLACE AORTIC VALVE PERQ | Operating Room Services | $33,900.00 |
| 2026413 | HC REPLACE AORTIC VALVE OPEN | Operating Room Services | $35,595.00 |
| 2026414 | HC REPLACE AORTIC VALVE OPEN AXILLARY | Operating Room Services | $37,375.00 |
| 2026416 | HC REPLACE AORTIC VALVE OPEN TRANS | Operating Room Services | $41,206.00 |
| 2026417 | HC TRCATH REPLACE AORTIC VALVE | Operating Room Services | $43,266.00 |
| 2026421 | HC TRANSCATH TMVR/REPLACE (OTHER CARDIAC SURG PROC) | Operating Room Services | $13,725.00 |
| 2026422 | HC TMVI TRANSTHORACIC EXPOSURE | Operating Room Services | $42,342.00 |
| 2010026 | HC S/P ABLATION | Operating Room Services - Minor Surgery | $11,461.59 |
| 2010027 | HC S/P ANGIOPLASTY | Operating Room Services - Minor Surgery | $9,353.30 |
| 2010028 | HC S/P ASPIRATION | Operating Room Services - Minor Surgery | $6,874.30 |
| 2010030 | HC S/P BILARY PROCEDURE | Operating Room Services - Minor Surgery | $7,915.16 |
| 2010031 | HC S/P BIOPSY | Operating Room Services - Minor Surgery | $8,567.82 |
| 2010032 | HC S/P CATH DECLOTTING PROC | Operating Room Services - Minor Surgery | $3,465.53 |
| 2010033 | HC S/P CATHETER REPOSITIONING | Operating Room Services - Minor Surgery | $1,107.06 |
| 2010034 | HC S/P DESTRUCT BY NEUROLYT AGENT | Operating Room Services - Minor Surgery | $1,817.45 |
| 2010035 | HC S/P DRAINAGE | Operating Room Services - Minor Surgery | $8,051.75 |
| 2010036 | HC S/P EMBOLIZATION | Operating Room Services - Minor Surgery | $30,889.06 |
| 2010037 | HC S/P INJECTION PROCEDURE | Operating Room Services - Minor Surgery | $6,685.93 |
| 2010038 | HC S/P INTRO TO NEEDLE | Operating Room Services - Minor Surgery | $7,541.47 |
| 2010039 | HC S/P KYPHOPLASTY | Operating Room Services - Minor Surgery | $26,379.05 |
| 2010040 | HC S/P OTHER PROCEDURE | Operating Room Services - Minor Surgery | $3,932.83 |
| 2010041 | HC S/P PERIPHERAL ANGIOPLASTY | Operating Room Services - Minor Surgery | $7,790.64 |
| 2010042 | HC S/P SELECTIVE CATH PLACEMENT | Operating Room Services - Minor Surgery | $20,572.18 |
| 2010044 | HC S/P STENT PROCEDURE | Operating Room Services - Minor Surgery | $6,632.80 |
| 2010045 | HC S/P THROMBECTOMY | Operating Room Services - Minor Surgery | $5,563.43 |
| 2010046 | HC S/P TIPS | Operating Room Services - Minor Surgery | $12,320.12 |
| 2010047 | HC S/P TRANSCATH THERAPY/PROC | Operating Room Services - Minor Surgery | $15,686.63 |
| 2010048 | HC S/P TUBE OR CATH PLACEMENT | Operating Room Services - Minor Surgery | $10,337.41 |
| 2010057 | HC S/P PERQ ART M-THROMBECT &/NFS | Operating Room Services - Minor Surgery | $6,425.41 |
| 2020002 | HC FNA BX W/O IMG GDN 1ST LES | Operating Room Services - Minor Surgery | $3,934.04 |
| 2020006 | HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | Operating Room Services - Minor Surgery | $1,226.39 |
| 2020007 | HC INCISION&DRAINAGE ABSCESS COMPLICATED/MULTIPLE | Operating Room Services - Minor Surgery | $2,133.92 |
| 2020008 | HC DRAINAGE OF HEMATOMA/FLUID | Operating Room Services - Minor Surgery | $2,755.52 |
| 2020010 | HC PUNCTURE DRAINAGE OF LESION | Operating Room Services - Minor Surgery | $2,472.36 |
| 2020011 | HC PUNCTURE DRAINAGE OF LESION | Operating Room Services - Minor Surgery | $2,472.36 |
| 2020012 | HC DEBRIDE INFECTED SKIN | Operating Room Services - Minor Surgery | $747.44 |
| 2020016 | HC DEBRIDE SKIN/TISSUE | Operating Room Services - Minor Surgery | $7,482.88 |
| 2020017 | HC DEBRIDE TISSUE/MUSCLE | Operating Room Services - Minor Surgery | $19,187.18 |
| 2020019 | HC DEBRIDE TISSUE/MUSCLE/BONE | Operating Room Services - Minor Surgery | $28,588.77 |
| 2020020 | HC TRIM SKIN LESION | Operating Room Services - Minor Surgery | $1,543.25 |
| 2020021 | HC TRIM SKIN LESIONS, 2 TO 4 | Operating Room Services - Minor Surgery | $2,175.73 |
| 2020022 | HC TRIM SKIN LESIONS, OVER 4 | Operating Room Services - Minor Surgery | $2,839.58 |
| 2020025 | HC REMOVAL OF SKIN TAGS | Operating Room Services - Minor Surgery | $603.75 |
| 2020029 | HC SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/< | Operating Room Services - Minor Surgery | $307.45 |
| 2020030 | HC SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM | Operating Room Services - Minor Surgery | $413.47 |
| 2020033 | HC EXC TR-EXT B9+MARG 0.5 < CM | Operating Room Services - Minor Surgery | $1,447.79 |
| 2020034 | HC EXC TR-EXT B9+MARG 0.6-1 CM | Operating Room Services - Minor Surgery | $3,401.53 |
| 2020035 | HC EXC TR-EXT B9+MARG 1.1-2 CM | Operating Room Services - Minor Surgery | $3,738.42 |
| 2020036 | HC EXC TR-EXT B9+MARG 2.1-3 CM | Operating Room Services - Minor Surgery | $4,822.76 |
| 2020037 | HC EXC TR-EXT B9+MARG 3.1-4 CM | Operating Room Services - Minor Surgery | $5,308.17 |
| 2020038 | HC EXC TR-EXT B9+MARG > 4.0 CM | Operating Room Services - Minor Surgery | $8,074.55 |
| 2020039 | HC EXC H-F-NK-SP B9+MARG 0.5 < | Operating Room Services - Minor Surgery | $3,499.34 |
| 2020040 | HC EXC H-F-NK-SP B9+MARG 0.6-1 | Operating Room Services - Minor Surgery | $4,086.18 |
| 2020042 | HC EXC H-F-NK-SP B9+MARG 2.1-3 | Operating Room Services - Minor Surgery | $5,802.37 |
| 2020044 | HC EXC H-F-NK-SP B9+MARG > 4 CM | Operating Room Services - Minor Surgery | $10,092.86 |
| 2020045 | HC EXC FACE-MM B9+MARG 0.5 < CM | Operating Room Services - Minor Surgery | $2,718.08 |
| 2020046 | HC EXC FACE-MM B9+MARG 0.6-1 CM | Operating Room Services - Minor Surgery | $2,904.04 |
| 2020047 | HC EXC FACE-MM B9+MARG 1.1-2 CM | Operating Room Services - Minor Surgery | $3,217.99 |
| 2020051 | HC EXC TR-EXT MLG+MARG 0.5 < CM | Operating Room Services - Minor Surgery | $4,307.15 |
| 2020052 | HC EXC TR-EXT MLG+MARG 0.6-1 CM | Operating Room Services - Minor Surgery | $5,368.55 |
| 2020053 | HC EXC TR-EXT MLG+MARG 1.1-2 CM | Operating Room Services - Minor Surgery | $5,899.85 |
| 2020056 | HC EXC H-F-NK-SP MLG+MARG 1.1-2 | Operating Room Services - Minor Surgery | $1,403.12 |
| 2020059 | HC EXC FACE-MM MALIG+MARG 1.1-2 | Operating Room Services - Minor Surgery | $2,083.37 |
| 2020061 | HC TRIM NAIL(S) | Operating Room Services - Minor Surgery | $208.90 |
| 2020062 | HC DEBRIDE NAIL, 1-5 | Operating Room Services - Minor Surgery | $613.68 |
| 2020063 | HC DEBRIDE NAIL, 6 OR MORE | Operating Room Services - Minor Surgery | $1,040.14 |
| 2020064 | HC REMOVAL OF NAIL PLATE | Operating Room Services - Minor Surgery | $1,477.98 |
| 2020066 | HC DRAIN BLOOD FROM UNDER NAIL | Operating Room Services - Minor Surgery | $265.65 |
| 2020067 | HC REMOVAL OF NAIL BED | Operating Room Services - Minor Surgery | $1,404.32 |
| 2020068 | HC BIOPSY, NAIL UNIT | Operating Room Services - Minor Surgery | $1,912.68 |
| 2020069 | HC EXCISION OF NAIL FOLD, TOE | Operating Room Services - Minor Surgery | $757.10 |
| 2020070 | HC INJECTION INTO SKIN LESIONS | Operating Room Services - Minor Surgery | $2,721.32 |
| 2020071 | HC ADDED SKIN LESIONS INJECTION | Operating Room Services - Minor Surgery | $3,991.27 |
| 2020074 | HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< | Operating Room Services - Minor Surgery | $1,496.09 |
| 2020075 | HC SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM | Operating Room Services - Minor Surgery | $1,989.96 |
| 2020076 | HC SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM | Operating Room Services - Minor Surgery | $2,483.83 |
| 2020077 | HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | Operating Room Services - Minor Surgery | $784.88 |
| 2020078 | HC SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM | Operating Room Services - Minor Surgery | $887.51 |
| 2020079 | HC CLOSURE OF SPLIT WOUND | Operating Room Services - Minor Surgery | $697.94 |
| 2020080 | HC INTMD WND REPAIR S/TR/EXT | Operating Room Services - Minor Surgery | $2,681.86 |
| 2020081 | HC INTMD WND REPAIR S/TR/EXT | Operating Room Services - Minor Surgery | $3,406.36 |
| 2020082 | HC INTMD WND REPAIR S/TR/EXT | Operating Room Services - Minor Surgery | $3,620.09 |
| 2020083 | HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/< | Operating Room Services - Minor Surgery | $1,800.00 |
| 2020084 | HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM | Operating Room Services - Minor Surgery | $2,400.00 |
| 2020085 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.5 CM/< | Operating Room Services - Minor Surgery | $2,450.02 |
| 2020086 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.6-5.0 CM | Operating Room Services - Minor Surgery | $2,916.11 |
| 2020087 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 5.1-7.5 CM | Operating Room Services - Minor Surgery | $3,111.73 |
| 2020088 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 12.6-20.0CM | Operating Room Services - Minor Surgery | $4,311.98 |
| 2020089 | HC REPAIR COMPLEX TRUNK 1.1 CM-2.5 CM | Operating Room Services - Minor Surgery | $2,011.66 |
| 2020090 | HC REPAIR COMPLEX TRUNK 2.6 CM-7.5 CM | Operating Room Services - Minor Surgery | $2,082.94 |
| 2020091 | HC REPAIR WOUND/LESION ADD-ON | Operating Room Services - Minor Surgery | $2,194.03 |
| 2020092 | HC REPAIR COMPLEX SCALP/ARM/LEG 1.1 CM-2.5 CM | Operating Room Services - Minor Surgery | $2,925.77 |
| 2020093 | HC REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5 CM | Operating Room Services - Minor Surgery | $3,288.02 |
| 2020094 | HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1 CM-2.5 CM | Operating Room Services - Minor Surgery | $3,059.81 |
| 2020095 | HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 CM-7.5 CM | Operating Room Services - Minor Surgery | $3,824.15 |
| 2020097 | HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM | Operating Room Services - Minor Surgery | $2,341.34 |
| 2020100 | HC ATT/REARRANGEMENT SCALP/ARM/LEG 10 CM/< | Operating Room Services - Minor Surgery | $4,710.46 |
| 2020102 | HC ATT/REARRANGEMENT F/C/C/M/N/AX/G/H/F 10 CM/< | Operating Room Services - Minor Surgery | $5,221.23 |
| 2020103 | HC ATT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0CM | Operating Room Services - Minor Surgery | $6,422.12 |
| 2020104 | HC ATT/REARGMT E/N/E/L DFCT 10 CM/< | Operating Room Services - Minor Surgery | $5,548.46 |
| 2020105 | HC ATT/REARGMT EYELID/NOSE/EAR/LIP 10.1-30.0 CM | Operating Room Services - Minor Surgery | $6,824.61 |
| 2020106 | HC WOUND PREP, TRK/ARM/LEG | Operating Room Services - Minor Surgery | $4,874.68 |
| 2020123 | HC DESTRUCT PREMALG LESION | Operating Room Services - Minor Surgery | $1,402.95 |
| 2020124 | HC DESTRUCT PREMALG LES, 2-14 | Operating Room Services - Minor Surgery | $140.42 |
| 2020125 | HC DESTROY PREMLG LESIONS 15+ | Operating Room Services - Minor Surgery | $3,675.12 |
| 2020128 | HC DESTRUCT B9 LESION, 1-14 | Operating Room Services - Minor Surgery | $3,045.32 |
| 2020129 | HC DESTRUCT LESION, 15 OR MORE | Operating Room Services - Minor Surgery | $1,186.97 |
| 2020130 | HC CHEMICAL CAUTERY, TISSUE | Operating Room Services - Minor Surgery | $1,292.05 |
| 2020131 | HC DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/< | Operating Room Services - Minor Surgery | $2,325.24 |
| 2020133 | HC DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM | Operating Room Services - Minor Surgery | $2,953.00 |
| 2020134 | HC DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM | Operating Room Services - Minor Surgery | $3,248.30 |
| 2020135 | HC DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM | Operating Room Services - Minor Surgery | $3,484.54 |
| 2020137 | HC DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/< | Operating Room Services - Minor Surgery | $2,325.24 |
| 2020151 | HC NEEDLE BIOPSY, MUSCLE | Operating Room Services - Minor Surgery | $5,041.31 |
| 2020152 | HC BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL | Operating Room Services - Minor Surgery | $8,822.00 |
| 2020153 | HC BIOPSY BONE TROCAR/NEEDLE DEEP | Operating Room Services - Minor Surgery | $7,986.41 |
| 2020154 | HC THER INJECTION, CARP TUNNEL BI | Operating Room Services - Minor Surgery | $1,563.71 |
| 2020155 | HC INJ TENDON SHEATH/LIGAMENT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2020156 | HC INJ TENDON SHEATH/LIGAMENT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2020157 | HC INJ TRIGGER POINT, 1/2 MUSCL | Operating Room Services - Minor Surgery | $3,500.61 |
| 2020158 | HC INJ TRIGGER POINT, 1/2 MUSCL | Operating Room Services - Minor Surgery | $3,500.61 |
| 2020159 | HC INJECT TRIGGER POINTS, =/> 3 | Operating Room Services - Minor Surgery | $3,990.69 |
| 2020161 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,918.53 |
| 2020162 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020163 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020164 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020166 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020167 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020169 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020170 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020171 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020174 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020175 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020176 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020177 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020178 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020179 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020180 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020181 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA RT | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020182 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA LT | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020183 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA BI | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020184 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020185 | HC ASPIRATE/INJ GANGLION CYST | Operating Room Services - Minor Surgery | $388.82 |
| 2020186 | HC ASPIRATE/INJ GANGLION CYST | Operating Room Services - Minor Surgery | $388.82 |
| 2020189 | HC ABLATE, BONE TUMOR(S) PERQ | Operating Room Services - Minor Surgery | $6,420.28 |
| 2020196 | HC INJECTION FOR SHOULDER X-RAY | Operating Room Services - Minor Surgery | $6,388.88 |
| 2020205 | HC TREAT SHOULDER DISLOCATION | Operating Room Services - Minor Surgery | $791.00 |
| 2020206 | HC TREAT SHOULDER DISLOCATION RT | Operating Room Services - Minor Surgery | $6,281.42 |
| 2020207 | HC TREAT SHOULDER DISLOCATION LT | Operating Room Services - Minor Surgery | $6,281.42 |
| 2020208 | HC INJECTION FOR ELBOW X-RAY | Operating Room Services - Minor Surgery | $1,299.27 |
| 2020212 | HC CL TX "NURSEMAID ELBOW" W MANIP | Operating Room Services - Minor Surgery | $751.07 |
| 2020216 | HC INJECTION FOR WRIST X-RAY RT | Operating Room Services - Minor Surgery | $1,615.64 |
| 2020217 | HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ RT | Operating Room Services - Minor Surgery | $2,931.81 |
| 2020218 | HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ LT | Operating Room Services - Minor Surgery | $2,931.81 |
| 2020219 | HC CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ RT | Operating Room Services - Minor Surgery | $4,258.85 |
| 2020220 | HC CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ LT | Operating Room Services - Minor Surgery | $4,258.85 |
| 2020221 | HC CLTX MTCRPL FX 1 W/O MNPJ EA B1 | Operating Room Services - Minor Surgery | $2,319.61 |
| 2020222 | HC CLTX MTCRPL FX 1 W/MNPJ EA B1 | Operating Room Services - Minor Surgery | $2,319.61 |
| 2020259 | HC INJECTION FOR HIP X-RAY | Operating Room Services - Minor Surgery | $1,994.57 |
| 2020264 | HC NJX CNTRST KNE ARTHG/CT/MRI | Operating Room Services - Minor Surgery | $3,494.51 |
| 2020265 | HC TREAT KNEECAP FRACTURE LT | Operating Room Services - Minor Surgery | $2,466.92 |
| 2020269 | HC INCISION OF ACHILLES TENDON BI | Operating Room Services - Minor Surgery | $7,243.79 |
| 2020271 | HC INCISION OF ACHILLES TENDON LT | Operating Room Services - Minor Surgery | $7,243.79 |
| 2020273 | HC CLTX TIBL SHFT FX W/O MNPJ RT | Operating Room Services - Minor Surgery | $2,648.05 |
| 2020280 | HC CLTX DSTL FIBULAR FX LAT MALLS W/MNPJ LT | Operating Room Services - Minor Surgery | $3,033.24 |
| 2020281 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ RT | Operating Room Services - Minor Surgery | $2,517.64 |
| 2020282 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ LT | Operating Room Services - Minor Surgery | $2,517.64 |
| 2020283 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ LT | Operating Room Services - Minor Surgery | $3,531.94 |
| 2020284 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ RT | Operating Room Services - Minor Surgery | $3,531.94 |
| 2020285 | HC REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS | Operating Room Services - Minor Surgery | $3,359.27 |
| 2020286 | HC REMOVAL FOREIGN BODY FOOT DEEP | Operating Room Services - Minor Surgery | $5,418.05 |
| 2020287 | HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION | Operating Room Services - Minor Surgery | $1,903.39 |
| 2020294 | HC APPLICATION OF LONG ARM CAST LT | Operating Room Services - Minor Surgery | $297.05 |
| 2020295 | HC APPLICATION OF LONG ARM CAST RT | Operating Room Services - Minor Surgery | $297.05 |
| 2020299 | HC APPLICATION OF FOREARM CAST LT | Operating Room Services - Minor Surgery | $357.54 |
| 2020300 | HC APPLICATION OF FOREARM CAST RT | Operating Room Services - Minor Surgery | $357.54 |
| 2020303 | HC APPLY LONG ARM SPLINT RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020304 | HC APPLY LONG ARM SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020307 | HC APPLY FOREARM SPLINT BI | Operating Room Services - Minor Surgery | $340.52 |
| 2020308 | HC APPLY FOREARM SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020309 | HC APPLY FOREARM SPLINT RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020312 | HC APPLICATION FINGER SPLINT STATIC | Operating Room Services - Minor Surgery | $340.52 |
| 2020313 | HC APPLICATION FINGER SPLINT STATIC F2 | Operating Room Services - Minor Surgery | $340.52 |
| 2020314 | HC APPLICATION FINGER SPLINT STATIC F3 | Operating Room Services - Minor Surgery | $340.52 |
| 2020315 | HC APPLICATION FINGER SPLINT STATIC F4 | Operating Room Services - Minor Surgery | $340.52 |
| 2020316 | HC APPLICATION FINGER SPLINT STATIC FA | Operating Room Services - Minor Surgery | $340.52 |
| 2020317 | HC APPLICATION FINGER SPLINT STATIC F6 | Operating Room Services - Minor Surgery | $340.52 |
| 2020318 | HC APPLICATION FINGER SPLINT STATIC F7 | Operating Room Services - Minor Surgery | $340.52 |
| 2020320 | HC APPLICATION FINGER SPLINT STATIC F9 | Operating Room Services - Minor Surgery | $340.52 |
| 2020321 | HC APPLICATION FINGER SPLINT STATIC F5 | Operating Room Services - Minor Surgery | $340.52 |
| 2020324 | HC APPLICATION FINGER SPLINT DYNAMIC F1 | Operating Room Services - Minor Surgery | $398.48 |
| 2020325 | HC APPLICATION FINGER SPLINT DYNAMIC F2 | Operating Room Services - Minor Surgery | $398.48 |
| 2020326 | HC APPLICATION FINGER SPLINT DYNAMIC F3 | Operating Room Services - Minor Surgery | $398.48 |
| 2020328 | HC APPLICATION FINGER SPLINT DYNAMIC F7 | Operating Room Services - Minor Surgery | $398.48 |
| 2020329 | HC APPLICATION FINGER SPLINT DYNAMIC F9 | Operating Room Services - Minor Surgery | $398.48 |
| 2020332 | HC STRAPPING OF SHOULDER | Operating Room Services - Minor Surgery | $340.52 |
| 2020336 | HC STRAPPING OF HAND OR FINGER F1 | Operating Room Services - Minor Surgery | $340.52 |
| 2020346 | HC APPLICATION OF LONG LEG CAST BI | Operating Room Services - Minor Surgery | $821.10 |
| 2020347 | HC APPLICATION OF LONG LEG CAST LT | Operating Room Services - Minor Surgery | $821.10 |
| 2020348 | HC APPLICATION OF LONG LEG CAST RT | Operating Room Services - Minor Surgery | $821.10 |
| 2020350 | HC APPLICATION OF LONG LEG CAST LT | Operating Room Services - Minor Surgery | $870.61 |
| 2020351 | HC APPLICATION OF LONG LEG CAST RT | Operating Room Services - Minor Surgery | $870.61 |
| 2020354 | HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE BI | Operating Room Services - Minor Surgery | $598.92 |
| 2020355 | HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE LT | Operating Room Services - Minor Surgery | $598.92 |
| 2020356 | HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE RT | Operating Room Services - Minor Surgery | $598.92 |
| 2020359 | HC APPLICATION SHORT LEG CAST WALKING/AMBULATORY LT | Operating Room Services - Minor Surgery | $565.11 |
| 2020360 | HC APPLICATION SHORT LEG CAST WALKING/AMBULATORY RT | Operating Room Services - Minor Surgery | $565.11 |
| 2020364 | HC APPLY RIGID LEG CAST RT | Operating Room Services - Minor Surgery | $716.10 |
| 2020365 | HC APPLY RIGID LEG CAST LT | Operating Room Services - Minor Surgery | $716.10 |
| 2020366 | HC APPLICATION OF LEG CAST BI | Operating Room Services - Minor Surgery | $565.11 |
| 2020367 | HC APPLICATION OF LEG CAST RT | Operating Room Services - Minor Surgery | $565.11 |
| 2020368 | HC APPLICATION OF LEG CAST LT | Operating Room Services - Minor Surgery | $565.11 |
| 2020369 | HC APPLICATION, LONG LEG SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020374 | HC APPLICATION LOWER LEG SPLINT RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020375 | HC APPLICATION LOWER LEG SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020378 | HC STRAPPING OF KNEE | Operating Room Services - Minor Surgery | $340.52 |
| 2020379 | HC STRAPPING OF ANKLE AND/OR FT | Operating Room Services - Minor Surgery | $340.52 |
| 2020380 | HC STRAPPING OF TOES | Operating Room Services - Minor Surgery | $227.01 |
| 2020381 | HC APPLICATION OF PASTE BOOT BI | Operating Room Services - Minor Surgery | $800.78 |
| 2020382 | HC APPLICATION OF PASTE BOOT RT | Operating Room Services - Minor Surgery | $800.78 |
| 2020383 | HC APPLICATION OF PASTE BOOT LT | Operating Room Services - Minor Surgery | $800.78 |
| 2020384 | HC APPLICATION OF PASTE BOOT | Operating Room Services - Minor Surgery | $800.78 |
| 2020386 | HC REMOVAL/REVISION OF CAST BI | Operating Room Services - Minor Surgery | $340.52 |
| 2020387 | HC REMOVAL/REVISION OF CAST RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020388 | HC REMOVAL/REVISION OF CAST LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020391 | HC INSERT EMERGENCY AIRWAY | Operating Room Services - Minor Surgery | $1,096.41 |
| 2020392 | HC LARYNGOSCOPY FLEXIBLE DIAGNOSTIC | Operating Room Services - Minor Surgery | $8,186.85 |
| 2020395 | HC IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ | Operating Room Services - Minor Surgery | $4,349.42 |
| 2020396 | HC BIOPSY, LUNG OR MEDIASTINUM | Operating Room Services - Minor Surgery | $1,497.09 |
| 2020448 | HC ESTABLISH ACCESS TO ARTERY | Operating Room Services - Minor Surgery | $1,442.50 |
| 2020451 | HC PLACE CATHETER IN AORTA | Operating Room Services - Minor Surgery | $2,154.15 |
| 2020460 | HC PLACE CATHETER IN ARTERY LT | Operating Room Services - Minor Surgery | $5,618.98 |
| 2020463 | HC PLACE CATHETER IN ARTERY RT | Operating Room Services - Minor Surgery | $9,414.02 |
| 2020465 | HC SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH | Operating Room Services - Minor Surgery | $11,202.12 |
| 2020469 | HC NON-ROUTINE BL DRAW > 3 YRS | Operating Room Services - Minor Surgery | $76.07 |
| 2020476 | HC APHERESIS WBC | Operating Room Services - Minor Surgery | $3,762.57 |
| 2020477 | HC APHERESIS RBC | Operating Room Services - Minor Surgery | $3,725.14 |
| 2020479 | HC APHERESIS PLASMA | Operating Room Services - Minor Surgery | $3,725.14 |
| 2020480 | HC APHERESIS, SELECTIVE | Operating Room Services - Minor Surgery | $13,189.52 |
| 2020481 | HC PHOTOPHERESIS | Operating Room Services - Minor Surgery | $10,871.12 |
| 2020483 | HC INSJ NON-TUN CTR CVC AGE 5 YR/> | Operating Room Services - Minor Surgery | $3,284.35 |
| 2020486 | HC INSJ TUN CTR CTR VAD W/SUBQ PORT AGE 5 YR/> | Operating Room Services - Minor Surgery | $3,366.51 |
| 2020487 | HC INSJ PICC 5 YR+ W/O IMAGING | Operating Room Services - Minor Surgery | $7,000.00 |
| 2020489 | HC REPLACE CVAD CATH | Operating Room Services - Minor Surgery | $1,229.97 |
| 2020491 | HC COMPL RPLCMT PICC RS&I | Operating Room Services - Minor Surgery | $6,343.00 |
| 2020492 | HC RMVL TUN CVC W/O SUBQ PORT/PMP | Operating Room Services - Minor Surgery | $1,142.30 |
| 2020493 | HC RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ | Operating Room Services - Minor Surgery | $2,078.98 |
| 2020495 | HC DECLOT VASCULAR DEVICE | Operating Room Services - Minor Surgery | $499.91 |
| 2020500 | HC TRANSCATHETER RETRIEVAL | Operating Room Services - Minor Surgery | $4,587.34 |
| 2020509 | HC INTRVASC US NONCORONARY 1ST | Operating Room Services - Minor Surgery | $7,628.99 |
| 2020513 | HC DIAG BONE ASPIRATION | Operating Room Services - Minor Surgery | $6,360.61 |
| 2020514 | HC DIAG BONE BIOPSY | Operating Room Services - Minor Surgery | $6,241.45 |
| 2020516 | HC NEEDLE BIOPSY, LYMPH NODES | Operating Room Services - Minor Surgery | $1,497.09 |
| 2020518 | HC IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ | Operating Room Services - Minor Surgery | $4,210.55 |
| 2020520 | HC NEEDLE BIOPSY OF LIVER | Operating Room Services - Minor Surgery | $1,497.09 |
| 2020532 | HC BIOPSY, ABDOMINAL MASS | Operating Room Services - Minor Surgery | $3,789.14 |
| 2020534 | HC PLACE GASTROSTOMY TUBE PERC | Operating Room Services - Minor Surgery | $3,925.99 |
| 2020536 | HC BIOPSY OF KIDNEY | Operating Room Services - Minor Surgery | $7,856.00 |
| 2020538 | HC INJECTION FOR BLADDER X-RAY | Operating Room Services - Minor Surgery | $4,994.22 |
| 2020539 | HC INSERT TEMP BLADDER CATH | Operating Room Services - Minor Surgery | $679.82 |
| 2020545 | HC BIOPSY OF VULVA/PERINEUM | Operating Room Services - Minor Surgery | $5,094.44 |
| 2020547 | HC BIOPSY OF VAGINA | Operating Room Services - Minor Surgery | $4,491.90 |
| 2020548 | HC EXAM OF CERVIX W/SCOPE | Operating Room Services - Minor Surgery | $2,203.69 |
| 2020549 | HC BX/CURETT OF CERVIX W/SCOPE | Operating Room Services - Minor Surgery | $3,401.70 |
| 2020550 | HC ENDOCERV CURETTAGE W/SCOPE | Operating Room Services - Minor Surgery | $1,250.97 |
| 2020553 | HC BIOPSY OF UTERUS LINING | Operating Room Services - Minor Surgery | $3,815.79 |
| 2020558 | HC REMOVE CERCLAGE SUTURE | Operating Room Services - Minor Surgery | $7,881.35 |
| 2020559 | HC OMMAYA RESERVOIR W/OUT CHEMO | Operating Room Services - Minor Surgery | $7,874.90 |
| 2020560 | HC SPI PNXR LMBR DX | Operating Room Services - Minor Surgery | $5,987.31 |
| 2020561 | HC SPI PNXR LMBR DX | Operating Room Services - Minor Surgery | $5,987.31 |
| 2020562 | HC THER SPI PNXR DRG CSF | Operating Room Services - Minor Surgery | $3,460.59 |
| 2020563 | HC INJECT EPIDURAL PATCH | Operating Room Services - Minor Surgery | $4,155.01 |
| 2020567 | HC NJX INTERLAMINAR CRV/THRC | Operating Room Services - Minor Surgery | $6,941.65 |
| 2020568 | HC NJX INTERLAMINAR LMBR/SAC W/O IMG GDN | Operating Room Services - Minor Surgery | $6,630.66 |
| 2020570 | HC ELEC ALYS PRGRBL PMP W/O REPRGRMG | Operating Room Services - Minor Surgery | $5,656.81 |
| 2020571 | HC ELEC ALYS PRGRBL PMP REPRGRMG | Operating Room Services - Minor Surgery | $7,749.05 |
| 2020572 | HC IMPLANT NEUROELECTRODES | Operating Room Services - Minor Surgery | $40,739.36 |
| 2020574 | HC NJX AA&/STRD OTHER PN/BRANCH | Operating Room Services - Minor Surgery | $8,351.07 |
| 2020575 | HC INJ PARAVERTEBRAL C/T | Operating Room Services - Minor Surgery | $11,760.87 |
| 2020576 | HC INJ PARAVERTEBRAL C/T ADD-ON | Operating Room Services - Minor Surgery | $14,112.32 |
| 2020577 | HC INJ PARAVERTEBRAL L/S | Operating Room Services - Minor Surgery | $16,053.59 |
| 2020578 | HC INJ PARAVERTEBRAL L/S ADD-ON | Operating Room Services - Minor Surgery | $9,508.25 |
| 2020579 | HC INJ FORAMEN EPIDURAL C/T | Operating Room Services - Minor Surgery | $15,086.51 |
| 2020580 | HC INJ FORAMEN EPIDURAL ADD-ON | Operating Room Services - Minor Surgery | $2,628.73 |
| 2020581 | HC INJ FORAMEN EPIDURAL L/S | Operating Room Services - Minor Surgery | $4,410.00 |
| 2020582 | HC INJ FORAMEN EPIDURAL ADD-ON | Operating Room Services - Minor Surgery | $5,556.60 |
| 2020583 | HC N BLOCK, STELLATE GANGLION | Operating Room Services - Minor Surgery | $2,187.99 |
| 2020584 | HC CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA | Operating Room Services - Minor Surgery | $915.29 |
| 2020591 | HC INJECTION TREATMENT OF NERVE RT | Operating Room Services - Minor Surgery | $3,155.20 |
| 2020592 | HC LASER SURGERY OF EYE RT | Operating Room Services - Minor Surgery | $5,879.32 |
| 2020593 | HC LASER SURGERY OF EYE LT | Operating Room Services - Minor Surgery | $5,879.32 |
| 2020601 | HC REVISION OF IRIS RT | Operating Room Services - Minor Surgery | $9,937.73 |
| 2020602 | HC REVISION OF IRIS LT | Operating Room Services - Minor Surgery | $9,937.73 |
| 2020607 | HC AFTER CATARACT LASER SURGERY RT | Operating Room Services - Minor Surgery | $3,268.70 |
| 2020608 | HC AFTER CATARACT LASER SURGERY LT | Operating Room Services - Minor Surgery | $3,268.70 |
| 2020617 | HC REPAIR DETACHED RETINA RT | Operating Room Services - Minor Surgery | $5,378.21 |
| 2020618 | HC REPAIR DETACHED RETINA LT | Operating Room Services - Minor Surgery | $5,378.21 |
| 2020620 | HC TREATMENT OF RETINA RT | Operating Room Services - Minor Surgery | $4,164.67 |
| 2020626 | HC EXTENSIVE RETINOPATHY 1+ SESS PHOTOCOAGULATION RT | Operating Room Services - Minor Surgery | $7,921.20 |
| 2020627 | HC EXTENSIVE RETINOPATHY 1+ SESS PHOTOCOAGULATION LT | Operating Room Services - Minor Surgery | $7,921.20 |
| 2022601 | HC SFT TISS BX - NECK/THORAX | Operating Room Services - Minor Surgery | $4,742.00 |
| 2022619 | HC BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL | Operating Room Services - Minor Surgery | $1,662.90 |
| 2022628 | HC BX THYR PRQ CORE NDL | Operating Room Services - Minor Surgery | $1,043.28 |
| 2022690 | HC CL TX RADIAL & ULNA FX | Operating Room Services - Minor Surgery | $3,694.95 |
| 2022693 | HC BRONCOSCOPY THERAPEUTIC | Operating Room Services - Minor Surgery | $1,500.63 |
| 2022695 | HC NON-ROUTINE BL DRAW 3/> YRS | Operating Room Services - Minor Surgery | $76.07 |
| 2022697 | HC FEM/POPL REVAS W/TLA | Operating Room Services - Minor Surgery | $13,138.68 |
| 2022698 | HC FEM/POPL REVAS W/TLA | Operating Room Services - Minor Surgery | $13,771.54 |
| 2022700 | HC FEM/POPL REVAS STN ATHER | Operating Room Services - Minor Surgery | $23,356.67 |
| 2022701 | HC TIB/PER REVASC W/ATHER | Operating Room Services - Minor Surgery | $13,734.11 |
| 2022702 | HC TIB/PER REVASC W/STENT | Operating Room Services - Minor Surgery | $13,734.11 |
| 2022704 | HC TIB/PER REVASC ADD-ON | Operating Room Services - Minor Surgery | $6,642.46 |
| 2022706 | HC REVSC OP/PRQ TIBPERO STN | Operating Room Services - Minor Surgery | $19,924.96 |
| 2022710 | HC EXT CEPHALIC VERSION | Operating Room Services - Minor Surgery | $4,733.40 |
| 2022712 | HC NJX AA&/STRD NTRCOST NRV 1 | Operating Room Services - Minor Surgery | $1,311.35 |
| 2022713 | HC INJ PARAVERT F JNT 3 LVL | Operating Room Services - Minor Surgery | $9,508.25 |
| 2022847 | HC INTRVASC US NONCORONARY ADDL | Operating Room Services - Minor Surgery | $6,422.69 |
| 2022893 | HC DEB SUBQ TISSUE ADD<20CM | Operating Room Services - Minor Surgery | $3,261.46 |
| 2022894 | HC DEB MUSC/FASCIA ADD<20CM | Operating Room Services - Minor Surgery | $6,716.12 |
| 2022898 | HC ADT'L NAIL AVLUSION | Operating Room Services - Minor Surgery | $591.68 |
| 2022902 | HC APP MULT COMP LWR LEG RT | Operating Room Services - Minor Surgery | $353.73 |
| 2022903 | HC APP MULT COMP LWR LEG LT | Operating Room Services - Minor Surgery | $353.73 |
| 2022904 | HC APP MULT COMP LWR L BIL | Operating Room Services - Minor Surgery | $353.73 |
| 2022905 | HC APP TTL CONTACT CAST RT | Operating Room Services - Minor Surgery | $716.10 |
| 2022906 | HC APP TTL CONTACT CAST LT | Operating Room Services - Minor Surgery | $716.10 |
| 2022907 | HC APP TTL CONTACT CAST BIL | Operating Room Services - Minor Surgery | $716.10 |
| 2022908 | HC REM BOOT OR BODY CAST | Operating Room Services - Minor Surgery | $297.36 |
| 2022915 | HC REPAIR OF NAIL BED | Operating Room Services - Minor Surgery | $2,172.29 |
| 2022943 | HC REMOVE IMPACTED EAR WAX | Operating Room Services - Minor Surgery | $705.18 |
| 2022946 | HC DX NASAL ENDOSCOPY | Operating Room Services - Minor Surgery | $3,042.90 |
| 2022947 | HC NASAL HEMORRH ANT SMP | Operating Room Services - Minor Surgery | $1,238.90 |
| 2022948 | HC REM FB INTRANASAL OFFICE | Operating Room Services - Minor Surgery | $1,081.92 |
| 2022953 | HC NONSEL CATH PLC IN VEIN | Operating Room Services - Minor Surgery | $92.98 |
| 2022954 | HC INSERT BLADDER CATHETER | Operating Room Services - Minor Surgery | $216.14 |
| 2022965 | HC REM FB AUD CANAL WO ANES | Operating Room Services - Minor Surgery | $719.67 |
| 2022968 | HC CHEMODENERVATION | Operating Room Services - Minor Surgery | $1,017.92 |
| 2022969 | HC CONT NAS HEMORRH ANT COM | Operating Room Services - Minor Surgery | $1,721.90 |
| 2022970 | HC NASAL ENDO W BLD CNTRL | Operating Room Services - Minor Surgery | $1,876.46 |
| 2022971 | HC NAS ENDO W BX POLY/DEBRI | Operating Room Services - Minor Surgery | $1,791.38 |
| 2023006 | HC BIOPSY OF CERVIX | Operating Room Services - Minor Surgery | $6,390.09 |
| 2023008 | HC UNLISTD PROC NERVOUS SYS | Operating Room Services - Minor Surgery | $5,192.25 |
| 2023083 | HC INJ PARAVERT F JNT C/T 2 LEV | Operating Room Services - Minor Surgery | $12,936.40 |
| 2023087 | HC SKIN SUB GRAFT TRNK/ARM/LEG | Operating Room Services - Minor Surgery | $6,705.25 |
| 2023088 | HC SKIN SUB GRAFT T/A/L ADD-ON | Operating Room Services - Minor Surgery | $402.10 |
| 2023091 | HC SKIN SUB GRAFT FACE/NK/HF/G | Operating Room Services - Minor Surgery | $2,011.70 |
| 2023092 | HC SKIN SUB GRAFT F/N/HF/G ADDL | Operating Room Services - Minor Surgery | $536.13 |
| 2023100 | HC INS ENDOVAS VENA CAVA FILTR | Operating Room Services - Minor Surgery | $29,799.89 |
| 2023101 | HC ABD PARACENTESIS | Operating Room Services - Minor Surgery | $4,887.96 |
| 2023102 | HC ABD PARACENTESIS W/IMAGING | Operating Room Services - Minor Surgery | $7,083.20 |
| 2023103 | HC PERITONEAL LAVAGE | Operating Room Services - Minor Surgery | $952.14 |
| 2023104 | HC DESTROY CERV/THOR FACET JNT | Operating Room Services - Minor Surgery | $4,546.27 |
| 2023105 | HC DESTROY C/TH FACET JNT ADDL | Operating Room Services - Minor Surgery | $1,285.63 |
| 2023106 | HC DESTROY LUMB/SAC FACET JNT | Operating Room Services - Minor Surgery | $4,816.09 |
| 2023107 | HC DESTROY L/S FACET JNT ADDL | Operating Room Services - Minor Surgery | $1,238.60 |
| 2023138 | HC INJ TENDON ORIGIN/INSERT | Operating Room Services - Minor Surgery | $3,030.83 |
| 2023141 | HC NJX AA&/STRD GR OCPL NRV | Operating Room Services - Minor Surgery | $1,092.79 |
| 2023143 | HC INJ DUPUYTREN CORD W/ENZYME | Operating Room Services - Minor Surgery | $484.21 |
| 2023145 | HC I&D CPLX POSTOP WND INF | Operating Room Services - Minor Surgery | $6,752.34 |
| 2023146 | HC DEB SKIN BONE AT FX SITE | Operating Room Services - Minor Surgery | $3,408.77 |
| 2023147 | HC CARPAL TUNNEL TX INJ | Operating Room Services - Minor Surgery | $1,563.71 |
| 2023148 | HC REMOVAL OF SUPPORT IMPLANT | Operating Room Services - Minor Surgery | $2,016.04 |
| 2023159 | HC CL TX SCAPULAR FX; W MANIP | Operating Room Services - Minor Surgery | $3,131.82 |
| 2023162 | HC CL TX HUMERUS FX WO MANIP | Operating Room Services - Minor Surgery | $2,709.63 |
| 2023163 | HC CL TX HUMERUS FX W MANIP | Operating Room Services - Minor Surgery | $9,761.43 |
| 2023167 | HC CL TX RADIAL HD/NECK FX; WO MANIP | Operating Room Services - Minor Surgery | $9,960.67 |
| 2023170 | HC CL TX ULNAR SHAFT FX; WO MANIP | Operating Room Services - Minor Surgery | $1,980.30 |
| 2023171 | HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP | Operating Room Services - Minor Surgery | $2,098.64 |
| 2023172 | HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP | Operating Room Services - Minor Surgery | $2,931.81 |
| 2023173 | HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP | Operating Room Services - Minor Surgery | $4,258.85 |
| 2023174 | HC CL TX CARPAL SCAPHOID FX; WO MANIP | Operating Room Services - Minor Surgery | $2,315.99 |
| 2023175 | HC CL TX PHAL SHAFT FX; WO MANIP | Operating Room Services - Minor Surgery | $1,534.28 |
| 2023176 | HC CL TX PHALANG SHFT FX; W MANIP | Operating Room Services - Minor Surgery | $2,515.22 |
| 2023177 | HC CL TX ART FX MCP/IP JNT; WO MAN | Operating Room Services - Minor Surgery | $1,787.10 |
| 2023178 | HC CL TX D PHAL FX FGR/THMB; WO MANIP | Operating Room Services - Minor Surgery | $1,741.22 |
| 2023179 | HC CL TX D PHAL FX FGRR/THMB; W MANIP | Operating Room Services - Minor Surgery | $2,576.81 |
| 2023183 | HC CL TX PROX TIBIAL FX WO MANIP | Operating Room Services - Minor Surgery | $2,349.80 |
| 2023184 | HC CL TX TIB SHFT FX WO MANIP | Operating Room Services - Minor Surgery | $2,648.05 |
| 2023185 | HC CL TX TIB SHFT FX W MANIP | Operating Room Services - Minor Surgery | $4,130.95 |
| 2023186 | HC CL TX DSTL FIB FX WO MANIP | Operating Room Services - Minor Surgery | $2,393.27 |
| 2023187 | HC CL TX DISTL FIB FX W MANIP | Operating Room Services - Minor Surgery | $3,033.24 |
| 2023188 | HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP | Operating Room Services - Minor Surgery | $2,517.64 |
| 2023189 | HC CLTX BIMALLEOLAR ANKLE FRACT W MNP | Operating Room Services - Minor Surgery | $3,531.94 |
| 2023192 | HC TX TARSAL BONE FX ; WO MANIPU | Operating Room Services - Minor Surgery | $1,608.39 |
| 2023194 | HC APPLY LONG ARM CAST | Operating Room Services - Minor Surgery | $297.05 |
| 2023195 | HC APPLY SHORT ARM CAST | Operating Room Services - Minor Surgery | $357.54 |
| 2023197 | HC APPLY FINGER CAST | Operating Room Services - Minor Surgery | $227.01 |
| 2023198 | HC APPLY LONG ARM SPLINT | Operating Room Services - Minor Surgery | $340.52 |
| 2023199 | HC APPLY SHORT ARM SPLINT; STATIC | Operating Room Services - Minor Surgery | $340.52 |
| 2023200 | HC APPLY SHORT ARM SPLINT; DYNAMIC | Operating Room Services - Minor Surgery | $422.63 |
| 2023201 | HC APPLY FINGER SPLINT; DYNAMIC | Operating Room Services - Minor Surgery | $398.48 |
| 2023202 | HC STRAPPING; ELBOW OR WRIST | Operating Room Services - Minor Surgery | $340.52 |
| 2023203 | HC STRAPPING; HAND OR FINGER | Operating Room Services - Minor Surgery | $340.52 |
| 2023204 | HC APPLY LONG LEG CAST | Operating Room Services - Minor Surgery | $821.10 |
| 2023206 | HC APPLY SH LEG CAST | Operating Room Services - Minor Surgery | $598.92 |
| 2023208 | HC APPLY LONG LEG SPLINT | Operating Room Services - Minor Surgery | $340.52 |
| 2023209 | HC APPLY SHORT LEG SPLINT | Operating Room Services - Minor Surgery | $340.52 |
| 2023211 | HC WEDGING OF CAST NOT CLUBFOOT CAST | Operating Room Services - Minor Surgery | $297.36 |
| 2023216 | HC CYSTO W MULTI OBSTR CLOT REM | Operating Room Services - Minor Surgery | $2,802.45 |
| 2023218 | HC NJX AA&/STRD NTRCOST NRV EA | Operating Room Services - Minor Surgery | $1,772.61 |
| 2023219 | HC INJ ANESTH; LUMB/THOR (SYMPATHETIC) | Operating Room Services - Minor Surgery | $1,772.61 |
| 2023221 | HC DESTR W NEUROLYTIC; OTHER PERIPH NRV | Operating Room Services - Minor Surgery | $3,155.20 |
| 2023240 | HC NJX PLATELET PLASMA | Operating Room Services - Minor Surgery | $2,698.76 |
| 2023294 | HC PUNCTURE ASPIR. CYST OF B | Operating Room Services - Minor Surgery | $1,565.82 |
| 2023303 | HC BIOPSY OF PALETE, UVULA | Operating Room Services - Minor Surgery | $1,467.97 |
| 2023304 | HC BIOPSY, OROPHARYNX | Operating Room Services - Minor Surgery | $2,396.10 |
| 2023305 | HC COLPOSCOPY W/LEEP OF CERVIX | Operating Room Services - Minor Surgery | $7,301.75 |
| 2023306 | HC ENDOCERVICAL CURETTAGE | Operating Room Services - Minor Surgery | $5,696.86 |
| 2023385 | HC DIAGNOSTIC COLONOSCOPY | Operating Room Services - Minor Surgery | $1,762.95 |
| 2023387 | HC COLONOSCOPY AND BIOPSY | Operating Room Services - Minor Surgery | $2,101.05 |
| 2023392 | HC COLONOSCOPY W/LESION REMOVAL | Operating Room Services - Minor Surgery | $2,500.25 |
| 2023394 | HC DIAGNOSTIC ANOSCOPY SPX | Operating Room Services - Minor Surgery | $336.89 |
| 2023396 | HC SCRN COLONOSCOPY PT NOT HI RISK | Operating Room Services - Minor Surgery | $1,762.95 |
| 2023442 | HC AMNIOCENTESIS DIAGNOSTIC | Operating Room Services - Minor Surgery | $908.47 |
| 2023443 | HC AMNIOCENTESIS THERAPEUTIC | Operating Room Services - Minor Surgery | $1,628.92 |
| 2023446 | HC CL TX PROX HUMERAL FX; W MANIP | Operating Room Services - Minor Surgery | $13,064.18 |
| 2023448 | HC ST BX U ARM/ELB; SUPERF | Operating Room Services - Minor Surgery | $4,932.64 |
| 2023450 | HC RX CL ELBOW DISLOC WO ANESTH | Operating Room Services - Minor Surgery | $2,625.11 |
| 2023451 | HC CL TX "NURSEMAID ELBOW" W MANIP | Operating Room Services - Minor Surgery | $751.07 |
| 2023452 | HC WRIST ARTHROGRAPHY INJ | Operating Room Services - Minor Surgery | $1,615.64 |
| 2023456 | HC CL TX POST HIP DISLOC WO ANESTH | Operating Room Services - Minor Surgery | $3,315.80 |
| 2023457 | HC SUPERF SFT TISS BX THIGH/KNEE | Operating Room Services - Minor Surgery | $2,016.04 |
| 2023462 | HC CL TX FX GT PHALANX(S); W MANIP | Operating Room Services - Minor Surgery | $1,269.32 |
| 2023465 | HC APPLY RIGID TOTAL CONTACT LEG CAST | Operating Room Services - Minor Surgery | $716.10 |
| 2023468 | HC OPEN BX OR EXC LN; SUPERFICIAL | Operating Room Services - Minor Surgery | $5,886.56 |
| 2023469 | HC OPEN BX/EXC LN; DEEP CERV NODE(S) | Operating Room Services - Minor Surgery | $3,414.81 |
| 2023470 | HC OPEN BX/EXC LN; AXILLARY NODE(S) | Operating Room Services - Minor Surgery | $3,562.13 |
| 2023472 | HC NJX AA&/STRD II IH NERVES | Operating Room Services - Minor Surgery | $3,042.90 |
| 2023473 | HC NJX AA&/STRD PUDENDAL NERVE | Operating Room Services - Minor Surgery | $2,556.28 |
| 2023474 | HC N BLOCK INJ PLANTAR DIGIT | Operating Room Services - Minor Surgery | $4,143.17 |
| 2023478 | HC REVISION OF IRIS LASER | Operating Room Services - Minor Surgery | $9,937.73 |
| 2023536 | HC SIJ ANESTH/STEROID INJ | Operating Room Services - Minor Surgery | $6,179.99 |
| 2023646 | HC IMPLANT TCAT PULM VLV PERQ | Operating Room Services - Minor Surgery | $19,933.41 |
| 2023668 | HC INCISION&REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | Operating Room Services - Minor Surgery | $4,514.84 |
| 2023676 | HC BIOPSY OF LIP | Operating Room Services - Minor Surgery | $595.30 |
| 2023677 | HC BIOPSY VESTIBULE MOUTH | Operating Room Services - Minor Surgery | $924.95 |
| 2023678 | HC BIOPSY TONGUE ANTERIOR TWO-THIRDS | Operating Room Services - Minor Surgery | $2,344.97 |
| 2023679 | HC BIOPSY TONGUE POSTERIOR ONE-THIRD | Operating Room Services - Minor Surgery | $2,396.10 |
| 2023680 | HC BIOPSY FLOOR MOUTH | Operating Room Services - Minor Surgery | $1,362.90 |
| 2023681 | HC REMOVAL TUNNELED INTRAPERITONEAL CATHETER | Operating Room Services - Minor Surgery | $7,946.56 |
| 2023682 | HC I&D OF BARTHOLINS GLAND ABSCESS | Operating Room Services - Minor Surgery | $712.43 |
| 2023683 | HC BIOPSY VULVA/PERINEUM EACH ADDL LESION | Operating Room Services - Minor Surgery | $2,495.90 |
| 2023684 | HC COLPOSCOPY VULVA | Operating Room Services - Minor Surgery | $695.52 |
| 2023687 | HC COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX | Operating Room Services - Minor Surgery | $1,339.12 |
| 2023688 | HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX | Operating Room Services - Minor Surgery | $4,241.95 |
| 2023692 | HC REMOVAL INTRAUTERINE DEVICE IUD | Operating Room Services - Minor Surgery | $576.88 |
| 2023693 | HC PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST | Operating Room Services - Minor Surgery | $782.91 |
| 2023696 | HC EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESIONS | Operating Room Services - Minor Surgery | $7,381.45 |
| 2023703 | HC EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM/> | Operating Room Services - Minor Surgery | $7,020.41 |
| 2023704 | HC EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM | Operating Room Services - Minor Surgery | $7,788.38 |
| 2023706 | HC EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM/> | Operating Room Services - Minor Surgery | $1,739.86 |
| 2023720 | HC BONE MARROW ASPIRATE & BIOPSY | Operating Room Services - Minor Surgery | $6,704.25 |
| 2023735 | HC I&D OF VULVA OR PERINEAL ABSCESS | Operating Room Services - Minor Surgery | $810.23 |
| 2023738 | HC COLPOSCOPY VULVA W BX | Operating Room Services - Minor Surgery | $932.00 |
| 2023739 | HC COLPOSCOPY OF VAGINA | Operating Room Services - Minor Surgery | $950.30 |
| 2023740 | HC COLPOSCOPY VAGINA W BX | Operating Room Services - Minor Surgery | $1,284.78 |
| 2023760 | HC TRANSABD AMNIOINFUS W US | Operating Room Services - Minor Surgery | $2,565.94 |
| 2023764 | HC FETAL FLUID DRAINAGE W US | Operating Room Services - Minor Surgery | $2,557.49 |
| 2023768 | HC INS CATH ABD/L EXT ART 1ST | Operating Room Services - Minor Surgery | $5,618.98 |
| 2024296 | HC PARTICAL MASTECTOMY | Operating Room Services - Minor Surgery | $5,270.74 |
| 2024297 | HC MAST SIMPLE COMPLETE | Operating Room Services - Minor Surgery | $8,157.87 |
| 2024304 | HC UNLISTED PROCEDURE HUMERUS OR ELBOW | Operating Room Services - Minor Surgery | $2,824.34 |
| 2024307 | HC ASPIRATE PLEURA W/O IMAGING | Operating Room Services - Minor Surgery | $1,846.03 |
| 2024308 | HC ASPIRATE PLEURA W/ IMAGING | Operating Room Services - Minor Surgery | $2,422.90 |
| 2024450 | HC CL TX IP JNT D W MANIP ; WO ANESTH | Operating Room Services - Minor Surgery | $2,014.11 |
| 2024460 | HC CLOSED TX MCP DISLOC SGL W MANIP | Operating Room Services - Minor Surgery | $2,905.25 |
| 2024461 | HC CLOSED TX DSTL RADIOULNAR DISLOC W MANIP | Operating Room Services - Minor Surgery | $3,341.15 |
| 2024464 | HC INSERT CATH PLEURA W/O IMAGE | Operating Room Services - Minor Surgery | $1,721.81 |
| 2024509 | HC INJ PARAVERT F JNT C/T 3 LEV | Operating Room Services - Minor Surgery | $14,112.32 |
| 2024513 | HC ANL SP INF PMP W/MDREPRG&FIL | Operating Room Services - Minor Surgery | $652.05 |
| 2024516 | HC DESTR W NEUROLYTIC; PUDENDA NRV | Operating Room Services - Minor Surgery | $1,689.29 |
| 2024583 | HC CHEMODENERV MUSC MIGRAINE | Operating Room Services - Minor Surgery | $1,050.53 |
| 2024608 | HC CL TX RADIAL SHFT FX W MANIP | Operating Room Services - Minor Surgery | $3,801.21 |
| 2024609 | HC GALEAZZI FX/DISLOC | Operating Room Services - Minor Surgery | $4,417.04 |
| 2024610 | HC REPAIR ELBOW PERC | Operating Room Services - Minor Surgery | $9,331.56 |
| 2024624 | HC CL TX TRIMALL ANKLE FX; W MANIP | Operating Room Services - Minor Surgery | $3,586.28 |
| 2024627 | HC DRAIN FINGER ABSC SIMPLE | Operating Room Services - Minor Surgery | $1,346.36 |
| 2024628 | HC DRAIN FINGER ABSC COMPLICATED | Operating Room Services - Minor Surgery | $1,517.83 |
| 2024630 | HC DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBS | Operating Room Services - Minor Surgery | $444.36 |
| 2024637 | HC FITTING AND INSERTION OF PESSARY OR OTHER INTRAVAGINAL SUPPORT DEVICE | Operating Room Services - Minor Surgery | $429.48 |
| 2024674 | HC DRESS/DEBRID P-THICK BURN M | Operating Room Services - Minor Surgery | $915.38 |
| 2024679 | HC INSERT IUD | Operating Room Services - Minor Surgery | $1,863.34 |
| 2024681 | HC SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM | Operating Room Services - Minor Surgery | $588.40 |
| 2024684 | HC CL TX POSTOP HIP DISLOC W ANESTH | Operating Room Services - Minor Surgery | $8,289.49 |
| 2024685 | HC REM SHOULDER OR HIP SPICA | Operating Room Services - Minor Surgery | $686.15 |
| 2024694 | HC NJX AA&/STRD TRIGEMINAL NRV | Operating Room Services - Minor Surgery | $3,290.44 |
| 2024746 | HC INF BURSA I&D - UA/ELBOW | Operating Room Services - Minor Surgery | $4,378.40 |
| 2024781 | HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE | Operating Room Services - Minor Surgery | $11,003.95 |
| 2024782 | HC BX BREAST W DEVICE ADDL LESION STEREOTACT GUIDE | Operating Room Services - Minor Surgery | $5,391.49 |
| 2024783 | HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | Operating Room Services - Minor Surgery | $11,003.95 |
| 2024784 | HC BX BREAST W DEVICE ADDL LESION ULTRASOUND GUIDE | Operating Room Services - Minor Surgery | $5,171.72 |
| 2024785 | HC BX BREAST W DEVICE 1ST LESION MAGNETIC RES GUIDE | Operating Room Services - Minor Surgery | $11,003.95 |
| 2024786 | HC BX BREAST W DEVICE ADDL LESION MAGNET RES GUIDE | Operating Room Services - Minor Surgery | $4,842.08 |
| 2024787 | HC PERQ DEVICE PLACEMT BREAST LOC 1ST LES W GUIDNCE | Operating Room Services - Minor Surgery | $3,577.11 |
| 2024788 | HC PERQ DEVICE PLACEMT BREAST LOC EA LES W GUIDNCE | Operating Room Services - Minor Surgery | $3,577.11 |
| 2024789 | HC PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GUID | Operating Room Services - Minor Surgery | $3,244.48 |
| 2024790 | HC PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC | Operating Room Services - Minor Surgery | $3,244.48 |
| 2024791 | HC PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG | Operating Room Services - Minor Surgery | $3,645.25 |
| 2024792 | HC PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE | Operating Room Services - Minor Surgery | $3,406.77 |
| 2024793 | HC PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID | Operating Room Services - Minor Surgery | $3,406.77 |
| 2024819 | HC CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE | Operating Room Services - Minor Surgery | $1,668.77 |
| 2024820 | HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE | Operating Room Services - Minor Surgery | $1,135.05 |
| 2024823 | HC CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES | Operating Room Services - Minor Surgery | $1,522.66 |
| 2024824 | HC CHEMODENERV TRUNK MUSC 6/> | Operating Room Services - Minor Surgery | $1,645.82 |
| 2024849 | HC INSERT CERVICAL DILATOR | Operating Room Services - Minor Surgery | $734.16 |
| 2024873 | HC DRAINAGE OF PILONIDAL CYST | Operating Room Services - Minor Surgery | $961.17 |
| 2024874 | HC DEBRIDE SKIN MUSC AT FX SITE | Operating Room Services - Minor Surgery | $2,420.23 |
| 2024875 | HC RPR S/N/A/GEN/TRK12.6-20.0CM | Operating Room Services - Minor Surgery | $3,350.81 |
| 2024876 | HC RPR S/N/A/GEN/TRK20.1-30.0CM | Operating Room Services - Minor Surgery | $967.21 |
| 2024877 | HC RPR F/E/E/N/L/M 5.1-7.5 CM | Operating Room Services - Minor Surgery | $1,114.52 |
| 2024878 | HC RPR F/E/E/N/L/M 7.6-12.5 CM | Operating Room Services - Minor Surgery | $1,397.08 |
| 2024879 | HC CLOSURE OF SPLIT WOUND | Operating Room Services - Minor Surgery | $8,073.35 |
| 2024880 | HC CMPLX RPR S/A/L ADDL 5 CM/> | Operating Room Services - Minor Surgery | $1,579.41 |
| 2024881 | HC CMPLX RPR E/N/E/L 2.6-7.5 CM | Operating Room Services - Minor Surgery | $12,913.09 |
| 2024882 | HC CMPLX RPR E/N/E/L ADDL 5CM/< | Operating Room Services - Minor Surgery | $1,170.68 |
| 2024883 | HC INITIAL TREATMENT OF BURN(S) | Operating Room Services - Minor Surgery | $502.32 |
| 2024884 | HC INCISION OF BREAST LESION | Operating Room Services - Minor Surgery | $4,547.45 |
| 2024885 | HC EXPLORE WOUND EXTREMITY | Operating Room Services - Minor Surgery | $3,059.39 |
| 2024886 | HC REPLANTATION DIGIT COMPLETE | Operating Room Services - Minor Surgery | $14,841.38 |
| 2024887 | HC INTERDENTAL FIXATION | Operating Room Services - Minor Surgery | $5,643.86 |
| 2024888 | HC CLOSED TX NOSE FX W/O STABLJ | Operating Room Services - Minor Surgery | $2,304.70 |
| 2024891 | HC RESET DISLOCATED JAW | Operating Room Services - Minor Surgery | $399.68 |
| 2024894 | HC TREAT DISLOCATION/FRACTURE | Operating Room Services - Minor Surgery | $3,266.29 |
| 2024896 | HC TREAT HUMERUS FRACTURE | Operating Room Services - Minor Surgery | $4,738.52 |
| 2024897 | HC TREAT HUMERUS FRACTURE | Operating Room Services - Minor Surgery | $4,019.77 |
| 2024898 | HC TREAT RADIUS FRACTURE | Operating Room Services - Minor Surgery | $3,301.31 |
| 2024899 | HC TREAT ULNAR FRACTURE | Operating Room Services - Minor Surgery | $3,434.13 |
| 2024903 | HC TREAT WRIST BONE FRACTURE | Operating Room Services - Minor Surgery | $3,327.87 |
| 2024904 | HC TREAT FINGER FRACTURE EACH | Operating Room Services - Minor Surgery | $2,787.88 |
| 2024905 | HC TREAT FINGER DISLOCATION | Operating Room Services - Minor Surgery | $2,879.89 |
| 2024907 | HC TREAT HIP DISLOCATION | Operating Room Services - Minor Surgery | $1,712.94 |
| 2024908 | HC TREAT KNEE DISLOCATION | Operating Room Services - Minor Surgery | $3,796.38 |
| 2024909 | HC TREAT KNEECAP DISLOCATION | Operating Room Services - Minor Surgery | $2,797.78 |
| 2024910 | HC CLTX MEDIAL ANKLE FX | Operating Room Services - Minor Surgery | $2,547.83 |
| 2024911 | HC CLTX MED ANKLE FX W/MNPJ | Operating Room Services - Minor Surgery | $3,628.54 |
| 2024912 | HC TREAT LOWER LEG FRACTURE | Operating Room Services - Minor Surgery | $4,535.92 |
| 2024914 | HC TREATMENT OF ANKLE FRACTURE | Operating Room Services - Minor Surgery | $3,628.54 |
| 2024915 | HC TREATMENT OF TOE FRACTURE | Operating Room Services - Minor Surgery | $7,310.21 |
| 2024916 | HC TREATMENT OF TOE FRACTURE | Operating Room Services - Minor Surgery | $8,626.04 |
| 2024917 | HC TREAT TOE DISLOCATION | Operating Room Services - Minor Surgery | $889.93 |
| 2024918 | HC TREAT TOE DISLOCATION | Operating Room Services - Minor Surgery | $730.54 |
| 2024921 | HC DRAINAGE OF NOSE LESION | Operating Room Services - Minor Surgery | $987.74 |
| 2024922 | HC CONTROL OF NOSEBLEED | Operating Room Services - Minor Surgery | $2,446.40 |
| 2024924 | HC REPAIR TONGUE LACERATION | Operating Room Services - Minor Surgery | $1,316.18 |
| 2024925 | HC REPAIR TONGUE LACERATION | Operating Room Services - Minor Surgery | $1,974.77 |
| 2024926 | HC REMOVE PHARYNX FOREIGN BODY | Operating Room Services - Minor Surgery | $1,109.69 |
| 2024927 | HC DRAINAGE OF RECTAL ABSCESS | Operating Room Services - Minor Surgery | $4,113.95 |
| 2024929 | HC REMOVE RECTAL OBSTRUCTION | Operating Room Services - Minor Surgery | $4,113.95 |
| 2024930 | HC INCISION OF RECTAL ABSCESS | Operating Room Services - Minor Surgery | $3,420.85 |
| 2024931 | HC INCISION OF RECTAL ABSCESS | Operating Room Services - Minor Surgery | $6,916.15 |
| 2024932 | HC INCISION OF ANAL ABSCESS | Operating Room Services - Minor Surgery | $6,926.22 |
| 2024933 | HC INCISE EXTERNAL HEMORRHOID | Operating Room Services - Minor Surgery | $877.85 |
| 2024934 | HC INJECTION FOR CHOLANGIOGRAM EXIST ACCESS | Operating Room Services - Minor Surgery | $4,412.21 |
| 2024935 | HC LAPAROSCOPIC CHOLECYSTECTOMY | Operating Room Services - Minor Surgery | $9,879.28 |
| 2024937 | HC EXCHANGE DRAINAGE CATHETER | Operating Room Services - Minor Surgery | $2,587.67 |
| 2024938 | HC REPLACE G/C TUBE PERC | Operating Room Services - Minor Surgery | $2,923.20 |
| 2024939 | HC REPLACE DUOD/JEJ TUBE PERC | Operating Room Services - Minor Surgery | $952.14 |
| 2024943 | HC EXCHANGE NEPHROSTOMY CATH | Operating Room Services - Minor Surgery | $4,443.60 |
| 2024944 | HC IRRIGATION OF BLADDER | Operating Room Services - Minor Surgery | $724.50 |
| 2024945 | HC CHANGE OF BLADDER TUBE | Operating Room Services - Minor Surgery | $1,541.98 |
| 2024949 | HC TREATMENT OF PENIS LESION | Operating Room Services - Minor Surgery | $1,056.56 |
| 2024950 | HC PENILE INJECTION | Operating Room Services - Minor Surgery | $920.12 |
| 2024951 | HC DRAINAGE OF SCROTUM | Operating Room Services - Minor Surgery | $5,028.03 |
| 2024952 | HC DRAINAGE OF SCROTUM ABSCESS | Operating Room Services - Minor Surgery | $1,558.96 |
| 2024953 | HC REPAIR OF VAGINA | Operating Room Services - Minor Surgery | $7,310.21 |
| 2024956 | HC CARE OF MISCARRIAGE | Operating Room Services - Minor Surgery | $3,984.75 |
| 2024957 | HC REMOVE FOREIGN BODY FROM EYE | Operating Room Services - Minor Surgery | $393.65 |
| 2024958 | HC REMOVE FOREIGN BODY FROM EYE | Operating Room Services - Minor Surgery | $668.96 |
| 2024959 | HC REMOVE FOREIGN BODY FROM EYE | Operating Room Services - Minor Surgery | $836.80 |
| 2024960 | HC DRAINAGE OF EYELID ABSCESS | Operating Room Services - Minor Surgery | $984.11 |
| 2024961 | HC REMOVE EYELID FOREIGN BODY | Operating Room Services - Minor Surgery | $980.49 |
| 2024962 | HC DRAIN EXTERNAL EAR LESION | Operating Room Services - Minor Surgery | $1,001.02 |
| 2024963 | HC DRAIN EXTERNAL EAR LESION | Operating Room Services - Minor Surgery | $3,059.39 |
| 2024967 | HC CLOSED TX OF ULNAR STYLOID FX | Operating Room Services - Minor Surgery | $2,497.11 |
| 2024972 | HC DX LARYNGOSCOPY EXCL NB | Operating Room Services - Minor Surgery | $5,233.24 |
| 2024974 | HC DR ABSC CYST HEMAT-MOUTH; SIMPLE | Operating Room Services - Minor Surgery | $1,127.81 |
| 2024975 | HC DR ABSC CYST HEMATOM - DENTOALVEOLAR | Operating Room Services - Minor Surgery | $1,220.78 |
| 2024976 | HC UNLISTED PROCEDURE DENTOALVEOLAR STRUCT | Operating Room Services - Minor Surgery | $288.59 |
| 2024977 | HC I&D ABSCESS; PERITONSILLAR | Operating Room Services - Minor Surgery | $1,094.00 |
| 2024979 | HC TX GASTRO INTUB W/ASP | Operating Room Services - Minor Surgery | $338.10 |
| 2024989 | HC DESTR W NEUROLYT TRIGEM NRV INF ALV BR | Operating Room Services - Minor Surgery | $5,700.00 |
| 2024999 | HC TRANSFUSION INTRAUTERINE FETAL | Operating Room Services - Minor Surgery | $1,226.98 |
| 2025012 | HC DRAINAGE OF ABSCESS OF PALATE UVULA | Operating Room Services - Minor Surgery | $1,123.37 |
| 2025013 | HC ESOPHAGUS MOTILITY STUDY | Operating Room Services - Minor Surgery | $1,258.22 |
| 2025046 | HC REP ET HAND; WO FG EA TENDON | Operating Room Services - Minor Surgery | $5,379.41 |
| 2025053 | HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5 | Operating Room Services - Minor Surgery | $2,568.00 |
| 2025054 | HC INTMD WND REPAIR N-HF/GENIT 12.6-20 | Operating Room Services - Minor Surgery | $3,216.00 |
| 2025057 | HC EPIDRM AUTOGRFT TRNK/ARM/LEG 100 SQ CM/1% BA | Operating Room Services - Minor Surgery | $9,725.84 |
| 2025059 | HC EPIDRM A-GRFT FACE/NCK/HF/G 100 SQ CM/1% BA | Operating Room Services - Minor Surgery | $9,823.10 |
| 2025140 | HC DRAIN/INJ SMALL JOINT/BURSA W/US | Operating Room Services - Minor Surgery | $6,360.38 |
| 2025141 | HC DRAIN/INJ INTER JOINT/BURSA W/US | Operating Room Services - Minor Surgery | $7,323.25 |
| 2025142 | HC DRAIN/INJ MAJOR JOINT/BURSA W/US | Operating Room Services - Minor Surgery | $7,300.00 |
| 2025143 | HC MYELOGRAPHY LUMBAR INJECTION; CERVICAL | Operating Room Services - Minor Surgery | $2,620.95 |
| 2025145 | HC MYELOGRAPHY LUMBAR INJECTION; LUMBOSACRAL | Operating Room Services - Minor Surgery | $2,620.95 |
| 2025146 | HC MYELOGRAPHY LUMBAR INJECTION; 2 OR MORE REGIONS | Operating Room Services - Minor Surgery | $2,620.95 |
| 2025188 | HC EPIDURAL LYSIS OF ADH MULTI 1 DAY | Operating Room Services - Minor Surgery | $2,867.51 |
| 2025222 | HC I&D ABSC/CYS FOM; MASTIC SPACE | Operating Room Services - Minor Surgery | $1,550.07 |
| 2025245 | HC TX CL ELBOW DISLOC W ANESTH | Operating Room Services - Minor Surgery | $4,909.63 |
| 2025248 | HC NJX AA&/STRD SPRSCAP NRV | Operating Room Services - Minor Surgery | $1,618.43 |
| 2025250 | HC PLACE NEEDLE INTRAOSSEOUS INFUSION | Operating Room Services - Minor Surgery | $571.98 |
| 2025262 | HC GUIDE CATHET FLUID DRAINAGE | Operating Room Services - Minor Surgery | $3,759.72 |
| 2025270 | HC REMOVE VAGINAL FOREIGN BODY | Operating Room Services - Minor Surgery | $8,015.57 |
| 2025271 | HC INSERT DRUG IMPLANT | Operating Room Services - Minor Surgery | $571.96 |
| 2025272 | HC REMOVE DRUG IMPLANT | Operating Room Services - Minor Surgery | $571.96 |
| 2025273 | HC REMOVE W INS DRUG IMPLANT | Operating Room Services - Minor Surgery | $784.88 |
| 2025342 | HC I&D PILONID CYST; CPLX | Operating Room Services - Minor Surgery | $1,575.79 |
| 2025344 | HC CL TX ULNAR SHFT FX W MANIP | Operating Room Services - Minor Surgery | $1,020.34 |
| 2025345 | HC CL TX PROX FIB/SHAFT FX W MANIP | Operating Room Services - Minor Surgery | $3,272.33 |
| 2025347 | HC TRACH TUBE CHG BEFORE FISTULA TRACT | Operating Room Services - Minor Surgery | $1,074.68 |
| 2025354 | HC REM FB EXT AUDITORY CANAL; W ANESTH | Operating Room Services - Minor Surgery | $5,473.60 |
| 2025355 | HC REM IMPL CONTRACEP CAPS | Operating Room Services - Minor Surgery | $739.02 |
| 2025360 | HC SREP F/E/N/L/MM; 12.6-20.0CM | Operating Room Services - Minor Surgery | $1,883.70 |
| 2025361 | HC INTMD WND REPAIR S/A/T/EXT | Operating Room Services - Minor Surgery | $4,210.55 |
| 2025362 | HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM | Operating Room Services - Minor Surgery | $3,259.04 |
| 2025363 | HC CREP H/A/G/EXTR; EA ADD 5 CM/< | Operating Room Services - Minor Surgery | $2,687.10 |
| 2025365 | HC CL TX CMC DISLOC THUMB W MANIP | Operating Room Services - Minor Surgery | $452.81 |
| 2025366 | HC CL TX CMC DISL W M EA | Operating Room Services - Minor Surgery | $452.81 |
| 2025367 | HC CL TX MCP DISLOC W MANIP & ANESTH | Operating Room Services - Minor Surgery | $1,563.24 |
| 2025368 | HC INS BLADDER CATH COMPLEX | Operating Room Services - Minor Surgery | $863.37 |
| 2025373 | HC CIRCUMCISION W/REGIONL BLOCK | Operating Room Services - Minor Surgery | $2,577.36 |
| 2025379 | HC POSTPARTUM CARE ONLY | Operating Room Services - Minor Surgery | $265.65 |
| 2025380 | HC SURG TX INCOMPL ABORTION | Operating Room Services - Minor Surgery | $4,734.07 |
| 2025381 | HC CL TX TRAUMA HIP DISLOC W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025382 | HC CL TX FEMORAL SHAFT FX W MANIP | Operating Room Services - Minor Surgery | $5,770.64 |
| 2025383 | HC CL TX PATELLAR DISLOCATION; W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025385 | HC CL TX ANKLE DISLOC W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025386 | HC CL TX IP JOINT DISL; W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025388 | HC UNLISTED PROCEDURE STOMACH | Operating Room Services - Minor Surgery | $2,545.41 |
| 2025390 | HC REMOVAL OF HEMORRHOID CLOT | Operating Room Services - Minor Surgery | $7,350.05 |
| 2025394 | HC ABSC CYST CONSTRAST INJ | Operating Room Services - Minor Surgery | $132.83 |
| 2025396 | HC PLMT NEPHROSTOMY CATHETER | Operating Room Services - Minor Surgery | $5,457.01 |
| 2025399 | HC INSERT PLEURAL CATH | Operating Room Services - Minor Surgery | $5,445.83 |
| 2025401 | HC INJ W/FLUOR EVAL CV DEVICE | Operating Room Services - Minor Surgery | $2,008.02 |
| 2025404 | HC EGD PLACE GASTROSTOMY TUBE | Operating Room Services - Minor Surgery | $4,350.72 |
| 2025409 | HC CL TX OF MAND FX W ID FIX | Operating Room Services - Minor Surgery | $14,294.03 |
| 2025411 | HC AMPUTATE FING/TH SGL; W DIR CLOSE | Operating Room Services - Minor Surgery | $5,177.76 |
| 2025414 | HC LAPAROSCOPY; APPENDECTOMY | Operating Room Services - Minor Surgery | $15,181.54 |
| 2025494 | HC TX SHOULDER DISLOCATION W/ANESTH | Operating Room Services - Minor Surgery | $3,845.00 |
| 2025538 | HC EXCHANGE BILIARY DRG CATH | Operating Room Services - Minor Surgery | $5,003.19 |
| 2025542 | HC NJX PX NFROSGRM &/URTRGRM EXIST ACCESS | Operating Room Services - Minor Surgery | $3,663.56 |
| 2025572 | HC CONIZATION OF CERVIX LEEP | Operating Room Services - Minor Surgery | $7,952.08 |
| 2025614 | HC REMOVE LUNG CATHETER | Operating Room Services - Minor Surgery | $2,062.95 |
| 2025619 | HC CSF SHUNT REPROGRAM | Operating Room Services - Minor Surgery | $1,030.46 |
| 2025629 | HC CORDOCENTESIS (INTRAUTERINE) | Operating Room Services - Minor Surgery | $1,072.01 |
| 2025632 | HC FLUORO EXAM OF G/COLON TUBE | Operating Room Services - Minor Surgery | $2,190.41 |
| 2025633 | HC PERCUTANEOUS CHOLECYSTOSTOMY | Operating Room Services - Minor Surgery | $7,833.77 |
| 2025637 | HC RPR S/N/A/GEN/TKR > 30CM | Operating Room Services - Minor Surgery | $952.72 |
| 2025689 | HC CYSTOURETHROSCOPY | Operating Room Services - Minor Surgery | $2,241.12 |
| 2025701 | HC BIOPSY SALIVARY GLAND; INCISIONAL | Operating Room Services - Minor Surgery | $6,908.36 |
| 2025703 | HC CIRCUMCISION NEONATE <=28 DAYS | Operating Room Services - Minor Surgery | $6,436.31 |
| 2025709 | HC COLPOPEXY LAPAROSCOPY | Operating Room Services - Minor Surgery | $29,313.89 |
| 2025715 | HC UNLISTED PROCEDURE FEMALE GENITAL SYS | Operating Room Services - Minor Surgery | $600.68 |
| 2025718 | HC REMOVE IMPACTED EAR WAX UNI | Operating Room Services - Minor Surgery | $139.47 |
| 2025719 | HC TRANSPERI NEEDLE PLACE PROS | Operating Room Services - Minor Surgery | $9,585.53 |
| 2025726 | HC OPEN TX FINGER DISLOCATION,SINGLE | Operating Room Services - Minor Surgery | $7,881.35 |
| 2025737 | HC LASER TX SKIN < 250 SQ CM | Operating Room Services - Minor Surgery | $501.04 |
| 2025738 | HC LASER TX SKIN 250-500 SQ CM | Operating Room Services - Minor Surgery | $501.04 |
| 2025755 | HC ABLTJ PERC LXTR/PERPH NRV | Operating Room Services - Minor Surgery | $17,095.30 |
| 2025756 | HC EXC LES MOUTH VESTIBULE W SIMPLE REPAIR | Operating Room Services - Minor Surgery | $7,670.00 |
| 2025772 | HC INTRO CATH DIALYSIS CIRCUIT | Operating Room Services - Minor Surgery | $3,484.95 |
| 2025780 | HC TRLUML BALO ANGIOP 1ST ART | Operating Room Services - Minor Surgery | $11,912.90 |
| 2025781 | HC TRLUML BALO ANGIOP ADDL ART | Operating Room Services - Minor Surgery | $11,913.30 |
| 2025782 | HC TRLUML BALO ANGIOP 1ST VEIN | Operating Room Services - Minor Surgery | $11,912.90 |
| 2025783 | HC TRLUML BALO ANGIOP ADDL VEIN | Operating Room Services - Minor Surgery | $11,102.70 |
| 2025799 | HC EXC TONGUE LESION W CL; ANT 2/3 | Operating Room Services - Minor Surgery | $8,049.86 |
| 2025800 | HC TAP BLOCK BI INJECTION | Operating Room Services - Minor Surgery | $3,771.60 |
| 2025807 | HC NJX INTERLAMINAR LMBR/SAC W/IMG GDN | Operating Room Services - Minor Surgery | $7,367.12 |
| 2025808 | HC NJX INTERLAMINAR CRV/THRC | Operating Room Services - Minor Surgery | $7,713.25 |
| 2025837 | HC CYSTO W DIL OF URETHRAL STRICTURE | Operating Room Services - Minor Surgery | $6,102.75 |
| 2025851 | HC N BLOCK INJ COMMON DIGIT | Operating Room Services - Minor Surgery | $855.82 |
| 2025853 | HC BIOPSY INTRANASAL | Operating Room Services - Minor Surgery | $3,847.73 |
| 2025870 | HC BX DONE W/COLPOSCOPY ADD-ON | Operating Room Services - Minor Surgery | $2,756.73 |
| 2025903 | HC SIALOLITHOTOMY; SM UNCOMPLICATED | Operating Room Services - Minor Surgery | $8,053.32 |
| 2025913 | HC INC/REPL SPINE NSTIM PG/RCVR | Operating Room Services - Minor Surgery | $33,402.32 |
| 2025918 | HC EXC LES/TUMOR DENTOALVEOLAR WO REPAIR | Operating Room Services - Minor Surgery | $8,053.32 |
| 2025919 | HC TRACHEOBRONCH THRU OLD INCISION | Operating Room Services - Minor Surgery | $1,639.86 |
| 2025930 | HC EXC LESION PALATE UVULA; WO CLOSURE | Operating Room Services - Minor Surgery | $8,053.32 |
| 2025935 | HC EXCISE TONGUE LESION WO CLOSURE | Operating Room Services - Minor Surgery | $8,269.80 |
| 2025950 | HC DRAINAGE OF ABSCESS; PAROTID SIMPLE | Operating Room Services - Minor Surgery | $3,847.73 |
| 2025955 | HC CL TX ANKLE DISLOCATION; WO ANESTH | Operating Room Services - Minor Surgery | $740.34 |
| 2025993 | HC EXC LES MOUTH VESTIBULE WO REPAIR | Operating Room Services - Minor Surgery | $6,972.73 |
| 2026024 | HC CYSTO W REM FB/STNT URETH/BLDR; SIMPLE | Operating Room Services - Minor Surgery | $5,965.00 |
| 2026028 | HC EXC NECK LES SC < 3 CM | Operating Room Services - Minor Surgery | $4,742.00 |
| 2026040 | HC CL TX MONTEGGIA ELB FX W MANIP | Operating Room Services - Minor Surgery | $2,530.92 |
| 2026068 | HC REPAIR OF DIGIT NERVE 1 | Operating Room Services - Minor Surgery | $16,278.39 |
| 2026070 | HC FORESKIN MANIPULATION | Operating Room Services - Minor Surgery | $807.42 |
| 2026072 | HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX | Operating Room Services - Minor Surgery | $4,003.74 |
| 2026074 | HC REPAIR LIP FT; VERMILION ONLY | Operating Room Services - Minor Surgery | $1,617.19 |
| 2026075 | HC REPAIR CVA CATHETER | Operating Room Services - Minor Surgery | $2,154.84 |
| 2026077 | HC AMPUTATE FING/TH SGL; W LOC ADV FLAP | Operating Room Services - Minor Surgery | $9,305.07 |
| 2026080 | HC EXTENSOR TENDON REPAIR EACH | Operating Room Services - Minor Surgery | $4,748.67 |
| 2026082 | HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA | Operating Room Services - Minor Surgery | $9,305.07 |
| 2026083 | HC REP T/M EXTENSOR FA/W ; 1' EA | Operating Room Services - Minor Surgery | $9,305.07 |
| 2026084 | HC REP TENDN/MSCL - FARM.WRIST | Operating Room Services - Minor Surgery | $9,305.07 |
| 2026089 | HC CL TX OF NASAL BONE FX; W STABILIZ | Operating Room Services - Minor Surgery | $7,735.59 |
| 2026092 | HC SKIN FULL GRFT FACE/GENIT/HF =< 20 SQ CM | Operating Room Services - Minor Surgery | $5,517.24 |
| 2026095 | HC INTMD WND RPR S/A/T/E 20.1-30.0 | Operating Room Services - Minor Surgery | $1,717.32 |
| 2026118 | HC SUTURE OF FACIAL NERVE; EXTRACRANIAL | Operating Room Services - Minor Surgery | $16,278.39 |
| 2026120 | HC INS VAG BRACHYTX DEVICE | Operating Room Services - Minor Surgery | $943.98 |
| 2026121 | HC PLACE RT DEVICE/MARKER PROS | Operating Room Services - Minor Surgery | $4,174.35 |
| 2026124 | HC MUSC MYOQ/FSCQ FLP H&N PEDCL | Operating Room Services - Minor Surgery | $9,534.60 |
| 2026137 | HC CL TX NASAL SEPTAL FX | Operating Room Services - Minor Surgery | $7,735.59 |
| 2026158 | HC TIS TRNFR ADDL 30 SQ CM | Operating Room Services - Minor Surgery | $1,382.00 |
| 2026162 | HC PERQ DEV SOFT TISS 1ST IMAG | Operating Room Services - Minor Surgery | $2,015.10 |
| 2026171 | HC EPILATION BY FORCEPS | Operating Room Services - Minor Surgery | $369.51 |
| 2026176 | HC BX; NASOPHARYNX VISIBLE LESION SIMPLE | Operating Room Services - Minor Surgery | $4,512.43 |
| 2026245 | HC THROMBOLYSIS CEREBRAL BY IV INFUSION | Operating Room Services - Minor Surgery | $1,046.76 |
| 2026252 | HC OPEN CHEST HEART MASSAGE | Operating Room Services - Minor Surgery | $6,829.35 |
| 2026263 | HC INTRAVITREAL INJECTION OF DRUG | Operating Room Services - Minor Surgery | $1,013.22 |
| 2026264 | HC FNA BX W/O IMG GDN EA ADDL | Operating Room Services - Minor Surgery | $2,754.00 |
| 2026265 | HC FNA BX W/US GDN 1ST LES | Operating Room Services - Minor Surgery | $4,331.00 |
| 2026266 | HC FNA BX W/US GDN EA ADDL | Operating Room Services - Minor Surgery | $2,887.33 |
| 2026267 | HC FNA BX W/FLUOR GDN 1ST LES | Operating Room Services - Minor Surgery | $4,331.00 |
| 2026269 | HC FNA BX W/CT GDN 1ST LES | Operating Room Services - Minor Surgery | $4,331.00 |
| 2026273 | HC TANGNTL BX SKIN SINGLE LES | Operating Room Services - Minor Surgery | $683.49 |
| 2026274 | HC TANGNTL BX SKIN EA SEP/ADDL | Operating Room Services - Minor Surgery | $413.30 |
| 2026275 | HC PUNCH BX SKIN SINGLE LESION | Operating Room Services - Minor Surgery | $619.95 |
| 2026276 | HC PUNCH BX SKIN EA SEP/ADDL | Operating Room Services - Minor Surgery | $413.30 |
| 2026277 | HC INCAL BX SKN SINGLE LES | Operating Room Services - Minor Surgery | $1,103.52 |
| 2026278 | HC INCAL BX SKN EA SEP/ADDL | Operating Room Services - Minor Surgery | $735.68 |
| 2026283 | HC RPLC GTUBE NO REVJ TRC | Operating Room Services - Minor Surgery | $813.09 |
| 2026284 | HC RPLC GTUBE REVJ GSTRST TRC | Operating Room Services - Minor Surgery | $1,084.12 |
| 2026370 | HC SKIN TISSUE REARRANGEMENT 30.1-60.0 SQ CM | Operating Room Services - Minor Surgery | $9,718.92 |
| 2026372 | HC CL TX LUNATE DISLOC W MANIP | Operating Room Services - Minor Surgery | $4,614.48 |
| 2026373 | HC REPR FOOT EXTENSOR TENDON EA | Operating Room Services - Minor Surgery | $9,217.20 |
| 2026380 | HC RECONST NAIL BED W GRFT | Operating Room Services - Minor Surgery | $5,442.33 |
| 2026398 | HC REPAIR BLD VESSEL DIRECT; LWR EXTREM | Operating Room Services - Minor Surgery | $2,035.53 |
| 2026399 | HC INSJ PICC RS&I <5 YR | Operating Room Services - Minor Surgery | $8,584.12 |
| 2026400 | HC INSJ PICC RS&I 5 YR+ | Operating Room Services - Minor Surgery | $7,947.77 |
| 2026409 | HC MUSCLE FLAP; TRUNK | Operating Room Services - Minor Surgery | $9,718.92 |
| 2026429 | HC LOW COST SKIN SUB TRNK/ARM/LEG < 100 SQ CM | Operating Room Services - Minor Surgery | $6,705.25 |
| 2026430 | HC LOW COST SKIN SUB T/A/L < 100 SQ CM ADD-ON | Operating Room Services - Minor Surgery | $402.10 |
| 2026431 | HC LOW COST SKIN SUB TRNK/ARM/LEG > 100 SQ CM | Operating Room Services - Minor Surgery | $3,495.84 |
| 2026433 | HC LOW COST SKIN SUB FACE/NK/HF/G < 100 SQ CM | Operating Room Services - Minor Surgery | $2,011.70 |
| 2026434 | HC LOW COST SKIN SUB F/N/HF/G < 100 SQ CM ADD-ON | Operating Room Services - Minor Surgery | $536.13 |
| 2026442 | HC MYOMECTOMY VAG METHOD 1-4 MYOMAS | Operating Room Services - Minor Surgery | $8,296.41 |
| 2026446 | HC REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS LT | Operating Room Services - Minor Surgery | $3,359.27 |
| 2026452 | HC STRAPPING OF TOES LT | Operating Room Services - Minor Surgery | $227.01 |
| 2026453 | HC STRAPPING OF TOES RT | Operating Room Services - Minor Surgery | $227.01 |
| 2026454 | HC BONE MARROW ASPIRATE & BIOPSY BIL | Operating Room Services - Minor Surgery | $6,704.25 |
| 2026455 | HC BONE MARROW ASPIRATE & BIOPSY LT | Operating Room Services - Minor Surgery | $6,704.25 |
| 2026456 | HC BONE MARROW ASPIRATE & BIOPSY RT | Operating Room Services - Minor Surgery | $6,704.25 |
| 2026457 | HC REM FB AUD CANAL WO ANES BIL | Operating Room Services - Minor Surgery | $719.67 |
| 2026460 | HC REMOVE IMPACTED EAR WAX BIL | Operating Room Services - Minor Surgery | $705.18 |
| 2026462 | HC REMOVE IMPACTED EAR WAX RT | Operating Room Services - Minor Surgery | $705.18 |
| 2026463 | HC INJ TENDON SHEATH/LIGAMENT BIL | Operating Room Services - Minor Surgery | $2,970.45 |
| 2026464 | HC INJ TENDON SHEATH/LIGAMENT LT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2026465 | HC INJ TENDON SHEATH/LIGAMENT RT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2026481 | HC DR ABSC/HEMATOMA NASAL SEPTUM | Operating Room Services - Minor Surgery | $1,711.56 |
| 2026482 | HC BIOPSY SALIVARY GLAND; NEEDLE | Operating Room Services - Minor Surgery | $2,035.53 |
| 2026486 | HC UNLISTED PROCEDURE PHARYNX ADENOIDS | Operating Room Services - Minor Surgery | $724.29 |
| 2026527 | HC SKIN FULL GRAFT EEN & LIPS =< 20 SQ CM | Operating Room Services - Minor Surgery | $5,422.33 |
| 2026535 | HC DRESS/DEBRID P-THICK BURN L | Operating Room Services - Minor Surgery | $1,876.00 |
| 2026537 | HC CL TX SHDR DISLOC W NK FX W MANIP | Operating Room Services - Minor Surgery | $4,614.00 |
| 2026676 | HC CL TX TMT JNT DISL; WO ANESTHESIA | Operating Room Services - Minor Surgery | $783.66 |
| 2026677 | HC DRAINAGE OF EYE | Operating Room Services - Minor Surgery | $7,347.66 |
| 2026678 | HC INJ ANTERIOR CHAMBER ; MEDICATION | Operating Room Services - Minor Surgery | $7,347.66 |
| 2026679 | HC TENDON SHEATH INCISION | Operating Room Services - Minor Surgery | $4,925.61 |
| 2026680 | HC CL TX ANKLE DISLOCATION; WO ANESTH | Operating Room Services - Minor Surgery | $783.66 |
| 2026681 | HC ASP VITREOUS SUBRETIN OR CHOROID FLUID | Operating Room Services - Minor Surgery | $7,347.66 |
| 2026698 | HC TRACHEOSTOMY EMERG; TRANSTRACHL | Operating Room Services - Minor Surgery | $4,904.19 |
| 2026784 | HC DX LMBR SPI PNXR W/FLUOR/CT | Operating Room Services - Minor Surgery | $5,702.20 |
| 2026785 | HC THER SPI PNXR CSF FLUOR/CT | Operating Room Services - Minor Surgery | $3,460.96 |
| 2026803 | HC LARYNGOSCOPY W/FB REMOVAL | Operating Room Services - Minor Surgery | $5,199.54 |
| 2026870 | HC NJX AA&/STRD NRV NRVTG SI JT | Operating Room Services - Minor Surgery | $8,768.62 |
| 2026871 | HC NJX AA&/STRD GNCLR NRV BRNCH | Operating Room Services - Minor Surgery | $8,768.62 |
| 2026872 | HC DSTRJ NULYT AGT GNCLR NRV | Operating Room Services - Minor Surgery | $6,428.97 |
| 2026873 | HC RF ABLTJ NRV NRVTG SI JT | Operating Room Services - Minor Surgery | $6,428.97 |
| 2026903 | HC REM TE WO INS PERM PROSTH | Operating Room Services - Minor Surgery | $8,428.02 |
| 2026962 | HC REPAIR RETINAL DETACHM; BY AIR INJ | Operating Room Services - Minor Surgery | $7,348.44 |
| 2026964 | HC ALVEOLECTOMY INCL CURETTAGE OF OSTEITIS | Operating Room Services - Minor Surgery | $9,519.81 |
| 2026971 | HC EXC LES MOUTH VESTIBULE; CPLX W EXCL | Operating Room Services - Minor Surgery | $8,437.00 |
| 2026983 | HC APPY PATELLAR TENDON BEARING CAST | Operating Room Services - Minor Surgery | $689.46 |
| 2026990 | HC EXPL P WND; ABD/FLANK | Operating Room Services - Minor Surgery | $5,897.85 |
| 2026991 | HC LIGATION/BAND ANGIOACCESS AV FISTULA | Operating Room Services - Minor Surgery | $10,072.23 |
| 2026994 | HC CL TX KNEE DISL; W ANESTHESIA | Operating Room Services - Minor Surgery | $4,656.12 |
| 2026996 | HC DISSECTION DEEP JUGULAR NODE | Operating Room Services - Minor Surgery | $17,568.12 |
| 2020511 | HC HARVEST AUTO STEM CELLS | Operating Room Services - Organ transplant - Other Than Kidney | $5,220.02 |
| 2020512 | HC CRYOPRESERVE STEM CELLS | Operating Room Services - Organ transplant - Other Than Kidney | $498.60 |
| 2020515 | HC BONE MARROW/STEM TRANSPLANT | Operating Room Services - Organ transplant - Other Than Kidney | $13,850.03 |
| 2026008 | HC TRANSPLT ALLO LYMPHOCYTES | Operating Room Services - Organ transplant - Other Than Kidney | $3,876.66 |
| 2020555 | HC FETAL NON-STRESS TEST | Other Diagnostic Services | $3,643.69 |
| 2022109 | HC DUP-SCAN XTRC ART COMPL BI STD | Other Diagnostic Services | $4,953.14 |
| 2022119 | HC DUP-SCAN XTR VEINS COMPL BI STD | Other Diagnostic Services | $2,524.06 |
| 2022177 | HC SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS | Other Diagnostic Services | $1,496.26 |
| 2022180 | HC C MOTOR EVOKED, UPPR LIMBS | Other Diagnostic Services | $1,926.32 |
| 2022183 | HC BLINK REFLEX TEST | Other Diagnostic Services | $541.41 |
| 2022782 | HC GLUCOSE MONITORING CONT | Other Diagnostic Services | $1,971.12 |
| 2023418 | HC C MOTOR EVOKED UPR&LWR LIMBS | Other Diagnostic Services | $3,295.86 |
| 2023441 | HC SOMATOSENSORY TESTING | Other Diagnostic Services | $2,424.23 |
| 2023643 | HC DUPLEX UE ART/BPG; BILAT | Other Diagnostic Services | $2,291.11 |
| 2023644 | HC DUPLEX A IVC IL/BPG; UNIL/LIM | Other Diagnostic Services | $1,582.28 |
| 2024349 | HC IONM REMOTE/>1 PT OR PER HR | Other Diagnostic Services | $2,355.10 |
| 2026109 | HC SLEEP STUDY UNATT&RESP EFFT | Other Diagnostic Services | $508.29 |
| 2026110 | HC MSLT/MWT; GLOBAL | Other Diagnostic Services | $3,366.98 |
| 2026467 | HC CONT INTRAOP NEURO MONITOR | Other Diagnostic Services | $588.77 |
| 2022148 | HC PERCUT ALLERGY SKIN TESTS | Other Diagnostic Services - Allergy Test | $1,101.19 |
| 2022150 | HC ALLERGY PATCH TESTS | Other Diagnostic Services - Allergy Test | $1,101.19 |
| 2022151 | HC PHOTO PATCH TEST | Other Diagnostic Services - Allergy Test | $152.31 |
| 2022152 | HC PHOTOSENSITIVITY TESTS | Other Diagnostic Services - Allergy Test | $499.18 |
| 2026025 | HC INGEST CHALLENGE INI 120 MIN | Other Diagnostic Services - Allergy Test | $1,657.00 |
| 2026026 | HC INGEST CHALLENGE ADDL 60 MIN | Other Diagnostic Services - Allergy Test | $828.39 |
| 2026508 | HC PERQ & ICUT ALLG TEST VENOMS | Other Diagnostic Services - Allergy Test | $119.63 |
| 2022162 | HC MUSCLE TEST, ONE LIMB | Other Diagnostic Services - Electromyogram | $559.34 |
| 2022163 | HC MUSCLE TEST, 2 LIMBS | Other Diagnostic Services - Electromyogram | $788.44 |
| 2022164 | HC MUSCLE TEST, 3 LIMBS | Other Diagnostic Services - Electromyogram | $977.88 |
| 2022166 | HC MUSCLE TEST CRAN NERV UNILAT | Other Diagnostic Services - Electromyogram | $655.33 |
| 2022167 | HC MUSCLE TEST CRAN NERVE BILAT | Other Diagnostic Services - Electromyogram | $924.12 |
| 2022168 | HC MUSCLE TEST, THOR PARASPINAL | Other Diagnostic Services - Electromyogram | $602.85 |
| 2022169 | HC MUSCLE TEST, NONPARASPINAL | Other Diagnostic Services - Electromyogram | $637.42 |
| 2022170 | HC MUSCLE TEST, ONE FIBER | Other Diagnostic Services - Electromyogram | $446.70 |
| 2022171 | HC GUIDE NERV DESTR, ELEC STIM | Other Diagnostic Services - Electromyogram | $490.21 |
| 2022178 | HC SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS | Other Diagnostic Services - Electromyogram | $1,433.54 |
| 2022182 | HC VISUAL EVOKED POTENTIAL TEST | Other Diagnostic Services - Electromyogram | $1,230.03 |
| 2022185 | HC NEUROMUSCULAR JUNCTION TEST | Other Diagnostic Services - Electromyogram | $383.98 |
| 2023415 | HC MUSC TST DONE W/NERV TST LIMTD | Other Diagnostic Services - Electromyogram | $295.95 |
| 2023416 | HC MUSC TEST DONE W/NERV TST COMPLETE | Other Diagnostic Services - Electromyogram | $460.78 |
| 2023417 | HC MUSC TST DONE W/N TST NONEXTREMITY | Other Diagnostic Services - Electromyogram | $410.49 |
| 2024341 | HC MOTOR&/SENS 1-2 NRV CNDJ TST | Other Diagnostic Services - Electromyogram | $414.70 |
| 2024342 | HC MOTOR&/SENS 3-4 NRV CNDJ TST | Other Diagnostic Services - Electromyogram | $523.50 |
| 2024343 | HC MOTOR&/SENS 5-6 NRV CNDJ TST | Other Diagnostic Services - Electromyogram | $622.06 |
| 2024344 | HC MOTOR&SENS 7-8 NRV CNDJ TEST | Other Diagnostic Services - Electromyogram | $829.40 |
| 2024345 | HC MOTOR&SEN 9-10 NRV CNDJ TEST | Other Diagnostic Services - Electromyogram | $988.12 |
| 2024346 | HC MOTOR&SEN 11-12 NRV CND TEST | Other Diagnostic Services - Electromyogram | $1,096.91 |
| 2024347 | HC MOTOR&SENS 13/> NRV CND TEST | Other Diagnostic Services - Electromyogram | $1,254.35 |
| 2025477 | HC SPECIMEN HANDLING OFFICE-LAB | Other Diagnostic Services - Pap Smear | $32.00 |
| 2022110 | HC DUP-SCAN XTRC ART UNI/LMTD STD | Other Diagnostic Services - Peripheral Vascular Lab | $3,165.23 |
| 2022111 | HC N-INVAS PHYSIOLOGIC STD UPR/LXTR ART 1 LVL BI | Other Diagnostic Services - Peripheral Vascular Lab | $1,304.26 |
| 2022113 | HC N-INVAS PHYSIOLOGIC STD UPR/LXTR BLAT MLT LVL BI | Other Diagnostic Services - Peripheral Vascular Lab | $2,006.96 |
| 2022115 | HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STD | Other Diagnostic Services - Peripheral Vascular Lab | $2,236.07 |
| 2022116 | HC DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD | Other Diagnostic Services - Peripheral Vascular Lab | $1,319.62 |
| 2022117 | HC UPPER EXTREMITY STUDY | Other Diagnostic Services - Peripheral Vascular Lab | $1,414.34 |
| 2022120 | HC DUP-SCAN XTR VEINS UNI/LMTD STD | Other Diagnostic Services - Peripheral Vascular Lab | $1,539.77 |
| 2022122 | HC EXTREMITY STUDY RT | Other Diagnostic Services - Peripheral Vascular Lab | $1,539.77 |
| 2022124 | HC DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COMPL | Other Diagnostic Services - Peripheral Vascular Lab | $3,699.11 |
| 2022125 | HC DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMTD | Other Diagnostic Services - Peripheral Vascular Lab | $2,138.22 |
| 2022126 | HC DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPL | Other Diagnostic Services - Peripheral Vascular Lab | $2,501.09 |
| 2022668 | HC DUP-SCAN OF HEMODIALYSIS ACCESS | Other Diagnostic Services - Peripheral Vascular Lab | $1,745.85 |
| 2024983 | HC INTRACRANIAL ARTERY DOPPLER; COMPL | Other Diagnostic Services - Peripheral Vascular Lab | $487.66 |
| 2024984 | HC INTRACRANIAL ARTERY DOPPLER; LIMITED | Other Diagnostic Services - Peripheral Vascular Lab | $282.85 |
| 2025003 | HC TCD VASOREACTIVITY STUDY | Other Diagnostic Services - Peripheral Vascular Lab | $613.71 |
| 2025004 | HC TCD EMBOLI DETECT W/O INJ | Other Diagnostic Services - Peripheral Vascular Lab | $643.81 |
| 2025005 | HC TCD EMBOLI DETECT W/INJ | Other Diagnostic Services - Peripheral Vascular Lab | $583.65 |
| 2026111 | HC NONINVAS VASC DX STUDY PROC | Other Diagnostic Services - Peripheral Vascular Lab | $65.12 |
| 2023341 | HC DX MAMMO INCL CAD BI | Other Imaging Services - Diagnostic Mammography | $1,562.77 |
| 2023535 | HC DX MAMMO INCL CAD UNI | Other Imaging Services - Diagnostic Mammography | $1,297.12 |
| 2025148 | HC BREAST TOMOSYNTHESIS UNI ADD ON | Other Imaging Services - Diagnostic Mammography | $124.32 |
| 2025274 | HC BREAST TOMOSYNTHESIS BI ADD ON | Other Imaging Services - Diagnostic Mammography | $124.32 |
| 2023330 | HC PET IM METABOLIC BRAIN W/O IVC | Other Imaging Services - Positron Emission Tomography | $9,087.65 |
| 2023331 | HC PET IMAGE W/CT SKULL-THIGH | Other Imaging Services - Positron Emission Tomography | $9,858.03 |
| 2023332 | HC PTCT IMAGE WHOLE BODY WOIVC | Other Imaging Services - Positron Emission Tomography | $10,087.46 |
| 2023577 | HC MYOCRD IMG PET SINGLE STUDY | Other Imaging Services - Positron Emission Tomography | $8,916.32 |
| 2023578 | HC MYOCRD IMG PET MLT RST&STRS | Other Imaging Services - Positron Emission Tomography | $10,285.49 |
| 2023579 | HC PET IMAGE W/CT LMTD | Other Imaging Services - Positron Emission Tomography | $8,916.32 |
| 2026734 | HC PET CDSM NDSC | Other Imaging Services - Positron Emission Tomography | $1.00 |
| 2023340 | HC SCR MAMMO BI INCL CAD | Other Imaging Services - Screening Mammography | $1,354.55 |
| 2025149 | HC BREAST TOMOSYNTHESIS BI | Other Imaging Services - Screening Mammography | $146.98 |
| 2020000 | HC CHD RISK IMT STUDY | Other Imaging Services - Ultrasound | $352.60 |
| 2021135 | HC ECHO EXAM OF HEAD | Other Imaging Services - Ultrasound | $1,250.97 |
| 2021136 | HC US EXAM OF HEAD AND NECK | Other Imaging Services - Ultrasound | $1,791.93 |
| 2021137 | HC US EXAM, CHEST | Other Imaging Services - Ultrasound | $1,052.94 |
| 2021141 | HC US EXAM, ABDOM, COMPLETE | Other Imaging Services - Ultrasound | $1,791.93 |
| 2021142 | HC ECHO EXAM OF ABDOMEN | Other Imaging Services - Ultrasound | $1,469.53 |
| 2021143 | HC US EXAM ABDO BACK WALL, COMP | Other Imaging Services - Ultrasound | $1,721.90 |
| 2021144 | HC US EXAM ABDO BACK WALL, LIM | Other Imaging Services - Ultrasound | $877.85 |
| 2021145 | HC US EXAM K TRANSPL W/DOPPLER | Other Imaging Services - Ultrasound | $1,188.18 |
| 2021146 | HC US EXAM, SPINAL CANAL | Other Imaging Services - Ultrasound | $687.07 |
| 2021147 | HC OB US < 14 WKS, SINGLE FETUS | Other Imaging Services - Ultrasound | $2,628.73 |
| 2021148 | HC OB US >/= 14 WKS, SNGL FETUS | Other Imaging Services - Ultrasound | $3,021.17 |
| 2021149 | HC OB US >/= 14 WKS, ADDL FETUS | Other Imaging Services - Ultrasound | $2,023.77 |
| 2021150 | HC FETAL BIOPHYS PROFILE W/NST | Other Imaging Services - Ultrasound | $3,800.00 |
| 2021151 | HC FETAL BIOPHYS PROFIL W/O NST | Other Imaging Services - Ultrasound | $2,712.87 |
| 2021153 | HC TRANSVAGINAL US, NON-OB | Other Imaging Services - Ultrasound | $1,945.28 |
| 2021154 | HC US EXAM, PELVIC, COMPLETE | Other Imaging Services - Ultrasound | $1,911.47 |
| 2021155 | HC US EXAM, PELVIC, LIMITED | Other Imaging Services - Ultrasound | $1,299.27 |
| 2021156 | HC US SCROTUM AND CONTENTS | Other Imaging Services - Ultrasound | $1,686.88 |
| 2021157 | HC ECHOGRAP TRANS R, PROS STUDY | Other Imaging Services - Ultrasound | $821.81 |
| 2021158 | HC US COMPL JOINT R-T W/IMG | Other Imaging Services - Ultrasound | $2,604.58 |
| 2021161 | HC US EXAM INFANT HIPS, DYNAMIC | Other Imaging Services - Ultrasound | $1,379.44 |
| 2021165 | HC US GUIDE, VASCULAR ACCESS | Other Imaging Services - Ultrasound | $745.03 |
| 2021166 | HC US GUIDE, TISSUE ABLATION | Other Imaging Services - Ultrasound | $766.76 |
| 2021167 | HC US GUIDED NEEDLE PLACEMENT | Other Imaging Services - Ultrasound | $3,308.55 |
| 2021168 | HC US GUIDE, INTRAOP | Other Imaging Services - Ultrasound | $543.38 |
| 2022580 | HC OB US FOLLOW-UP PER FETUS | Other Imaging Services - Ultrasound | $4,212.45 |
| 2022587 | HC OB US LIMITED 1+ FETUS(S) | Other Imaging Services - Ultrasound | $3,079.66 |
| 2022729 | HC TRANSVAGINAL OB US | Other Imaging Services - Ultrasound | $3,556.02 |
| 2022730 | HC FETAL CARDIOVASC 2-D US | Other Imaging Services - Ultrasound | $1,677.22 |
| 2023137 | HC US LMTD JT/NONVASC XTR STRUX | Other Imaging Services - Ultrasound | $809.03 |
| 2023541 | HC OB US < 14 WKS ADDL FETUS | Other Imaging Services - Ultrasound | $1,389.83 |
| 2023638 | HC US GUIDED AMNIOCENTESIS | Other Imaging Services - Ultrasound | $268.07 |
| 2023765 | HC OB US NUCHAL MEAS 1 GEST | Other Imaging Services - Ultrasound | $557.49 |
| 2023766 | HC TRANSRECTAL US | Other Imaging Services - Ultrasound | $461.36 |
| 2024834 | HC UMBILICAL ARTERY ECHO | Other Imaging Services - Ultrasound | $309.12 |
| 2025034 | HC FETAL MIDL CEREBRAL ARTERY ECHO | Other Imaging Services - Ultrasound | $525.97 |
| 2025085 | HC ULTRASOUND BREAST COMPLETE | Other Imaging Services - Ultrasound | $1,350.00 |
| 2025086 | HC ULTRASOUND BREAST LIMITED | Other Imaging Services - Ultrasound | $1,232.86 |
| 2025427 | HC OB US DETAILED SNGL FETUS | Other Imaging Services - Ultrasound | $820.24 |
| 2025430 | HC US FOLLOW-UP STUDY | Other Imaging Services - Ultrasound | $546.02 |
| 2025622 | HC US FOR FETAL TRANSF/CORDOCENTESIS | Other Imaging Services - Ultrasound | $358.63 |
| 2026134 | HC US ABDL AORTA SCREEN AAA | Other Imaging Services - Ultrasound | $402.63 |
| 2026982 | HC US EXAM INFANT HIPS STATIC | Other Imaging Services - Ultrasound | $1,379.44 |
| 2022189 | HC RFL&MAIN IMPLT PMP/RSVR F/DRUG DLVR SPI/BRN | Other Therapeutic Services | $7,468.76 |
| 2022224 | HC ULTRAVIOLET LIGHT THERAPY | Other Therapeutic Services | $340.47 |
| 2022226 | HC PHOTOCHEMOTHERAPY WITH UV-B | Other Therapeutic Services | $1,103.32 |
| 2022245 | HC ULTRAVIOLET THERAPY | Other Therapeutic Services | $61.43 |
| 2022328 | HC PHLEBOTOMY | Other Therapeutic Services | $1,118.68 |
| 2024477 | HC ACUPUNCT W/O STIMUL 15 MIN | Other Therapeutic Services | $83.55 |
| 2024499 | HC ACUPUNCT W/O STIMUL ADDL 15 MIN | Other Therapeutic Services | $83.55 |
| 2024500 | HC ACUPUNCT W/STIMUL ADDL 15 MIN | Other Therapeutic Services | $88.55 |
| 2024658 | HC CHIRO MANIPULATIVE TREATMENT;CMT; SPINAL, 1-2 REGIONS | Other Therapeutic Services | $183.03 |
| 2024659 | HC CHIRO MANIPULATIVE TREATMENT;CMT; SPINAL, 3-4 REGIONS | Other Therapeutic Services | $271.34 |
| 2022108 | HC CARDIAC REHAB/MONITOR | Other Therapeutic Services - Cardiac Rehabilitation | $299.51 |
| 2026126 | HC ALCOHOL/DRUG SERVICE 15 MIN | Other Therapeutic Services - Drug Rehabilitation | $133.56 |
| 2026127 | HC ALCOHOL/DRUG SCREENING | Other Therapeutic Services - Drug Rehabilitation | $126.14 |
| 2022319 | HC MED NUTRITION THERAPY INIT, EA 15 MIN | Other Therapeutic Services - Education/Training | $53.00 |
| 2022320 | HC MED NUTRITION THERAPY INIT, EA 15 MIN | Other Therapeutic Services - Education/Training | $59.62 |
| 2022321 | HC MED NUTRITION THERAPY REASSES, EA 15 MIN | Other Therapeutic Services - Education/Training | $39.75 |
| 2022322 | HC MED NUTRITION THERAPY REASSES, EA 15 MIN | Other Therapeutic Services - Education/Training | $37.10 |
| 2022323 | HC MEDICAL NUTRITION, GROUP | Other Therapeutic Services - Education/Training | $121.90 |
| 2022324 | HC SELF-MGMT EDUC & TRAIN, 1 PT | Other Therapeutic Services - Education/Training | $198.69 |
| 2022325 | HC SELF-MGMT EDUC/TRAIN, 2-4 PT | Other Therapeutic Services - Education/Training | $264.52 |
| 2022354 | HC BEHAV CHNG SMOKING 3-10 MIN | Other Therapeutic Services - Education/Training | $96.30 |
| 2022355 | HC BEHAV CHNG SMOKING > 10 MIN | Other Therapeutic Services - Education/Training | $200.30 |
| 2022411 | HC DIAB MANAGE TRN PER INDIV | Other Therapeutic Services - Education/Training | $429.40 |
| 2022412 | HC DIAB MANAGE TRN IND/GROUP | Other Therapeutic Services - Education/Training | $151.91 |
| 2025464 | HC INSULIN PUMP INSTRUCTION | Other Therapeutic Services - Education/Training | $95.42 |
| 2025467 | HC DIABETES MANAGEMENT - GROUP | Other Therapeutic Services - Education/Training | $219.42 |
| 2025812 | HC DM PROGRAM NURSE VISIT | Other Therapeutic Services - Education/Training | $237.19 |
| 2025813 | HC DM PROGRAM DIETITIAN VISIT | Other Therapeutic Services - Education/Training | $237.19 |
| 2025814 | HC DM PROGRAM F/U TO NON-MD | Other Therapeutic Services - Education/Training | $237.19 |
| 2025816 | HC PT EDUCATION NOC INDIVID | Other Therapeutic Services - Education/Training | $237.19 |
| 2026145 | HC 2 EM CORE MS MO 7-9 NO WL | Other Therapeutic Services - Education/Training | $47.70 |
| 2026146 | HC 2 EM CORE MS MO 10-12 NO WL | Other Therapeutic Services - Education/Training | $47.70 |
| 2026147 | HC 2 EM CORE MS MO 7-9 WL | Other Therapeutic Services - Education/Training | $190.80 |
| 2026148 | HC 2 EM CORE MS MO 10-12 WL | Other Therapeutic Services - Education/Training | $190.80 |
| 2026149 | HC EM 5 PERCENT WL | Other Therapeutic Services - Education/Training | $508.80 |
| 2026150 | HC EM 9 PERCENT WL | Other Therapeutic Services - Education/Training | $79.50 |
| 2026151 | HC 2 EM ONGOING MS MO 13-15 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026152 | HC 2 EM ONGOING MS MO 16-18 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026153 | HC 2 EM ONGOING MS MO 19-21 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026154 | HC 2 EM ONGOING MS MO 22-24 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026156 | HC EM SESSION REPORTING | Other Therapeutic Services - Education/Training | $1.06 |
| 2026382 | HC NM FAMILY PLANNING EDUC | Other Therapeutic Services - Education/Training | $126.14 |
| 2026383 | HC AUDIT/DAST OVER 30 MIN | Other Therapeutic Services - Education/Training | $437.78 |
| 2022664 | HC PULMONARY REHAB W EXER | Other Therapeutic Services - Pulmonary Rehabilitation | $119.97 |
| 2022489 | HC CHILD LIFE IND TRMNT 15MIN | Other Therapeutic Services - Recreational Therapy | $147.90 |
| 1011001 | HC RB STANDARD PRIVATE ROOM DIFFERENTIAL | Patient Convenience Items | $375.00 |
| 1011002 | HC RB PREMIUM PRIVATE ROOM DIFFERENTIAL | Patient Convenience Items | $525.00 |
| 2022496 | HC THERAPEUTIC REC 15M IND | Patient Convenience Items | $144.80 |
| 2022498 | HC THERAPEUTIC REC 15M GRP | Patient Convenience Items | $157.50 |
| 2022508 | HC COMMUNITY REINTEG 180M GRP | Patient Convenience Items | $276.60 |
| 2022514 | HC MUSIC THERAPY 30M EVAL | Patient Convenience Items | $154.61 |
| 2022516 | HC MUSIC THERAPY 15M IND | Patient Convenience Items | $158.06 |
| 2022518 | HC MUSIC THERAPY 15M GRP | Patient Convenience Items | $160.67 |
| 2022525 | HC THERAPEUTIC REC 30M EVAL | Patient Convenience Items | $133.42 |
| 2023244 | HC HEALTH AND FITNESS EVAL 90 MIN | Patient Convenience Items | $325.00 |
| 2023246 | HC GHF PRSNL TRAIN 60 MIN | Patient Convenience Items | $175.00 |
| 2023247 | HC GHF PRSNL TRAIN 30 MIN | Patient Convenience Items | $90.00 |
| 2023248 | HC SPORTS SPECIFIC TRAINING 60 MIN | Patient Convenience Items | $175.00 |
| 2023251 | HC MT LACTATE PROF 60 MIN | Patient Convenience Items | $225.00 |
| 2023252 | HC AEROBIC CAPACITY WITH LACTATE | Patient Convenience Items | $350.00 |
| 2023253 | HC MT REST MR 45 MIN | Patient Convenience Items | $175.00 |
| 2023255 | HC RUNNERS EVALUATION | Patient Convenience Items | $395.00 |
| 2023349 | HC PERSONAL TRAINING 30 MIN 8 SESSION PACKAGE | Patient Convenience Items | $570.00 |
| 2023351 | HC PERSONAL TRAINING 60 MIN 8 SESSION PACKAGE | Patient Convenience Items | $1,140.00 |
| 2023788 | HC FUNCTIONAL MVMT SCREEN 60 MIN | Patient Convenience Items | $200.00 |
| 2024298 | HC SPORTS NUTRIT ASSESS 60MIN | Patient Convenience Items | $225.00 |
| 2024299 | HC SPORTS NUTRIT FUP 30MIN | Patient Convenience Items | $75.00 |
| 2024480 | HC MASSAGE THERAPY (FULL BODY) 60 MIN | Patient Convenience Items | $91.22 |
| 2024689 | HC ACUPUNCTURE W/ OR W/O STIM - 1 HOUR | Patient Convenience Items | $91.22 |
| 2024860 | HC RUNNING LAB EVALUATION 180 MIN | Patient Convenience Items | $495.00 |
| 2024993 | HC WELLNESS EXE CLASS 60 MIN | Patient Convenience Items | $20.00 |
| 2025147 | HC MASSAGE THERAPY (FULL BODY) 30 MIN | Patient Convenience Items | $45.19 |
| 2025168 | HC CARD REHAB MAINT PRG 3X/WEEK | Patient Convenience Items | $200.67 |
| 2025169 | HC CARD REHAB MAINT PRG 2X/WEEK | Patient Convenience Items | $145.95 |
| 2025192 | HC RUNNERS EXERCISE CLASS 60 MIN | Patient Convenience Items | $40.00 |
| 2025223 | HC PERSONAL TRAINING 30 MIN 16 SESSION PACKAGE | Patient Convenience Items | $1,080.00 |
| 2025225 | HC PERSONAL TRAINING 60 MIN 16 SESSION PACKAGE | Patient Convenience Items | $2,160.00 |
| 2025227 | HC SPORTS PERFORMANCE EVALUATION 120 MIN | Patient Convenience Items | $425.00 |
| 2025230 | HC SPORTS SPECIFIC TRAINING 60 MIN 16 SESSION PACKAGE | Patient Convenience Items | $2,160.00 |
| 2025580 | HC GHF TRNG 30MIN 8 SES PKG | Patient Convenience Items | $570.00 |
| 2025581 | HC GHF TRAINING 60MIN 8 SES PKG | Patient Convenience Items | $1,140.00 |
| 2025751 | HC CARD REHAB MAINT PRG 1X/WEEK | Patient Convenience Items | $80.00 |
| 2025801 | HC SPORTS SPECIFIC TRAINING 30 MIN | Patient Convenience Items | $90.00 |
| 2025987 | HC SPORTS SPECIFIC EVALUATION W/LACTATE | Patient Convenience Items | $475.00 |
| 2026027 | HC COOLING CAP ADMINISTRATION | Patient Convenience Items | $72.51 |
| 2026202 | HC NW CARDIAC REHAB SESS PHASE III | Patient Convenience Items | $22.00 |
| 2026224 | HC ACL RETURN TO SPORT EVALUATION | Patient Convenience Items | $495.00 |
| 2026228 | HC GOLF EXERCISE CLASS | Patient Convenience Items | $40.00 |
| 2026401 | HC RUNNING 3D EVALUATION | Patient Convenience Items | $425.00 |
| 2026439 | HC INTENSIVE SPEECH LANGUAGE THERAPY FOR STROKE SURVIVORS | Patient Convenience Items | $10,000.00 |
| 2026557 | HC NW DIABETES PREVENTION IND COUNSEL | Patient Convenience Items | $140.00 |
| D015999 | HC PREMIUM DENTURE UP-CHARGE | Patient Convenience Items | $1,080.00 |
| D018999 | HC INVISALIGN WORK-UP | Patient Convenience Items | $270.00 |
| D025999 | HC ESSEX RETAINER | Patient Convenience Items | $250.00 |
| D038999 | HC INVISALIGN | Patient Convenience Items | $8,000.00 |
| RX-1 | 0.45% SODIUM ACETATE, HEPARIN 0.5 UNITS/ML IV INFUSION | Pharmacy | $63.00 |
| RX-10 | ACETIC ACID 2 % OTIC SOLN | Pharmacy | $47.04 |
| RX-1000 | IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,955.29 |
| RX-1002 | IPRATROPIUM BROMIDE 0.03 % NASAL SPRY | Pharmacy | $114.24 |
| RX-1003 | IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHALATION HFAA | Pharmacy | $364.64 |
| RX-1005 | IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHALATION MIST | Pharmacy | $1,011.78 |
| RX-1006 | IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $31.20 |
| RX-1007 | IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS DISP | Pharmacy | $627.96 |
| RX-1008 | IRON DEXTRAN 50 MG/ML INJECTION SOLN | Pharmacy | $181.19 |
| RX-101 | ARGININE-LYSINE IN 0.9 % NACL 25-25 MG/ML INTRAVENOUS SOLN | Pharmacy | $3,024.00 |
| RX-1010 | ISAVUCONAZONIUM SULFATE 186 MG ORAL CAP | Pharmacy | $293.86 |
| RX-1012 | ISOPROTERENOL 200 MCG/50 ML D5W IVPB | Pharmacy | $67.81 |
| RX-1013 | ISOPROTERENOL HCL 0.2 MG/ML INJECTION SOLN | Pharmacy | $8,231.96 |
| RX-1014 | ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN | Pharmacy | $77.01 |
| RX-1015 | IXABEPILONE 15 MG INTRAVENOUS SOLR | Pharmacy | $1,210.52 |
| RX-1016 | KETAMINE 50 MG/ML (1 ML) INTRAVENOUS SYRG | Pharmacy | $65.52 |
| RX-1019 | KETOCONAZOLE 2 % TOP CREA | Pharmacy | $56.18 |
| RX-102 | ARIPIPRAZOLE 300 MG IM SERS | Pharmacy | $86.21 |
| RX-1020 | KETOCONAZOLE 2 % TOP SHAM | Pharmacy | $37.80 |
| RX-1021 | KETOROLAC 0.4 % OPHTHALMIC DROP | Pharmacy | $161.88 |
| RX-1022 | KETOROLAC 0.5 % OPHTHALMIC DROP | Pharmacy | $88.90 |
| RX-1026 | KIT FOR OF PREP TC-99M-ALBUMIN 2.5 MG INTRAVENOUS SOLR | Pharmacy | $2,413.03 |
| RX-1027 | KIT FOR PREP OF GA 68-DOTATATE 40 MCG INTRAVENOUS SOLR | Pharmacy | $4,083.33 |
| RX-1028 | KIT FOR PREP TC-99M-BICISATE 0.9 MG INTRAVENOUS SOLR | Pharmacy | $17,019.45 |
| RX-1029 | KIT FOR TC 99M FILTERED SULFUR COLLOID | Pharmacy | $11,740.68 |
| RX-103 | ARIPIPRAZOLE 300 MG IM SSRR | Pharmacy | $64.66 |
| RX-1030 | KIT FOR TC 99M-SOD THIOSULFATE 2 MG MISC. SOLR | Pharmacy | $1,153.03 |
| RX-1031 | KIT FOR TC-99M-TILMANOCEPT 250 MCG INJECTION SOLR | Pharmacy | $18,798.26 |
| RX-1032 | KIT PREP OF TC-99M-MEBROFENIN 45 MG INTRAVENOUS SOLR | Pharmacy | $420.21 |
| RX-1033 | KIT PREP OF TC-99M-SOD PYROPH 12 MG INTRAVENOUS SOLR | Pharmacy | $967.05 |
| RX-1034 | KIT PREP OF TC-99M-TETROFOSMIN 1.38 MG INTRAVENOUS SOLR | Pharmacy | $548.10 |
| RX-1035 | KIT PREP TC 99M-PENTETIC ACID 20 MG AEROSOL | Pharmacy | $3,425.63 |
| RX-1036 | KIT PREP TC 99M-PENTETIC ACID 20 MG INTRAVENOUS SOLR | Pharmacy | $2,770.98 |
| RX-1037 | KIT PREP TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS KIT | Pharmacy | $20,278.57 |
| RX-1038 | KIT PREP TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS SOLR | Pharmacy | $25,779.60 |
| RX-1039 | KIT PREP TC-99M-MEDRONATE SOD 25 MG INTRAVENOUS SOLR | Pharmacy | $494.05 |
| RX-104 | ARIPIPRAZOLE 400 MG IM SERS | Pharmacy | $64.66 |
| RX-1043 | LACOSAMIDE 100 MG ORAL TAB | Pharmacy | $51.84 |
| RX-1044 | LACOSAMIDE 100 MG/50 ML NS | Pharmacy | $228.90 |
| RX-1045 | LACOSAMIDE 150 MG ORAL TAB | Pharmacy | $49.91 |
| RX-1046 | LACOSAMIDE 200 MG ORAL TAB | Pharmacy | $54.92 |
| RX-1048 | LACOSAMIDE 200 MG/50 ML NS | Pharmacy | $112.70 |
| RX-1049 | LACTATED RINGERS INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-105 | ARIPIPRAZOLE 400 MG IM SSRR | Pharmacy | $86.21 |
| RX-1050 | LACTATED RINGERS IV BOLUS | Pharmacy | $63.00 |
| RX-1051 | LACTATED RINGERS IV KVO | Pharmacy | $63.00 |
| RX-1052 | LANOLIN-MINERAL OIL TOP LOTN | Pharmacy | $181.72 |
| RX-1053 | LANOLIN-MINERAL OIL-NACL-W.PET TOP LOTN | Pharmacy | $117.60 |
| RX-1054 | LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $802.04 |
| RX-1055 | LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRG | Pharmacy | $802.04 |
| RX-1056 | LANSOPRAZOLE 3 MG/ML ORAL SUSR | Pharmacy | $3,867.26 |
| RX-1057 | LENALIDOMIDE 10 MG ORAL CAP | Pharmacy | $2,670.54 |
| RX-1058 | LEUCOVORIN CALCIUM 50 MG INJECTION SOLR | Pharmacy | $41.95 |
| RX-1059 | LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLN | Pharmacy | $41.96 |
| RX-106 | ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $555.33 |
| RX-1060 | LEUCOVORIN CALCIUM 100 MG INJECTION SOLR | Pharmacy | $41.95 |
| RX-1061 | LEUCOVORIN CALCIUM 350 MG INJECTION SOLR | Pharmacy | $41.95 |
| RX-1062 | LEUPROLIDE 3.75 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1063 | LEUPROLIDE 7.5 MG IM SYKT | Pharmacy | $2,898.93 |
| RX-1064 | LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1065 | LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT | Pharmacy | $2,898.94 |
| RX-1066 | LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG | Pharmacy | $2,898.94 |
| RX-1067 | LEUPROLIDE (4 MONTH) 30 MG IM SYKT | Pharmacy | $2,898.93 |
| RX-1068 | LEUPROLIDE (6 MONTH) 45 MG IM SYKT | Pharmacy | $2,898.93 |
| RX-1069 | LEUPROLIDE (6 MONTH) 45 MG SUBCUTANEOUS SYRG | Pharmacy | $2,898.93 |
| RX-107 | ARSENIC TRIOXIDE 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $555.33 |
| RX-1070 | LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1071 | LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1072 | LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT | Pharmacy | $127.61 |
| RX-1073 | LEUPROLIDE 11.25 MG IM KIT | Pharmacy | $15,999.86 |
| RX-1074 | LEUPROLIDE 15 MG IM KIT | Pharmacy | $2,898.93 |
| RX-1075 | LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRG | Pharmacy | $2,898.93 |
| RX-1079 | LEVALBUTEROL TARTRATE 45 MCG/ACTUATION INHALATION HFAA | Pharmacy | $182.70 |
| RX-108 | ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OPHTHALMIC DROP | Pharmacy | $81.90 |
| RX-1085 | LEVOCARNITINE 20 MG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $258.99 |
| RX-1086 | LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLN | Pharmacy | $249.73 |
| RX-109 | ASPARAGINASE (ERWINIA CHRYSAN) 10000 UNITS INJECTION SOLR | Pharmacy | $5,226.78 |
| RX-1091 | LEVONORGESTREL 1.5 MG ORAL TAB | Pharmacy | $103.25 |
| RX-1092 | LEVONORGESTREL 14 MCG/24 HRS (3 YRS) 13.5 MG INTRAUTERINE IUD | Pharmacy | $8,403.32 |
| RX-1093 | LEVONORGESTREL 17.5 MCG/24 HRS (5 YRS) 19.5 MG INTRAUTERINE IUD | Pharmacy | $10,091.97 |
| RX-1094 | LEVONORGESTREL 20 MCG/24 HOURS (5 YRS) 52 MG INTRAUTERINE IUD | Pharmacy | $10,091.97 |
| RX-1095 | LEVONORGESTREL 20.1 MCG/24 HRS (6 YRS) 52 MG INTRAUTERINE IUD | Pharmacy | $9,914.56 |
| RX-1096 | LEVOTHYROXINE 100 MCG INTRAVENOUS SOLR | Pharmacy | $1,049.71 |
| RX-1097 | LEVOTHYROXINE 20 MCG/ML INJECTION (PED-NEO) | Pharmacy | $1,041.64 |
| RX-1098 | LEVOTHYROXINE 200 MCG INTRAVENOUS SOLR | Pharmacy | $1,865.43 |
| RX-1099 | LEVOTHYROXINE 500 MCG INTRAVENOUS SOLR | Pharmacy | $4,515.59 |
| RX-11 | ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT | Pharmacy | $197.47 |
| RX-110 | ATAZANAVIR 200 MG ORAL CAP | Pharmacy | $82.36 |
| RX-1105 | LIDOCAINE (PF) 3.5 % OPHTHALMIC GEL | Pharmacy | $64.19 |
| RX-111 | ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLN | Pharmacy | $981.00 |
| RX-1113 | LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMBR SOLN | Pharmacy | $63.00 |
| RX-1118 | LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLN | Pharmacy | $10.33 |
| RX-112 | ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLN | Pharmacy | $981.00 |
| RX-1127 | LINACLOTIDE 145 MCG ORAL CAP | Pharmacy | $47.08 |
| RX-1128 | LINACLOTIDE 290 MCG ORAL CAP | Pharmacy | $47.08 |
| RX-1129 | LINDANE 1 % TOP SHAM | Pharmacy | $348.60 |
| RX-1130 | LINEZOLID 2 MG/ML IV DISPENSABLE | Pharmacy | $70.56 |
| RX-1131 | LINEZOLID IN DEXTROSE 5% 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $70.56 |
| RX-1132 | LINEZOLID IN DEXTROSE 5% 600 MG/300 ML INTRAVENOUS PGBK | Pharmacy | $70.56 |
| RX-1133 | LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLN | Pharmacy | $3,087.00 |
| RX-1134 | LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBCUTANEOUS PNIJ | Pharmacy | $3,688.52 |
| RX-1135 | LOMUSTINE 10 MG ORAL CAP | Pharmacy | $1,040.13 |
| RX-1136 | LOMUSTINE 40 MG ORAL CAP | Pharmacy | $1,155.67 |
| RX-1137 | LOMUSTINE 100 MG ORAL CAP | Pharmacy | $1,148.49 |
| RX-1141 | LOTEPREDNOL ETABONATE 0.5 % OPHTHALMIC DRPS | Pharmacy | $800.28 |
| RX-1142 | LURASIDONE 20 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1143 | LURASIDONE 40 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1144 | LURASIDONE 60 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1145 | LURASIDONE 80 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1146 | LURASIDONE 120 MG ORAL TAB | Pharmacy | $196.74 |
| RX-1147 | LURBINECTEDIN 4 MG INTRAVENOUS SOLR | Pharmacy | $83,575.80 |
| RX-1148 | LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLR | Pharmacy | $433.59 |
| RX-1149 | LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLN | Pharmacy | $2,254.56 |
| RX-115 | ATROPINE 1 % OPHTHALMIC DROP | Pharmacy | $148.40 |
| RX-1150 | LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $16,274.32 |
| RX-1151 | MACITENTAN 10 MG ORAL TAB | Pharmacy | $806.16 |
| RX-116 | ATROPINE 1 % OPHTHALMIC OINT | Pharmacy | $53.41 |
| RX-1164 | MANGANESE CHLORIDE 0.01 MG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $24.07 |
| RX-1165 | MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $24.07 |
| RX-1166 | MANGANESE SULFATE 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $28.22 |
| RX-1167 | MANNITOL 20 % 20 % INTRAVENOUS SOLP | Pharmacy | $25.83 |
| RX-1168 | MANNITOL 25 % 25 % INTRAVENOUS SOLN | Pharmacy | $25.83 |
| RX-1169 | MARAVIROC 150 MG ORAL TAB | Pharmacy | $82.39 |
| RX-1170 | MARAVIROC 300 MG ORAL TAB | Pharmacy | $82.39 |
| RX-1171 | MEASLES,MUMPS,RUB,VARICEL(PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR | Pharmacy | $5,388.77 |
| RX-1172 | MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLR | Pharmacy | $858.44 |
| RX-1175 | MELPHALAN HCL 50 MG INTRAVENOUS SOLR | Pharmacy | $7,980.69 |
| RX-1176 | MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT | Pharmacy | $1,142.32 |
| RX-1177 | MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN | Pharmacy | $734.96 |
| RX-1178 | MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG | Pharmacy | $1,740.56 |
| RX-1179 | MENTHOL-ZINC OXIDE 0.44-20.6 % TOP OINT | Pharmacy | $88.10 |
| RX-118 | AVELUMAB 20 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,059.86 |
| RX-1180 | MEPERIDINE (PF) 25 MG/ML INJECTION SOLN | Pharmacy | $59.52 |
| RX-1181 | MEPERIDINE (PF) 25 MG/ML INJECTION SYRG | Pharmacy | $59.52 |
| RX-1182 | MEPERIDINE (PF) 50 MG/ML INJECTION SOLN | Pharmacy | $59.52 |
| RX-1183 | MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLN | Pharmacy | $29.36 |
| RX-1184 | MEPIVACAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLN | Pharmacy | $29.36 |
| RX-1185 | MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLN | Pharmacy | $29.36 |
| RX-1186 | MEROPENEM 1 G INTRAVENOUS SOLR | Pharmacy | $10.04 |
| RX-1187 | MEROPENEM 500 MG INTRAVENOUS SOLR | Pharmacy | $10.04 |
| RX-1188 | MEROPENEM-0.9% SODIUM CHLORIDE 1 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.08 |
| RX-1189 | MEROPENEM-0.9% SODIUM CHLORIDE 500 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $10.04 |
| RX-119 | AZACITIDINE 100 MG INJECTION SOLR | Pharmacy | $12.89 |
| RX-1190 | MESALAMINE 1000 MG RECTAL SUPP | Pharmacy | $122.99 |
| RX-1191 | MESNA 100 MG/ML INTRAVENOUS SOLN | Pharmacy | $27.95 |
| RX-1192 | METFORMIN 1000 MG ORAL TG24 | Pharmacy | $44.10 |
| RX-1193 | METHADONE 10 MG/ML INJECTION SOLN | Pharmacy | $213.87 |
| RX-1194 | METHOCARBAMOL 100 MG/ML INJECTION SOLN | Pharmacy | $104.20 |
| RX-1195 | METHOHEXITAL 500 MG INJECTION SOLR | Pharmacy | $15.37 |
| RX-1197 | METHOTREXATE SODIUM (PF) 1 G INJECTION SOLR | Pharmacy | $31.37 |
| RX-12 | ACETYLCYSTEINE 100 MG/ML (10 %) MISC. SOLN | Pharmacy | $71.69 |
| RX-120 | AZACITIDINE INJ SUBQ 100 MG (CC) | Pharmacy | $12.89 |
| RX-1202 | METHOXSALEN 20 MCG/ML INJECTION SOLN | Pharmacy | $1,337.00 |
| RX-1203 | METHYL SALICYLATE-MENTHOL TOP OINT | Pharmacy | $90.16 |
| RX-1204 | METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $77.01 |
| RX-1205 | METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) INTRAVENOUS SOLN | Pharmacy | $77.01 |
| RX-1206 | METHYLERGONOVINE 0.2 MG ORAL TAB | Pharmacy | $139.76 |
| RX-1207 | METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLN | Pharmacy | $227.34 |
| RX-1211 | METHYLNALTREXONE 150 MG ORAL TAB | Pharmacy | $65.98 |
| RX-1213 | METHYLPHENIDATE HCL 27 MG ORAL TR24 | Pharmacy | $38.47 |
| RX-1214 | METHYLPHENIDATE HCL 54 MG ORAL TR24 | Pharmacy | $43.19 |
| RX-122 | AZELASTINE 0.15 % (205.5 MCG) NASAL SPRY | Pharmacy | $93.45 |
| RX-1220 | METHYLPREDNISOLONE ACETATE 40 MG/ML INJECTION SUSP | Pharmacy | $79.22 |
| RX-1221 | METHYLPREDNISOLONE ACETATE 80 MG/ML INJECTION SUSP | Pharmacy | $149.88 |
| RX-1222 | METHYLPREDNISOLONE SOD SUC(PF) 1000 MG/8 ML INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-1223 | METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJECTION SOLR | Pharmacy | $79.59 |
| RX-1224 | METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJECTION SOLR | Pharmacy | $57.73 |
| RX-1225 | METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-1226 | METHYLPREDNISOLONE SODIUM SUCC 40 MG INJECTION SOLR | Pharmacy | $57.73 |
| RX-1227 | METHYLPREDNISOLONE SODIUM SUCC 125 MG INJECTION SOLR | Pharmacy | $79.59 |
| RX-1228 | METHYLPREDNISOLONE SODIUM SUCC 500 MG INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-1229 | METHYLPREDNISOLONE SODIUM SUCC 1000 MG INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-123 | AZITHROMYCIN 1 G ORAL PACK | Pharmacy | $277.58 |
| RX-1230 | METHYLPREDNISOLONE SODIUM SUCC 40 MG/ML INJECTION SOLR | Pharmacy | $57.73 |
| RX-1231 | METOCLOPRAMIDE HCL 5 MG/ML INJECTION SOLN | Pharmacy | $15.15 |
| RX-1232 | METOCLOPRAMIDE HCL 5 MG/ML INJECTION SYRG | Pharmacy | $15.15 |
| RX-1233 | METOPROLOL IN 0.9 % NACL 5 MG/50 ML IVPB | Pharmacy | $31.50 |
| RX-1235 | METRONIDAZOLE 0.75 % TOP CREA | Pharmacy | $151.20 |
| RX-1236 | METRONIDAZOLE 0.75 % VAGINAL GEL | Pharmacy | $218.05 |
| RX-1237 | METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-1239 | MICAFUNGIN 50 MG INTRAVENOUS SOLR | Pharmacy | $13.32 |
| RX-124 | AZITHROMYCIN 200 MG/5 ML ORAL SUSR | Pharmacy | $144.90 |
| RX-1240 | MICAFUNGIN 100 MG INTRAVENOUS SOLR | Pharmacy | $13.32 |
| RX-1241 | MICONAZOLE NITRATE 2 % TOP CREA | Pharmacy | $92.61 |
| RX-1242 | MICONAZOLE NITRATE 2 % TOP OINT | Pharmacy | $474.81 |
| RX-1243 | MICROFIBRIL. COLLAGEN HEMOSTAT TOP POWD | Pharmacy | $364.70 |
| RX-125 | AZITHROMYCIN 250 MG ORAL TAB | Pharmacy | $15.12 |
| RX-1255 | MIDOSTAURIN 25 MG ORAL CAP | Pharmacy | $508.62 |
| RX-1256 | MILRINONE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $19.22 |
| RX-1257 | MILRINONE IN 5 % DEXTROSE 40 MG/200 ML (200 MCG/ML) INTRAVENOUS PGBK | Pharmacy | $19.22 |
| RX-1258 | MILRINONE IN 5 % DEXTROSE 50 ML (200 MCG/ML) INTRAVENOUS | Pharmacy | $19.22 |
| RX-1259 | MINOCYCLINE 100 MG INTRAVENOUS SOLR | Pharmacy | $22.86 |
| RX-126 | AZITHROMYCIN 500 MG INTRAVENOUS SOLR | Pharmacy | $32.75 |
| RX-1260 | MIRABEGRON 25 MG ORAL TB24 | Pharmacy | $42.88 |
| RX-1261 | MIRABEGRON 50 MG ORAL TB24 | Pharmacy | $42.88 |
| RX-1262 | MITOMYCIN 0.2 MG OPHTHALMIC KIT | Pharmacy | $4,523.40 |
| RX-1263 | MITOMYCIN 20 MG INTRAVENOUS SOLR | Pharmacy | $1,006.60 |
| RX-1264 | MITOMYCIN 20 MG NON-ONCOLOGY USE IV SOLR | Pharmacy | $1,006.60 |
| RX-1265 | MITOMYCIN 40 MG IV SOLUTION | Pharmacy | $1,006.60 |
| RX-1266 | MITOMYCIN TOPICAL SOLUTION 0.4 MG/ML | Pharmacy | $278.67 |
| RX-1267 | MITOXANTRONE 2 MG/ML INTRAVENOUS CONC | Pharmacy | $350.34 |
| RX-1268 | MITOXANTRONE 2 MG/ML NON-ONCOLOGY USE IV CONC | Pharmacy | $350.34 |
| RX-1269 | MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLN | Pharmacy | $2,530.96 |
| RX-127 | AZITHROMYCIN 500 MG ORAL TAB | Pharmacy | $110.38 |
| RX-1270 | MOMETASONE 100 MCG/ACTUATION INHALATION HFAA | Pharmacy | $18.27 |
| RX-1271 | MOMETASONE 1350 MCG SINU IMPL | Pharmacy | $117.52 |
| RX-1272 | MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION INHALATION HFAA | Pharmacy | $273.80 |
| RX-1273 | MORPHINE 2 MG/ML INJECTION SYRG | Pharmacy | $25.58 |
| RX-1274 | MORPHINE 2 MG/ML INTRAVENOUS SYRG | Pharmacy | $25.58 |
| RX-1275 | MORPHINE 4 MG/ML INJECTION SYRG | Pharmacy | $25.58 |
| RX-1276 | MORPHINE 4 MG/ML INTRAVENOUS CRTG | Pharmacy | $25.57 |
| RX-1277 | MORPHINE 4 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.58 |
| RX-1278 | MORPHINE 4 MG/ML INTRAVENOUS SYRG | Pharmacy | $25.58 |
| RX-1279 | MORPHINE (PF) 0.5 MG/ML INJECTION SOLN | Pharmacy | $25.70 |
| RX-128 | AZITHROMYCIN 600 MG ORAL TAB | Pharmacy | $80.87 |
| RX-1280 | MORPHINE (PF) 1 MG/ML INJECTION SOLN | Pharmacy | $25.58 |
| RX-1281 | MORPHINE (PF) 10 MG/ML INJECTION SOLN | Pharmacy | $25.57 |
| RX-1282 | MORPHINE (PF) 25 MG/ML INJECTION SOLN | Pharmacy | $25.57 |
| RX-1283 | MORPHINE (PF) IN 0.9 % SOD CHL 0.5 MG/ML INTRAVENOUS SYRG | Pharmacy | $25.70 |
| RX-1284 | MORPHINE (PF) IN 0.9 % SOD CHL 100 MG/100 ML (1 MG/ML) INTRAVENOUS RESV | Pharmacy | $25.58 |
| RX-1285 | MORPHINE 0.5 MG/ML SUPER ORDERABLE | Pharmacy | $148.72 |
| RX-1286 | MORPHINE 10 MG/ML INJECTION SOLN | Pharmacy | $25.57 |
| RX-1287 | MORPHINE 10 MG/ML INJECTION SYRG | Pharmacy | $25.57 |
| RX-1288 | MORPHINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.57 |
| RX-1289 | MORPHINE 10 MG/ML SUPER ORDERABLE | Pharmacy | $25.57 |
| RX-129 | AZTREONAM 1 G INJECTION SOLR | Pharmacy | $154.60 |
| RX-1290 | MORPHINE 100 MG/4 ML INTRAVENOUS SOLN | Pharmacy | $25.57 |
| RX-1291 | MORPHINE 2 MG/ML SUPER ORDERABLE | Pharmacy | $25.58 |
| RX-1292 | MORPHINE 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.57 |
| RX-1293 | MORPHINE 4 MG/ML SUPER ORDERABLE | Pharmacy | $25.58 |
| RX-1294 | MORPHINE 8 MG/ML SUPER ORDERABLE | Pharmacy | $25.58 |
| RX-1295 | MORPHINE IN 0.9 % NACL 100 MG/100 ML (1 MG/ML) INFUSION | Pharmacy | $25.58 |
| RX-1296 | MORPHINE IN 0.9 % NACL 60 MG/30 ML (PED-NEO) PCA STANDARD | Pharmacy | $25.58 |
| RX-1297 | MORPHINE IN 0.9 % NACL 60 MG/30 ML (PED-NEO) PCA STANDARD FLAT DOSING | Pharmacy | $25.64 |
| RX-1298 | MORPHINE IN 0.9 % NACL 60 MG/30 ML PCA RESTRICTED | Pharmacy | $25.58 |
| RX-1299 | MORPHINE IN 0.9 % SODIUM CHLOR 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.58 |
| RX-13 | ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLN | Pharmacy | $11.44 |
| RX-130 | AZTREONAM 2 G INJECTION SOLR | Pharmacy | $154.57 |
| RX-1300 | MORPHINE IN 0.9 % SODIUM CHLOR 60 MG/30 ML (2 MG/ML) INTRAVENOUS SPCA | Pharmacy | $25.58 |
| RX-1301 | MOXIFLOXACIN 0.5 % OPHTHALMIC DROP | Pharmacy | $77.07 |
| RX-1302 | MOXIFLOXACIN-SOD.ACE,SUL-WATER 400 MG/250 ML INTRAVENOUS PGBK | Pharmacy | $113.40 |
| RX-1303 | MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML INTRAVENOUS PGBK | Pharmacy | $113.40 |
| RX-1304 | MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD | Pharmacy | $46.73 |
| RX-1305 | MUPIROCIN CALCIUM 2 % TOP CREA | Pharmacy | $537.08 |
| RX-1306 | MVI ADULT TPN INJECTION | Pharmacy | $45.36 |
| RX-1308 | MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML INTRAVENOUS SOLN | Pharmacy | $20.16 |
| RX-1309 | MYCOPHENOLATE MOFETIL (HCL) 500 MG INTRAVENOUS SOLR | Pharmacy | $514.58 |
| RX-131 | BACITRACIN 500 UNIT/GRAM OPHTHALMIC OINT | Pharmacy | $313.48 |
| RX-1313 | MYCOPHENOLATE SODIUM 180 MG ORAL TBEC | Pharmacy | $33.57 |
| RX-1314 | MYCOPHENOLATE SODIUM 360 MG ORAL TBEC | Pharmacy | $33.57 |
| RX-1315 | N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG | Pharmacy | $1,527.06 |
| RX-1316 | NAFCILLIN 1 G INJECTION SOLR | Pharmacy | $65.27 |
| RX-1317 | NAFCILLIN 2 G INJECTION SOLR | Pharmacy | $92.11 |
| RX-1318 | NALBUPHINE 10 MG/ML INJECTION SOLN | Pharmacy | $39.63 |
| RX-1319 | NALOXONE 0.4 MG/ML INJECTION SOLN | Pharmacy | $167.33 |
| RX-132 | BACITRACIN 50000 UNITS IM SOLR | Pharmacy | $55.44 |
| RX-1320 | NALOXONE 1 MG/ML INJECTION SYRG | Pharmacy | $167.30 |
| RX-1321 | NALOXONE 1 MG/ML ORAL SOLUTION | Pharmacy | $48.58 |
| RX-1322 | NALTREXONE MICROSPHERES 380 MG IM SSRR | Pharmacy | $40.76 |
| RX-1323 | NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLN | Pharmacy | $263.37 |
| RX-1324 | NELARABINE 250 MG/50 ML INTRAVENOUS SOLN | Pharmacy | $1,924.27 |
| RX-1325 | NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOP OINT | Pharmacy | $143.85 |
| RX-1326 | NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OPHTHALMIC DRPS | Pharmacy | $47.08 |
| RX-1327 | NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75 MG-10,000 UNIT-0.025MG/ML OPHTHALMIC DROP | Pharmacy | $156.45 |
| RX-1328 | NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS | Pharmacy | $182.00 |
| RX-1329 | NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC SOLN | Pharmacy | $199.15 |
| RX-133 | BACITRACIN ZINC 500 UNIT/GRAM TOP OINT | Pharmacy | $57.82 |
| RX-1330 | NEOMYCIN-POLYMYXIN-HC 3.5-10,000-10 MG-UNIT-MG/ML OPHTHALMIC DRPS | Pharmacy | $353.59 |
| RX-1331 | NEOMY-POLYMYXINB-BACITRACIN-HC 1 % TOP OINT | Pharmacy | $505.05 |
| RX-1335 | NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $18.27 |
| RX-1336 | NICARDIPINE IN D5W 25 MG/250 ML (CUPID OSM USE ONLY) | Pharmacy | $4,580.10 |
| RX-1337 | NICARDIPINE IN DEXTROSE,ISO-OS 20 MG/200 ML (0.1 MG/ML) INTRAVENOUS PGBK | Pharmacy | $1,159.20 |
| RX-1338 | NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML (0.1 MG/ML) INTRAVENOUS PGBK | Pharmacy | $630.00 |
| RX-1339 | NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) INTRAVENOUS PGBK | Pharmacy | $1,033.20 |
| RX-134 | BACLOFEN 50 MCG/ML INTRATHECAL SOLN | Pharmacy | $756.86 |
| RX-1340 | NICARDIPINE IN NS 25 MG/250 ML (CUPID OSM USE ONLY) | Pharmacy | $4,580.10 |
| RX-1341 | NIMODIPINE 30 MG/10 ML ORAL SOLN | Pharmacy | $1,506.05 |
| RX-1342 | NIMODIPINE 30 MG/5 ML ORAL SYRG | Pharmacy | $27.46 |
| RX-1343 | NIMODIPINE 60 MG/10 ML ORAL SYRG | Pharmacy | $27.46 |
| RX-1344 | NIMODIPINE 60 MG/20 ML ORAL SOLN | Pharmacy | $263.20 |
| RX-1345 | NINTEDANIB 150 MG ORAL CAP | Pharmacy | $611.59 |
| RX-1346 | NITAZOXANIDE 500 MG ORAL TAB | Pharmacy | $460.25 |
| RX-1347 | NITROGLYCERIN 0.3 MG/HR TRANSDERMAL PT24 | Pharmacy | $99.72 |
| RX-1348 | NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL SPRY | Pharmacy | $425.66 |
| RX-1349 | NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $13.73 |
| RX-135 | BACLOFEN 500 MCG/ML INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1352 | NITROGLYCERIN IN 5 % DEXTROSE 100 MG/250 ML (400 MCG/ML) IV SOLN (CATHLAB ONLY) | Pharmacy | $157.50 |
| RX-1358 | NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $354.84 |
| RX-1359 | NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLN | Pharmacy | $354.84 |
| RX-136 | BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1360 | NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLN | Pharmacy | $354.84 |
| RX-1361 | NORELGESTROMIN-ETHIN.ESTRADIOL 150-35 MCG/24 HR TRANSDERMAL PTWK | Pharmacy | $129.33 |
| RX-1362 | NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $19.03 |
| RX-1363 | NOREPINEPHRINE BITARTRATE-NACL 16 MG/250 ML (64 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $598.50 |
| RX-1364 | NOREPINEPHRINE BITARTRATE-NACL 4 MG/250 ML (16 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $299.25 |
| RX-1365 | NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLN | Pharmacy | $6,169.83 |
| RX-1366 | NYSTATIN 100000 UNIT/GRAM TOP POWD | Pharmacy | $44.52 |
| RX-1367 | NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOP CREA | Pharmacy | $84.00 |
| RX-1368 | NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOP OINT | Pharmacy | $284.97 |
| RX-1369 | OBINUTUZUMAB 1000 MG/40 ML INTRAVENOUS SOLN | Pharmacy | $800.29 |
| RX-137 | BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1370 | OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLN | Pharmacy | $723.45 |
| RX-1371 | OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1372 | OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1373 | OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1374 | OCTREOTIDE ACETATE 1000 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1375 | OCTREOTIDE,MICROSPHERES 10 MG IM SSRR | Pharmacy | $2,596.67 |
| RX-1376 | OCTREOTIDE,MICROSPHERES 20 MG IM SSRR | Pharmacy | $2,596.67 |
| RX-1377 | OCTREOTIDE,MICROSPHERES 30 MG IM SSRR | Pharmacy | $2,596.67 |
| RX-1378 | OLANZAPINE 10 MG IM SOLR | Pharmacy | $32.94 |
| RX-1379 | OLARATUMAB 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $657.28 |
| RX-138 | BACLOFEN 10,000 MCG/5 ML (2,000 MCG/ML) IT SOLN | Pharmacy | $2,187.36 |
| RX-1380 | OLOPATADINE 0.1 % OPHTHALMIC DROP | Pharmacy | $125.65 |
| RX-1381 | OMALIZUMAB 150 MG SUBCUTANEOUS SOLR | Pharmacy | $470.70 |
| RX-1382 | OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $470.70 |
| RX-1383 | OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $470.70 |
| RX-1384 | ONABOTULINUMTOXINA (COSMETIC) 50 UNITS IM SOLR | Pharmacy | $77.14 |
| RX-1385 | ONABOTULINUMTOXINA 100 UNITS INJECTION SOLR | Pharmacy | $77.14 |
| RX-1386 | ONABOTULINUMTOXINA 200 UNITS INJECTION SOLR | Pharmacy | $77.14 |
| RX-139 | BACLOFEN 20,000 MCG/20ML (1,000 MCG/ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1396 | OXACILLIN 1 G INJECTION SOLR | Pharmacy | $16.47 |
| RX-1397 | OXACILLIN 2 G INJECTION SOLR | Pharmacy | $16.47 |
| RX-1399 | OXCARBAZEPINE 600 MG ORAL TB24 | Pharmacy | $57.79 |
| RX-14 | ACETYLCYSTEINE 200 MG/ML (20 %) MISC. SOLN | Pharmacy | $71.69 |
| RX-140 | BACLOFEN 2000 MCG/ML INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1400 | OXYCODONE 40 MG ORAL TR12 | Pharmacy | $35.14 |
| RX-1401 | OXYTOCIN 10 UNITS/ML INJECTION SOLN | Pharmacy | $34.27 |
| RX-1402 | OXYTOCIN IN LACTACTED RINGERS 20 UNITS/1,000 ML INFUSION (POST-PARTUM) NON TIT | Pharmacy | $18.90 |
| RX-1403 | OXYTOCIN IN LACTATED RINGERS 20 UNIT/1,000 ML INTRAVENOUS SOLN | Pharmacy | $18.90 |
| RX-1404 | OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML INTRAVENOUS SOLN | Pharmacy | $16.80 |
| RX-1406 | PACLITAXEL-PROTEIN BOUND 100 MG INTRAVENOUS SUSR | Pharmacy | $158.18 |
| RX-1407 | PALIPERIDONE 3 MG ORAL TR24 | Pharmacy | $38.22 |
| RX-1408 | PALIPERIDONE 6 MG ORAL TR24 | Pharmacy | $76.72 |
| RX-1409 | PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG | Pharmacy | $145.93 |
| RX-141 | BACLOFEN 40,000 MCG/20ML (2,000 MCG/ML) INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1410 | PALIPERIDONE PALMITATE 156 MG/ML IM SYRG | Pharmacy | $145.93 |
| RX-1411 | PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG | Pharmacy | $145.93 |
| RX-1412 | PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG | Pharmacy | $145.93 |
| RX-1413 | PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG | Pharmacy | $145.93 |
| RX-1414 | PALIVIZUMAB 100 MG/ML IM SOLN | Pharmacy | $23,167.37 |
| RX-1415 | PALIVIZUMAB 50 MG/0.5 ML IM SOLN | Pharmacy | $23,167.37 |
| RX-1416 | PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $78.25 |
| RX-1417 | PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLN (PED-NEO) | Pharmacy | $78.25 |
| RX-1418 | PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLN | Pharmacy | $139.48 |
| RX-1419 | PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLN | Pharmacy | $139.42 |
| RX-142 | BACLOFEN 40,000 MCG/20ML (2,000 MCG/ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1420 | PAMIDRONATE 90 MG INTRAVENOUS SOLR | Pharmacy | $139.37 |
| RX-1421 | PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,493.33 |
| RX-1422 | PANTOPRAZOLE 2 MG/ML ORAL SUSP | Pharmacy | $45.22 |
| RX-1423 | PANTOPRAZOLE 4 MG/ML INJECTION (PED-NEO) | Pharmacy | $35.78 |
| RX-1424 | PANTOPRAZOLE 40 MG INTRAVENOUS SOLR | Pharmacy | $57.20 |
| RX-1425 | PANTOPRAZOLE 40 MG ORAL GRPS | Pharmacy | $45.22 |
| RX-1426 | PAPAVERINE 30 MG/ML INJECTION SOLN | Pharmacy | $350.53 |
| RX-1427 | PARENTERAL AMINO ACID 10% NO.4 10 % INTRAVENOUS SOLP | Pharmacy | $126.00 |
| RX-1428 | PARENTERAL AMINO ACID 15% NO.1 15 % INTRAVENOUS SOLP | Pharmacy | $756.00 |
| RX-143 | BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1431 | PAROXETINE MESYLATE 20 MG ORAL TAB | Pharmacy | $35.35 |
| RX-1432 | PATIROMER CALCIUM SORBITEX 8.4 G ORAL PWPK | Pharmacy | $1,067.22 |
| RX-1433 | PATIROMER CALCIUM SORBITEX 16.8 G ORAL PWPK | Pharmacy | $1,597.01 |
| RX-1434 | PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR | Pharmacy | $42.00 |
| RX-1435 | PEGASPARGASE 750 UNITS/ML INJECTION SOLN | Pharmacy | $221,402.48 |
| RX-1436 | PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYIN | Pharmacy | $53,639.42 |
| RX-1437 | PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRG | Pharmacy | $53,639.42 |
| RX-1438 | PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRG | Pharmacy | $4,240.16 |
| RX-1439 | PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLN | Pharmacy | $11,679.07 |
| RX-144 | BARIUM SULFATE 0.1 % ORAL SUSP | Pharmacy | $12.60 |
| RX-1440 | PEGLOTICASE 8 MG/ML INTRAVENOUS SOLN | Pharmacy | $33,034.31 |
| RX-1441 | PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $633.33 |
| RX-1442 | PEMETREXED 500 MG INTRAVENOUS SOLR | Pharmacy | $891.99 |
| RX-1443 | PENICILLIN G BENZATHIN,PROCAIN 1,200,000 UNIT/ 2 ML(600K/600K) IM SYRG | Pharmacy | $136.91 |
| RX-1444 | PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG | Pharmacy | $173.43 |
| RX-1445 | PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG | Pharmacy | $173.43 |
| RX-1446 | PENICILLIN G BENZATHINE 600000 UNITS/ML IM SYRG | Pharmacy | $173.43 |
| RX-1447 | PENICILLIN G POTASSIUM 5 MILLION UNIT INJECTION SOLR | Pharmacy | $13.22 |
| RX-1448 | PENICILLIN G POTASSIUM 5 MU/50 ML | Pharmacy | $13.23 |
| RX-1449 | PENICILLIN G SODIUM 5 MILLION UNIT INJECTION SOLR | Pharmacy | $317.39 |
| RX-145 | BARIUM SULFATE 40 % (W/V) ORAL SUSP | Pharmacy | $50.40 |
| RX-1450 | PENICILLIN G SODIUM IN D5W 2.5 MU/100 ML IVPB | Pharmacy | $13.31 |
| RX-1451 | PENICILLIN G SODIUM IN D5W 3 MU/100 ML IVPB | Pharmacy | $199.16 |
| RX-1452 | PENICILLIN G SODIUM IN D5W 5 MU/100 ML IVPB | Pharmacy | $13.31 |
| RX-1453 | PENTAMIDINE 300 MG INHALATION SOLR | Pharmacy | $1,527.26 |
| RX-1454 | PENTAMIDINE 300 MG INJECTION SOLR | Pharmacy | $86.18 |
| RX-1455 | PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLN | Pharmacy | $440.75 |
| RX-1456 | PEP PACK 1-DAY | Pharmacy | $393.60 |
| RX-1457 | PEP PACK 4-DAY | Pharmacy | $2,298.32 |
| RX-1458 | PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $21.15 |
| RX-1459 | PERAMPANEL 2 MG ORAL TAB | Pharmacy | $54.01 |
| RX-146 | BARIUM SULFATE 60 % (W/V) ORAL SUSP | Pharmacy | $484.58 |
| RX-1460 | PERAMPANEL 4 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1461 | PERAMPANEL 6 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1462 | PERAMPANEL 10 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1463 | PERAMPANEL 12 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1464 | PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSP | Pharmacy | $607.27 |
| RX-1465 | PERMETHRIN 1 % TOP LIQD | Pharmacy | $456.37 |
| RX-1466 | PERMETHRIN 5 % TOP CREA | Pharmacy | $48.30 |
| RX-1467 | PERPHENAZINE 2 MG ORAL TAB | Pharmacy | $21.67 |
| RX-147 | BARIUM SULFATE 40 % (W/V) 29% (W/W) ORAL SUSP | Pharmacy | $175.00 |
| RX-1471 | PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLN | Pharmacy | $158.97 |
| RX-1472 | PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBCUTANEOUS SOLN | Pharmacy | $106,734.60 |
| RX-1473 | PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML ORAL ELIX | Pharmacy | $51.63 |
| RX-1474 | PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLN | Pharmacy | $534.18 |
| RX-1475 | PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLN | Pharmacy | $534.17 |
| RX-1476 | PHENTOLAMINE 5 MG INJECTION SOLR | Pharmacy | $4,811.97 |
| RX-1477 | PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT | Pharmacy | $636.41 |
| RX-1478 | PHENYLEPHRINE HCL 0.25 % NASAL SPRY | Pharmacy | $302.40 |
| RX-1479 | PHENYLEPHRINE HCL 0.5 % NASAL SPRY | Pharmacy | $302.40 |
| RX-148 | BARIUM SULFATE 40 % (W/V), 30% (W/W) ORAL PSTE | Pharmacy | $177.10 |
| RX-1480 | PHENYLEPHRINE HCL 1 % NASAL DROP | Pharmacy | $132.30 |
| RX-1481 | PHENYLEPHRINE HCL 2.5 % OPHTHALMIC DROP | Pharmacy | $96.04 |
| RX-1482 | PHENYLEPHRINE HCL 10 % OPHTHALMIC DROP | Pharmacy | $109.73 |
| RX-1483 | PHENYLEPHRINE HCL 10 MG/ML INJECTION SOLN | Pharmacy | $34.65 |
| RX-1484 | PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) INTRAVENOUS SYRG | Pharmacy | $53.26 |
| RX-1486 | PHENYLEPHRINE HCL IN 0.9% NACL 400 MCG/ML INTRAVENOUS SOLN | Pharmacy | $223.65 |
| RX-1487 | PHENYLEPHRINE IN 0.9 % NACL 100 MG/250 ML (400 MCG/ML) IVPB | Pharmacy | $223.65 |
| RX-1488 | PHENYLEPHRINE IN 0.9% NACL(PF) 1 MG/10 ML (100 MCG/ML) INTRAVENOUS SYRG | Pharmacy | $53.26 |
| RX-1489 | PHENYLEPHRINE-KETOROLAC 1-0.3 % INTRAOCULAR CONC | Pharmacy | $1,382.18 |
| RX-149 | BASILIXIMAB 20 MG INTRAVENOUS SOLR | Pharmacy | $47,981.81 |
| RX-1490 | PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $12.31 |
| RX-1491 | PHYSOSTIGMINE SALICYLATE 1 MG/ML INJECTION SOLN | Pharmacy | $447.55 |
| RX-1492 | PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLN | Pharmacy | $53.32 |
| RX-1493 | PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRG | Pharmacy | $53.32 |
| RX-1494 | PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLN | Pharmacy | $53.32 |
| RX-1495 | PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB | Pharmacy | $171.19 |
| RX-1496 | PHYTONADIONE 2.5 MG ORAL PARTIAL TAB | Pharmacy | $186.62 |
| RX-1497 | PILOCARPINE HCL 1 % OPHTHALMIC DROP | Pharmacy | $148.58 |
| RX-1498 | PILOCARPINE HCL 2 % OPHTHALMIC DROP | Pharmacy | $300.83 |
| RX-1499 | PILOCARPINE HCL 4 % OPHTHALMIC DROP | Pharmacy | $252.53 |
| RX-15 | ACYCLOVIR 5 % TOP OINT | Pharmacy | $134.93 |
| RX-150 | BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHALATION AERO | Pharmacy | $419.56 |
| RX-1500 | PIPERACILLIN-TAZOBACTAM 2.25 G INTRAVENOUS SOLR | Pharmacy | $23.30 |
| RX-1501 | PIPERACILLIN-TAZOBACTAM 3.375 G INTRAVENOUS SOLR | Pharmacy | $23.30 |
| RX-1502 | PIPERACILLIN-TAZOBACTAM 4.5 G INTRAVENOUS SOLR | Pharmacy | $23.30 |
| RX-1503 | PIPERACILLIN-TAZOBACTAM-DEXTRS 2.25 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $23.30 |
| RX-1504 | PLASMA-LYTE WITH HEPARIN 32000 UNITS 1000 ML SOLUTION | Pharmacy | $45.50 |
| RX-1505 | PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $4,381.35 |
| RX-1506 | PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | Pharmacy | $2,704.21 |
| RX-1507 | PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJECTION SOLN | Pharmacy | $1,439.06 |
| RX-1508 | PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJECTION SYRG | Pharmacy | $1,439.06 |
| RX-1509 | POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLR | Pharmacy | $1,400.05 |
| RX-151 | BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION INHALATION AERO | Pharmacy | $700.35 |
| RX-1510 | POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJECTION SUSP | Pharmacy | $403.52 |
| RX-1511 | POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD | Pharmacy | $441.49 |
| RX-1512 | POLYMYXIN B SULFATE 500000 UNITS INJECTION SOLR | Pharmacy | $47.50 |
| RX-1513 | PORACTANT ALFA 120 MG/1.5 ML INTRATRACH SUSP | Pharmacy | $1,449.47 |
| RX-1514 | PORACTANT ALFA 240 MG/3 ML INTRATRACH SUSP | Pharmacy | $2,820.93 |
| RX-1515 | POSACONAZOLE 100 MG ORAL TBEC | Pharmacy | $217.63 |
| RX-1516 | POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP | Pharmacy | $43.54 |
| RX-1517 | POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLN | Pharmacy | $290.56 |
| RX-1519 | POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-152 | BELATACEPT 250 MG INTRAVENOUS SOLR | Pharmacy | $47.53 |
| RX-1520 | POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1521 | POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1522 | POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-1523 | POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1524 | POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1525 | POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1526 | POTASSIUM CHLORIDE IN SWFI 10 MEQ/100 ML IVPB | Pharmacy | $63.00 |
| RX-1527 | POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1528 | POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1529 | POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-153 | BELIMUMAB 120 MG INTRAVENOUS SOLR | Pharmacy | $573.19 |
| RX-1530 | POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1531 | POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1532 | POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1533 | POTASSIUM CHLORIDE-D5-0.3%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1534 | POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1535 | POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1536 | POTASSIUM IODIDE 1 G/ML ORAL SOLN | Pharmacy | $37.70 |
| RX-1537 | POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML INTRAVENOUS SOLN | Pharmacy | $10.58 |
| RX-1538 | POVIDONE-IODINE 10 % TOP OINT | Pharmacy | $117.29 |
| RX-1539 | POVIDONE-IODINE 10 % TOP SOLN | Pharmacy | $467.68 |
| RX-154 | BELINOSTAT 500 MG INTRAVENOUS SOLR | Pharmacy | $514.42 |
| RX-1540 | PRALATREXATE 20 MG/ML (1 ML) INTRAVENOUS SOLN | Pharmacy | $3,723.59 |
| RX-1541 | PRAZIQUANTEL 600 MG ORAL TAB | Pharmacy | $186.38 |
| RX-1543 | PREDNISOLONE ACETATE 0.12 % OPHTHALMIC DRPS | Pharmacy | $485.10 |
| RX-1544 | PREDNISOLONE ACETATE 1 % OPHTHALMIC DRPS | Pharmacy | $152.95 |
| RX-1545 | PREDNISOLONE SODIUM PHOSPHATE 1 % OPHTHALMIC DROP | Pharmacy | $78.75 |
| RX-155 | BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG RECTAL SUPP | Pharmacy | $69.93 |
| RX-1554 | PROCAINAMIDE 100 MG/ML INJECTION SOLN | Pharmacy | $1,225.48 |
| RX-1555 | PROCAINAMIDE 500 MG/ML INJECTION SOLN | Pharmacy | $1,225.43 |
| RX-1556 | PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLN | Pharmacy | $108.86 |
| RX-1557 | PROCHLORPERAZINE EDISYLATE 5 MG/ML INJECTION SOLN | Pharmacy | $108.86 |
| RX-156 | BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $273.74 |
| RX-1560 | PROGESTERONE 50 MG/ML IM OIL | Pharmacy | $23.21 |
| RX-1564 | PROMETHAZINE 25 MG/ML INJECTION SOLN | Pharmacy | $25.96 |
| RX-1565 | PROPARACAINE 0.5 % OPHTHALMIC DROP | Pharmacy | $108.68 |
| RX-1569 | PROPRANOLOL 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $23.66 |
| RX-157 | BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,148.19 |
| RX-1570 | PROTAMINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $13.68 |
| RX-1571 | PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLN | Pharmacy | $152.21 |
| RX-1572 | PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLN | Pharmacy | $83.21 |
| RX-1573 | PYRIMETHAMINE 25 MG ORAL TAB | Pharmacy | $997.50 |
| RX-1574 | RABIES IMMUNE GLOBULIN (PF) 150 UNITS/ML IM SOLN | Pharmacy | $3,494.48 |
| RX-1575 | RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN | Pharmacy | $3,494.48 |
| RX-1576 | RABIES VACC,HUMAN DIPLOID (PF) 2.5 UNITS IM SOLR | Pharmacy | $3,500.48 |
| RX-1577 | RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR | Pharmacy | $3,500.48 |
| RX-1578 | RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) INTRAVENOUS SOLN | Pharmacy | $474,635.70 |
| RX-1579 | RALTEGRAVIR 400 MG ORAL TAB | Pharmacy | $93.07 |
| RX-158 | BENZOCAINE 20 % MUCOUS MEMBR SPRA | Pharmacy | $141.65 |
| RX-1580 | RAMELTEON 8 MG ORAL TAB | Pharmacy | $40.78 |
| RX-1581 | RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $751.84 |
| RX-1582 | RASAGILINE 0.5 MG ORAL TAB | Pharmacy | $43.68 |
| RX-1583 | RASBURICASE 1.5 MG INTRAVENOUS SOLR | Pharmacy | $3,683.37 |
| RX-1584 | RASBURICASE 7.5 MG INTRAVENOUS SOLR | Pharmacy | $3,683.37 |
| RX-1585 | RAVULIZUMAB-CWVZ 300 MG/30 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,787.57 |
| RX-1586 | REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRG | Pharmacy | $746.91 |
| RX-1587 | REGULAR INSULIN 100 UNITS IN 100ML NS IVPB | Pharmacy | $11.34 |
| RX-1588 | REMIFENTANIL (ULTIVA) IN 0.9 % NACL 2,000 MCG/100 ML (20 MCG/ML) INFUN | Pharmacy | $1,404.90 |
| RX-1589 | REMIFENTANIL 1 MG INTRAVENOUS SOLR | Pharmacy | $233.60 |
| RX-159 | BENZOCAINE 20 % MUCOUS MEMBR SPRY | Pharmacy | $62.48 |
| RX-1590 | REMIFENTANIL 2 MG INTRAVENOUS SOLR | Pharmacy | $280.35 |
| RX-1591 | RHO(D) IMMUNE GLOBULIN 250 UNIT (50 MCG) IM SYRG | Pharmacy | $318.10 |
| RX-1592 | RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT (300 MCG)/1.3 ML INJECTION SOLN | Pharmacy | $375.30 |
| RX-1593 | RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJECTION SOLN | Pharmacy | $375.30 |
| RX-1594 | RIFAMPIN 600 MG INTRAVENOUS SOLR | Pharmacy | $36.04 |
| RX-1595 | RIFAXIMIN 200 MG ORAL TAB | Pharmacy | $70.98 |
| RX-1596 | RIFAXIMIN 550 MG ORAL TAB | Pharmacy | $135.28 |
| RX-1597 | RILPIVIRINE 25 MG ORAL TAB | Pharmacy | $123.38 |
| RX-1598 | RIOCIGUAT 0.5 MG ORAL TAB | Pharmacy | $426.15 |
| RX-1599 | RIOCIGUAT 1 MG ORAL TAB | Pharmacy | $426.15 |
| RX-160 | BENZOCAINE 40 MG/SPRAY (20 %) MUCOUS MEMBR SPRM | Pharmacy | $72.07 |
| RX-1600 | RIOCIGUAT 2.5 MG ORAL TAB | Pharmacy | $426.15 |
| RX-1601 | RISEDRONATE 30 MG ORAL TAB | Pharmacy | $157.40 |
| RX-1602 | RISPERIDONE MICROSPHERES 12.5 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1603 | RISPERIDONE MICROSPHERES 25 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1604 | RISPERIDONE MICROSPHERES 37.5 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1605 | RISPERIDONE MICROSPHERES 50 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1606 | RITUXIMAB 10 MG/ML INTRAVENOUS CONC | Pharmacy | $1,189.58 |
| RX-1607 | RITUXIMAB 10 MG/ML NON-ONCOLOGY USE IV CONC | Pharmacy | $1,189.58 |
| RX-1608 | RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS CONC | Pharmacy | $1,097.36 |
| RX-1609 | RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $540.15 |
| RX-161 | BENZOCAINE-MENTHOL 20-0.5 % TOP AERO | Pharmacy | $384.16 |
| RX-1610 | RITUXIMAB-HYALURONIDASE,HUMAN 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $540.15 |
| RX-1611 | RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS CONC | Pharmacy | $930.26 |
| RX-1612 | RIVAROXABAN 10 MG ORAL TAB | Pharmacy | $37.31 |
| RX-1613 | RIVAROXABAN 15 MG ORAL TAB | Pharmacy | $37.31 |
| RX-1614 | RIVAROXABAN 20 MG ORAL TAB | Pharmacy | $37.31 |
| RX-1616 | ROMIDEPSIN 10 MG/2 ML INTRAVENOUS SOLR | Pharmacy | $2,783.05 |
| RX-1617 | ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLR | Pharmacy | $902.22 |
| RX-1618 | ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLR | Pharmacy | $935.68 |
| RX-1619 | ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBCUTANEOUS SYRG | Pharmacy | $114.48 |
| RX-162 | BENZOIN TOP TINC | Pharmacy | $793.80 |
| RX-1623 | ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50/ML ORAL SUSR | Pharmacy | $1,137.40 |
| RX-1624 | ROTIGOTINE 1 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1625 | ROTIGOTINE 2 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1626 | ROTIGOTINE 3 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1627 | ROTIGOTINE 4 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1628 | ROTIGOTINE 6 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1629 | ROTIGOTINE 8 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-163 | BENZTROPINE 1 MG/ML INJECTION SOLN | Pharmacy | $223.41 |
| RX-1630 | RUFINAMIDE 200 MG ORAL TAB | Pharmacy | $40.22 |
| RX-1631 | RUFINAMIDE 400 MG ORAL TAB | Pharmacy | $80.47 |
| RX-1632 | SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLR | Pharmacy | $362.75 |
| RX-1633 | SALICYLIC ACID-SULFUR 2-2 % TOP SHAM | Pharmacy | $206.50 |
| RX-1634 | SARGRAMOSTIM 250 MCG INJECTION SOLR | Pharmacy | $548.15 |
| RX-1635 | SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D | Pharmacy | $59.47 |
| RX-1636 | SELENIUM 4 MCG/ML INTRAVENOUS SOLN FOR TPN | Pharmacy | $16.38 |
| RX-1637 | SELENIUM 40 MCG/ML INTRAVENOUS SOLN | Pharmacy | $16.38 |
| RX-1638 | SELENIUM SULFIDE 1 % TOP SHAM | Pharmacy | $304.29 |
| RX-1639 | SELENIUM SULFIDE 2.5 % TOP LOTN | Pharmacy | $697.20 |
| RX-164 | BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL SOLN | Pharmacy | $460.51 |
| RX-1640 | SELEXIPAG 200 MCG ORAL TAB | Pharmacy | $757.37 |
| RX-1641 | SELEXIPAG 1000 MCG ORAL TAB | Pharmacy | $968.98 |
| RX-1642 | SEVELAMER CARBONATE 2.4 G ORAL PWPK | Pharmacy | $56.70 |
| RX-1643 | SEVOFLURANE INHALATION LIQD | Pharmacy | $253.75 |
| RX-1644 | SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLN | Pharmacy | $153.09 |
| RX-1645 | SILDENAFIL (PULM.HYPERTENSION) 10 MG/ML ORAL SUSR | Pharmacy | $21.31 |
| RX-1646 | SINCALIDE 5 MCG INJECTION SOLR | Pharmacy | $1,397.71 |
| RX-1647 | SIPULEUCEL-T-LACTATED RINGERS 50 MILLION CELL/250 ML INTRAVENOUS SUSP | Pharmacy | $362,947.73 |
| RX-1648 | SIROLIMUS 0.5 MG ORAL TAB | Pharmacy | $75.63 |
| RX-1649 | SIROLIMUS 1 MG ORAL TAB | Pharmacy | $75.63 |
| RX-165 | BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJECTION SUSP | Pharmacy | $89.11 |
| RX-1650 | SIROLIMUS 1 MG/ML ORAL SOLN | Pharmacy | $75.63 |
| RX-1651 | SITAGLIPTIN 25 MG ORAL TAB | Pharmacy | $50.12 |
| RX-1652 | SITAGLIPTIN 50 MG ORAL TAB | Pharmacy | $50.12 |
| RX-1653 | SITAGLIPTIN 100 MG ORAL TAB | Pharmacy | $50.12 |
| RX-1654 | SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLN | Pharmacy | $17.64 |
| RX-1655 | SODIUM BICARBONATE 1 MEQ/ML INTRAVENOUS SOLN | Pharmacy | $100.80 |
| RX-1656 | SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRG | Pharmacy | $693.00 |
| RX-1657 | SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRG | Pharmacy | $11.21 |
| RX-1658 | SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLN | Pharmacy | $18.65 |
| RX-1659 | SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRG | Pharmacy | $100.80 |
| RX-166 | BETAMETHASONE DIPROPIONATE 0.05 % TOP CREA | Pharmacy | $47.78 |
| RX-1660 | SODIUM BICARBONATE IN D5W 150 MEQ/1,000 ML INTRAVENOUS SOLN | Pharmacy | $302.40 |
| RX-1662 | SODIUM CHLORIDE 0.45 % 0.45 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1663 | SODIUM CHLORIDE 0.9 % INJECTION SOLN | Pharmacy | $63.00 |
| RX-1664 | SODIUM CHLORIDE 0.9 % INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1665 | SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1666 | SODIUM CHLORIDE 0.9 % IV BOLUS | Pharmacy | $63.00 |
| RX-1667 | SODIUM CHLORIDE 0.9 % IV DISPENSABLE | Pharmacy | $63.00 |
| RX-1668 | SODIUM CHLORIDE 0.9 % IV KVO | Pharmacy | $16.29 |
| RX-1669 | SODIUM CHLORIDE 23.4 % (4 MEQ/ML) IV SOLP | Pharmacy | $30.24 |
| RX-167 | BETAMETHASONE VALERATE 0.1 % TOP CREA | Pharmacy | $40.43 |
| RX-1670 | SODIUM CHLORIDE 3 % 3 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1671 | SODIUM CHLORIDE 3 % IV BOLUS | Pharmacy | $63.00 |
| RX-1672 | SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLP | Pharmacy | $30.24 |
| RX-1673 | SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $25.04 |
| RX-1674 | SODIUM HYALURONATE (VISCOSUP) 10 MG/ML INTRAARTICLR SYRG | Pharmacy | $1,043.88 |
| RX-1675 | SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) INTRAARTICLR SYRG | Pharmacy | $1,823.14 |
| RX-1676 | SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG | Pharmacy | $109.91 |
| RX-1677 | SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRG | Pharmacy | $1,498.90 |
| RX-1678 | SODIUM HYPOCHLORITE 0.125 % MISC. SOLN | Pharmacy | $993.30 |
| RX-1679 | SODIUM HYPOCHLORITE 0.25 % MISC. SOLN | Pharmacy | $761.53 |
| RX-168 | BETAMETHASONE VALERATE 0.1 % TOP LOTN | Pharmacy | $109.20 |
| RX-1680 | SODIUM IODIDE I-123 2 MCI CAP PER MCI | Pharmacy | $6,696.02 |
| RX-1681 | SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) ORAL CAP | Pharmacy | $936.68 |
| RX-1682 | SODIUM IODIDE-131 1000 MCI/ML (1 ML) ORAL KIT | Pharmacy | $198.45 |
| RX-1684 | SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $743.27 |
| RX-1685 | SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLN | Pharmacy | $19.78 |
| RX-1686 | SODIUM PHOSPHATE IN 0.9 % NACL 15 MMOL/100 ML IVPB | Pharmacy | $214.20 |
| RX-1687 | SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM | Pharmacy | $74.48 |
| RX-1688 | SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML RECTAL ENEM | Pharmacy | $113.19 |
| RX-1689 | SODIUM POLYSTYRENE SULFONATE 30 GRAM/120 ML RECTAL ENEM | Pharmacy | $46.20 |
| RX-169 | BETAMETHASONE, AUGMENTED 0.05 % TOP LOTN | Pharmacy | $141.75 |
| RX-1690 | SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLN | Pharmacy | $424.24 |
| RX-1691 | SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLN | Pharmacy | $22.43 |
| RX-1692 | SODIUM ZIRCONIUM CYCLOSILICATE 5 G ORAL PWPK | Pharmacy | $44.38 |
| RX-1693 | SODIUM ZIRCONIUM CYCLOSILICATE 10 G ORAL PWPK | Pharmacy | $44.38 |
| RX-1694 | SODIUM,POTASSIUM,MAG SULFATES 17.5-3.13-1.6 GRAM ORAL SOLR | Pharmacy | $234.17 |
| RX-1695 | SOLIFENACIN 5 MG ORAL TAB | Pharmacy | $40.81 |
| RX-1696 | SOLIFENACIN 10 MG ORAL TAB | Pharmacy | $40.81 |
| RX-1697 | STERILE TALC 4 G INTRAPLEURAL AERP | Pharmacy | $101.85 |
| RX-1698 | STERILE TALC 4 G INTRAPLEURAL SUSR | Pharmacy | $521.50 |
| RX-1699 | SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLN | Pharmacy | $20.79 |
| RX-17 | ADEFOVIR 10 MG ORAL TAB | Pharmacy | $89.92 |
| RX-170 | BETAXOLOL 0.25 % OPHTHALMIC DRPS | Pharmacy | $981.40 |
| RX-1700 | SUCCINYLCHOLINE CHLORIDE 100 MG/5 ML (20 MG/ML) INTRAVENOUS SYRG | Pharmacy | $21.24 |
| RX-1701 | SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLN | Pharmacy | $19.03 |
| RX-1703 | SUGAMMADEX 100 MG/ML INTRAVENOUS SOLN | Pharmacy | $598.63 |
| RX-1704 | SULFACETAMIDE SODIUM 10 % OPHTHALMIC DROP | Pharmacy | $116.03 |
| RX-1705 | SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $10.33 |
| RX-1706 | SULFUR HEXAFLUORIDE LIPID-TYPE A MICROSPHERES | Pharmacy | $246.77 |
| RX-1707 | SULFUR HEXAFLUORIDE MICROSPHR 25 MG INTRAVENOUS SUSR | Pharmacy | $246.77 |
| RX-1708 | SUMATRIPTAN 20 MG/ACTUATION NASAL SPRY | Pharmacy | $122.89 |
| RX-1709 | SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN | Pharmacy | $79.88 |
| RX-171 | BEVACIZUMAB 1.25 MG/0.05 ML INTRAVITREAL INJECTION | Pharmacy | $1,016.10 |
| RX-1710 | TACROLIMUS 0.1 % TOP OINT | Pharmacy | $279.30 |
| RX-1713 | TACROLIMUS 0.75 MG ORAL TB24 | Pharmacy | $17.05 |
| RX-1715 | TACROLIMUS 1 MG ORAL TB24 | Pharmacy | $17.05 |
| RX-1717 | TACROLIMUS 4 MG ORAL TB24 | Pharmacy | $17.05 |
| RX-1719 | TACROLIMUS 5 MG/ML INTRAVENOUS SOLN | Pharmacy | $2,666.10 |
| RX-172 | BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,016.10 |
| RX-1720 | TALIGLUCERASE ALFA 200 UNITS INTRAVENOUS SOLR | Pharmacy | $503.53 |
| RX-1721 | TALIMOGENE LAHERPAREPVEC 10EXP6 (1 MILLION) PFU/ML INJECTION SUSP | Pharmacy | $648.12 |
| RX-1722 | TAPENTADOL 100 MG ORAL TB12 | Pharmacy | $44.24 |
| RX-1723 | TC 99M HDP | Pharmacy | $510.43 |
| RX-1724 | TC 99M MERTIATIDE =< 15 MCI | Pharmacy | $24,766.56 |
| RX-1725 | TC 99M SESTAMIBI | Pharmacy | $945.00 |
| RX-1726 | TC 99M SODIUM PERTECHNETATE 25 MCI | Pharmacy | $11.34 |
| RX-1727 | TC 99M TAGGED ULTRATAG RBC | Pharmacy | $1,738.80 |
| RX-1728 | TEMOZOLOMIDE 100 MG ORAL CAP | Pharmacy | $11.44 |
| RX-1729 | TEMOZOLOMIDE 140 MG ORAL CAP | Pharmacy | $11.44 |
| RX-173 | BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $879.13 |
| RX-1730 | TEMOZOLOMIDE ORAL SUSP 10 MG/ML | Pharmacy | $19.53 |
| RX-1731 | TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) INTRAVENOUS SOLR | Pharmacy | $603.89 |
| RX-1732 | TENECTEPLASE 50 MG INTRAVENOUS SOLR | Pharmacy | $1,534.84 |
| RX-1733 | TENOFOVIR ALAFENAMIDE 25 MG ORAL TAB | Pharmacy | $124.15 |
| RX-1734 | TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLR | Pharmacy | $3,980.09 |
| RX-1735 | TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN | Pharmacy | $26.70 |
| RX-1736 | TERBUTALINE INFUSION 1 MG/ML (PED-NEO) | Pharmacy | $26.70 |
| RX-1737 | TERIPARATIDE 20 MCG/DOSE - 600 MCG/2.4 ML SUBCUTANEOUS PNIJ | Pharmacy | $729.10 |
| RX-1738 | TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GLPK | Pharmacy | $67.73 |
| RX-174 | BEXAROTENE 75 MG ORAL CAP | Pharmacy | $591.95 |
| RX-1740 | TETANUS AND DIPHTHER. TOX (PF) 5 LF UNIT- 2 LF UNIT/0.5ML IM SUSP | Pharmacy | $316.34 |
| RX-1741 | TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG | Pharmacy | $316.34 |
| RX-1742 | TETANUS IMMUNE GLOBULIN (PF) 250 UNITS IM SYRG | Pharmacy | $5,833.65 |
| RX-1743 | TETRABENAZINE 12.5 MG ORAL TAB | Pharmacy | $41.55 |
| RX-1744 | THALLOUS CHLORIDE TL-201 37 MBQ/ML (1 MCI/ML) INTRAVENOUS SOLN | Pharmacy | $203.11 |
| RX-1745 | THALLOUS CHLORIDE TL-201 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLN | Pharmacy | $228.19 |
| RX-1746 | THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLN | Pharmacy | $20.84 |
| RX-1747 | THIOTEPA 15 MG INJECTION SOLR | Pharmacy | $5,191.29 |
| RX-1748 | THIOTEPA 100 MG INJECTION SOLR | Pharmacy | $5,191.29 |
| RX-1749 | THROMB,HM-FIBRIN-APROTIN,S-CA 4 ML TOP SYRG | Pharmacy | $842.24 |
| RX-175 | BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB | Pharmacy | $342.83 |
| RX-1750 | THROMB,HM-FIBRIN-APROTIN,S-CA 10 ML TOP SYRG | Pharmacy | $2,066.75 |
| RX-1751 | THROMB,HM-FIBRIN-APROTIN,S-CA 2.5 TO 6.5 UNIT/ML (10ML) TOP SYRG | Pharmacy | $1,976.21 |
| RX-1752 | THROMB,HM-FIBRIN-APROTIN,S-CA 2.5 TO 6.5 UNIT/ML (4 ML) TOP SYRG | Pharmacy | $1,976.21 |
| RX-1753 | THROMBIN (BOVINE) 5000 UNITS TOP SOLR | Pharmacy | $177.80 |
| RX-1754 | THROMBIN (RECOMBINANT) 5000 UNITS TOP SOLR | Pharmacy | $150.22 |
| RX-1755 | THROMBIN-FIBRINOGN-APROTIN-CAL 4 ML TOP SYRG | Pharmacy | $817.71 |
| RX-1756 | THROMBIN-FIBRINOGN-APROTIN-CAL 10 ML TOP SYRG | Pharmacy | $2,006.55 |
| RX-1757 | THYROTROPIN ALFA 1.1 MG (0.9 MG/ ML FINAL CONC.) IM SOLR | Pharmacy | $21,425.17 |
| RX-1758 | TIGECYCLINE 50 MG INTRAVENOUS SOLR | Pharmacy | $20.60 |
| RX-1759 | TIMOLOL 0.5 % OPHTHALMIC DROP | Pharmacy | $81.80 |
| RX-176 | BIMATOPROST 0.01 % OPHTHALMIC DROP | Pharmacy | $656.51 |
| RX-1760 | TIMOLOL MALEATE 0.5 % OPHTHALMIC DRPD | Pharmacy | $273.00 |
| RX-1761 | TIMOLOL MALEATE 0.5 % OPHTHALMIC SOLG | Pharmacy | $526.40 |
| RX-1762 | TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHALATION MIST | Pharmacy | $42.84 |
| RX-1763 | TOBRAMYCIN 0.3 % OPHTHALMIC OINT | Pharmacy | $677.43 |
| RX-1764 | TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU | Pharmacy | $503.12 |
| RX-1765 | TOBRAMYCIN SULFATE 1.2 G INJECTION SOLR | Pharmacy | $46.51 |
| RX-1766 | TOBRAMYCIN SULFATE 40 MG/ML INJECTION SOLN | Pharmacy | $46.52 |
| RX-1767 | TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHTHALMIC DRPS | Pharmacy | $292.95 |
| RX-1768 | TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHTHALMIC OINT | Pharmacy | $721.16 |
| RX-1769 | TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $64.01 |
| RX-177 | BIMATOPROST 0.03 % OPHTHALMIC DROP | Pharmacy | $168.26 |
| RX-1770 | TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $64.01 |
| RX-1771 | TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $64.01 |
| RX-1772 | TOLNAFTATE 1 % TOP CREA | Pharmacy | $119.70 |
| RX-1773 | TOLVAPTAN 15 MG ORAL TAB | Pharmacy | $1,725.33 |
| RX-1774 | TOLVAPTAN 30 MG ORAL TAB | Pharmacy | $1,789.83 |
| RX-1775 | TOPOTECAN 4 MG INTRAVENOUS SOLR | Pharmacy | $12.34 |
| RX-1776 | TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.34 |
| RX-1777 | TRABECTEDIN 1 MG INTRAVENOUS SOLR | Pharmacy | $3,943.02 |
| RX-1778 | TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60MCG-5MG/ML INTRAVENOUS SOLN | Pharmacy | $24.19 |
| RX-1782 | TRASTUZUMAB 150 MG INTRAVENOUS SOLR | Pharmacy | $1,333.77 |
| RX-1783 | TRASTUZUMAB 440 MG INTRAVENOUS SOLR | Pharmacy | $1,333.77 |
| RX-1784 | TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLR | Pharmacy | $1,142.45 |
| RX-1785 | TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLR | Pharmacy | $1,151.59 |
| RX-1786 | TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBCUTANEOUS SOLN | Pharmacy | $997.73 |
| RX-1787 | TRAVOPROST 0.004 % OPHTHALMIC DROP | Pharmacy | $616.09 |
| RX-1788 | TREPROSTINIL DIOLAMINE 0.25 MG ORAL TBSR | Pharmacy | $47.27 |
| RX-1789 | TREPROSTINIL DIOLAMINE 1 MG ORAL TBSR | Pharmacy | $189.08 |
| RX-1790 | TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1791 | TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1792 | TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1793 | TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1794 | TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP | Pharmacy | $82.57 |
| RX-1795 | TRETINOIN 0.05 % TOP CREA | Pharmacy | $163.10 |
| RX-1796 | TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR INJECTION | Pharmacy | $48.38 |
| RX-1797 | TRIAMCINOLONE ACETONIDE 0.025 % TOP LOTN | Pharmacy | $56.70 |
| RX-1798 | TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE | Pharmacy | $204.75 |
| RX-1799 | TRIAMCINOLONE ACETONIDE 0.1 % TOP LOTN | Pharmacy | $73.50 |
| RX-180 | BLEOMYCIN 15 UNITS INJECTION SOLR | Pharmacy | $285.58 |
| RX-1800 | TRIAMCINOLONE ACETONIDE 10 MG/ML INJECTION | Pharmacy | $19.66 |
| RX-1801 | TRIAMCINOLONE ACETONIDE 40 MG/ML INJECTION SUSP | Pharmacy | $19.66 |
| RX-1802 | TRIFLURIDINE 1 % OPHTHALMIC DROP | Pharmacy | $622.65 |
| RX-1803 | TRIMETHOBENZAMIDE 100 MG/ML IM SOLN | Pharmacy | $459.42 |
| RX-1804 | TRIMETHOBENZAMIDE 300 MG ORAL CAP | Pharmacy | $10.92 |
| RX-1805 | TRIPTORELIN PAMOATE 11.25 MG IM SUSR | Pharmacy | $3,323.16 |
| RX-1806 | TRIPTORELIN PAMOATE 11.25 MG/2 ML IM SYRG | Pharmacy | $3,323.16 |
| RX-1807 | TUMESCENT LIPOSUCTION SOLUTION FOR SUBCUTANEOUS 1000 ML | Pharmacy | $403.20 |
| RX-1808 | UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION INHALATION DSDV | Pharmacy | $183.26 |
| RX-1809 | USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLN | Pharmacy | $150.34 |
| RX-181 | BLEOMYCIN 30 UNIT NON-ONCOLOGY INJ SOLR | Pharmacy | $285.58 |
| RX-1810 | USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SOLN | Pharmacy | $2,398.50 |
| RX-1811 | USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $2,398.50 |
| RX-1812 | USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,398.50 |
| RX-1814 | VANCOMYCIN 1.25 G INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1815 | VANCOMYCIN 10 G INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1816 | VANCOMYCIN 500 MG INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1817 | VANCOMYCIN 750 MG INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1818 | VANCOMYCIN (BULK) 900 MCG/MG (NOT LESS THAN) MISC. POWD | Pharmacy | $84.21 |
| RX-1819 | VANCOMYCIN 1000 MG INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-182 | BLEOMYCIN 30 UNITS INJECTION SOLR | Pharmacy | $285.58 |
| RX-1820 | VANCOMYCIN 1000 MG INTRAVENOUS SOLR FOR POWDER USE | Pharmacy | $42.68 |
| RX-1821 | VANCOMYCIN 500 MG IV SOLR (CUSTOM) | Pharmacy | $42.68 |
| RX-1823 | VANCOMYCIN IN 0.9 % SODIUM CHL 1 GRAM/250 ML INTRAVENOUS SOLN | Pharmacy | $44.10 |
| RX-1824 | VANCOMYCIN IN 0.9 % SODIUM CHL 1250 MG INTRAVENOUS SOLN | Pharmacy | $42.84 |
| RX-1825 | VANCOMYCIN IN 0.9 % SODIUM CHL 1500 MG INTRAVENOUS SOLN | Pharmacy | $43.05 |
| RX-1826 | VANCOMYCIN IN 0.9% SODIUM CL 1750 MG/500 ML IV SOLN | Pharmacy | $43.20 |
| RX-1827 | VANCOMYCIN IN 0.9% SODIUM CL 2000 MG/500 ML IV SOLN | Pharmacy | $44.10 |
| RX-1828 | VANCOMYCIN IN D5W 750 MG/250 ML IVPB | Pharmacy | $44.10 |
| RX-1829 | VANCOMYCIN IN DEXTROSE 5 % 1250 MG INTRAVENOUS SOLN | Pharmacy | $42.84 |
| RX-183 | BLINATUMOMAB 35 MCG INTRAVENOUS KIT | Pharmacy | $1,428.13 |
| RX-1830 | VANCOMYCIN IN DEXTROSE 5 % 1500 MG INTRAVENOUS SOLN | Pharmacy | $42.68 |
| RX-1831 | VANCOMYCIN IN NS 10 MG/ML 1ML SYG | Pharmacy | $42.84 |
| RX-1832 | VANCOMYCIN IN NS 750 MG/250 ML IVPB | Pharmacy | $42.68 |
| RX-1833 | VANCOMYCIN-HEPARIN ALT 2.5 MG-2500 UNIT/ML INJ | Pharmacy | $42.84 |
| RX-1834 | VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR | Pharmacy | $3,420.14 |
| RX-1835 | VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR | Pharmacy | $1,696.59 |
| RX-1836 | VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN | Pharmacy | $21,486.97 |
| RX-1837 | VASOPRESSIN 20 UNITS/ML INJECTION SOLN | Pharmacy | $2,252.38 |
| RX-1838 | VASOPRESSIN 20 UNITS/ML INTRAVENOUS SOLN | Pharmacy | $2,252.38 |
| RX-1839 | VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLR | Pharmacy | $49.14 |
| RX-184 | BORTEZOMIB 2.5 MG INJ SOLR SUBCUT (CC) | Pharmacy | $565.17 |
| RX-1840 | VEDOLIZUMAB 300 MG INTRAVENOUS SOLR | Pharmacy | $255.05 |
| RX-1841 | VELAGLUCERASE ALFA 400 UNITS INTRAVENOUS SOLR | Pharmacy | $4,352.25 |
| RX-1842 | VERAPAMIL 2.5 MG/ML IA SOLN | Pharmacy | $74.47 |
| RX-1843 | VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLN | Pharmacy | $45.99 |
| RX-1844 | VIGABATRIN 500 MG ORAL PWPK | Pharmacy | $236.72 |
| RX-1845 | VINBLASTINE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $48.95 |
| RX-1846 | VINCRISTINE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $61.54 |
| RX-1847 | VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLN | Pharmacy | $61.54 |
| RX-1848 | VINCRISTINE 2 MG/2 ML IV SOLN FOR HODGKINS DISEASE | Pharmacy | $61.54 |
| RX-1849 | VINORELBINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $150.70 |
| RX-185 | BORTEZOMIB 3.5 MG INJECTION SOLR | Pharmacy | $565.17 |
| RX-1850 | VINORELBINE 50 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $150.70 |
| RX-1851 | VITAMIN A PALMITATE 50000 UNITS/ML ORAL SOLUTION | Pharmacy | $686.07 |
| RX-1852 | VORICONAZOLE 200 MG INTRAVENOUS SOLR | Pharmacy | $26.64 |
| RX-1856 | XE133 XENON PER 10 MCI | Pharmacy | $2,421.34 |
| RX-1857 | ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $19.08 |
| RX-1858 | ZILEUTON 600 MG ORAL TAB | Pharmacy | $99.47 |
| RX-1859 | ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $43.19 |
| RX-186 | BORTEZOMIB NON-ONCOLOGY USE 3.5 MG INJ SOLR | Pharmacy | $565.17 |
| RX-1860 | ZINC OXIDE 4 X 10 "-YARD TOP BNDG | Pharmacy | $44.03 |
| RX-1861 | ZINC SULFATE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $17.89 |
| RX-1862 | ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR | Pharmacy | $226.25 |
| RX-1863 | ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $137.12 |
| RX-1864 | ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $137.34 |
| RX-1865 | ZOLEDRONIC AC-MANNITOL-0.9NACL 4 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $137.34 |
| RX-1866 | ZOSTER VACCINE LIVE (PF) 19400 UNIT/0.65 ML SUBCUTANEOUS SUSR | Pharmacy | $2,625.97 |
| RX-187 | BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLR | Pharmacy | $2,134.11 |
| RX-188 | BREXPIPRAZOLE 1 MG ORAL TAB | Pharmacy | $123.31 |
| RX-189 | BRIMONIDINE 0.1 % OPHTHALMIC DROP | Pharmacy | $533.23 |
| RX-190 | BRIMONIDINE 0.15 % OPHTHALMIC DROP | Pharmacy | $445.03 |
| RX-191 | BRIMONIDINE-TIMOLOL 0.2-0.5 % OPHTHALMIC DROP | Pharmacy | $587.83 |
| RX-192 | BRINZOLAMIDE 1 % OPHTHALMIC DRPS | Pharmacy | $1,027.95 |
| RX-193 | BRINZOLAMIDE-BRIMONIDINE 1-0.2 % OPHTHALMIC DRPS | Pharmacy | $542.64 |
| RX-194 | BRIVARACETAM 50 MG ORAL TAB | Pharmacy | $62.44 |
| RX-195 | BRIVARACETAM 100 MG ORAL TAB | Pharmacy | $62.44 |
| RX-196 | BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $57.83 |
| RX-197 | BROMFENAC 0.07 % OPHTHALMIC DROP | Pharmacy | $897.75 |
| RX-198 | BROMFENAC 0.09 % OPHTHALMIC DROP | Pharmacy | $421.58 |
| RX-199 | BUDESONIDE 90 MCG/ACTUATION INHALATION AEPB | Pharmacy | $33.26 |
| RX-200 | BUDESONIDE 0.25 MG/2 ML INHALATION NBSP | Pharmacy | $21.87 |
| RX-201 | BUDESONIDE 0.5 MG/2 ML INHALATION NBSP | Pharmacy | $21.87 |
| RX-202 | BUDESONIDE 1 MG/2 ML INHALATION NBSP | Pharmacy | $21.87 |
| RX-203 | BUDESONIDE 180 MCG/ACTUATION INHALATION AEPB | Pharmacy | $22.30 |
| RX-204 | BUDESONIDE 9 MG ORAL TADE | Pharmacy | $189.81 |
| RX-205 | BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION INHALATION HFAA | Pharmacy | $388.46 |
| RX-206 | BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION INHALATION HFAA | Pharmacy | $94.50 |
| RX-218 | BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP | Pharmacy | $15.79 |
| RX-219 | BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJECTION SOLN | Pharmacy | $12.22 |
| RX-222 | BUPRENORPHINE 5 MCG/HR TRANSDERMAL PTWK | Pharmacy | $153.48 |
| RX-223 | BUPRENORPHINE 15 MCG/HR TRANSDERMAL PTWK | Pharmacy | $477.23 |
| RX-224 | BUPRENORPHINE 20 MCG/HR TRANSDERMAL PTWK | Pharmacy | $452.83 |
| RX-225 | BUSULFAN 60 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $61.67 |
| RX-226 | BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOP SPRA | Pharmacy | $386.90 |
| RX-227 | BUTORPHANOL 1 MG/ML INJECTION SOLN | Pharmacy | $31.16 |
| RX-228 | BUTORPHANOL 2 MG/ML INJECTION SOLN | Pharmacy | $31.16 |
| RX-229 | C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLR | Pharmacy | $353.77 |
| RX-230 | CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLN | Pharmacy | $2,218.13 |
| RX-231 | CABERGOLINE 0.5 MG ORAL TAB | Pharmacy | $17.89 |
| RX-232 | CADEXOMER IODINE 0.9 % TOP GEL | Pharmacy | $315.98 |
| RX-233 | CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.95 |
| RX-234 | CALCIPOTRIENE 0.005 % TOP OINT | Pharmacy | $663.60 |
| RX-235 | CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRY | Pharmacy | $46.88 |
| RX-236 | CALCITONIN (SALMON) 200 UNITS/ML INJECTION | Pharmacy | $33,471.67 |
| RX-237 | CALCITONIN (SALMON) 200 UNITS/ML INJECTION SOLN | Pharmacy | $33,471.67 |
| RX-24 | ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLR | Pharmacy | $404.55 |
| RX-241 | CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-242 | CALCIUM GLUCONATE 100 MG/ML (10%) INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-243 | CALCIUM GLUCONATE IN 0.9% NACL 1 G/100 ML INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-244 | CALCIUM GLUCONATE IN 0.9% NACL 1 GRAM/110 ML INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-245 | CAMPHOR-MENTHOL 0.5-0.5 % TOP LOTN | Pharmacy | $279.72 |
| RX-246 | CANAKINUMAB (PF) 150 MG/ML SUBCUTANEOUS SOLN | Pharmacy | $1,398.63 |
| RX-247 | CANGRELOR 50 MG INTRAVENOUS SOLR | Pharmacy | $193.11 |
| RX-248 | CANNABIDIOL 100 MG/ML ORAL SOLN | Pharmacy | $45.85 |
| RX-249 | CAPLACIZUMAB-YHDP 11 MG INJECTION SOLR | Pharmacy | $8,686.25 |
| RX-25 | AGALSIDASE BETA 5 MG INTRAVENOUS SOLR | Pharmacy | $2,315.19 |
| RX-250 | CARBACHOL 0.01 % INTRAOCULAR SOLN | Pharmacy | $42.58 |
| RX-251 | CARBOPLATIN 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $33.89 |
| RX-252 | CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN | Pharmacy | $4,038.30 |
| RX-253 | CARFILZOMIB 60 MG INTRAVENOUS SOLR | Pharmacy | $473.00 |
| RX-254 | CARMUSTINE 100 MG INTRAVENOUS SOLR | Pharmacy | $32,994.62 |
| RX-255 | CASPOFUNGIN 50 MG INTRAVENOUS SOLR | Pharmacy | $88.59 |
| RX-256 | CASPOFUNGIN 70 MG INTRAVENOUS SOLR | Pharmacy | $88.59 |
| RX-257 | CEFAZOLIN 1 G INJECTION SOLR | Pharmacy | $10.29 |
| RX-258 | CEFAZOLIN 1 G INTRAVENOUS SOLR | Pharmacy | $10.29 |
| RX-259 | CEFAZOLIN 1,000 MG/50 ML D5W | Pharmacy | $11.34 |
| RX-26 | AGALSIDASE BETA 35 MG INTRAVENOUS SOLR | Pharmacy | $2,315.19 |
| RX-260 | CEFAZOLIN 2,000 MG/50 ML D5W | Pharmacy | $10.40 |
| RX-261 | CEFAZOLIN 500 MG INJECTION SOLR | Pharmacy | $10.29 |
| RX-262 | CEFAZOLIN IN DEXTROSE (ISO-OS) 1 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.29 |
| RX-263 | CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.29 |
| RX-264 | CEFAZOLIN IN DEXTROSE 5 % 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.29 |
| RX-265 | CEFEPIME 1 G INJECTION SOLR | Pharmacy | $22.42 |
| RX-266 | CEFEPIME 1 G INTRAVENOUS SOLR | Pharmacy | $22.42 |
| RX-267 | CEFEPIME 2 G INJECTION SOLR | Pharmacy | $22.42 |
| RX-268 | CEFEPIME 2 G INTRAVENOUS SOLR | Pharmacy | $22.42 |
| RX-269 | CEFEPIME IN DEXTROSE 5 % 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $22.42 |
| RX-27 | ALBENDAZOLE 200 MG ORAL TAB | Pharmacy | $157.22 |
| RX-270 | CEFOTAXIME 1 G INJECTION SOLR | Pharmacy | $29.38 |
| RX-271 | CEFOTAXIME 300 MG/ML IM INJECTION | Pharmacy | $29.40 |
| RX-272 | CEFOXITIN 1 G INTRAVENOUS SOLR | Pharmacy | $66.68 |
| RX-273 | CEFOXITIN 2 G INTRAVENOUS SOLR | Pharmacy | $66.68 |
| RX-274 | CEFOXITIN IN DEXTROSE, ISO-OSM 1 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $66.68 |
| RX-275 | CEFOXITIN IN DEXTROSE, ISO-OSM 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $66.68 |
| RX-276 | CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLR | Pharmacy | $40.04 |
| RX-277 | CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLR | Pharmacy | $40.04 |
| RX-278 | CEFTAZIDIME 1 G INJECTION SOLR | Pharmacy | $25.55 |
| RX-279 | CEFTAZIDIME 1000 MG INJ SOLR | Pharmacy | $25.55 |
| RX-28 | ALBUMIN, HUMAN 25 % 25 % INTRAVENOUS SOLP | Pharmacy | $660.87 |
| RX-280 | CEFTAZIDIME 2 G INJECTION SOLR | Pharmacy | $25.55 |
| RX-281 | CEFTAZIDIME 500 MG INJECTION SOLR | Pharmacy | $25.55 |
| RX-282 | CEFTAZIDIME-AVIBACTAM 2.5 G INTRAVENOUS SOLR | Pharmacy | $1,159.53 |
| RX-283 | CEFTOLOZANE-TAZOBACTAM 1.5 G INTRAVENOUS SOLR | Pharmacy | $74.66 |
| RX-29 | ALBUMIN, HUMAN 5 % 5 % INTRAVENOUS SOLP | Pharmacy | $661.50 |
| RX-293 | CEFUROXIME IN STERILE WATER 1.5 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $28.00 |
| RX-294 | CEFUROXIME SODIUM 1.5 G INTRAVENOUS SOLR | Pharmacy | $28.00 |
| RX-295 | CEFUROXIME SODIUM 750 MG INJECTION SOLR | Pharmacy | $28.00 |
| RX-296 | CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $345.67 |
| RX-297 | CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYKT | Pharmacy | $103.41 |
| RX-298 | CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLN | Pharmacy | $796.45 |
| RX-299 | CHLORHEXIDINE GLUCONATE 4 % TOP LIQD | Pharmacy | $445.20 |
| RX-300 | CHLOROPROCAINE (PF) 10 MG/ML (1 %) INTRATHECAL SOLN | Pharmacy | $307.69 |
| RX-301 | CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLN | Pharmacy | $307.69 |
| RX-302 | CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLN | Pharmacy | $307.69 |
| RX-303 | CHLOROPROCAINE 20 MG/ML (2 %) INJECTION SOLN | Pharmacy | $307.57 |
| RX-304 | CHLOROTHIAZIDE IV 27.8 MG/ML (PED-NEO) | Pharmacy | $631.83 |
| RX-305 | CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLR | Pharmacy | $631.80 |
| RX-306 | CHLORPROMAZINE 25 MG/ML INJECTION SOLN | Pharmacy | $397.61 |
| RX-307 | CHROMIUM CHLORIDE 0.4 MCG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $21.29 |
| RX-308 | CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLN | Pharmacy | $21.17 |
| RX-309 | CICLOPIROX 0.77 % TOP SUSP | Pharmacy | $147.00 |
| RX-310 | CIDOFOVIR 75 MG/ML INTRAVENOUS SOLN | Pharmacy | $7,980.90 |
| RX-314 | CIPROFLOXACIN HCL 0.2 % OTIC DPET | Pharmacy | $287.58 |
| RX-315 | CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $15.12 |
| RX-316 | CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML INTRAVENOUS PGBK | Pharmacy | $15.12 |
| RX-317 | CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS | Pharmacy | $787.24 |
| RX-318 | CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) INTRAVENOUS SOLN | Pharmacy | $72.83 |
| RX-319 | CISATRACURIUM 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $10.58 |
| RX-320 | CISPLATIN 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $24.32 |
| RX-321 | CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $254.27 |
| RX-322 | CLEVIDIPINE 0.5 MG/ML INTRAVENOUS EMULSION WRAPPER | Pharmacy | $32.76 |
| RX-323 | CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMUL | Pharmacy | $32.76 |
| RX-324 | CLEVIDIPINE 50 MG/100 ML INTRAVENOUS EMUL | Pharmacy | $35.08 |
| RX-325 | CLINDAMYCIN 600 MG IN 1000 ML NS SOLUTION | Pharmacy | $25.20 |
| RX-326 | CLINDAMYCIN IN 5 % DEXTROSE 300 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $69.30 |
| RX-327 | CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $69.30 |
| RX-328 | CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $44.10 |
| RX-329 | CLINDAMYCIN PHOSPHATE 1 % TOP LOTN | Pharmacy | $216.30 |
| RX-33 | ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA | Pharmacy | $387.49 |
| RX-330 | CLINDAMYCIN PHOSPHATE 1 % TOP SOLN | Pharmacy | $39.90 |
| RX-331 | CLINDAMYCIN PHOSPHATE 150 MG/ML INJECTION SOLN | Pharmacy | $11.84 |
| RX-332 | CLINDAMYCIN PHOSPHATE 600 MG/4 ML INTRAVENOUS SOLN | Pharmacy | $18.14 |
| RX-333 | CLOBAZAM 5 MG PARTIAL TABLET | Pharmacy | $69.97 |
| RX-334 | CLOBETASOL 0.05 % SCALP SOLN | Pharmacy | $61.25 |
| RX-335 | CLOBETASOL 0.05 % TOP GEL | Pharmacy | $35.70 |
| RX-336 | CLOBETASOL 0.05 % TOP LOTN | Pharmacy | $214.97 |
| RX-337 | CLOMIPRAMINE 50 MG ORAL CAP | Pharmacy | $37.07 |
| RX-338 | CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN | Pharmacy | $215.33 |
| RX-339 | CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK | Pharmacy | $46.52 |
| RX-34 | ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLN | Pharmacy | $15,398.44 |
| RX-340 | CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK | Pharmacy | $59.08 |
| RX-341 | COAGULATION FACTOR IX (RECOMB) 2000 UNITS INTRAVENOUS SOLR | Pharmacy | $19.25 |
| RX-342 | COAGULATION FACTOR IX (RECOMB) 3000 UNITS INTRAVENOUS SOLR | Pharmacy | $19.25 |
| RX-343 | COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLR | Pharmacy | $27.18 |
| RX-344 | COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLR | Pharmacy | $27.18 |
| RX-345 | COAGULATION FACTOR VIIA RECOMB IV SYRINGE 1 MG/ML | Pharmacy | $26.21 |
| RX-346 | COAGULATION FACTOR VIIA RECOMB IV SYRINGE 1 MG/ML (PED-NEO) | Pharmacy | $27.18 |
| RX-347 | COCAINE 4 % NASAL SOLN | Pharmacy | $10.80 |
| RX-348 | COCAINE 4 % TOP SOLN | Pharmacy | $558.32 |
| RX-349 | COLISTIN (COLISTIMETHATE NA) 150 MG INJECTION SOLR | Pharmacy | $248.45 |
| RX-35 | ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLR | Pharmacy | $2,157.23 |
| RX-350 | COLLAGENASE CLOSTRIDIUM HISTO. 0.9 MG INJECTION SOLR | Pharmacy | $613.96 |
| RX-351 | COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOP OINT | Pharmacy | $387.45 |
| RX-352 | COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOP OINT (WOUND CARE CHARGE PER PT) | Pharmacy | $774.90 |
| RX-353 | CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREA | Pharmacy | $1,245.30 |
| RX-354 | CONJUGATED ESTROGENS 25 MG INJECTION SOLR | Pharmacy | $3,889.67 |
| RX-355 | COPANLISIB 60 MG INTRAVENOUS SOLR | Pharmacy | $1,000.07 |
| RX-356 | COPPER 380 SQUARE MM INTRAUTERINE IUD | Pharmacy | $10,187.10 |
| RX-357 | CORTICORELIN OVINE TRIFLUTATE 100 MCG INTRAVENOUS SOLR | Pharmacy | $116.41 |
| RX-358 | CORTICOTROPIN 80 UNITS/ML INJECTION GEL | Pharmacy | $49,439.65 |
| RX-359 | COSYNTROPIN 0.25 MG INJECTION SOLR | Pharmacy | $477.79 |
| RX-36 | ALIROCUMAB 75 MG/ML SUBCUTANEOUS PNIJ | Pharmacy | $1,891.40 |
| RX-360 | CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,542.71 |
| RX-361 | CROMOLYN 20 MG/2 ML INHALATION NEBU | Pharmacy | $61.70 |
| RX-362 | CUPRIC CHLORIDE 0.04 MG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $21.29 |
| RX-363 | CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLN | Pharmacy | $21.17 |
| RX-365 | CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML INJECTION SOLN | Pharmacy | $27.87 |
| RX-366 | CYCLOPHOSPHAMIDE 50 MG ORAL CAP | Pharmacy | $33.40 |
| RX-367 | CYCLOPHOSPHAMIDE 1 G INTRAVENOUS SOLR | Pharmacy | $418.76 |
| RX-368 | CYCLOPHOSPHAMIDE 2 G INTRAVENOUS SOLR | Pharmacy | $418.76 |
| RX-369 | CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS SOLR | Pharmacy | $418.76 |
| RX-37 | ALLOPURINOL SODIUM 500 MG INTRAVENOUS SOLR | Pharmacy | $23,174.55 |
| RX-370 | CYCLOPHOSPHAMIDE NON-ONCOLOGY USE 1 G IV SOLR | Pharmacy | $418.76 |
| RX-371 | CYCLOPHOSPHAMIDE NON-ONCOLOGY USE 50 MG ORAL CAP | Pharmacy | $33.40 |
| RX-373 | CYCLOSPORINE 0.05 % OPHTHALMIC DPET | Pharmacy | $77.46 |
| RX-374 | CYCLOSPORINE 100 MG ORAL CAP | Pharmacy | $30.00 |
| RX-375 | CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $740.19 |
| RX-377 | CYCLOSPORINE MODIFIED 100 MG ORAL CAP | Pharmacy | $30.00 |
| RX-378 | CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN | Pharmacy | $30.00 |
| RX-379 | CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $82.91 |
| RX-38 | ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG (+/-)/20 ML INTRAVENOUS SOLN | Pharmacy | $56.08 |
| RX-380 | CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLN | Pharmacy | $10.21 |
| RX-381 | CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLN | Pharmacy | $10.16 |
| RX-382 | CYTOMEGALOVIRUS IMMUNE GLOB 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $14,227.92 |
| RX-383 | D10 %-0.45 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-384 | D10-0.225 % NACL WITH POTASSIUM CHLORIDE 1.5 MEQ/50 ML INJ SYRINGE | Pharmacy | $63.00 |
| RX-385 | D10-0.225 % NACL WITH POTASSIUM CHLORIDE 15 MEQ/500 ML IVPB | Pharmacy | $63.00 |
| RX-386 | D2.5 %-0.45 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-387 | D5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-388 | D5 %-0.45 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-389 | D5-0.45 % NACL WITH POTASSIUM CHLORIDE 1.5 MEQ/50 ML INJ SYRINGE | Pharmacy | $63.00 |
| RX-39 | ALPROSTADIL 20 MCG INTRACAVRNSL KIT | Pharmacy | $62.84 |
| RX-390 | D5-0.45 % NACL WITH POTASSIUM CHLORIDE 15 MEQ/500 ML IVPB | Pharmacy | $63.00 |
| RX-391 | DABRAFENIB 75 MG ORAL CAP | Pharmacy | $320.86 |
| RX-392 | DACARBAZINE 200 MG INTRAVENOUS SOLR | Pharmacy | $51.31 |
| RX-393 | DACTINOMYCIN 0.5 MG INTRAVENOUS SOLR | Pharmacy | $13,941.33 |
| RX-394 | DALBAVANCIN 500 MG INTRAVENOUS SOLN | Pharmacy | $189.72 |
| RX-395 | DANTROLENE 250 MG INTRAVENOUS SUSR | Pharmacy | $1,154.79 |
| RX-398 | DARATUMUMAB 20 MG/ML INTRAVENOUS SOLN | Pharmacy | $680.78 |
| RX-399 | DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-4 | ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG ORAL TAB | Pharmacy | $341.36 |
| RX-400 | DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-401 | DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-402 | DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-403 | DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-404 | DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-405 | DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-406 | DARBEPOETIN ALFA IN POLYSORBAT 150 MCG/0.3 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-407 | DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-408 | DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-409 | DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-41 | ALTEPLASE 2 MG INTRACATHTR SOLR | Pharmacy | $1,106.94 |
| RX-410 | DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-411 | DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-412 | DARIFENACIN 15 MG ORAL TB24 | Pharmacy | $40.36 |
| RX-413 | DARUNAVIR ETHANOLATE 600 MG ORAL TAB | Pharmacy | $99.40 |
| RX-414 | DARUNAVIR ETHANOLATE 800 MG ORAL TAB | Pharmacy | $198.80 |
| RX-415 | DARUNAVIR-COBICISTAT 800-150 MG-MG ORAL TAB | Pharmacy | $227.22 |
| RX-416 | DASATINIB 70 MG ORAL TAB | Pharmacy | $906.26 |
| RX-417 | DASATINIB 100 MG ORAL TAB | Pharmacy | $1,633.35 |
| RX-418 | DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLN | Pharmacy | $609.79 |
| RX-419 | DECITABINE 50 MG INTRAVENOUS SOLR | Pharmacy | $54.22 |
| RX-42 | ALTEPLASE 50 MG INTRAVENOUS SOLR | Pharmacy | $1,106.94 |
| RX-420 | DEFEROXAMINE 2 G INJECTION SOLR | Pharmacy | $99.67 |
| RX-421 | DEGARELIX 80 MG SUBCUTANEOUS SOLR | Pharmacy | $49.85 |
| RX-422 | DEGARELIX 120 MG SUBCUTANEOUS SOLR | Pharmacy | $49.85 |
| RX-423 | DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $242.90 |
| RX-424 | DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $242.90 |
| RX-425 | DESMOPRESSIN 4 MCG/ML INJECTION SOLN | Pharmacy | $145.18 |
| RX-426 | DESMOPRESSIN 4 MCG/ML ORAL SOLUTION | Pharmacy | $46.75 |
| RX-427 | DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRP | Pharmacy | $531.65 |
| RX-428 | DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRY | Pharmacy | $531.65 |
| RX-429 | DEXAMETHASONE 0.4 MG INCA INST | Pharmacy | $1,709.06 |
| RX-43 | ALTEPLASE 1 MG/ML IA SOLN | Pharmacy | $1,106.94 |
| RX-435 | DEXAMETHASONE 0.1 % OPHTHALMIC DRPS | Pharmacy | $44.56 |
| RX-44 | ALTEPLASE 100 MG INTRAVENOUS SOLR | Pharmacy | $1,106.94 |
| RX-445 | DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OPHTHALMIC DROP | Pharmacy | $162.58 |
| RX-447 | DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLN | Pharmacy | $18.52 |
| RX-45 | ALVIMOPAN 12 MG ORAL CAP | Pharmacy | $606.13 |
| RX-454 | DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLR | Pharmacy | $2,488.79 |
| RX-455 | DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLR | Pharmacy | $2,488.79 |
| RX-456 | DEXTRAN 40 10 % IN 0.9 % NACL 10 % INTRAVENOUS SOLP | Pharmacy | $315.00 |
| RX-457 | DEXTROMETHORPHAN-QUINIDINE 20-10 MG ORAL CAP | Pharmacy | $66.19 |
| RX-458 | DEXTROSE 10 % IN WATER (D10W) 10 % INTRAVENOUS SOLP | Pharmacy | $15.75 |
| RX-459 | DEXTROSE 10% IN WATER (D10W) IV BOLUS | Pharmacy | $63.00 |
| RX-46 | AMBRISENTAN 5 MG ORAL TAB | Pharmacy | $259.49 |
| RX-460 | DEXTROSE 20 % IN WATER (D20W) 20 % INTRAVENOUS SOLP | Pharmacy | $126.00 |
| RX-461 | DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRG | Pharmacy | $90.72 |
| RX-462 | DEXTROSE 5 % IN WATER (D5W) 5 % INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-463 | DEXTROSE 5 % IN WATER (D5W) 5 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-464 | DEXTROSE 5 % IN WATER (D5W) 5 % IV DISPENSABLE | Pharmacy | $63.00 |
| RX-465 | DEXTROSE 5 % IV BOLUS | Pharmacy | $63.00 |
| RX-466 | DEXTROSE 5 % IV KVO | Pharmacy | $63.00 |
| RX-467 | DEXTROSE 5 %-0.45 % NACL BOLUS | Pharmacy | $63.00 |
| RX-468 | DEXTROSE 5 %-0.45 % NACL IV KVO | Pharmacy | $63.00 |
| RX-469 | DEXTROSE 5 %-0.9 % NACL BOLUS | Pharmacy | $63.00 |
| RX-47 | AMBRISENTAN 10 MG ORAL TAB | Pharmacy | $259.49 |
| RX-470 | DEXTROSE 5 %-LACTATED RINGERS INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-471 | DEXTROSE 5%-0.2 % SOD CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-472 | DEXTROSE 5%-0.3 % SOD.CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-473 | DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-474 | DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRG | Pharmacy | $63.00 |
| RX-475 | DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-48 | AMIFOSTINE CRYSTALLINE 500 MG INTRAVENOUS SOLR | Pharmacy | $12,749.80 |
| RX-480 | DIAZEPAM 2.5 MG RECTAL KIT | Pharmacy | $406.11 |
| RX-481 | DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT | Pharmacy | $463.17 |
| RX-482 | DIAZEPAM 5 MG/ML INJECTION SOLN | Pharmacy | $118.72 |
| RX-483 | DIAZEPAM 5 MG/ML INJECTION SYRG | Pharmacy | $118.72 |
| RX-484 | DIAZEPAM 5-7.5-10 MG RECTAL KIT | Pharmacy | $457.52 |
| RX-485 | DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 | Pharmacy | $39.10 |
| RX-486 | DICLOFENAC SODIUM 1 % TOP GEL | Pharmacy | $52.50 |
| RX-487 | DIFLUPREDNATE 0.05 % OPHTHALMIC DROP | Pharmacy | $621.95 |
| RX-488 | DIGOXIN 100 MCG/ML (0.1 MG/ML) INJECTION SOLN | Pharmacy | $70.37 |
| RX-489 | DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLN | Pharmacy | $70.33 |
| RX-49 | AMIKACIN 1000 MG/4 ML INJECTION SOLN | Pharmacy | $16.08 |
| RX-490 | DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SYRG | Pharmacy | $70.32 |
| RX-491 | DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLR | Pharmacy | $47,630.43 |
| RX-492 | DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLN | Pharmacy | $686.02 |
| RX-494 | DILTIAZEM HCL IN 0.9% NACL 125 MG/125 ML (1 MG/ML) INFUSION | Pharmacy | $64.58 |
| RX-497 | DIMERCAPROL 100 MG/ML IM SOLN | Pharmacy | $689.99 |
| RX-498 | DINOPROSTONE 10 MG VAGINAL INSR | Pharmacy | $1,347.71 |
| RX-499 | DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLN | Pharmacy | $28,927.08 |
| RX-5 | ABACAVIR-LAMIVUDINE 600-300 MG ORAL TAB | Pharmacy | $145.43 |
| RX-50 | AMIKACIN 500 MG/2 ML INJECTION SOLN | Pharmacy | $16.08 |
| RX-500 | DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP | Pharmacy | $365.59 |
| RX-501 | DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SUSP | Pharmacy | $229.70 |
| RX-502 | DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | Pharmacy | $229.70 |
| RX-503 | DIPH,PERTUS(ACEL),TET,POL (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SUSP | Pharmacy | $247.53 |
| RX-504 | DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP | Pharmacy | $423.83 |
| RX-505 | DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG | Pharmacy | $423.83 |
| RX-508 | DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SOLN | Pharmacy | $11.33 |
| RX-509 | DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SYRG | Pharmacy | $11.33 |
| RX-510 | DIPHENHYDRAMINE-0.9 % SOD.CHLR 50 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $11.34 |
| RX-511 | DIPHENHYDRAMINE-ZINC ACETATE 1-0.1 % TOP CREA | Pharmacy | $108.96 |
| RX-512 | DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP | Pharmacy | $423.83 |
| RX-513 | DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG | Pharmacy | $423.83 |
| RX-514 | DIP-PERT(A)-TET-POLIO-HIB (PF) 15 LF UNIT-20 MCG-5 LF/0.5 ML IM KIT | Pharmacy | $2,293.96 |
| RX-515 | DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $76.86 |
| RX-516 | DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) INTRAVENOUS SOLP | Pharmacy | $77.18 |
| RX-517 | DOBUTAMINE IN D5W 250 MG/250 ML (1 MG/ML) INTRAVENOUS SOLP | Pharmacy | $78.75 |
| RX-518 | DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) INTRAVENOUS SOLP | Pharmacy | $77.18 |
| RX-519 | DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-520 | DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-521 | DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-522 | DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-523 | DOCOSANOL 10 % TOP CREA | Pharmacy | $42.56 |
| RX-524 | DOLUTEGRAVIR 50 MG ORAL TAB | Pharmacy | $205.63 |
| RX-528 | DORNASE ALFA 1 MG/ML INHALATION SOLN | Pharmacy | $602.19 |
| RX-529 | DORZOLAMIDE 2 % OPHTHALMIC DROP | Pharmacy | $69.30 |
| RX-530 | DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHTHALMIC DROP | Pharmacy | $79.28 |
| RX-531 | DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $36.16 |
| RX-532 | DOXORUBICIN 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $36.16 |
| RX-533 | DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLN | Pharmacy | $36.16 |
| RX-534 | DOXORUBICIN FOR LC BEAD EMBOLIZATION | Pharmacy | $36.12 |
| RX-535 | DOXORUBICIN POWDER FOR EMBOLIZATION | Pharmacy | $36.12 |
| RX-536 | DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML INTRAVENOUS SUSP | Pharmacy | $3,723.55 |
| RX-537 | DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS SOLR | Pharmacy | $230.58 |
| RX-538 | DOXYCYCLINE MONOHYDRATE 40 MG ORAL CPID | Pharmacy | $60.03 |
| RX-542 | DROXIDOPA 100 MG ORAL CAP | Pharmacy | $108.85 |
| RX-543 | DROXIDOPA 200 MG ORAL CAP | Pharmacy | $217.70 |
| RX-544 | DROXIDOPA 300 MG ORAL CAP | Pharmacy | $326.59 |
| RX-545 | DUPILUMAB 300 MG/2 ML SUBCUTANEOUS SYRG | Pharmacy | $18,907.81 |
| RX-546 | DURVALUMAB 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $952.31 |
| RX-547 | ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLN | Pharmacy | $2,904.04 |
| RX-548 | EDARAVONE 30 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $245.55 |
| RX-549 | EFAVIRENZ 600 MG ORAL TAB | Pharmacy | $103.81 |
| RX-55 | AMINO ACIDS 4.25%-LYTES-CA-D5W 4.25 % INTRAVENOUS SOLP | Pharmacy | $210.00 |
| RX-550 | EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG ORAL TAB | Pharmacy | $337.16 |
| RX-551 | ELECTROLYTE-A INTRAVENOUS SOLP | Pharmacy | $35.00 |
| RX-553 | ELOTUZUMAB 300 MG INTRAVENOUS SOLR | Pharmacy | $82.93 |
| RX-554 | ELOTUZUMAB 400 MG INTRAVENOUS SOLR | Pharmacy | $82.93 |
| RX-555 | ELTROMBOPAG 25 MG ORAL TAB | Pharmacy | $614.99 |
| RX-556 | ELTROMBOPAG 50 MG ORAL TAB | Pharmacy | $1,040.13 |
| RX-557 | ELUXADOLINE 100 MG ORAL TAB | Pharmacy | $69.69 |
| RX-558 | ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG ORAL TAB | Pharmacy | $364.60 |
| RX-559 | ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG ORAL TAB | Pharmacy | $382.45 |
| RX-56 | AMINO ACIDS-PROTEIN HYDROLYS 15-100 GRAM-KCAL/30 ML ORAL LIQD | Pharmacy | $66.15 |
| RX-560 | EMOLLIENT COMBINATION NO.10 TOP EMUL | Pharmacy | $58.28 |
| RX-561 | EMTRICITABINE 200 MG ORAL CAP | Pharmacy | $56.81 |
| RX-562 | EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB | Pharmacy | $207.41 |
| RX-563 | EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG ORAL TAB | Pharmacy | $207.41 |
| RX-564 | EMTRICITAB-RILPIVIR-TENOFO ALA 200-25-25 MG ORAL TAB | Pharmacy | $331.80 |
| RX-565 | EMTRICITA-RILPIVIRINE-TENOF DF 200-25-300 MG ORAL TAB | Pharmacy | $331.80 |
| RX-566 | ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLN | Pharmacy | $44.35 |
| RX-567 | ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLR | Pharmacy | $352.27 |
| RX-57 | AMINOCAPROIC ACID 500 MG ORAL TAB | Pharmacy | $50.33 |
| RX-577 | EPHEDRINE SULFATE 50 MG/ML INJECTION SOLN | Pharmacy | $168.58 |
| RX-578 | EPHEDRINE SULFATE-0.9%NACL(PF) 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRG | Pharmacy | $77.91 |
| RX-579 | EPHEDRINE SULFATE-0.9%NACL(PF) 50 MG/10 ML (5 MG/ML) INTRAVENOUS SYRG | Pharmacy | $14.18 |
| RX-58 | AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLN | Pharmacy | $37.52 |
| RX-580 | EPINEPHRINE 0.1 MG/ML INJECTION SYRG | Pharmacy | $10.31 |
| RX-581 | EPINEPHRINE 0.15 MG/0.3 ML INJECTION ATIN | Pharmacy | $10.31 |
| RX-582 | EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLN | Pharmacy | $10.31 |
| RX-583 | EPINEPHRINE 1 MG/ML INJECTION ATIN | Pharmacy | $10.31 |
| RX-584 | EPINEPHRINE 1 MG/ML INJECTION SOLN | Pharmacy | $10.31 |
| RX-585 | EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLN | Pharmacy | $10.31 |
| RX-586 | EPINEPHRINE HCL IN 0.9 % NACL 100 MCG/10 ML (10 MCG/ML) INTRAVENOUS SYRG | Pharmacy | $10.33 |
| RX-587 | EPINEPHRINE HCL IN 0.9 % NACL 16 MG/250 ML (64 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $10.32 |
| RX-588 | EPINEPHRINE HCL IN 5% DEXTROSE 4 MG/250 ML (16 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $10.32 |
| RX-589 | EPINEPHRINE IN 0.9 % NACL 0.5 MG/50 ML INJ SYRINGE | Pharmacy | $10.33 |
| RX-590 | EPINEPHRINE IN 0.9 % NACL 0.5 MG/50 ML INJ SYRINGE | Pharmacy | $10.33 |
| RX-591 | EPINEPHRINE IN 0.9 % NACL 1 MG/10 ML INJ SYRINGE | Pharmacy | $10.31 |
| RX-592 | EPINEPHRINE IN 0.9 % NACL 1 MG/250 ML IVPB (CUPID) | Pharmacy | $10.40 |
| RX-593 | EPINEPHRINE IN 0.9 % NACL 4 MG/250 ML IVPB | Pharmacy | $10.32 |
| RX-594 | EPIRUBICIN 50 MG/25 ML INTRAVENOUS SOLN | Pharmacy | $14.11 |
| RX-595 | EPOETIN ALFA 2000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-596 | EPOETIN ALFA 4000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-597 | EPOETIN ALFA 10000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-598 | EPOETIN ALFA 20000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-599 | EPOETIN ALFA 40000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-6 | ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLR | Pharmacy | $691.10 |
| RX-60 | AMINOLEVULINIC ACID HCL 30 MG/ML ORAL SOLR | Pharmacy | $195.23 |
| RX-600 | EPOETIN ALFA-EPBX 2000 UNITS/ML INJECTION SOLN | Pharmacy | $117.50 |
| RX-601 | EPOETIN ALFA-EPBX 10000 UNITS/ML INJECTION SOLN | Pharmacy | $117.50 |
| RX-602 | EPOETIN ALFA-EPBX 40000 UNITS/ML INJECTION SOLN | Pharmacy | $117.50 |
| RX-603 | EPOPROSTENOL (ARGININE) 1.5 MG INTRAVENOUS SOLR | Pharmacy | $203.64 |
| RX-604 | EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLR | Pharmacy | $203.64 |
| RX-605 | EPOPROSTENOL (GLYCINE) 1.5 MG INTRAVENOUS SOLR | Pharmacy | $203.64 |
| RX-606 | EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLN | Pharmacy | $42.34 |
| RX-607 | EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $42.30 |
| RX-608 | EPTIFIBATIDE IA (INTERVENTIONAL RADIOLOGY) | Pharmacy | $42.30 |
| RX-609 | ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,464.59 |
| RX-61 | AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $132.80 |
| RX-610 | ERTAPENEM 1 G INJECTION SOLR | Pharmacy | $487.61 |
| RX-611 | ERTAPENEM 1 G INTRAVENOUS SOLR | Pharmacy | $487.61 |
| RX-612 | ERYTHROMYCIN 500 MG ORAL TAB | Pharmacy | $45.01 |
| RX-613 | ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLR | Pharmacy | $947.90 |
| RX-614 | ERYTHROMYCIN LACTOBIONATE 1000 MG INTRAVENOUS SOLR | Pharmacy | $947.90 |
| RX-615 | ERYTHROMYCIN-BENZOYL PEROXIDE 3-5 % TOP GEL | Pharmacy | $198.98 |
| RX-616 | ESLICARBAZEPINE 200 MG ORAL TAB | Pharmacy | $107.24 |
| RX-617 | ESLICARBAZEPINE 400 MG ORAL TAB | Pharmacy | $107.24 |
| RX-618 | ESLICARBAZEPINE 600 MG ORAL TAB | Pharmacy | $107.24 |
| RX-619 | ESLICARBAZEPINE 800 MG ORAL TAB | Pharmacy | $107.24 |
| RX-620 | ESMOLOL 10 MG/ML IV BOLUS FROM PUMP | Pharmacy | $24.44 |
| RX-623 | ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) INTRAVENOUS SOLP | Pharmacy | $315.00 |
| RX-624 | ESTRADIOL VALERATE 20 MG/ML IM OIL | Pharmacy | $106.14 |
| RX-625 | ETELCALCETIDE 5 MG/ML INTRAVENOUS SOLN | Pharmacy | $30.82 |
| RX-626 | ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $2,108.58 |
| RX-627 | ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLR | Pharmacy | $9,718.25 |
| RX-628 | ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLN | Pharmacy | $283.78 |
| RX-629 | ETHIODIZED OIL 480 MG IODINE/ML INJECTION OIL | Pharmacy | $1,294.02 |
| RX-630 | ETHYL CHLORIDE 100 % TOP SPRA | Pharmacy | $101.43 |
| RX-632 | ETOMIDATE 2 MG/ML INTRAVENOUS SYRG | Pharmacy | $16.25 |
| RX-633 | ETONOGESTREL 68 MG SUBDERMAL IMPL | Pharmacy | $10,683.54 |
| RX-634 | ETONOGESTREL-ETHINYL ESTRADIOL 0.12-0.015 MG/24 HR VAGINAL RING | Pharmacy | $516.50 |
| RX-638 | ETRAVIRINE 100 MG ORAL TAB | Pharmacy | $36.61 |
| RX-639 | ETRAVIRINE 200 MG ORAL TAB | Pharmacy | $73.26 |
| RX-64 | AMIODARONE IN DEXTROSE 5 % 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $2,202.48 |
| RX-640 | EVEROLIMUS (ANTINEOPLASTIC) 5 MG ORAL TAB | Pharmacy | $1,963.33 |
| RX-641 | EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG ORAL TAB | Pharmacy | $112.95 |
| RX-642 | EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB | Pharmacy | $112.95 |
| RX-643 | FACTOR VIII REC,FC FUSION PROT (ELOCTATE) INJ ORD/DISPENSABLE | Pharmacy | $25.44 |
| RX-644 | FACTOR VIII/VWF COMPLEX (ALPHANATE) INJ ORD/DISPENSABLE | Pharmacy | $13.49 |
| RX-645 | FACTOR VIII/VWF COMPLEX (HUMATE-P) INJ ORD/DISPENSABLE | Pharmacy | $14.69 |
| RX-647 | FAMOTIDINE (PF)-NACL (ISO-OS) 20 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $50.40 |
| RX-648 | FAMOTIDINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $11.34 |
| RX-651 | FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG INTRAVENOUS SOLR | Pharmacy | $304.79 |
| RX-652 | FAT EMULSION 20 % INTRAVENOUS EMUL | Pharmacy | $25.20 |
| RX-654 | FATTY ACID6-FISH OIL-GLY-P-LIP 10 % INTRAVENOUS EMUL | Pharmacy | $10.96 |
| RX-655 | FENOLDOPAM 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $3,622.50 |
| RX-656 | FENTANYL 12 MCG/HR TRANSDERMAL PT72 | Pharmacy | $42.63 |
| RX-657 | FENTANYL (PF)-BUPIVACAINE-NACL 2 MCG/ML- 0.1 % INJECTION SOLN | Pharmacy | $12.60 |
| RX-659 | FENTANYL 500 MCG IN 10 ML INFUSION | Pharmacy | $10.46 |
| RX-66 | AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $80.64 |
| RX-660 | FENTANYL CITRATE (PF) 50 MCG/ML INJECTION SOLN | Pharmacy | $12.45 |
| RX-661 | FENTANYL CITRATE (PF)-0.9%NACL 750 MCG/30 ML INJECTION PCAS | Pharmacy | $12.45 |
| RX-662 | FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML INTRAVENOUS SOLN | Pharmacy | $12.47 |
| RX-663 | FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML INTRAVENOUS SYRG | Pharmacy | $12.47 |
| RX-664 | FENTANYL CITRATE IN 0.9 % NACL 1250 MCG/50 ML PCA | Pharmacy | $12.45 |
| RX-665 | FENTANYL IN 0.9 % NACL 250 MCG/25 ML INJ SYR | Pharmacy | $12.47 |
| RX-666 | FENTANYL IN 0.9 % NACL 2500 MCG/250 ML (10 MCG/ML) INFUSION | Pharmacy | $12.47 |
| RX-667 | FENTANYL IN 0.9 % NACL 5 MCG/0.5 ML INJ SYR | Pharmacy | $12.47 |
| RX-668 | FENTANYL INFUSION 50 MCG/ML | Pharmacy | $12.45 |
| RX-669 | FENTANYL-BUPIVACAINE IN 0.9 % NACL 1250 MCG-312.5 MG/250 ML IVPB | Pharmacy | $94.50 |
| RX-67 | AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) INTRAVENOUS SOLN | Pharmacy | $46.20 |
| RX-670 | FENTANYL-BUPIVACAINE IN 0.9 % NACL 500 MCG-150 MG/250 ML IVPB | Pharmacy | $12.60 |
| RX-672 | FERRIC CARBOXYMALTOSE 50 IRON MG/ML INTRAVENOUS SOLN | Pharmacy | $13.92 |
| RX-673 | FERRIC PYROPHOSPHATE CITRATE 27.2 MG IRON/5 ML HEMODIALYSIS SOLN | Pharmacy | $2,038.40 |
| RX-674 | FERRIC PYROPHOSPHATE CITRATE 272 MG IRON HEMODIALYSIS PWPK | Pharmacy | $107.77 |
| RX-675 | FERRIC SUBSULFATE 259 MG/G TOP SOLN | Pharmacy | $45.92 |
| RX-676 | FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLN | Pharmacy | $13.13 |
| RX-677 | FIDAXOMICIN 200 MG ORAL TAB | Pharmacy | $315.84 |
| RX-678 | FILGRASTIM 300 MCG/0.5 ML INJECTION SYRG | Pharmacy | $12.03 |
| RX-679 | FILGRASTIM 300 MCG/ML INJECTION SOLN | Pharmacy | $12.03 |
| RX-68 | AMOBARBITAL 500 MG INJECTION SOLR | Pharmacy | $1,199.02 |
| RX-680 | FILGRASTIM 480 MCG/0.8 ML INJECTION SYRG | Pharmacy | $12.03 |
| RX-681 | FILGRASTIM 480 MCG/1.6 ML INJECTION SOLN | Pharmacy | $12.03 |
| RX-684 | FLU VAC QS 2016(4 YR UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $288.99 |
| RX-685 | FLU VAC QS 2017-18(6-35MO)(PF) 30 MCG (7.5 MCG X 4)/0.25 ML IM SYRG | Pharmacy | $274.84 |
| RX-686 | FLU VAC QS 2018(4 YR UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $302.99 |
| RX-687 | FLU VAC QS2016-17 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.80 |
| RX-688 | FLU VAC QS2017-18 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-689 | FLU VAC QS2018-19 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-69 | AMPHOTERICIN B 50 MG INJECTION SOLR | Pharmacy | $479.77 |
| RX-690 | FLU VAC QV 2019(18YR UP)RC(PF) 180 MCG (45 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $705.68 |
| RX-691 | FLU VAC QV 2020(18YR UP)RC(PF) 180 MCG (45 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $768.37 |
| RX-692 | FLU VACC QS 2019-20 (6 MOS UP) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $224.73 |
| RX-693 | FLU VACC QS2018-19 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-694 | FLU VACC QS2019-20 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-695 | FLU VACC QS2020-21 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $246.72 |
| RX-696 | FLU VACC QS2020-21 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $246.72 |
| RX-697 | FLU VACC QS2020-21(65YR UP)-PF 240 MCG/0.7 ML IM SYRG | Pharmacy | $768.37 |
| RX-698 | FLU VACC QV LIVE 2019(2-49YRS) 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY | Pharmacy | $338.64 |
| RX-699 | FLU VACC TS2016-17 65YR UP(PF) 180 MCG/0.5 ML IM SYRG | Pharmacy | $672.50 |
| RX-7 | ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $438.73 |
| RX-70 | AMPHOTERICIN B LIPOSOME 50 MG INJECTION | Pharmacy | $336.75 |
| RX-700 | FLU VACC TS2017-18 65YR UP(PF) 180 MCG/0.5 ML IM SYRG | Pharmacy | $672.50 |
| RX-701 | FLU VACC TS2018-19 65YR UP(PF) 180 MCG/0.5 ML IM SYRG | Pharmacy | $672.50 |
| RX-702 | FLU VACC TS2019-20(65YR UP)PF 180 MCG/0.5 ML IM SYRG | Pharmacy | $705.68 |
| RX-703 | FLU VACCINE QS2016-17(36MO,UP) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $230.19 |
| RX-704 | FLU VACCINE QS2020-21(6MOS UP) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $239.80 |
| RX-705 | FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLN | Pharmacy | $53,512.20 |
| RX-706 | FLUCONAZOLE IN DEXTROSE(ISO-O) 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $59.22 |
| RX-707 | FLUCONAZOLE IN NACL (ISO-OSM) 1,000 MG/500 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $59.22 |
| RX-708 | FLUCONAZOLE IN NACL (ISO-OSM) 1,200 MG/600 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $70.56 |
| RX-709 | FLUCONAZOLE IN NACL (ISO-OSM) 2 MG/ML IV DISPENSABLE | Pharmacy | $59.22 |
| RX-71 | AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSR | Pharmacy | $336.75 |
| RX-710 | FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $59.22 |
| RX-711 | FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML INTRAVENOUS PGBK | Pharmacy | $59.22 |
| RX-712 | FLUCONAZOLE IN NACL (ISO-OSM) 600 MG/300 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $59.22 |
| RX-713 | FLUCONAZOLE IN NACL (ISO-OSM) 800 MG/400 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $59.22 |
| RX-714 | FLUCYTOSINE 250 MG ORAL CAP | Pharmacy | $41.55 |
| RX-715 | FLUCYTOSINE 500 MG ORAL CAP | Pharmacy | $172.31 |
| RX-716 | FLUDARABINE 50 MG INTRAVENOUS SOLR | Pharmacy | $603.39 |
| RX-717 | FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $11.34 |
| RX-718 | FLUOCINOLONE 0.025 % TOP CREA | Pharmacy | $77.70 |
| RX-719 | FLUOCINONIDE 0.05 % TOP GEL | Pharmacy | $54.08 |
| RX-72 | AMPICILLIN IM INJECTION ORDERABLE | Pharmacy | $12.35 |
| RX-720 | FLUOCINONIDE 0.05 % TOP OINT | Pharmacy | $41.48 |
| RX-721 | FLUOCINONIDE 0.05 % TOP SOLN | Pharmacy | $182.70 |
| RX-722 | FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLN | Pharmacy | $106.47 |
| RX-723 | FLUORODEOXYGLUCOSE F-18 FDG =< 45 MCI | Pharmacy | $1,877.40 |
| RX-724 | FLUOROMETHOLONE 0.1 % OPHTHALMIC DRPS | Pharmacy | $218.05 |
| RX-725 | FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLN | Pharmacy | $19.15 |
| RX-726 | FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLN | Pharmacy | $19.15 |
| RX-727 | FLUOROURACIL 5 G/100 ML INTRAVENOUS SOLN | Pharmacy | $19.15 |
| RX-728 | FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLN | Pharmacy | $125.75 |
| RX-729 | FLUPHENAZINE HCL 2.5 MG/ML INJECTION SOLN | Pharmacy | $103.82 |
| RX-73 | AMPICILLIN SODIUM 1 G INJECTION SOLR | Pharmacy | $12.35 |
| RX-730 | FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE INHALATION DSDV | Pharmacy | $1,081.50 |
| RX-731 | FLUTICASONE PROPIONATE 44 MCG/ACTUATION INHALATION HFAA | Pharmacy | $187.74 |
| RX-732 | FLUTICASONE PROPIONATE 110 MCG/ACTUATION INHALATION HFAA | Pharmacy | $221.89 |
| RX-733 | FLUTICASONE PROPIONATE 220 MCG/ACTUATION INHALATION HFAA | Pharmacy | $344.74 |
| RX-734 | FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE INHALATION DSDV | Pharmacy | $59.85 |
| RX-735 | FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION INHALATION HFAA | Pharmacy | $1,242.36 |
| RX-736 | FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION INHALATION HFAA | Pharmacy | $1,633.80 |
| RX-737 | FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE INHALATION DSDV | Pharmacy | $74.34 |
| RX-738 | FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE INHALATION DSDV | Pharmacy | $97.78 |
| RX-739 | FOLIC ACID 5 MG/ML INJECTION SOLN | Pharmacy | $26.33 |
| RX-74 | AMPICILLIN SODIUM 2 G INJECTION SOLR | Pharmacy | $12.35 |
| RX-740 | FOMEPIZOLE 1 G/ML INTRAVENOUS SOLN | Pharmacy | $107.96 |
| RX-741 | FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-742 | FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-743 | FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-744 | FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-745 | FORMOTEROL FUMARATE 20 MCG/2 ML INHALATION NEBU | Pharmacy | $152.21 |
| RX-746 | FOSAMPRENAVIR 700 MG ORAL TAB | Pharmacy | $61.32 |
| RX-747 | FOSAPREPITANT 150 MG INTRAVENOUS SOLR | Pharmacy | $24.95 |
| RX-748 | FOSCARNET 24 MG/ML INJ | Pharmacy | $1,036.88 |
| RX-749 | FOSCARNET 24 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,036.88 |
| RX-75 | AMPICILLIN SODIUM 500 MG INJECTION SOLR | Pharmacy | $12.35 |
| RX-750 | FOSFOMYCIN TROMETHAMINE 3 G ORAL PACK | Pharmacy | $289.87 |
| RX-751 | FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLN | Pharmacy | $17.39 |
| RX-752 | FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLN | Pharmacy | $17.39 |
| RX-753 | FULVESTRANT 250 MG/5 ML IM SYRG | Pharmacy | $1,070.46 |
| RX-76 | AMPICILLIN-SULBACTAM 1.5 G INJECTION SOLR | Pharmacy | $32.47 |
| RX-762 | GADODIAMIDE 10 MMOL/20 ML (287 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-763 | GADODIAMIDE 5 MMOL/10 ML (287 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-764 | GADODIAMIDE 7.5 MMOL/15 ML (287 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-765 | GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML (469.01 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-766 | GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML (469.01 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-767 | GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-769 | GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLN | Pharmacy | $185.79 |
| RX-77 | AMPICILLIN-SULBACTAM 3 G INJECTION SOLR | Pharmacy | $32.47 |
| RX-770 | GALLIUM CITRATE GA-67 PER 1 MCI | Pharmacy | $743.27 |
| RX-771 | GALSULFASE 5 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $5,013.04 |
| RX-772 | GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLR | Pharmacy | $436.50 |
| RX-773 | GATIFLOXACIN 0.5 % OPHTHALMIC DROP | Pharmacy | $130.11 |
| RX-774 | GEL DRESSING TOP GEL | Pharmacy | $44.63 |
| RX-775 | GELATIN SPONGE,ABSORB-PORCINE 100 TOP SPGE | Pharmacy | $60.55 |
| RX-776 | GEMCITABINE 1 G INTRAVENOUS SOLR | Pharmacy | $52.37 |
| RX-777 | GEMCITABINE 2 G INTRAVENOUS SOLR | Pharmacy | $52.37 |
| RX-778 | GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLN | Pharmacy | $52.42 |
| RX-779 | GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) INTRAVENOUS SOLR | Pharmacy | $2,514.36 |
| RX-78 | ANAKINRA 100 MG/0.67 ML IV SYRG (COVID19) | Pharmacy | $1,953.11 |
| RX-780 | GENTAMICIN 0.1 % TOP CREA | Pharmacy | $77.18 |
| RX-781 | GENTAMICIN 0.3 % (3 MG/GRAM) OPHTHALMIC OINT | Pharmacy | $90.04 |
| RX-782 | GENTAMICIN 20 MG/2 ML INJECTION SOLN | Pharmacy | $24.90 |
| RX-783 | GENTAMICIN 40 MG/ML INJECTION SOLN | Pharmacy | $24.85 |
| RX-784 | GENTAMICIN 5 MG/ML INJ IN NS (PF) | Pharmacy | $24.85 |
| RX-785 | GENTAMICIN IN NACL (ISO-OSM) 80 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-786 | GENTAMICIN IN NACL (ISO-OSM) 80 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-787 | GENTAMICIN IN NACL (ISO-OSM) 100 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-788 | GENTAMICIN IN NS INTRATHECAL 4MG IN 2ML SYG | Pharmacy | $25.20 |
| RX-789 | GENTAMICIN IV (PF) 10 MG/ML - DISPENSABLE (PED-NEO) | Pharmacy | $24.90 |
| RX-79 | ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRG | Pharmacy | $1,953.14 |
| RX-790 | GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML INJECTION SOLN | Pharmacy | $24.90 |
| RX-791 | GENTIAN VIOLET 1 % TOP SOLN | Pharmacy | $239.54 |
| RX-792 | GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,032.62 |
| RX-793 | GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,032.62 |
| RX-794 | GLECAPREVIR-PIBRENTASVIR 100-40 MG ORAL TAB | Pharmacy | $530.74 |
| RX-795 | GLUCAGON (HUMAN RECOMBINANT) 1 MG INJECTION SOLR | Pharmacy | $2,741.31 |
| RX-796 | GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML INJECTION SOLR | Pharmacy | $2,741.31 |
| RX-797 | GLUCARPIDASE 1000 UNITS INTRAVENOUS SOLR | Pharmacy | $3,988.91 |
| RX-798 | GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML ORAL LIQD | Pharmacy | $718.20 |
| RX-799 | GLUCOSE ORAL SOLN 5 GM/30 ML | Pharmacy | $76.13 |
| RX-80 | ANTIHEMOPHIL FVIII,FULL LENGTH (ADVATE) IV SOLR ORDER/DISPENSABLE | Pharmacy | $16.25 |
| RX-800 | GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLN | Pharmacy | $80.01 |
| RX-801 | GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLN | Pharmacy | $1,562.79 |
| RX-802 | GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLN | Pharmacy | $260.30 |
| RX-803 | GOSERELIN 3.6 MG SUBCUTANEOUS IMPL | Pharmacy | $6,350.20 |
| RX-804 | GOSERELIN 10.8 MG SUBCUTANEOUS IMPL | Pharmacy | $6,350.20 |
| RX-808 | H PAPILLOMAVIRUS VAC,QVAL (PF) 20-40-40-20 MCG/0.5 ML IM SUSP | Pharmacy | $2,350.05 |
| RX-809 | HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR | Pharmacy | $197.95 |
| RX-81 | ANTIHEMOPHIL FVIII,FULL LENGTH 500 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $16.25 |
| RX-810 | HALOPERIDOL DECANOATE 50 MG/ML IM SOLN | Pharmacy | $205.12 |
| RX-811 | HALOPERIDOL DECANOATE 100 MG/ML IM SOLN | Pharmacy | $205.12 |
| RX-812 | HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLN | Pharmacy | $15.18 |
| RX-813 | HEMIN 350 MG INTRAVENOUS SOLR | Pharmacy | $298.86 |
| RX-814 | HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG | Pharmacy | $705.92 |
| RX-815 | HEPARIN (PORCINE) 1000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-816 | HEPARIN (PORCINE) 5000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-817 | HEPARIN (PORCINE) 10,000 UNITS/10 ML INJ SYRG | Pharmacy | $63.00 |
| RX-818 | HEPARIN (PORCINE) 10,000 UNITS/20 ML NS SYRINGE | Pharmacy | $63.00 |
| RX-819 | HEPARIN (PORCINE) 100 UNITS/ML IV BOLUS FROM PUMP | Pharmacy | $63.00 |
| RX-82 | ANTIHEMOPHILIC FACTOR (RECOMB) 1,000 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $16.25 |
| RX-820 | HEPARIN (PORCINE) 10000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-821 | HEPARIN (PORCINE) 5000 UNIT/ML INJ(PRE-OP) NO DOSE CK | Pharmacy | $63.00 |
| RX-822 | HEPARIN (PORCINE) 5000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-823 | HEPARIN (PORCINE) IN 0.45 % SODIUM CHLORIDE 0.5 UNITS/ML INFUSION 500 ML | Pharmacy | $63.00 |
| RX-824 | HEPARIN (PORCINE) IN 0.45% SODIUM CHLORIDE 0.5 UNITS/ML INFUSION 500 ML | Pharmacy | $63.00 |
| RX-825 | HEPARIN (PORCINE) IN 0.9 % NACL 0.5 UNITS/ML INFUSION | Pharmacy | $63.00 |
| RX-826 | HEPARIN (PORCINE) IN 0.9 % NACL 1,000 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-827 | HEPARIN (PORCINE) IN 0.9 % NACL 4,000 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-828 | HEPARIN (PORCINE) IN 0.9 % NACL 4,000 UNITS/1,000 ML SOLUTION | Pharmacy | $63.00 |
| RX-829 | HEPARIN (PORCINE) IN 0.9 % NACL 7,500 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-83 | ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $16.25 |
| RX-830 | HEPARIN (PORCINE) IN 0.9 % NACL 8,000 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-831 | HEPARIN (PORCINE) IN 0.9% NACL 10 UNITS/ML INTRAVENOUS KIT | Pharmacy | $63.00 |
| RX-832 | HEPARIN (PORCINE) IN 0.9% NACL 5000 UNIT/1,000 ML INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-833 | HEPARIN (PORCINE) IN 0.9% NACL 2,500 UNIT/500 ML (5 UNIT/ML) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-834 | HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-835 | HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/500 ML (50 UNIT/ML) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-836 | HEPARIN (PORCINE) IN D10W 25 UNITS/50 ML INFUSION | Pharmacy | $63.00 |
| RX-837 | HEPARIN (PORCINE) IN D10W 250 UNITS/500 ML IVPB | Pharmacy | $63.00 |
| RX-838 | HEPARIN (PORCINE) IN D5W 0.5 UNITS/ML INFUSION 500 ML | Pharmacy | $63.00 |
| RX-839 | HEPARIN (PORCINE) IN NACL (PF) 2 UNITS/ML INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-84 | ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLR | Pharmacy | $13.49 |
| RX-840 | HEPARIN IA 100 UNIT/ML INFUSION | Pharmacy | $63.00 |
| RX-841 | HEPARIN LOCK FLUSH (PORCINE) 10 UNITS/ML INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-842 | HEPARIN LOCK FLUSH (PORCINE) 100 UNITS/ML INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-843 | HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-844 | HEPARIN, PORCINE (PF) 10 UNITS/ML INTRAVENOUS SYRG | Pharmacy | $63.00 |
| RX-845 | HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS (CUSTOM 3 ML) | Pharmacy | $63.00 |
| RX-846 | HEPARIN, PORCINE (PF) 100 UNITS/ML INTRAVENOUS SYRG | Pharmacy | $63.00 |
| RX-847 | HEPARIN, PORCINE (PF) 100 UNIT/ML (1 ML) INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-848 | HEPARIN, PORCINE (PF) 1000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-849 | HEPATITIS A AND B VACCINE (PF) 720 ELISA UNIT- 20 MCG/ML IM SYRG | Pharmacy | $1,047.69 |
| RX-85 | ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT INTRAVENOUS SOLR | Pharmacy | $14.69 |
| RX-850 | HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SUSP | Pharmacy | $754.83 |
| RX-851 | HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG | Pharmacy | $754.83 |
| RX-852 | HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM SUSP | Pharmacy | $345.74 |
| RX-853 | HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SUSP | Pharmacy | $301.77 |
| RX-854 | HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG | Pharmacy | $301.77 |
| RX-855 | HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG | Pharmacy | $1,460.79 |
| RX-856 | HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN | Pharmacy | $1,460.79 |
| RX-857 | HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN | Pharmacy | $1,460.79 |
| RX-858 | HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG | Pharmacy | $1,651.86 |
| RX-859 | HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP | Pharmacy | $338.91 |
| RX-86 | ANTIHEMOPHILIC FACTOR-VWF 2,000 (800 VWF) UNIT/10 ML INTRAVENOUS SOLR | Pharmacy | $13.49 |
| RX-860 | HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SYRG | Pharmacy | $338.91 |
| RX-861 | HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG | Pharmacy | $338.91 |
| RX-862 | HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP | Pharmacy | $844.97 |
| RX-863 | HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | Pharmacy | $844.97 |
| RX-864 | HES 130/0.4 6 % IN 0.9 % NACL 6 % INTRAVENOUS SOLN | Pharmacy | $819.00 |
| RX-865 | HETASTARCH 6 % IN 0.9 % NACL 6 % INTRAVENOUS SOLN | Pharmacy | $189.00 |
| RX-866 | HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLR | Pharmacy | $14,429.02 |
| RX-867 | HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT | Pharmacy | $462,099.14 |
| RX-868 | HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) INTRAVENOUS SOLR | Pharmacy | $25.29 |
| RX-869 | HUM PROTHROMBIN CPLX(PCC)4FACT 500 UNIT (400-620 UNIT) INTRAVENOUS SOLR | Pharmacy | $25.29 |
| RX-87 | ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $41.32 |
| RX-870 | HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP | Pharmacy | $2,528.95 |
| RX-871 | HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML INTRAARTICLR SYRG | Pharmacy | $14,691.61 |
| RX-872 | HYALURONATE SODIUM, STABILIZED 88 MG/4 ML INTRAARTICLR SYRG | Pharmacy | $9,843.98 |
| RX-874 | HYALURONIDASE 150 UNITS/ML INJECTION SOLN | Pharmacy | $384.55 |
| RX-876 | HYDRALAZINE 20 MG/ML INJECTION SOLN | Pharmacy | $47.26 |
| RX-877 | HYDROCORTISONE 1 % TOP OINT | Pharmacy | $191.10 |
| RX-878 | HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJECTION SOLR | Pharmacy | $164.43 |
| RX-879 | HYDROCORTISONE SOD SUCC (PF) 250 MG/2 ML INJECTION SOLR | Pharmacy | $164.43 |
| RX-88 | ANTI-THYMOCYTE GLOB (RABBIT) 25 MG INTRAVENOUS SOLR | Pharmacy | $9,648.29 |
| RX-880 | HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML INJECTION SOLR | Pharmacy | $164.43 |
| RX-881 | HYDROCORTISONE SOD SUCCINATE 100 MG INJECTION SOLR | Pharmacy | $164.43 |
| RX-882 | HYDROGEN PEROXIDE 3 % MISC. SOLN | Pharmacy | $215.22 |
| RX-883 | HYDROMORPHONE 1 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-884 | HYDROMORPHONE 2 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-885 | HYDROMORPHONE 2 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-886 | HYDROMORPHONE 4 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-887 | HYDROMORPHONE (DILAUDID) IN 0.9% NACL 25 MG/250 ML IV BOLUS FROM PUMP | Pharmacy | $39.31 |
| RX-888 | HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-889 | HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-89 | APRACLONIDINE 0.5 % OPHTHALMIC DROP | Pharmacy | $98.35 |
| RX-890 | HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-891 | HYDROMORPHONE (PF) 2 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-892 | HYDROMORPHONE (PF) 4 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-893 | HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-894 | HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-895 | HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-896 | HYDROMORPHONE 1 MG/ML SUPER ORDERABLE | Pharmacy | $39.06 |
| RX-897 | HYDROMORPHONE 10 MG/250 ML NS EPIDURAL | Pharmacy | $39.06 |
| RX-898 | HYDROMORPHONE 2 MG/ML INJ SOLN SUPER ORDERABLE | Pharmacy | $39.06 |
| RX-899 | HYDROMORPHONE IN 0.9 % NACL 25 MG/250 ML (0.1 MG/ML) INFUSION | Pharmacy | $39.31 |
| RX-9 | ACETAZOLAMIDE SODIUM 500 MG INJECTION SOLR | Pharmacy | $178.14 |
| RX-90 | APRACLONIDINE 1 % OPHTHALMIC DPET | Pharmacy | $87.62 |
| RX-900 | HYDROMORPHONE IN 0.9 % NACL 25 MG/250 ML IVPB | Pharmacy | $39.31 |
| RX-901 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML (PED-NEO) PCA STANDARD | Pharmacy | $39.06 |
| RX-902 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML INFUSION | Pharmacy | $39.06 |
| RX-903 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML PCA RESTRICTED | Pharmacy | $39.06 |
| RX-904 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML PCA STANDARD | Pharmacy | $39.06 |
| RX-905 | HYDROMORPHONE IN 0.9 % NACL 50 MG/250 ML (0.2 MG/ML) INFUSION | Pharmacy | $39.06 |
| RX-906 | HYDROMORPHONE IN NS 100 MG/100 ML (1 MG/ML) | Pharmacy | $39.06 |
| RX-907 | HYDROXOCOBALAMIN 5 G INTRAVENOUS SOLR | Pharmacy | $2,712.78 |
| RX-908 | HYDROXYPROGEST(PF)(PREG PRESV) 250 MG/ML (1 ML) IM OIL | Pharmacy | $253.41 |
| RX-909 | HYDROXYPROGEST(PF)(PREG PRESV) 275 MG/1.1 ML SUBCUTANEOUS ATIN | Pharmacy | $253.41 |
| RX-91 | APREMILAST 30 MG ORAL TAB | Pharmacy | $202.20 |
| RX-910 | HYDROXYPROGESTERONE CAP(PPRES) 250 MG/ML IM OIL | Pharmacy | $253.41 |
| RX-911 | HYDROXYZINE HCL 25 MG/ML IM SOLN | Pharmacy | $88.45 |
| RX-912 | HYDROXYZINE HCL 50 MG/ML IM SOLN | Pharmacy | $88.45 |
| RX-915 | HYPROMELLOSE 2.5 % OPHTHALMIC DROP | Pharmacy | $56.12 |
| RX-916 | IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRG | Pharmacy | $557.80 |
| RX-917 | IBRUTINIB 140 MG ORAL CAP | Pharmacy | $518.63 |
| RX-918 | IBUPROFEN 400 MG/4 ML (100 MG/ML) INTRAVENOUS SOLR | Pharmacy | $13.97 |
| RX-919 | IBUPROFEN 800 MG/200 ML (4 MG/ML) INTRAVENOUS PGBK | Pharmacy | $30.87 |
| RX-92 | APREPITANT 40 MG ORAL CAP | Pharmacy | $61.35 |
| RX-920 | IBUPROFEN 800 MG/8 ML (100 MG/ML) INTRAVENOUS SOLR | Pharmacy | $24.82 |
| RX-921 | IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLN | Pharmacy | $15,327.90 |
| RX-922 | IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $3,253.57 |
| RX-923 | IDARUBICIN 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $457.51 |
| RX-924 | IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLN | Pharmacy | $25,242.84 |
| RX-925 | IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLN | Pharmacy | $6,840.41 |
| RX-926 | IFOSFAMIDE 1 G INTRAVENOUS SOLR | Pharmacy | $336.39 |
| RX-927 | ILOPROST 10 MCG/ML INHALATION NEBU | Pharmacy | $1,761.91 |
| RX-928 | ILOPROST 20 MCG/ML INHALATION NEBU | Pharmacy | $1,761.90 |
| RX-929 | IMATINIB 100 MG ORAL TAB | Pharmacy | $316.26 |
| RX-93 | APREPITANT 80 MG ORAL CAP | Pharmacy | $61.35 |
| RX-930 | IMIGLUCERASE 400 UNITS INTRAVENOUS SOLR | Pharmacy | $537.21 |
| RX-931 | IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLR | Pharmacy | $71.63 |
| RX-932 | IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJECTION SOLN | Pharmacy | $503.06 |
| RX-933 | IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % INTRAVENOUS SOLN | Pharmacy | $514.65 |
| RX-934 | IMMUN GLOB G-GLY-GLUC-IGA 0-50 5 % INTRAVENOUS SOLR | Pharmacy | $796.17 |
| RX-935 | IMMUN GLOBG(IGG)-MALT-IGA OV50 5 % INTRAVENOUS SOLN | Pharmacy | $481.57 |
| RX-936 | IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % INTRAVENOUS SOLN | Pharmacy | $481.57 |
| RX-937 | IMMUNE GLOB G (IGG)-GLYCINE 15-18 % RANGE IM SOLN | Pharmacy | $514.76 |
| RX-938 | IMMUNE GLOBUL G-GLY-IGA AVG 46 1 GRAM/10 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-939 | IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-94 | APREPITANT 125 MG (25 MG/ ML FINAL CONC.) ORAL SUSR | Pharmacy | $61.35 |
| RX-940 | IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-941 | IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-942 | IMMUNE GLOBULIN (10%) (IGA<1 MCG/ML) GAMMAGARD S-D INFUSION | Pharmacy | $796.17 |
| RX-943 | IMMUNE GLOBULIN (HUMAN) (IGG) 10 % IV SOLN (PRIVIGEN) | Pharmacy | $514.65 |
| RX-944 | INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLN | Pharmacy | $460.43 |
| RX-945 | INDIUM 111 DTPA | Pharmacy | $17,921.04 |
| RX-946 | INDIUM 111-PENTETREOTIDE 3-10 MCI/ML-MCG INTRAVENOUS KIT | Pharmacy | $77,568.62 |
| RX-947 | INDIUM IN-111 LABELED WBC IV SOLUTION | Pharmacy | $41,328.00 |
| RX-948 | INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN | Pharmacy | $30,507.75 |
| RX-949 | INDOMETHACIN 50 MG RECTAL SUPP | Pharmacy | $270.76 |
| RX-95 | APREPITANT 125 MG ORAL CAP | Pharmacy | $61.35 |
| RX-950 | INDOMETHACIN SODIUM 1 MG INTRAVENOUS SOLR | Pharmacy | $3,104.14 |
| RX-951 | INFLIXIMAB 100 MG INTRAVENOUS SOLR | Pharmacy | $722.56 |
| RX-952 | INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLR | Pharmacy | $652.05 |
| RX-953 | INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLR | Pharmacy | $601.91 |
| RX-954 | INHALAT. SPACING DEV,SM. MASK MISC. SPCR | Pharmacy | $41.30 |
| RX-955 | INHALAT.SPACING DEV,LARGE MASK MISC. SPCR | Pharmacy | $44.49 |
| RX-956 | INHALAT.SPACING DEV,MED. MASK MISC. SPCR | Pharmacy | $41.30 |
| RX-957 | INHALATIONAL SPACING DEVICE MISC. SPCR | Pharmacy | $156.07 |
| RX-958 | INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) INTRAVENOUS SOLR | Pharmacy | $28,649.38 |
| RX-959 | INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-96 | APREPITANT 20 MG/ML ORAL SUSP | Pharmacy | $125.34 |
| RX-960 | INSULIN ASPART INJECTION ORDERABLE | Pharmacy | $10.85 |
| RX-961 | INSULIN ASPART U-100 100 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-962 | INSULIN ASPART U-100 100 UNITS/ML SUBCUTANEOUS CRTG | Pharmacy | $11.33 |
| RX-963 | INSULIN ASPART U-100 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-964 | INSULIN DEGLUDEC 100 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $102.48 |
| RX-965 | INSULIN DETEMIR U-100 100 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-966 | INSULIN DETEMIR U-100 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-967 | INSULIN GLARGINE 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-968 | INSULIN LISPRO 100 UNITS/ML SUBCUTANEOUS CRTG | Pharmacy | $11.33 |
| RX-969 | INSULIN LISPRO 100 UNITS/ML SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-97 | APREPITANT 7.2 MG/ML INTRAVENOUS EMUL | Pharmacy | $26.30 |
| RX-970 | INSULIN LISPRO 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-971 | INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP | Pharmacy | $11.33 |
| RX-972 | INSULIN NPH HUMAN RECOMB 100 UNIT/ML SUBQ SUSP (PED-NEO) | Pharmacy | $11.33 |
| RX-973 | INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SUBCUTANEOUS SUSP | Pharmacy | $11.33 |
| RX-974 | INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-975 | INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION | Pharmacy | $11.21 |
| RX-976 | INSULIN REGULAR HUMAN 100 UNITS/ML INJECTION SOLN | Pharmacy | $11.33 |
| RX-977 | INSULIN REGULAR IN 0.9 % NACL 100 UNIT/100 ML (1 UNIT/ML) INTRAVENOUS SOLN | Pharmacy | $11.34 |
| RX-978 | INTERFERON ALFA-2B 10 MILLION UNIT (1 ML) INJECTION SOLR | Pharmacy | $431.03 |
| RX-979 | INTERFERON ALFA-2B 6 MILLION UNIT/ML INJECTION SOLN | Pharmacy | $431.03 |
| RX-98 | ARGATROBAN 100 MG/ML INTRAVENOUS SOLN | Pharmacy | $15.35 |
| RX-980 | IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN | Pharmacy | $214,987.50 |
| RX-981 | IODIDE I-131 DIAGNOSTIC CAP PER MCI | Pharmacy | $209.48 |
| RX-982 | IODINE I-131 IODINATED SERUM ALBUMIN DIAGNOSTIC IV SOLUTION | Pharmacy | $4,095.00 |
| RX-985 | IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) INTRAVENOUS SOLN | Pharmacy | $31,210.93 |
| RX-986 | IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLN | Pharmacy | $11.13 |
| 2020349 | HC PT APPLICATION LONG LEG CAST THIGH-TOE GP | Physical Therapy | $821.10 |
| 2020352 | HC PT APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE | Physical Therapy | $870.61 |
| 2020357 | HC PT APPLICATION SHORT LEG CAST BELOW KNEE-TOE GP | Physical Therapy | $598.92 |
| 2020361 | HC PT APPLICATION SHORT LEG CAST WALKING/AMBULATORY GP | Physical Therapy | $565.11 |
| 2020362 | HC APPLICATION SHORT LEG CAST WALKING/AMBULATORY | Physical Therapy | $565.11 |
| 2022237 | HC PT HOT OR COLD PACKS THERAPY GP | Physical Therapy | $77.28 |
| 2022238 | HC PT HOT OR COLD PACKS THERAPY GP | Physical Therapy | $77.28 |
| 2022239 | HC PT MECHANICAL TRACTION THERAPY GP | Physical Therapy | $175.09 |
| 2022246 | HC PT ELECTRICAL STIMULATION GP | Physical Therapy | $144.90 |
| 2022249 | HC PT ELECTRIC CURRENT THERAPY GP | Physical Therapy | $246.33 |
| 2022252 | HC PT ULTRASOUND THERAPY GP | Physical Therapy | $140.07 |
| 2022258 | HC PT THERAPEUTIC EXERCISES GP | Physical Therapy | $397.27 |
| 2022259 | HC PT THERAPEUTIC EXERCISES GP | Physical Therapy | $397.27 |
| 2022261 | HC PT NEUROMUSCULAR REEDUCATION GP | Physical Therapy | $431.08 |
| 2022265 | HC AQUATIC THERAPY/EXERCISES GP | Physical Therapy | $379.16 |
| 2022268 | HC PT GAIT TRAINING THERAPY GP | Physical Therapy | $345.35 |
| 2022269 | HC PT MASSAGE THERAPY EA 15 MINS - GP | Physical Therapy | $272.90 |
| 2022275 | HC PT MANUAL THERAPY EA 15 MINS - GP | Physical Therapy | $365.87 |
| 2022279 | HC PT GROUP THERAPEUTIC PROCEDURES GP | Physical Therapy | $216.14 |
| 2022282 | HC PT THERAPEUTIC ACTIVITIES GP EA 15 MINS | Physical Therapy | $363.46 |
| 2022292 | HC PT SENSORY INTEGRATION GP EA 15 MINS | Physical Therapy | $385.19 |
| 2022294 | HC PT SELF CARE MNGMENT TRAINING GP EA 15 MINS | Physical Therapy | $420.21 |
| 2022297 | HC PT COMMUNITY/WORK REINTEGRATION GP EA 15 MINS | Physical Therapy | $324.82 |
| 2022298 | HC PT WHEELCHAIR MNGMENT TRAINING GP EA 15 MINS | Physical Therapy | $276.52 |
| 2022308 | HC PT PHYSICAL PERFORMANCE TEST GP | Physical Therapy | $329.65 |
| 2022312 | HC PT INI ORTH MGMT/TRAINING GP | Physical Therapy | $458.85 |
| 2022316 | HC PT C/O FOR ORTHOTIC/PROSTH USE 15 MIN GP | Physical Therapy | $310.33 |
| 2022420 | HC PT ELEC STIM OTHER THAN WOUND GP | Physical Therapy | $188.37 |
| 2022780 | HC PT EDUC PERCUSSION CHEST | Physical Therapy | $234.14 |
| 2022781 | HC PT MANIULATIONCHEST | Physical Therapy | $251.34 |
| 2023555 | HC CANALITH REPOSITIONING PROC GP | Physical Therapy | $350.18 |
| 2025433 | HC DEVELOPMENTAL SCREEN W/SCORE GP | Physical Therapy | $361.04 |
| 2025861 | HC NEG PRESS WND TX <=50 SQ CM PT | Physical Therapy | $1,149.18 |
| 2026632 | HC PT PTA WHEELCHAIR MNGMENT TRAINING EA 15 MINS GPCQ | Physical Therapy | $276.52 |
| 2026634 | HC PT PTA THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN GPCQ | Physical Therapy | $363.46 |
| 2026636 | HC PT PTA ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS GPCQ | Physical Therapy | $458.85 |
| 2026638 | HC PT PTA PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS CPCQ | Physical Therapy | $280.14 |
| 2026642 | HC PT PTA ULTRASOUND THERAPY EA 15 MINS GPCQ | Physical Therapy | $140.07 |
| 2026644 | HC PT PTA NEUROMUSCULAR REEDUCATION EA 15 MINS GPCQ | Physical Therapy | $431.08 |
| 2026646 | HC PT PTA THERAPEUTIC EXERCISES EA 15 MINS GPCQ | Physical Therapy | $397.27 |
| 2026648 | HC PT PTA AQUATIC THERAPY/EXERCISES EA 15 MINS GPCQ | Physical Therapy | $379.16 |
| 2026649 | HC PT PTA COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN GPCQ | Physical Therapy | $324.82 |
| 2026651 | HC PT PTA GAIT TRAINING THERAPY EA 15 MINS GPCQ | Physical Therapy | $345.35 |
| 2026652 | HC PT PTA MANUAL THERAPY EA 15 MINS GPCQ | Physical Therapy | $365.87 |
| 2026654 | HC PT PTA NON WND ELECT STIM GPCQ | Physical Therapy | $188.37 |
| 2026657 | HC PT PTA THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS GPCQ | Physical Therapy | $216.14 |
| 2026658 | HC PT PTA MASSAGE THERAPY EA 15 MINS GPCQ | Physical Therapy | $272.90 |
| 2026947 | HC PT HCPRO PHONE CALL 5-10MIN GP | Physical Therapy | $19.29 |
| 2026950 | HC PT HCPRO PHONE CALL 11-20MIN GP | Physical Therapy | $38.09 |
| 2026953 | HC PT HCPRO PHONE CALL 21-30MIN GP | Physical Therapy | $55.00 |
| 2022231 | HC PT RE-EVAL EST PLAN CARE GP | Physical Therapy - Evaluation or Re-evaluation | $470.93 |
| 2022232 | HC PT RE-EVAL EST PLAN CARE | Physical Therapy - Evaluation or Re-evaluation | $470.93 |
| 2025786 | HC PT EVAL MOD COMPLEX GP | Physical Therapy - Evaluation or Re-evaluation | $1,262.45 |
| 2025787 | HC PT EVAL HIGH COMPLEX GP | Physical Therapy - Evaluation or Re-evaluation | $1,893.66 |
| 2025792 | HC PT EVAL LOW COMPLEX GP | Physical Therapy - Evaluation or Re-evaluation | $841.63 |
| 2022274 | HC PT PHYSICAL MEDICINE PROCEDURE GP | Physical Therapy - Visit Charge | $135.24 |
| 2022301 | HC WORK HARDENING ADD-ON | Physical Therapy - Visit Charge | $550.02 |
| 2025840 | HC HH HHC PT MAINT EA 15 MIN | Physical Therapy - Visit Charge | $420.00 |
| 2026570 | HC HH SERV OF PT EA 15 MIN | Physical Therapy - Visit Charge | $420.00 |
| 2024676 | HC CA SCRNING PELV & BRST EXAM | Preventive Care Services | $256.84 |
| 2024677 | HC PPPS INITIAL, ANNUAL WELLNESS VISIT | Preventive Care Services | $1,480.50 |
| 2026117 | HC APP TOPICAL FLUORIDE VARNISH | Preventive Care Services | $95.40 |
| 2021943 | HC IMMUN ADMIN | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2021944 | HC IMMUN ADMIN EACH ADDL VACCINE/COMPONENT | Preventive Care Services - Vaccine Administration | $700.13 |
| 2022684 | HC ADMIN FLU VACCINE | Preventive Care Services - Vaccine Administration | $179.19 |
| 2023241 | HC ADMIN PNEUMONIA VACCINE | Preventive Care Services - Vaccine Administration | $176.63 |
| 2023759 | HC ADMIN HEPATITIS B VACCINE | Preventive Care Services - Vaccine Administration | $700.13 |
| 2025289 | HC IMMUNE ADMIN ORAL/NASAL 1 VACCINE | Preventive Care Services - Vaccine Administration | $79.56 |
| 2025290 | HC IMMUNE ADMIN ORAL/NASAL ADDL | Preventive Care Services - Vaccine Administration | $46.94 |
| 2025471 | HC IMMUN ADMIN EACH ADDL VACCINE/COMPONENT W/ COUNSELING <18 YEARS OF AGE | Preventive Care Services - Vaccine Administration | $38.40 |
| 2025806 | HC IMMUN ADMIN 1ST/ONLY COMPONENT W/ COUNSELING <18 YEARS OF AGE | Preventive Care Services - Vaccine Administration | $211.76 |
| 2027036 | HC ADM SARSCOV2 30MCG/0.3ML 1ST | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2027037 | HC ADM SARSCOV2 30MCG/0.3ML 2ND | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2027038 | HC ADM SARSCOV2 100MCG/0.5ML1ST | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2027039 | HC ADM SARSCOV2 100MCG/0.5ML2ND | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2026843 | HC EXTERNAL PT ACTIVATED DWNLD W/R&I ONLY | Professional Fees | $205.00 |
| 2026857 | HC HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/< | Professional Fees | $84.00 |
| 2026860 | HC INITIAL INPATIENT CONSULT NEW/EST PT 40 MIN | Professional Fees | $238.46 |
| 2026861 | HC INITIAL INPATIENT CONSULT NEW/EST PT 55 MIN | Professional Fees | $357.69 |
| 2026865 | HC SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/< | Professional Fees | $455.00 |
| 2026866 | HC INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS | Professional Fees | $911.00 |
| 2022129 | HC BREATHING CAPACITY TEST | Pulmonary Function | $718.46 |
| 2022130 | HC BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN | Pulmonary Function | $1,407.95 |
| 2022131 | HC BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT | Pulmonary Function | $1,365.68 |
| 2022132 | HC VITAL CAPACITY TEST | Pulmonary Function | $228.22 |
| 2022133 | HC LUNG FUNCTION TEST (MBC/MVV) | Pulmonary Function | $342.93 |
| 2022137 | HC PULMONARY STRESS TEST | Pulmonary Function | $740.20 |
| 2022138 | HC CARDIOPULM EXCER TEST MIN VENT | Pulmonary Function | $2,177.12 |
| 2022145 | HC DIFFUSING CAPACITY EX. CARBON MONOXIDE, MEMBRANE | Pulmonary Function | $665.33 |
| 2022146 | HC N-INVAS EAR/PLS OXIMTRY F/O2 SAT 1 DETER | Pulmonary Function | $346.55 |
| 2022147 | HC N-INVAS EAR/PLS OXIMTRY F/O2 SAT MLT DETERS | Pulmonary Function | $540.96 |
| 2023012 | HC CO EXPIRED GAS BY IR | Pulmonary Function | $350.18 |
| 2023116 | HC PULM FUNCT TST PLETHYSMOGRAP | Pulmonary Function | $439.53 |
| 2023117 | HC PULM FUNCTION TEST BY GAS | Pulmonary Function | $351.38 |
| 2023118 | HC AIRWY RESIST BY OSCILLOMETRY | Pulmonary Function | $324.82 |
| 2023225 | HC FLOW VOLUME LOOP | Pulmonary Function | $683.45 |
| 2024980 | HC UNLISTED PULMONARY SERVICE | Pulmonary Function | $229.39 |
| 2025208 | HC MEAS LUNG VOL THRU 2 YRS | Pulmonary Function | $1,010.63 |
| 2025209 | HC PATIENT RECORDED SPIROMETRY | Pulmonary Function | $687.92 |
| 2025210 | HC PI SPIROMETRY/30 DAYS - RECORDING | Pulmonary Function | $687.92 |
| 2025214 | HC PULMONARY COMPLIANCE | Pulmonary Function | $687.92 |
| 2025438 | HC SURFACTANT ADMIN THRU TUBE | Pulmonary Function | $714.75 |
| 2025487 | HC CONTINUOUS PULSE OX | Pulmonary Function | $2,679.44 |
| 2025939 | HC OXYGEN UPTAKE % O2 | Pulmonary Function | $860.67 |
| 2020629 | HC CONTRAST X-RAY OF BRAIN | Radiology - Diagnostic | $2,570.77 |
| 2020630 | HC RADEX MNDBL PRTL < 4 VIEWS | Radiology - Diagnostic | $330.86 |
| 2020631 | HC RADEX MNDBL COMPL MINIMUM 4 VIEWS | Radiology - Diagnostic | $380.36 |
| 2020633 | HC X-RAY EXAM OF MIDDLE EAR | Radiology - Diagnostic | $583.43 |
| 2020634 | HC X-RAY EXAM OF FACIAL BONES | Radiology - Diagnostic | $480.95 |
| 2020635 | HC X-RAY EXAM OF FACIAL BONES | Radiology - Diagnostic | $687.07 |
| 2020636 | HC X-RAY EXAM OF NASAL BONES | Radiology - Diagnostic | $468.51 |
| 2020637 | HC X-RAY EXAM OF EYE SOCKETS | Radiology - Diagnostic | $388.82 |
| 2020638 | HC X-RAY EXAM OF SINUSES | Radiology - Diagnostic | $544.58 |
| 2020639 | HC X-RAY EXAM OF SKULL | Radiology - Diagnostic | $627.90 |
| 2020640 | HC X-RAY EXAM OF SKULL | Radiology - Diagnostic | $790.91 |
| 2020642 | HC RADEX TMPRMAND JT OPN&CLSD MOUTH BI | Radiology - Diagnostic | $438.32 |
| 2020644 | HC X-RAY EXAM OF NECK | Radiology - Diagnostic | $544.58 |
| 2020680 | HC X-RAY EXAM OF RIBS | Radiology - Diagnostic | $549.41 |
| 2020687 | HC X-RAY EXAM OF RIBS/CHEST | Radiology - Diagnostic | $653.26 |
| 2020690 | HC X-RAY EXAM OF RIBS/CHEST | Radiology - Diagnostic | $653.26 |
| 2020691 | HC X-RAY EXAM OF RIBS | Radiology - Diagnostic | $670.16 |
| 2020693 | HC X-RAY EXAM OF BREASTBONE | Radiology - Diagnostic | $388.82 |
| 2020694 | HC X-RAY EXAM OF BREASTBONE | Radiology - Diagnostic | $480.59 |
| 2020704 | HC X-RAY EXAM ENTIRE SPI 2-3 VIEW | Radiology - Diagnostic | $1,455.04 |
| 2020705 | HC X-RAY EXAM OF SPINE | Radiology - Diagnostic | $450.40 |
| 2020706 | HC RADEX SPI CRV 2/3 VIEWS | Radiology - Diagnostic | $917.70 |
| 2020707 | HC RADEX SPI CRV MINIMUM 4 VIEWS | Radiology - Diagnostic | $1,240.10 |
| 2020708 | HC RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | Radiology - Diagnostic | $1,550.43 |
| 2020710 | HC X-RAY EXAM OF THORACIC SPINE | Radiology - Diagnostic | $572.36 |
| 2020711 | HC X-RAY EXAM OF THORACIC SPINE | Radiology - Diagnostic | $624.28 |
| 2020712 | HC X-RAY EXAM OF THORACIC SPINE | Radiology - Diagnostic | $710.01 |
| 2020713 | HC X-RAY EXAM OF TRUNK SPINE MIN OF 2 VWS | Radiology - Diagnostic | $412.97 |
| 2020715 | HC RADEX SPI LUMBOSAC 2/3 VIEWS | Radiology - Diagnostic | $677.41 |
| 2020716 | HC RADEX SPI LUMBOSAC MINIMUM 4 VIEWS | Radiology - Diagnostic | $940.64 |
| 2020717 | HC RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS | Radiology - Diagnostic | $1,194.22 |
| 2020718 | HC RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | Radiology - Diagnostic | $771.59 |
| 2020740 | HC RADEX PELVIS 1/2 VIEWS | Radiology - Diagnostic | $580.81 |
| 2020741 | HC RADEX PELVIS 1/2 VIEWS 76 | Radiology - Diagnostic | $580.81 |
| 2020742 | HC RADEX PELVIS COMPL MINIMUM 3 VIEWS | Radiology - Diagnostic | $812.65 |
| 2020743 | HC RADEX PELVIS COMPL MINIMUM 3 VIEWS 76 | Radiology - Diagnostic | $580.81 |
| 2020754 | HC RADEX SI JTS < 3 VIEWS | Radiology - Diagnostic | $507.15 |
| 2020755 | HC RADEX SI JTS 3/MORE VIEWS | Radiology - Diagnostic | $583.22 |
| 2020756 | HC X-RAY EXAM OF TAILBONE | Radiology - Diagnostic | $501.11 |
| 2020760 | HC CONTRAST X-RAY, SPINE | Radiology - Diagnostic | $2,743.44 |
| 2020783 | HC X-RAY EXAM OF SHOULDERS | Radiology - Diagnostic | $619.45 |
| 2020831 | HC RADEX HAND 2 VIEWS | Radiology - Diagnostic | $748.65 |
| 2020903 | HC X-RAY EXAM OF KNEE, 1 OR 2 | Radiology - Diagnostic | $731.75 |
| 2020916 | HC X-RAY KNEE EXAM; BOTH KNEES STANDING AP | Radiology - Diagnostic | $825.93 |
| 2020926 | HC X-RAY EXAM OF LOWER LEG | Radiology - Diagnostic | $926.15 |
| 2020957 | HC X-RAY EXAM OF TOE(S) | Radiology - Diagnostic | $668.96 |
| 2020990 | HC XRAY EX OF AB 1 VIEW | Radiology - Diagnostic | $531.30 |
| 2021000 | HC X-RAY XM ESOPHAGUS 1CNTRST | Radiology - Diagnostic | $1,109.69 |
| 2021001 | HC X-RAY XM SWLNG FUNCJ C+ | Radiology - Diagnostic | $993.77 |
| 2021002 | HC X-RAY XM UPR GI TRC 1CNTRST | Radiology - Diagnostic | $662.22 |
| 2021007 | HC X-RAY XM SM INT 1CNTRST STD | Radiology - Diagnostic | $1,503.34 |
| 2021009 | HC X-RAY XM COLON 1CNTRST STD | Radiology - Diagnostic | $1,586.66 |
| 2021010 | HC X-RAY XM COLON 2CNTRST STD | Radiology - Diagnostic | $2,221.80 |
| 2021011 | HC THER ENEMA C+ RDCTJ INTUSSUSCEPTION/OBSTRCJ | Radiology - Diagnostic | $919.46 |
| 2021012 | HC CHOLANGRPH&/PCG INTRAOP RS&I | Radiology - Diagnostic | $778.84 |
| 2021016 | HC X-RAY BILE DUCT ENDOSCOPY | Radiology - Diagnostic | $912.87 |
| 2021024 | HC CONTRAST X-RAY, BLADDER | Radiology - Diagnostic | $1,387.42 |
| 2021025 | HC X-RAY, URETHRA/BLADDER | Radiology - Diagnostic | $3,242.28 |
| 2021028 | HC DILATION URTR/URT RS&I | Radiology - Diagnostic | $2,147.30 |
| 2021033 | HC AORTOGRAPY THRC SRLOGRAPY RS&I | Radiology - Diagnostic | $5,568.28 |
| 2021037 | HC X-RAY AORTA, LEG ARTERIES | Radiology - Diagnostic | $9,315.86 |
| 2021057 | HC ANGRPH SPI SLCTV RS&I | Radiology - Diagnostic | $7,194.29 |
| 2021059 | HC ARTERY X-RAYS, ARM/LEG | Radiology - Diagnostic | $7,149.61 |
| 2021068 | HC ARTERY X-RAYS, ABDOMEN | Radiology - Diagnostic | $11,360.16 |
| 2021070 | HC ARTERY X-RAYS, PELVIS | Radiology - Diagnostic | $6,838.07 |
| 2021072 | HC ANGRPH PULM UNI SLCTV RS&I | Radiology - Diagnostic | $11,084.85 |
| 2021073 | HC ANGRPH PULM BI SLCTV RS&I | Radiology - Diagnostic | $11,084.85 |
| 2021077 | HC NONVASCULAR SHUNT, X-RAY | Radiology - Diagnostic | $700.35 |
| 2021080 | HC CATH/EP VEIN X-RAY, ARM/LEG | Radiology - Diagnostic | $3,370.13 |
| 2021081 | HC VEIN X-RAY, ARMS/LEGS | Radiology - Diagnostic | $3,976.30 |
| 2021083 | HC VEIN X-RAY, TRUNK | Radiology - Diagnostic | $3,874.87 |
| 2021084 | HC VEIN X-RAY, CHEST | Radiology - Diagnostic | $1,240.10 |
| 2021085 | HC VNGRPH RNL UNI SLCTV RS&I | Radiology - Diagnostic | $11,084.85 |
| 2021087 | HC VEIN X-RAY, NECK | Radiology - Diagnostic | $3,874.54 |
| 2021089 | HC VNGRPH SUPRIOR SGTL SINUS RS&I | Radiology - Diagnostic | $4,029.52 |
| 2021092 | HC PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I | Radiology - Diagnostic | $4,558.31 |
| 2021093 | HC PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVAL RS&I | Radiology - Diagnostic | $1,976.11 |
| 2021094 | HC HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I | Radiology - Diagnostic | $3,874.54 |
| 2021095 | HC VENOUS SAMPLING BY CATHETER | Radiology - Diagnostic | $11,084.85 |
| 2021096 | HC TCAT THER EMBOLIZATION ANY METH RS&I | Radiology - Diagnostic | $17,061.98 |
| 2021118 | HC XRAY CONTROL CATHETER CHANGE | Radiology - Diagnostic | $1,967.02 |
| 2021119 | HC ABSCESS DRAINAGE UNDER X-RAY | Radiology - Diagnostic | $2,331.68 |
| 2021122 | HC FLUOROSCOPE EXAMINATION | Radiology - Diagnostic | $1,777.66 |
| 2021125 | HC X-RAY EXAM OF FISTULA | Radiology - Diagnostic | $1,271.50 |
| 2021126 | HC RAD XM SURG SPEC | Radiology - Diagnostic | $1,434.51 |
| 2021134 | HC RADIOGRAPHIC PROCEDURE | Radiology - Diagnostic | $388.06 |
| 2021169 | HC FLUOROGUIDE FOR VEIN DEVICE | Radiology - Diagnostic | $1,579.54 |
| 2021170 | HC NEEDLE LOCALIZATION BY XRAY | Radiology - Diagnostic | $2,089.34 |
| 2021171 | HC FLUOROGUIDE FOR SPINE INJECT | Radiology - Diagnostic | $1,128.83 |
| 2021178 | HC X-RAYS FOR BONE AGE | Radiology - Diagnostic | $556.66 |
| 2021179 | HC X-RAYS, BONE LENGTH STUDIES | Radiology - Diagnostic | $653.26 |
| 2021181 | HC X-RAYS, BONE SURVEY COMPLETE | Radiology - Diagnostic | $1,184.56 |
| 2021182 | HC X-RAYS, BONE SURVEY, INFANT | Radiology - Diagnostic | $1,290.82 |
| 2021183 | HC DXA BONE DENSITY, AXIAL | Radiology - Diagnostic | $1,120.56 |
| 2021184 | HC DXA BONE DENSITY/PERIPHERAL | Radiology - Diagnostic | $694.31 |
| 2022419 | HC CATH/EP ILIAC ART ANGIO,CARDIAC CATH | Radiology - Diagnostic | $92.98 |
| 2022718 | HC TRANS CATH FALLOP TUBE | Radiology - Diagnostic | $402.23 |
| 2022725 | HC TRANSCATHETER BIOPSY S&I | Radiology - Diagnostic | $9,239.79 |
| 2022882 | HC ANKLE WT BEAR ONLY | Radiology - Diagnostic | $681.03 |
| 2022883 | HC URETHOGRAM RETRO | Radiology - Diagnostic | $1,769.70 |
| 2022885 | HC UEXTREM INFANT MIN 2 VW | Radiology - Diagnostic | $329.65 |
| 2023085 | HC EXISTING CATH ANGIOGR FOR FOLLOW-UP | Radiology - Diagnostic | $2,795.17 |
| 2023486 | HC CLAVICLE COMPLETE | Radiology - Diagnostic | $654.47 |
| 2023487 | HC SCAPULA COMPLETE | Radiology - Diagnostic | $723.29 |
| 2023488 | HC X-RAY EXAM OF SHOULDER 1 VIEW | Radiology - Diagnostic | $555.45 |
| 2023489 | HC X-RAY EXAM OF SHOULDER 2+ VIEWS | Radiology - Diagnostic | $694.31 |
| 2023491 | HC X-RAY EXAM OF HUMERUS 2+ VIEWS | Radiology - Diagnostic | $639.98 |
| 2023492 | HC X-RAY EXAM OF ELBOW 2 VIEWS | Radiology - Diagnostic | $690.69 |
| 2023493 | HC X-RAY EXAM OF ELBOW 3+ VIEWS | Radiology - Diagnostic | $793.33 |
| 2023495 | HC X-RAY EXAM OF FOREARM 2 VIEWS | Radiology - Diagnostic | $677.41 |
| 2023496 | HC X-RAY EXAM OF WRIST 2 VIEWS | Radiology - Diagnostic | $646.01 |
| 2023497 | HC X-RAY EXAM OF WRIST 3+ VIEWS | Radiology - Diagnostic | $777.63 |
| 2023499 | HC X-RAY EXAM OF HAND 3+ VIEWS | Radiology - Diagnostic | $868.19 |
| 2023500 | HC X-RAY EXAM OF FINGER(S) 2+ VIEWS | Radiology - Diagnostic | $504.74 |
| 2023511 | HC X-RAY EXAM OF HIP 1 VIEW UNILAT | Radiology - Diagnostic | $387.61 |
| 2023516 | HC X-RAY EXAM OF KNEE 3 | Radiology - Diagnostic | $860.95 |
| 2023517 | HC X-RAY EXAM KNEE 4 OR MORE | Radiology - Diagnostic | $998.60 |
| 2023519 | HC X-RAY EXAM OF ANKLE 3+ VIEWS | Radiology - Diagnostic | $792.12 |
| 2023521 | HC X-RAY EXAM OF FOOT; 2 VIEWS | Radiology - Diagnostic | $695.52 |
| 2023522 | HC X-RAY EXAM OF FOOT; 3+ VIEWS | Radiology - Diagnostic | $781.25 |
| 2023523 | HC X-RAY EXAM OF HEEL 2+ VIEWS | Radiology - Diagnostic | $548.21 |
| 2023573 | HC TOMOGRAM | Radiology - Diagnostic | $597.74 |
| 2023633 | HC X-RAY XM UPR GI TRC 2CNTRST | Radiology - Diagnostic | $662.22 |
| 2023636 | HC HYSTEROSALPINGOGRAM | Radiology - Diagnostic | $517.31 |
| 2024309 | HC THROMBOLYTIC ART THERAPY | Radiology - Diagnostic | $5,568.28 |
| 2025010 | HC DILATE FOR STRICTURE/OBSTR | Radiology - Diagnostic | $608.50 |
| 2025237 | HC DXA BONE DENSITY STUDY | Radiology - Diagnostic | $1,120.56 |
| 2025240 | HC HEPATIC VENOGRAM WO HDM | Radiology - Diagnostic | $11,116.52 |
| 2025524 | HC X-RAY EXAM HIP UNI 2-3 VIEWS | Radiology - Diagnostic | $535.62 |
| 2025525 | HC X-RAY EXAM HIP UNI 4+ VIEWS | Radiology - Diagnostic | $669.28 |
| 2025528 | HC X-RAY EXAM ENTIRE SPI 1 VIEW | Radiology - Diagnostic | $903.76 |
| 2025529 | HC X-RAY EXAM ENTIRE SPI 4-5 VIEW | Radiology - Diagnostic | $1,577.01 |
| 2025530 | HC X-RAY EXAM ENTIRE SPI 6+ VIEW | Radiology - Diagnostic | $1,876.29 |
| 2025531 | HC X-RAY EXAM HIPS BI 2 VIEWS | Radiology - Diagnostic | $517.10 |
| 2025532 | HC X-RAY EXAM HIPS BI 3-4 VIEWS | Radiology - Diagnostic | $632.28 |
| 2025534 | HC X-RAY EXAM HIPS BI 5+ VIEWS | Radiology - Diagnostic | $734.04 |
| 2025535 | HC X-RAY EXAM OF FEMUR 1 | Radiology - Diagnostic | $717.26 |
| 2025536 | HC X-RAY EXAM OF FEMUR 2+ | Radiology - Diagnostic | $837.22 |
| 2025568 | HC X-RAY EXAM HIPS BI 3-4 VIEWS | Radiology - Diagnostic | $406.99 |
| 2025971 | HC X-RAY EXAM ABDOMEN 2 VIEWS | Radiology - Diagnostic | $828.35 |
| 2025972 | HC X-RAY EXAM ABDOMEN 3+ VIEWS | Radiology - Diagnostic | $911.19 |
| 2026170 | HC UNLISTED FLUORO | Radiology - Diagnostic | $218.52 |
| 2026629 | HC X-RAY SM INT F-THRU STD | Radiology - Diagnostic | $400.00 |
| 2026665 | HC XRAY CDSM EVICORE | Radiology - Diagnostic | $1.00 |
| 2026668 | HC XRAY CDSM NDSC | Radiology - Diagnostic | $1.00 |
| 2026670 | HC XRAY CDSM TEST APPROP | Radiology - Diagnostic | $1.00 |
| 2026671 | HC XRAY CDSM AIM | Radiology - Diagnostic | $1.00 |
| 2026675 | HC XRAY CDSM QUALIFIED NOS | Radiology - Diagnostic | $1.00 |
| 2021036 | HC CATH/EP AORTOGRAPY ABDL SRLOGRAPY RS&I | Radiology - Diagnostic - Arteriography | $7,513.07 |
| 2021062 | HC CATH/EP ARTERY X-RAYS, ARM/LEG | Radiology - Diagnostic - Arteriography | $7,149.61 |
| 2021064 | HC CATH/EP ARTERY X-RAYS, ARMS/LEGS | Radiology - Diagnostic - Arteriography | $8,313.64 |
| 2021069 | HC CATH/EP ARTERY X-RAYS, ABDOMEN | Radiology - Diagnostic - Arteriography | $11,360.16 |
| 2021074 | HC CATH/EP ARTERY X-RAY, EACH VESSEL | Radiology - Diagnostic - Arteriography | $3,440.17 |
| 2021106 | HC CATH/EP RETRIEVAL, BROKEN CATHETER | Radiology - Diagnostic - Arteriography | $4,587.34 |
| 2022724 | HC ANGIOGR EA ADDTL VESSEL | Radiology - Diagnostic - Arteriography | $3,440.17 |
| 2025335 | HC PULMONARY NONSELECTIVE ANGIO | Radiology - Diagnostic - Arteriography | $3,874.54 |
| 2023490 | HC SHOULDER ARTHROGRAM | Radiology - Diagnostic - Arthrography | $1,405.53 |
| 2023513 | HC HIP ARTHROGRAM | Radiology - Diagnostic - Arthrography | $1,861.97 |
| 2023518 | HC KNEE ARTHROGRAM | Radiology - Diagnostic - Arthrography | $1,261.84 |
| 2020670 | HC RADEX CHEST 1 VIEW | Radiology - Diagnostic - Chest X-Ray | $394.85 |
| 2020671 | HC RADEX CHEST 2 VIEWS | Radiology - Diagnostic - Chest X-Ray | $489.04 |
| 2020673 | HC RADEX CHEST 3 VIEWS | Radiology - Diagnostic - Chest X-Ray | $596.51 |
| 2020676 | HC RADEX CHEST 4 OR MORE VIEWS | Radiology - Diagnostic - Chest X-Ray | $685.00 |
| 2022212 | HC CHEMO NON-HORMONAL ANTI-NEOPLASTIC, SC / IM | Radiology - Therapeutic - Chemotherapy Administration - Injected | $1,214.42 |
| 2022213 | HC CHEMO HORMON ANTINEOPL SQ/IM | Radiology - Therapeutic - Chemotherapy Administration - Injected | $526.23 |
| 2022214 | HC CHEMO IV PUSH 0 -15 MINUTES, INITIAL | Radiology - Therapeutic - Chemotherapy Administration - Injected | $1,732.76 |
| 2022215 | HC CHEMO IV PUSH 0-15 MINUTES, SEQ | Radiology - Therapeutic - Chemotherapy Administration - Injected | $970.83 |
| 2022220 | HC CHEMO, IA, PUSH TECNIQUE | Radiology - Therapeutic - Chemotherapy Administration - Injected | $1,638.58 |
| 2022221 | HC CHEMO INTRA-THECAL | Radiology - Therapeutic - Chemotherapy Administration - Injected | $2,922.15 |
| 2023660 | HC CHEMOTHERAPY ADMINISTRATION INTRALESIONAL | Radiology - Therapeutic - Chemotherapy Administration - Injected | $236.67 |
| 2022216 | HC CHEMO IV INFUSION, 1ST HOUR | Radiology - Therapeutic - Chemotherapy Administration - IV | $3,129.84 |
| 2022217 | HC CHEMO IV INFUSION, ADDITIONAL HOUR | Radiology - Therapeutic - Chemotherapy Administration - IV | $887.00 |
| 2022218 | HC PROLONG CHEMO IV INFUSION REQUIRING PUMP, > 8 HOURS | Radiology - Therapeutic - Chemotherapy Administration - IV | $2,506.77 |
| 2022219 | HC CHEMO IV INFUSION, SEQ 1ST HOUR | Radiology - Therapeutic - Chemotherapy Administration - IV | $1,102.45 |
| 2023336 | HC CHEMO INTRA-PERITONEAL | Radiology - Therapeutic - Chemotherapy Administration - IV | $400.89 |
| 2023667 | HC CHEMO OMMAYA RESERVOIR | Radiology - Therapeutic - Chemotherapy Administration - IV | $677.80 |
| 2021185 | HC THER RAD SIMULAJ-AIDED FLD SETTING SMPL | Radiology - Therapeutic - Radiation Therapy | $1,819.70 |
| 2021186 | HC THER RAD SIMULAJ-AIDED FLD SETTING CPLX | Radiology - Therapeutic - Radiation Therapy | $5,351.64 |
| 2021187 | HC THER RAD SIMULAJ-AIDED FLD SETTING 3-DIMENSIONAL | Radiology - Therapeutic - Radiation Therapy | $13,377.89 |
| 2021188 | HC RADIATION THERAPY DOSE PLAN | Radiology - Therapeutic - Radiation Therapy | $935.81 |
| 2021189 | HC RADIATION THERAPY DOSE PLAN | Radiology - Therapeutic - Radiation Therapy | $935.81 |
| 2021190 | HC BRACHYTX ISODOSE COMPLEX | Radiology - Therapeutic - Radiation Therapy | $2,014.11 |
| 2021191 | HC SPECIAL RADIATION DOSIMETRY | Radiology - Therapeutic - Radiation Therapy | $185.42 |
| 2021192 | HC RADIATION TREATMENT AID(S) | Radiology - Therapeutic - Radiation Therapy | $1,341.53 |
| 2021193 | HC TX DEVICES - INTERMED -59 | Radiology - Therapeutic - Radiation Therapy | $869.40 |
| 2021194 | HC TX DEVICES - COMPLEX -59 | Radiology - Therapeutic - Radiation Therapy | $2,485.04 |
| 2021195 | HC CONTINUING MEDICAL PHYSICS CONSLTJ PR WK | Radiology - Therapeutic - Radiation Therapy | $1,253.39 |
| 2021196 | HC SPEC MEDICAL RADJ PHYSICS CONSLTJ | Radiology - Therapeutic - Radiation Therapy | $1,905.44 |
| 2021197 | HC SRS, MULTISOURCE | Radiology - Therapeutic - Radiation Therapy | $113,915.55 |
| 2021198 | HC SPECIAL RADIATION TREATMENT | Radiology - Therapeutic - Radiation Therapy | $4,367.53 |
| 2021199 | HC APPLY INTERSTIT RADIAT COMPL | Radiology - Therapeutic - Radiation Therapy | $2,558.76 |
| 2023315 | HC IMRT PLANNING | Radiology - Therapeutic - Radiation Therapy | $13,357.37 |
| 2023316 | HC TELETHX ISODOSE PLAN SIMPLE | Radiology - Therapeutic - Radiation Therapy | $1,136.52 |
| 2023317 | HC TELETHX ISODOSE PLAN CPLX | Radiology - Therapeutic - Radiation Therapy | $1,515.36 |
| 2023318 | HC BRACHYTX ISODOSE PLAN SIMPLE | Radiology - Therapeutic - Radiation Therapy | $1,067.43 |
| 2023319 | HC BRACHYTX ISODOSE INTERMED | Radiology - Therapeutic - Radiation Therapy | $1,389.83 |
| 2023320 | HC DESIGN MLC DEVICE FOR IMRT | Radiology - Therapeutic - Radiation Therapy | $5,014.75 |
| 2023322 | HC RADIATION TREATMENT DELIVERY, >= 1 MEV COMPLEX | Radiology - Therapeutic - Radiation Therapy | $3,010.30 |
| 2023325 | HC TREATMENT PORT VERIFICATI | Radiology - Therapeutic - Radiation Therapy | $759.52 |
| 2023327 | HC GUIDANCE FOR RADJ TX DLVR | Radiology - Therapeutic - Radiation Therapy | $1,482.81 |
| 2023534 | HC TX DEVICES; COMPLEX | Radiology - Therapeutic - Radiation Therapy | $2,485.04 |
| 2023596 | HC US INTERSTITIAL RE APPLIC | Radiology - Therapeutic - Radiation Therapy | $388.82 |
| 2023601 | HC RADIATION TREATMENT DELIVERY, >= 1 MEV SIMPLE | Radiology - Therapeutic - Radiation Therapy | $1,749.67 |
| 2025043 | HC SBRT DELIVERY PER FRACTION | Radiology - Therapeutic - Radiation Therapy | $107,000.00 |
| 2025087 | HC NTSTY MODUL RAD TX DLVR SMPL | Radiology - Therapeutic - Radiation Therapy | $6,824.79 |
| 2025088 | HC NTSTY MODUL RAD TX DLVR CPLX | Radiology - Therapeutic - Radiation Therapy | $6,824.79 |
| 2025124 | HC TX DEVICES; INTERMED MODIFIER XU | Radiology - Therapeutic - Radiation Therapy | $869.40 |
| 2026475 | HC TPRNL PLMT BIODEGRDABL MATRL | Radiology - Therapeutic - Radiation Therapy | $14,126.34 |
| 2026909 | HC ROBOT LIN-RADSURG FRACTX 1ST | Radiology - Therapeutic - Radiation Therapy | $107,000.00 |
| 2026910 | HC ROBOT LIN-RADSURG FRACTX 2-5 | Radiology - Therapeutic - Radiation Therapy | $107,000.00 |
| 2010002 | HC RECOVERY ROOM TO .5 HRS | Recovery Room | $607.76 |
| 2010003 | HC RECOVERY ROOM .5 - 1.5 HRS | Recovery Room | $1,853.04 |
| 2010004 | HC RECOVERY ROOM 1.5 - 3 HRS | Recovery Room | $3,388.47 |
| 2010005 | HC RECOVERY ROOM 3 - 4.5 HRS | Recovery Room | $4,978.79 |
| 2010006 | HC RECOVERY ROOM 4.5 - 6 HRS | Recovery Room | $6,422.47 |
| 2010007 | HC RECOVERY ROOM 6 - 7.5 HRS | Recovery Room | $7,875.57 |
| 2010008 | HC RECOVERY ROOM 7.5 - 9 HRS | Recovery Room | $9,315.33 |
| 2010009 | HC RECOVERY ROOM 9 - 10.5 HRS | Recovery Room | $11,721.98 |
| 2010010 | HC RECOVERY ROOM 10.5 - 12 HRS | Recovery Room | $13,193.09 |
| 2010011 | HC RECOVERY ROOM > 12 HRS | Recovery Room | $23,233.02 |
| 2010012 | HC POST PROC MONITORING TO 0.5 HR | Recovery Room | $834.36 |
| 2010013 | HC POST PROC MONITORING TO 1 HRS | Recovery Room | $1,670.31 |
| 2010014 | HC POST PROC MONITORING TO 2 HRS | Recovery Room | $3,340.62 |
| 2010015 | HC POST PROC MONITORING TO 3 HRS | Recovery Room | $5,010.94 |
| 2010016 | HC POST PROC MONITORING TO 4 HRS | Recovery Room | $6,681.26 |
| 2010017 | HC POST PROC MONITORING TO 5 HRS | Recovery Room | $8,351.56 |
| 2010018 | HC POST PROC MONITORING TO 6 HRS | Recovery Room | $10,021.86 |
| 2010019 | HC POST PROC MONITORING TO 7 HRS | Recovery Room | $11,692.19 |
| 2010020 | HC POST PROC MONITORING > 7 HRS | Recovery Room | $13,362.49 |
| 2022682 | HC RECOVERY ROOM 15 MIN OPTIME | Recovery Room | $0.00 |
| 2026795 | HC RECOVERY ROOM 15 MIN BED CHARGE BILLING | Recovery Room | $0.00 |
| 2020394 | HC CLEARANCE OF AIRWAYS | Respiratory Services | $602.54 |
| 2020496 | HC WITHDRAWAL OF ARTERIAL BLOOD | Respiratory Services | $348.97 |
| 2022003 | HC HEART/LUNG RESUSCITATION CPR | Respiratory Services | $2,211.75 |
| 2022127 | HC VENT MGMT INPAT, INIT DAY | Respiratory Services | $1,510.00 |
| 2022128 | HC VENT MGMT INPAT, SUBQ DAY | Respiratory Services | $1,510.00 |
| 2022139 | HC AIRWAY INHALATION TREATMENT | Respiratory Services | $362.25 |
| 2022140 | HC AIRWAY INHALATION TREATMENT 76 | Respiratory Services | $362.25 |
| 2022141 | HC CBT, 1ST HOUR | Respiratory Services | $396.71 |
| 2022142 | HC CBT, EACH ADDL HOUR | Respiratory Services | $126.64 |
| 2022143 | HC POS AIRWAY PRESSURE, CPAP | Respiratory Services | $603.75 |
| 2022413 | HC OTH RESP PROC, INDIV | Respiratory Services | $161.69 |
| 2022414 | HC PT OTH RESP PROC, INDIV | Respiratory Services | $161.69 |
| 2022473 | HC PEAK FLOW | Respiratory Services | $368.08 |
| 2022474 | HC RESPIRATORY THERAPY CONSULT | Respiratory Services | $155.37 |
| 2024301 | HC EVALUATE PT USE OF INHALER | Respiratory Services | $309.12 |
| 2025212 | HC AEROSOL PENTAMIDEN FOR P. CARINII | Respiratory Services | $667.75 |
| 2025213 | HC MECHANICAL CHEST WALL OSCILL | Respiratory Services | $737.78 |
| 2025219 | HC RESP MS THERAPY/15 MIN | Respiratory Services | $230.15 |
| 2025484 | HC DEMO-SMOKING CESSATION COUN 6-10 MIN | Respiratory Services | $0.00 |
| 2024451 | HC HBOT, FULL BODY CHAMBER, 30M | Respiratory Services - Hyperbaric Oxygen Therapy | $1,174.08 |
| 1011004 | HC RB PRIVATE 1B MED/SURG/GYN | Room & Board - Private (One Bed) - Medical/Surgical/GYN | $8,450.00 |
| 1011005 | HC RB PRIVATE 1B OB | Room & Board - Private (One Bed) - Obstetrics (OB) | $10,290.00 |
| 1011006 | HC RB PRIVATE 1B PEDIATRICS | Room & Board - Private (One Bed) - Pediatric | $8,000.00 |
| 1011007 | HC RB PRIVATE 1B PSYCHIATRY | Room & Board - Private (One Bed) - Psychiatric | $8,000.00 |
| 1011008 | HC RB PRIVATE 1B REHAB | Room & Board - Private (One Bed) - Rehabilitation | $6,175.26 |
| 1010005 | HC RB SEMIPRIVATE 2B MED/SURG/GYN | Room & Board - Semi-private (Two Beds) - Medical/Surgical/GYN | $8,100.00 |
| 1010008 | HC RB SEMIPRIVATE 2B OB | Room & Board - Semi-private (Two Beds) - Obstetrics (OB) | $7,725.00 |
| 1010006 | HC RB SEMIPRIVATE 2B PEDIATRICS | Room & Board - Semi-private (Two Beds) - Pediatric | $7,350.00 |
| 1010007 | HC RB SEMIPRIVATE 2B PSYCHIATRY | Room & Board - Semi-private (Two Beds) - Psychiatric | $7,625.00 |
| 1010009 | HC RB SEMIPRIVATE RB REHAB | Room & Board - Semi-private (Two Beds) - Rehabilitation | $5,800.00 |
| 1010011 | HC RB SEMIPRIVATE 4B MED/SURG/GYN | Room & Board - Three and Four Beds - Medical/Surgical/GYN | $8,300.00 |
| 1010014 | HC RB SEMIPRIVATE 4B OB | Room & Board - Three and Four Beds - Obstetrics (OB) | $9,895.12 |
| 2025843 | HC HH HHC RN E&M PLAN SVS 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026575 | HC HH HH/HOSPICE OF RN EA 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026580 | HC HH HOME INFUSION VISIT SN 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026582 | HC HH PRENATAL NEWBORN VISIT SN 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026548 | HC HH NY EPS RECERTIFICATION | Special Charges - Other | $420.00 |
| 2026549 | HC HH NY EPS START OF CARE | Special Charges - Other | $420.00 |
| 2022422 | HC HOSPITAL OBSERVATION PER HR | Specialty Services - Observation Hours | $0.00 |
| 2023023 | HC NON-ED OBSERVATION PER HOUR | Specialty Services - Observation Hours | $0.00 |
| 2023347 | HC DIRECT REFER HOSPITAL OBSERV | Specialty Services - Observation Hours | $793.32 |
| 2021978 | HC TX SP LANG COMUNICAJ PCX DISORDER INDIV | Speech Therapy - Language Pathology | $615.83 |
| 2021980 | HC TX SP LANG COMUNICAJ PCX DISORDER 2/> | Speech Therapy - Language Pathology | $179.59 |
| 2021982 | HC LARYNGEAL FUNCTION STUDIES | Speech Therapy - Language Pathology | $319.99 |
| 2021983 | HC ORAL FUNCTION THERAPY GN | Speech Therapy - Language Pathology | $676.20 |
| 2021992 | HC EX FOR SPEECH DEVICE RX, 1HR GN | Speech Therapy - Language Pathology | $793.33 |
| 2021993 | HC USE OF SPEECH DEVICE SERVICE GN | Speech Therapy - Language Pathology | $966.00 |
| 2021994 | HC EVALUATE SWALLOWING FUNCTION GN | Speech Therapy - Language Pathology | $1,052.94 |
| 2021995 | HC EVALUATE SWALLOWING FUNCTION 59 | Speech Therapy - Language Pathology | $1,052.94 |
| 2021996 | HC MOTION FLUOROSCOPY/SWALLOW GN | Speech Therapy - Language Pathology | $1,327.04 |
| 2021997 | HC MOTION FLUOROSCOPY/SWALLOW | Speech Therapy - Language Pathology | $1,327.04 |
| 2022194 | HC ASSESSMENT OF APHASIA GN | Speech Therapy - Language Pathology | $874.23 |
| 2022199 | HC COGNITIVE TEST BY HC PRO GN | Speech Therapy - Language Pathology | $858.53 |
| 2022283 | HC THERAPEUTIC ACTIVITIES EA 15 MINS | Speech Therapy - Language Pathology | $363.46 |
| 2022921 | HC FACIAL NERVE FUNCTION | Speech Therapy - Language Pathology | $315.13 |
| 2025063 | HC EX FOR NONSPEECH DEVICE RX | Speech Therapy - Language Pathology | $992.57 |
| 2025065 | HC EX FOR SPEECH DEVICE RX EA ADDL 30 MIN | Speech Therapy - Language Pathology | $521.64 |
| 2025694 | HC DEVELOPMENTAL SCREEN W/SCORE GN | Speech Therapy - Language Pathology | $361.04 |
| 2026683 | HC SLP THER IVNTJ COG FUNC EA ADDL 15 MIN GN | Speech Therapy - Language Pathology | $60.80 |
| 2026684 | HC SLP THER IVNTJ COG FUNC 1ST 15 MIN GN | Speech Therapy - Language Pathology | $229.43 |
| 2026952 | HC SLP HCPRO PHONE CALL 11-20MIN GN | Speech Therapy - Language Pathology | $38.09 |
| 2026955 | HC SLP HCPRO PHONE CALL 21-30MIN GN | Speech Therapy - Language Pathology | $55.00 |
| 2021991 | HC ORAL SPEECH DEVICE EVAL GN | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $607.37 |
| 2021998 | HC ENDOSCOPY SWALLOW TST (FEES) GN | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $954.71 |
| 2024825 | HC EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER) | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $723.29 |
| 2024826 | HC EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $1,096.41 |
| 2024827 | HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $1,666.35 |
| 2024828 | HC BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE | Speech Therapy - Language Pathology - Other | $1,096.41 |
| 2026572 | HC HH SVS OF S/L PATH EA 15 MIN | Speech Therapy - Language Pathology - Visit Charge | $420.00 |
| 6020006 | LOW AIR/TURNING BED | Supply/Implant | $932.95 |
| 6020009 | PRONE THERAPY BED (ROTOPRONE) | Supply/Implant | $13,098.87 |
| 6020851 | PT KNEE WO JOINT CUSTOM L1834 | Supply/Implant | $919.00 |
| 6020869 | BARIATRIC BED STD | Supply/Implant | $1,392.23 |
| 6020956 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,515.78 |
| 6020957 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,515.78 |
| 6020958 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,515.78 |
| 6020961 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6020962 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6020963 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6020964 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6020966 | GUIDE WIRE | Supply/Implant | $6,784.00 |
| 6020971 | SUPPLY IMPLANT | Supply/Implant | $479.36 |
| 6020973 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6020977 | SUPPLY IMPLANT | Supply/Implant | $99,200.00 |
| 6020981 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $5,532.80 |
| 6020982 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,596.48 |
| 6020983 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6020984 | SUPPLY IMPLANT | Supply/Implant | $990.46 |
| 6020985 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $192.00 |
| 6020986 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6020987 | RET DEV, INSERTABLE | Supply/Implant | $3,776.00 |
| 6020988 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6020989 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6020991 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6020994 | SUPPLY IMPLANT | Supply/Implant | $1,530.88 |
| 6020995 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,308.80 |
| 6020997 | SUPPLY IMPLANT | Supply/Implant | $2,980.61 |
| 6021001 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,816.32 |
| 6021007 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $57,894.40 |
| 6021011 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $7,360.00 |
| 6021018 | SUPPLY IMPLANT | Supply/Implant | $3,164.16 |
| 6021019 | SUPPLY IMPLANT | Supply/Implant | $3,184.64 |
| 6021020 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6021021 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021022 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021023 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021024 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021025 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021026 | CATH, DRAINAGE | Supply/Implant | $1,084.67 |
| 6021027 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021029 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021030 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021031 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021032 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021033 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6021034 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021035 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021037 | VENA CAVA FILTER | Supply/Implant | $14,171.52 |
| 6021038 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,163.20 |
| 6021039 | SUPPLY IMPLANT | Supply/Implant | $1,540.22 |
| 6021040 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6021041 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6021043 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6021044 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6021049 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021050 | SUPPLY IMPLANT | Supply/Implant | $46,016.00 |
| 6021054 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,904.00 |
| 6021066 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $16,234.37 |
| 6021073 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6021075 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021076 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021078 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6021079 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6021080 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021081 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6021084 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6021086 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6021087 | GUIDE WIRE | Supply/Implant | $712.96 |
| 6021089 | GUIDE WIRE | Supply/Implant | $232.96 |
| 6021090 | INTRO/SHEATH, NON-LASER | Supply/Implant | $951.04 |
| 6021098 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021099 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021100 | INTRO/SHEATH, NON-LASER | Supply/Implant | $921.22 |
| 6021103 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021104 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021106 | INTRO/SHEATH, NON-LASER | Supply/Implant | $793.60 |
| 6021107 | INTRO/SHEATH, NON-LASER | Supply/Implant | $831.62 |
| 6021108 | INTRO/SHEATH, NON-LASER | Supply/Implant | $831.62 |
| 6021110 | GENERAL SUPPLY | Supply/Implant | $284.03 |
| 6021111 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6021113 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,410.94 |
| 6021114 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,190.40 |
| 6021115 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,998.08 |
| 6021118 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021119 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021120 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021122 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021123 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6021127 | GUIDE WIRE | Supply/Implant | $382.34 |
| 6021129 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6021135 | SUPPLY IMPLANT | Supply/Implant | $668.16 |
| 6021136 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6021137 | SUPPLY IMPLANT | Supply/Implant | $281.73 |
| 6021141 | GUIDE WIRE | Supply/Implant | $1,490.05 |
| 6021144 | SUPPLY IMPLANT | Supply/Implant | $672.00 |
| 6021147 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6021152 | GUIDE WIRE | Supply/Implant | $132.35 |
| 6021154 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,689.60 |
| 6021155 | GUIDE WIRE | Supply/Implant | $386.69 |
| 6021156 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $19,841.92 |
| 6021157 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021158 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.64 |
| 6021159 | STERILE SUPPLY | Supply/Implant | $456.19 |
| 6021160 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6021161 | SUPPLY IMPLANT | Supply/Implant | $22,808.32 |
| 6021167 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021168 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6021169 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021170 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6021171 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6021172 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6021173 | GUIDE WIRE | Supply/Implant | $574.08 |
| 6021174 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021175 | GUIDE WIRE | Supply/Implant | $588.80 |
| 6021176 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6021177 | CATHETER, GUIDING | Supply/Implant | $278.27 |
| 6021178 | CATHETER, GUIDING | Supply/Implant | $278.27 |
| 6021180 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021181 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021183 | GUIDE WIRE | Supply/Implant | $1,600.00 |
| 6021184 | GUIDE WIRE | Supply/Implant | $620.16 |
| 6021185 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,196.10 |
| 6021186 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,956.80 |
| 6021189 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6021190 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021191 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021192 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6021193 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021198 | INTRO/SHEATH, NON-LASER | Supply/Implant | $560.51 |
| 6021199 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021200 | CATHETER, GUIDING | Supply/Implant | $7,168.00 |
| 6021202 | CATHETER, GUIDING | Supply/Implant | $11,571.20 |
| 6021203 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021205 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6021206 | SUPPLY IMPLANT | Supply/Implant | $142.34 |
| 6021207 | SUPPLY IMPLANT | Supply/Implant | $142.34 |
| 6021208 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021209 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021210 | SUPPLY IMPLANT | Supply/Implant | $142.34 |
| 6021211 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021212 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021214 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021218 | SUPPLY IMPLANT | Supply/Implant | $1,653.76 |
| 6021219 | SUPPLY IMPLANT | Supply/Implant | $52,416.00 |
| 6021220 | SUPPLY IMPLANT | Supply/Implant | $15,296.00 |
| 6021221 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6021224 | GUIDE WIRE | Supply/Implant | $1,412.86 |
| 6021225 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6021227 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6021233 | SUPPLY IMPLANT | Supply/Implant | $311.94 |
| 6021238 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021239 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6021240 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6021241 | GUIDE WIRE | Supply/Implant | $929.28 |
| 6021242 | GUIDE WIRE | Supply/Implant | $158.98 |
| 6021243 | INTRO/SHEATH, NON-LASER | Supply/Implant | $837.12 |
| 6021244 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,609.54 |
| 6021245 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6021247 | INTRO/SHEATH, NON-LASER | Supply/Implant | $526.08 |
| 6021248 | INTRO/SHEATH, NON-LASER | Supply/Implant | $659.97 |
| 6021251 | STERILE SUPPLY | Supply/Implant | $454.14 |
| 6021252 | GUIDE WIRE | Supply/Implant | $640.00 |
| 6021254 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $18,278.40 |
| 6021255 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021256 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6021257 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6021258 | SUPPLY IMPLANT | Supply/Implant | $509.18 |
| 6021259 | INTRO/SHEATH, NON-LASER | Supply/Implant | $677.12 |
| 6021261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021262 | SUPPLY IMPLANT | Supply/Implant | $330.37 |
| 6021264 | GUIDE WIRE | Supply/Implant | $2,995.20 |
| 6021265 | GUIDE WIRE | Supply/Implant | $6,054.40 |
| 6021266 | GUIDE WIRE | Supply/Implant | $7,155.20 |
| 6021268 | SUPPLY IMPLANT | Supply/Implant | $7,808.00 |
| 6021269 | SUPPLY IMPLANT | Supply/Implant | $288.64 |
| 6021283 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6021284 | CATHETER, GUIDING | Supply/Implant | $278.27 |
| 6021285 | SUPPLY IMPLANT | Supply/Implant | $46,016.00 |
| 6021286 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $192.00 |
| 6021288 | CATHETER, GUIDING | Supply/Implant | $208.64 |
| 6021290 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6021292 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6021296 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6021301 | CATHETER, GUIDING | Supply/Implant | $11,571.20 |
| 6021305 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021306 | CATHETER, GUIDING | Supply/Implant | $208.64 |
| 6021307 | GUIDE WIRE | Supply/Implant | $221.44 |
| 6021312 | SUPPLY IMPLANT | Supply/Implant | $509.18 |
| 6021313 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6021314 | GENERAL SUPPLY | Supply/Implant | $173.06 |
| 6021315 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6021317 | SUPPLY IMPLANT | Supply/Implant | $5,608.96 |
| 6021318 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6021319 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6021320 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6021321 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6021324 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6021325 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6021327 | GUIDE WIRE | Supply/Implant | $1,077.76 |
| 6021329 | GUIDE WIRE | Supply/Implant | $568.58 |
| 6021330 | GUIDE WIRE | Supply/Implant | $420.74 |
| 6021331 | GUIDE WIRE | Supply/Implant | $344.06 |
| 6021333 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021337 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,088.00 |
| 6021366 | INTRO/SHEATH, NON-LASER | Supply/Implant | $657.15 |
| 6021373 | GENERAL SUPPLY | Supply/Implant | $493.06 |
| 6021374 | GENERAL SUPPLY | Supply/Implant | $479.74 |
| 6021375 | GENERAL SUPPLY | Supply/Implant | $293.12 |
| 6021388 | GENERAL SUPPLY | Supply/Implant | $132.86 |
| 6021406 | GENERAL SUPPLY | Supply/Implant | $139.14 |
| 6021410 | GENERAL SUPPLY | Supply/Implant | $173.06 |
| 6021422 | SUPPLY IMPLANT | Supply/Implant | $230.14 |
| 6021423 | STERILE SUPPLY | Supply/Implant | $363.65 |
| 6021433 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $6,515.20 |
| 6021435 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6021441 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $54,118.40 |
| 6021460 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6021461 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021462 | RET DEV, INSERTABLE | Supply/Implant | $7,253.34 |
| 6021464 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $6,630.40 |
| 6021472 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021478 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6021482 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6021485 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6021486 | SUPPLY IMPLANT | Supply/Implant | $23,936.00 |
| 6021487 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6021488 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6021496 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,680.00 |
| 6021501 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021504 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021515 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6021521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,008.00 |
| 6021524 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6021525 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,653.79 |
| 6021528 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6021531 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6021547 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6021548 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $21,696.00 |
| 6021549 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $22,976.00 |
| 6021552 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $22,976.00 |
| 6021569 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6021571 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6021583 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6021616 | SUPPLY IMPLANT | Supply/Implant | $80,768.00 |
| 6021619 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,576.00 |
| 6021623 | INTRO/SHEATH, NON-LASER | Supply/Implant | $742.40 |
| 6021624 | INTRO/SHEATH, NON-LASER | Supply/Implant | $742.40 |
| 6021625 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $9,981.82 |
| 6021636 | INTRO/SHEATH, NON-LASER | Supply/Implant | $645.89 |
| 6021637 | INTRO/SHEATH, NON-LASER | Supply/Implant | $668.16 |
| 6021643 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $12,480.00 |
| 6021645 | CLOSURE DEV, VASC | Supply/Implant | $4,096.00 |
| 6021647 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021649 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021650 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021651 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021652 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021653 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021655 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021656 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021657 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021659 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021660 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021667 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6021672 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021673 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021674 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021677 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021678 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021680 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6021683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021685 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021686 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021696 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6021698 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6021699 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6021700 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6021706 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $42,112.00 |
| 6021712 | GUIDE WIRE | Supply/Implant | $147.20 |
| 6021714 | LEAD, CORONARY VENOUS | Supply/Implant | $48,640.00 |
| 6021718 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,318.40 |
| 6021731 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6021734 | GUIDE WIRE | Supply/Implant | $1,958.40 |
| 6021735 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6021745 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6021748 | CATH, DRAINAGE | Supply/Implant | $1,604.74 |
| 6021750 | GUIDE WIRE | Supply/Implant | $661.12 |
| 6021751 | GUIDE WIRE | Supply/Implant | $758.02 |
| 6021752 | GUIDE WIRE | Supply/Implant | $2,273.92 |
| 6021754 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $208.64 |
| 6021755 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6021756 | GUIDE WIRE | Supply/Implant | $903.17 |
| 6021757 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6021758 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6021759 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6021761 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,080.00 |
| 6021765 | GUIDE WIRE | Supply/Implant | $588.80 |
| 6021766 | GUIDE WIRE | Supply/Implant | $648.32 |
| 6021767 | GUIDE WIRE | Supply/Implant | $1,318.40 |
| 6021768 | GUIDE WIRE | Supply/Implant | $398.34 |
| 6021770 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021771 | SUPPLY IMPLANT | Supply/Implant | $304.38 |
| 6021772 | GUIDE WIRE | Supply/Implant | $1,779.20 |
| 6021773 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6021774 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $30,720.00 |
| 6021776 | CATHETER, GUIDING | Supply/Implant | $1,088.00 |
| 6021777 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021778 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6021781 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021784 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021785 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021786 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6021787 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6021789 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021790 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6021794 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021795 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6021800 | GUIDE WIRE | Supply/Implant | $710.91 |
| 6021802 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021807 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021809 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6021810 | GUIDE WIRE | Supply/Implant | $140.80 |
| 6021811 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6021815 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021816 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021818 | GUIDE WIRE | Supply/Implant | $547.20 |
| 6021820 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021821 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021822 | GUIDE WIRE | Supply/Implant | $264.96 |
| 6021824 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6021826 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $13,312.00 |
| 6021829 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6021830 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,322.43 |
| 6021831 | SUPPLY IMPLANT | Supply/Implant | $1,497.60 |
| 6021833 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021834 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021835 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021837 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021842 | CATHETER, GUIDING | Supply/Implant | $1,779.20 |
| 6021843 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6021845 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $896.00 |
| 6021880 | CATHETER, GUIDING | Supply/Implant | $1,126.40 |
| 6021881 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6021882 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6021883 | SUPPLY IMPLANT | Supply/Implant | $328.45 |
| 6021884 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021886 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6021887 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6021889 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6021890 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021891 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021893 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021894 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021895 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6021897 | INTRO/SHEATH, NON-LASER | Supply/Implant | $230.40 |
| 6021898 | INTRO/SHEATH, NON-LASER | Supply/Implant | $384.00 |
| 6021899 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,713.60 |
| 6021900 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6021901 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,176.00 |
| 6021903 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6021904 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6021906 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6021907 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,713.60 |
| 6021908 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $15,603.20 |
| 6021909 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,352.00 |
| 6021910 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021911 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021912 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021915 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,408.00 |
| 6021916 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021923 | STERILE SUPPLY | Supply/Implant | $1,356.80 |
| 6021924 | STERILE SUPPLY | Supply/Implant | $1,228.80 |
| 6021927 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021928 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021929 | CATHETER, GUIDING | Supply/Implant | $7,219.20 |
| 6021930 | CATHETER, GUIDING | Supply/Implant | $2,026.75 |
| 6021933 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6021934 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6021935 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6021942 | SUPPLY IMPLANT | Supply/Implant | $1,136.00 |
| 6021945 | SUPPLY IMPLANT | Supply/Implant | $3,980.80 |
| 6021946 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6021947 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,728.00 |
| 6021948 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6021950 | CATHETER, GUIDING | Supply/Implant | $6,105.60 |
| 6021951 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $20,480.00 |
| 6021953 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6021954 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021956 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021957 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021958 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021963 | GUIDE WIRE | Supply/Implant | $185.60 |
| 6021964 | GUIDE WIRE | Supply/Implant | $764.80 |
| 6021965 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021966 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021967 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021969 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021970 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021971 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021972 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021973 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021977 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021979 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021981 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021982 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021984 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021990 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021998 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6022039 | STERILE SUPPLY | Supply/Implant | $914.94 |
| 6022040 | STERILE SUPPLY | Supply/Implant | $1,702.31 |
| 6022042 | SUPPLY IMPLANT | Supply/Implant | $19,129.60 |
| 6022043 | INTRO/SHEATH, NON-LASER | Supply/Implant | $128.00 |
| 6022048 | SUPPLY IMPLANT | Supply/Implant | $266.62 |
| 6022050 | SUPPLY IMPLANT | Supply/Implant | $1,412.86 |
| 6022051 | GUIDE WIRE | Supply/Implant | $1,412.86 |
| 6022052 | GUIDE WIRE | Supply/Implant | $591.36 |
| 6022053 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6022054 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6022057 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6022058 | INTRO/SHEATH, NON-LASER | Supply/Implant | $128.00 |
| 6022070 | INTRO/SHEATH, NON-LASER | Supply/Implant | $360.06 |
| 6022072 | SUPPLY IMPLANT | Supply/Implant | $1,446.40 |
| 6022073 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $1,510.40 |
| 6022075 | GUIDE WIRE | Supply/Implant | $1,253.63 |
| 6022077 | GUIDE WIRE | Supply/Implant | $352.00 |
| 6022079 | GUIDE WIRE | Supply/Implant | $233.60 |
| 6022081 | GUIDE WIRE | Supply/Implant | $1,266.18 |
| 6022083 | GUIDE WIRE | Supply/Implant | $2,571.52 |
| 6022084 | SUPPLY IMPLANT | Supply/Implant | $1,190.40 |
| 6022088 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6022089 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6022090 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,728.00 |
| 6022091 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,728.00 |
| 6022092 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6022093 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $10,880.00 |
| 6022098 | SUPPLY IMPLANT | Supply/Implant | $800.64 |
| 6022099 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $588.80 |
| 6022121 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022123 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022125 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022126 | STERILE SUPPLY | Supply/Implant | $1,497.60 |
| 6022129 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6022130 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $5,824.00 |
| 6022131 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6022132 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6022137 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6022141 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6022150 | GENERAL SUPPLY | Supply/Implant | $240.90 |
| 6022151 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6022152 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6022163 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6022164 | STERILE SUPPLY | Supply/Implant | $2,053.67 |
| 6022165 | GUIDE WIRE | Supply/Implant | $1,512.32 |
| 6022167 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6022168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6022170 | GUIDE WIRE | Supply/Implant | $351.49 |
| 6022172 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022173 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022174 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $648.32 |
| 6022176 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $19,129.60 |
| 6022177 | STERILE SUPPLY | Supply/Implant | $1,921.28 |
| 6022188 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022189 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022192 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022197 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6022198 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6022199 | VENA CAVA FILTER | Supply/Implant | $17,856.00 |
| 6022200 | VENA CAVA FILTER | Supply/Implant | $17,856.00 |
| 6022201 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6022203 | GUIDE WIRE | Supply/Implant | $526.72 |
| 6022204 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6022205 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,096.00 |
| 6022206 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022211 | INTRO/SHEATH, NON-LASER | Supply/Implant | $128.00 |
| 6022213 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $8,128.00 |
| 6022214 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $10,496.00 |
| 6022215 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $8,128.00 |
| 6022218 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6022219 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,484.80 |
| 6022220 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,484.80 |
| 6022221 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6022222 | CATHETER, GUIDING | Supply/Implant | $2,017.28 |
| 6022223 | SUPPLY IMPLANT | Supply/Implant | $1,441.43 |
| 6022224 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6022225 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6022226 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6022227 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6022243 | GENERAL SUPPLY | Supply/Implant | $572.90 |
| 6022244 | SUPPLY IMPLANT | Supply/Implant | $648.32 |
| 6022246 | GENERAL SUPPLY | Supply/Implant | $331.90 |
| 6022250 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022254 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,504.00 |
| 6022255 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,620.80 |
| 6022256 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $17,600.00 |
| 6022257 | STERILE SUPPLY | Supply/Implant | $3,571.20 |
| 6022261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,728.00 |
| 6022262 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6022264 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6022275 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6022276 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6022277 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6022280 | GUIDE WIRE | Supply/Implant | $1,760.00 |
| 6022281 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6022282 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6022289 | CLOSURE DEV, VASC | Supply/Implant | $3,136.00 |
| 6022294 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6022296 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6022298 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $14,976.00 |
| 6022299 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $57,536.00 |
| 6022302 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6022316 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6022317 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,728.00 |
| 6022320 | SUPPLY IMPLANT | Supply/Implant | $437.25 |
| 6022323 | GUIDE WIRE | Supply/Implant | $661.12 |
| 6022324 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6022329 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022330 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022331 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022332 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022333 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,365.76 |
| 6022334 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,365.76 |
| 6022335 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022337 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $12,480.00 |
| 6022341 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6022342 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6022343 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6022346 | STERILE SUPPLY | Supply/Implant | $1,665.54 |
| 6022350 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6022351 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6022352 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6022353 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6022356 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6022359 | CLOSURE DEV, VASC | Supply/Implant | $3,289.60 |
| 6022361 | SUPPLY IMPLANT | Supply/Implant | $2,519.04 |
| 6022364 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,950.40 |
| 6022365 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,950.40 |
| 6022371 | CLOSURE DEV, VASC | Supply/Implant | $4,096.00 |
| 6022375 | CLOSURE DEV, VASC | Supply/Implant | $3,136.00 |
| 6022382 | COMPUTER ASSISTED SURGERY | Supply/Implant | $29,342.60 |
| 6022383 | PMKR, DUAL, RATE-RESP | Supply/Implant | $55,756.80 |
| 6022385 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6022386 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6022389 | STERILE SUPPLY | Supply/Implant | $3,968.00 |
| 6022396 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6022400 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6022401 | SUPPLY IMPLANT | Supply/Implant | $4,377.60 |
| 6022403 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6022404 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6022405 | STERILE SUPPLY | Supply/Implant | $4,377.60 |
| 6022406 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $29,440.00 |
| 6022408 | SUPPLY IMPLANT | Supply/Implant | $165.38 |
| 6022440 | STERILE SUPPLY | Supply/Implant | $855.81 |
| 6022445 | STERILE SUPPLY | Supply/Implant | $152.58 |
| 6022452 | STERILE SUPPLY | Supply/Implant | $148.86 |
| 6022483 | AIR FLUIDIZED BED | Supply/Implant | $792.52 |
| 6022494 | BARIATRIC BED OBESE | Supply/Implant | $2,034.81 |
| 6022541 | VAC RENTAL DAILY E0182 | Supply/Implant | $698.63 |
| 6022545 | PULMO/ROTATE BED | Supply/Implant | $1,516.00 |
| 6022549 | LOW AIR LOSS OVERLAY STANDARD | Supply/Implant | $310.16 |
| 6023421 | OT WH W NONTORSION W FIT | Supply/Implant | $986.00 |
| 6023529 | OT HF WO JT W FIT PREFAB | Supply/Implant | $89.00 |
| 6023619 | OT HF W JT W FIT CUSTOM | Supply/Implant | $269.00 |
| 6023721 | LOW AIR LOSS OVERLAY, OBESE | Supply/Implant | $471.23 |
| 6023744 | OT EWH RIGID W FIT CUST | Supply/Implant | $766.00 |
| 6023745 | OT WHF W JT W FIT CUSTOM | Supply/Implant | $451.00 |
| 6023849 | BARIATRIC BED, SIDE EGRESS | Supply/Implant | $963.87 |
| 6023883 | OT ELBOW W FIT CUSTOM | Supply/Implant | $287.00 |
| 6023884 | OT F WO JT W FIT CUSTOM | Supply/Implant | $212.00 |
| 6023985 | OT F PIP/DIP W JT W FIT | Supply/Implant | $51.00 |
| 6024063 | OT HF WO JT W FIT CUSTOM | Supply/Implant | $269.00 |
| 6024069 | WHFO RIGID W/O JOINTS | Supply/Implant | $1,049.43 |
| 6024089 | OT WH WO JOINTS CUSTOM | Supply/Implant | $418.00 |
| 6024116 | GENERAL SUPPLY | Supply/Implant | $258.05 |
| 6024136 | SUPPLY IMPLANT | Supply/Implant | $496.13 |
| 6024142 | GENERAL SUPPLY | Supply/Implant | $288.64 |
| 6024143 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6024144 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6024158 | GENERAL SUPPLY | Supply/Implant | $250.50 |
| 6024159 | STERILE SUPPLY | Supply/Implant | $812.67 |
| 6024161 | GENERAL SUPPLY | Supply/Implant | $476.42 |
| 6024162 | GENERAL SUPPLY | Supply/Implant | $225.79 |
| 6024166 | GENERAL SUPPLY | Supply/Implant | $131.26 |
| 6024188 | GENERAL SUPPLY | Supply/Implant | $287.49 |
| 6024196 | GENERAL SUPPLY | Supply/Implant | $656.90 |
| 6024209 | CATHETER, URETERAL | Supply/Implant | $228.22 |
| 6024221 | SUPPLY IMPLANT | Supply/Implant | $490.37 |
| 6024226 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6024230 | GENERAL SUPPLY | Supply/Implant | $144.51 |
| 6024240 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6024254 | GENERAL DRUG | Supply/Implant | $199.74 |
| 6024286 | STERILE SUPPLY | Supply/Implant | $391.55 |
| 6024294 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6024295 | SUPPLY IMPLANT | Supply/Implant | $701.44 |
| 6024297 | STERILE SUPPLY | Supply/Implant | $343.17 |
| 6024300 | GUIDE WIRE | Supply/Implant | $526.72 |
| 6024302 | STERILE SUPPLY | Supply/Implant | $511.23 |
| 6024303 | STERILE SUPPLY | Supply/Implant | $551.17 |
| 6024308 | SUPPLY IMPLANT | Supply/Implant | $2,520.32 |
| 6024310 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6024312 | SUPPLY IMPLANT | Supply/Implant | $52,416.00 |
| 6024319 | STERILE SUPPLY | Supply/Implant | $281.09 |
| 6024324 | GENERAL SUPPLY | Supply/Implant | $168.96 |
| 6024327 | SUPPLY IMPLANT | Supply/Implant | $1,530.88 |
| 6024331 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6024335 | INTRO/SHEATH, NON-LASER | Supply/Implant | $544.00 |
| 6024342 | GUIDE WIRE | Supply/Implant | $1,157.12 |
| 6024344 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,255.04 |
| 6024348 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6024349 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,619.20 |
| 6024358 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $8,320.00 |
| 6024360 | RET DEV, INSERTABLE | Supply/Implant | $8,640.00 |
| 6024361 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6024362 | GUIDE WIRE | Supply/Implant | $6,935.04 |
| 6024364 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,160.00 |
| 6024365 | RET DEV, INSERTABLE | Supply/Implant | $8,640.00 |
| 6024366 | EMBOLIZATION PROTECT SYST | Supply/Implant | $19,136.00 |
| 6024369 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,619.20 |
| 6024373 | GUIDE WIRE | Supply/Implant | $3,686.40 |
| 6024374 | CATHETER, GUIDING | Supply/Implant | $1,653.76 |
| 6024375 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $14,310.40 |
| 6024376 | CATH OCCLUSION | Supply/Implant | $14,310.40 |
| 6024386 | GUIDE WIRE | Supply/Implant | $7,980.80 |
| 6024396 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,163.20 |
| 6024397 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6024398 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6024408 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,868.80 |
| 6024415 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6024417 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6024422 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6024436 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6024439 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6024444 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6024453 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6024470 | VENA CAVA FILTER | Supply/Implant | $1,536.00 |
| 6024471 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6024472 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6024474 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6024488 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6024490 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,352.45 |
| 6024491 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,352.45 |
| 6024504 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $640.00 |
| 6024506 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,816.32 |
| 6024518 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $21,160.32 |
| 6024520 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6024523 | SUPPLY IMPLANT | Supply/Implant | $1,305.60 |
| 6024529 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6024530 | SUPPLY IMPLANT | Supply/Implant | $729.60 |
| 6024550 | CATHETER, GUIDING | Supply/Implant | $13,824.00 |
| 6024559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,126.72 |
| 6024562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,128.00 |
| 6024566 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6024567 | GRAFT, VASCULAR | Supply/Implant | $3,942.40 |
| 6024570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $685.57 |
| 6024574 | MESH (IMPLANTABLE) | Supply/Implant | $10,973.57 |
| 6024578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6024580 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024581 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024582 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024587 | PROS, URINARY SPH, IMP | Supply/Implant | $34,280.96 |
| 6024588 | PROS, URINARY SPH, IMP | Supply/Implant | $70,786.56 |
| 6024589 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024591 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024592 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024595 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024596 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024597 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024599 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6024600 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6024601 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6024604 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6024606 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6024615 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6024616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6024617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024618 | MESH (IMPLANTABLE) | Supply/Implant | $7,375.87 |
| 6024626 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024628 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024629 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024630 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024631 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024632 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024633 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024634 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024635 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024636 | MESH (IMPLANTABLE) | Supply/Implant | $1,731.46 |
| 6024637 | MESH (IMPLANTABLE) | Supply/Implant | $6,111.74 |
| 6024638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,924.74 |
| 6024646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024649 | PORT, INDWELLING, IMP | Supply/Implant | $6,720.00 |
| 6024657 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024658 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024660 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024666 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024667 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6024669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024670 | MESH (IMPLANTABLE) | Supply/Implant | $1,019.52 |
| 6024673 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024674 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $545.92 |
| 6024685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6024692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6024700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6024702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6024703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,060.80 |
| 6024705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6024710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024722 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024725 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024726 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6024728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6024729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,686.40 |
| 6024731 | MESH (IMPLANTABLE) | Supply/Implant | $6,528.00 |
| 6024734 | MESH (IMPLANTABLE) | Supply/Implant | $9,597.95 |
| 6024735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6024741 | MESH (IMPLANTABLE) | Supply/Implant | $8,625.79 |
| 6024743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6024745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6024752 | MESH (IMPLANTABLE) | Supply/Implant | $1,731.46 |
| 6024753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6024754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6024760 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,881.60 |
| 6024761 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,881.60 |
| 6024762 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $140,553.00 |
| 6024764 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024765 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024770 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $983.04 |
| 6024788 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024789 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6024796 | GUIDE WIRE | Supply/Implant | $2,396.16 |
| 6024797 | GUIDE WIRE | Supply/Implant | $2,396.16 |
| 6024798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6024799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6024800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6024803 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $18,880.00 |
| 6024804 | LEAD, NEUROSTIMULATOR | Supply/Implant | $45,504.00 |
| 6024806 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024812 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6024816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6024817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6024818 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $21,120.00 |
| 6024831 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6024854 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,584.00 |
| 6024864 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024865 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024868 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024871 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6024874 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024875 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,266.30 |
| 6024880 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $31,993.60 |
| 6024881 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6024884 | LEAD, NEUROSTIMULATOR | Supply/Implant | $87,398.40 |
| 6024886 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024891 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,008.00 |
| 6024892 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6024894 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,738.30 |
| 6024895 | GUIDE WIRE | Supply/Implant | $154.75 |
| 6024896 | SUPPLY IMPLANT | Supply/Implant | $825.34 |
| 6024897 | SUPPLY IMPLANT | Supply/Implant | $4,247.04 |
| 6024898 | GUIDE WIRE | Supply/Implant | $558.82 |
| 6024899 | GUIDE WIRE | Supply/Implant | $558.85 |
| 6024900 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $72,199.68 |
| 6024901 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $74,967.04 |
| 6024902 | APLIGRAF SKIN SUB | Supply/Implant | $21,004.80 |
| 6024904 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6024907 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $255,418.90 |
| 6024914 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6024915 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6024916 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6024925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $723.97 |
| 6024927 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024928 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024936 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6024938 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6024945 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $122,640.00 |
| 6024946 | GUIDE WIRE | Supply/Implant | $344.06 |
| 6024947 | INTRO/SHEATH, NON-LASER | Supply/Implant | $542.08 |
| 6024948 | GUIDE WIRE | Supply/Implant | $560.38 |
| 6024949 | SUPPLY IMPLANT | Supply/Implant | $825.34 |
| 6024950 | SUPPLY IMPLANT | Supply/Implant | $1,335.42 |
| 6024951 | SUPPLY IMPLANT | Supply/Implant | $1,833.28 |
| 6024952 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6024954 | GUIDE WIRE | Supply/Implant | $558.85 |
| 6024955 | GUIDE WIRE | Supply/Implant | $154.75 |
| 6024958 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024980 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $15,232.00 |
| 6024982 | GUIDE WIRE | Supply/Implant | $1,003.52 |
| 6024987 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6025005 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6025012 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025014 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6025015 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6025023 | PROS, URINARY SPH, IMP | Supply/Implant | $74,967.04 |
| 6025024 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025029 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025030 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025033 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,279.36 |
| 6025035 | GUIDE WIRE | Supply/Implant | $198.91 |
| 6025036 | GUIDE WIRE | Supply/Implant | $144.00 |
| 6025038 | CATHETER, URETERAL | Supply/Implant | $845.82 |
| 6025040 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6025042 | INTRO/SHEATH, NON-LASER | Supply/Implant | $268.80 |
| 6025045 | GUIDE WIRE | Supply/Implant | $977.66 |
| 6025046 | INTRO/SHEATH, NON-LASER | Supply/Implant | $403.97 |
| 6025047 | GUIDE WIRE | Supply/Implant | $1,516.42 |
| 6025050 | SUPPLY IMPLANT | Supply/Implant | $2,912.51 |
| 6025051 | INTRO/SHEATH, NON-LASER | Supply/Implant | $540.93 |
| 6025053 | GUIDE WIRE | Supply/Implant | $755.20 |
| 6025054 | GENERAL DRUG | Supply/Implant | $838.02 |
| 6025056 | GUIDE WIRE | Supply/Implant | $651.39 |
| 6025057 | GUIDE WIRE | Supply/Implant | $1,305.47 |
| 6025058 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6025062 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6025063 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6025065 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6025067 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,204.67 |
| 6025068 | SUPPLY IMPLANT | Supply/Implant | $720.00 |
| 6025071 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6025075 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.38 |
| 6025077 | GUIDE WIRE | Supply/Implant | $1,424.13 |
| 6025079 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,238.72 |
| 6025080 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6025091 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6025092 | GUIDE WIRE | Supply/Implant | $183.30 |
| 6025095 | REP DEV, URINARY, W/SLING | Supply/Implant | $17,248.00 |
| 6025096 | GUIDE WIRE | Supply/Implant | $1,766.40 |
| 6025097 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6025098 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6025099 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6025100 | GUIDE WIRE | Supply/Implant | $217.60 |
| 6025101 | INTRO/SHEATH, NON-LASER | Supply/Implant | $390.40 |
| 6025103 | PORT, INDWELLING, IMP | Supply/Implant | $6,592.00 |
| 6025106 | INTRO/SHEATH, NON-LASER | Supply/Implant | $352.77 |
| 6025109 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6025110 | SUPPLY IMPLANT | Supply/Implant | $2,954.50 |
| 6025111 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6025112 | GUIDE WIRE | Supply/Implant | $2,184.96 |
| 6025113 | PORT, INDWELLING, IMP | Supply/Implant | $9,676.80 |
| 6025115 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025116 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025117 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025118 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025119 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,738.30 |
| 6025120 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025131 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025132 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025133 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,738.30 |
| 6025134 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025135 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025136 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025138 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025139 | SYNTHETIC IMPLNT URINARY 1ML | Supply/Implant | $4,929.41 |
| 6025142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,139.20 |
| 6025143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,497.60 |
| 6025150 | GUIDE WIRE | Supply/Implant | $2,150.40 |
| 6025152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6025158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6025159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6025160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6025162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6025163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6025168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6025169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6025179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6025180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6025187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6025190 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6025191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,160.00 |
| 6025194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6025200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,958.40 |
| 6025201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6025203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6025214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $251.90 |
| 6025224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $251.90 |
| 6025225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6025227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6025237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6025238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6025239 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6025243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6025252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,160.96 |
| 6025256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6025260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6025273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,340.80 |
| 6025363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $665.60 |
| 6025364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6025378 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025379 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025380 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025381 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025382 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025389 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025390 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025411 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025421 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6025429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6025433 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025434 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025435 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025436 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025437 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025444 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025446 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025464 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6025466 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6025491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,160.96 |
| 6025540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,048.00 |
| 6025541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6025542 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6025552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $534.78 |
| 6025565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $691.20 |
| 6025567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6025586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6025587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6025591 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,934.40 |
| 6025604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6025612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6025615 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $800.00 |
| 6025656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6025709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,120.00 |
| 6025800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6025804 | GUIDE WIRE | Supply/Implant | $532.74 |
| 6025814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,190.40 |
| 6025816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,646.40 |
| 6025845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6025855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6025868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025973 | GUIDE WIRE | Supply/Implant | $2,140.16 |
| 6025975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6025988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,171.20 |
| 6026009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $685.57 |
| 6026011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $685.57 |
| 6026013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,375.68 |
| 6026027 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $17,920.00 |
| 6026033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,340.80 |
| 6026034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,340.80 |
| 6026035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,441.60 |
| 6026036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,283.20 |
| 6026039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6026043 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,625.60 |
| 6026098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6026131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,532.80 |
| 6026132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6026143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $352.00 |
| 6026176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026178 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,150.40 |
| 6026179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,576.00 |
| 6026191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6026192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026210 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6026212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026239 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,035.20 |
| 6026246 | GUIDE WIRE | Supply/Implant | $1,881.60 |
| 6026247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026255 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,467.20 |
| 6026259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026263 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6026273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6026282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,820.74 |
| 6026288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026304 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026305 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6026330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,820.74 |
| 6026360 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $352.00 |
| 6026370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6026371 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6026374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $537.60 |
| 6026378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,222.40 |
| 6026379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,222.40 |
| 6026380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6026393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,228.80 |
| 6026407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6026434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6026438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6026474 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,836.80 |
| 6026475 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,836.80 |
| 6026487 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,836.80 |
| 6026504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.85 |
| 6026515 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6026525 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $140,553.00 |
| 6026559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6026562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $717.18 |
| 6026571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6026620 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $6,630.40 |
| 6026630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6026640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6026653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6026666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6026698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026727 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6026729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6026736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026739 | GUIDE WIRE | Supply/Implant | $1,648.64 |
| 6026766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6026811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6026812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6026815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6026822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6026823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6026846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,680.00 |
| 6026853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6026863 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6026867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6026884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026927 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $12,185.60 |
| 6026986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $163.20 |
| 6027008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6027028 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6027029 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6027030 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6027031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,516.16 |
| 6027032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6027035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6027054 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,934.40 |
| 6027057 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6027077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,736.00 |
| 6027120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,736.00 |
| 6027121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,736.00 |
| 6027136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6027161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $624.00 |
| 6027162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $624.00 |
| 6027166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6027179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6027181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6027286 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $9,820.16 |
| 6027289 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,934.40 |
| 6027296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6027310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6027333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6027355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6027358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027415 | INFUSION PUMP, PROGRAMMABLE | Supply/Implant | $123,900.00 |
| 6027422 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027423 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $8,320.00 |
| 6027432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6027433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027438 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027441 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027444 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6027459 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,240.00 |
| 6027460 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,680.00 |
| 6027463 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027465 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6027484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,042.05 |
| 6027493 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6027496 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6027506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6027513 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,933.44 |
| 6027540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027567 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $12,160.00 |
| 6027579 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6027611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6027617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6027641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6027643 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $34,835.84 |
| 6027645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,243.52 |
| 6027649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6027650 | GUIDE WIRE | Supply/Implant | $2,931.20 |
| 6027663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,933.44 |
| 6027665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6027668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6027699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,164.80 |
| 6027702 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027711 | CLOSURE DEV, VASC | Supply/Implant | $3,008.00 |
| 6027712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6027732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $694.78 |
| 6027737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6027747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027748 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6027751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027769 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6027770 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $8,470.40 |
| 6027799 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6027803 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6027805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $717.18 |
| 6027813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6027828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6027833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027838 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6027857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6027872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6027875 | PMKR, DUAL, RATE-RESP | Supply/Implant | $55,756.80 |
| 6027884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6027885 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6027886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,933.44 |
| 6027887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6027893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027897 | GUIDE WIRE | Supply/Implant | $1,982.08 |
| 6027898 | SUPPLY IMPLANT | Supply/Implant | $2,538.88 |
| 6027899 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,859.20 |
| 6027901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027902 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6027908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $717.18 |
| 6027931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6027934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6027946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6028000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6028001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6028016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6028027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6028030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6028058 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6028077 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6028100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6028102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6028103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6028111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6028135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6028143 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $11,520.00 |
| 6028146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6028147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6028148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6028157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6028160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6028161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6028162 | GRAFT, VASCULAR | Supply/Implant | $35,737.60 |
| 6028177 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,008.00 |
| 6028183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6028184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6028188 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6028189 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $21,452.80 |
| 6028206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6028207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6028209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6028210 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6028211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6028212 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $28,160.00 |
| 6028213 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6028234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6028246 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $54,118.40 |
| 6028250 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6028254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6028255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6028257 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $13,801.22 |
| 6028261 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.33 |
| 6028270 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.33 |
| 6028277 | GUIDE WIRE | Supply/Implant | $1,356.42 |
| 6028282 | INTRO/SHEATH, NON-LASER | Supply/Implant | $263.55 |
| 6028283 | GUIDE WIRE | Supply/Implant | $620.16 |
| 6028284 | GUIDE WIRE | Supply/Implant | $550.40 |
| 6028299 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,940.61 |
| 6028300 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,204.67 |
| 6028301 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,940.61 |
| 6028311 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,891.84 |
| 6028312 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,806.08 |
| 6028319 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6028320 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6028322 | GUIDE WIRE | Supply/Implant | $1,334.91 |
| 6028323 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,241.60 |
| 6028330 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028331 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028336 | GUIDE WIRE | Supply/Implant | $712.96 |
| 6028342 | GUIDE WIRE | Supply/Implant | $321.28 |
| 6028344 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028348 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6028349 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6028354 | GUIDE WIRE | Supply/Implant | $432.00 |
| 6028357 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6028358 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6028368 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $960.00 |
| 6028371 | GUIDE WIRE | Supply/Implant | $2,867.20 |
| 6028374 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6028375 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6028376 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6028392 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $32,000.00 |
| 6028393 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,382.53 |
| 6028406 | SUPPLY IMPLANT | Supply/Implant | $1,507.20 |
| 6028435 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028440 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,779.20 |
| 6028445 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028447 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028455 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,276.29 |
| 6028459 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6028462 | CATHETER, GUIDING | Supply/Implant | $496.00 |
| 6028469 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028470 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,113.60 |
| 6028471 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028473 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028474 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028475 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028476 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6028479 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028480 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028481 | GUIDE WIRE | Supply/Implant | $17,670.27 |
| 6028483 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028484 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028489 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028502 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028506 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028509 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028537 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6028570 | GUIDE WIRE | Supply/Implant | $5,721.60 |
| 6028602 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6028603 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6028607 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6028608 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6028623 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6028626 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6028632 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6028633 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6028635 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6028642 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6028646 | GUIDE WIRE | Supply/Implant | $166.40 |
| 6028650 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6028651 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6028656 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6028661 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028668 | LEAD, NEUROSTIMULATOR | Supply/Implant | $1,920.00 |
| 6028670 | GUIDE WIRE | Supply/Implant | $433.92 |
| 6028683 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028684 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028685 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028692 | GUIDE WIRE | Supply/Implant | $1,422.87 |
| 6028702 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028704 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6028705 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028712 | INTRO/SHEATH, NON-LASER | Supply/Implant | $969.98 |
| 6028713 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,635.26 |
| 6028716 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $8,960.00 |
| 6028721 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,792.00 |
| 6028736 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6028737 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6028738 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6028739 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6028742 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028743 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028747 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,195.26 |
| 6028750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $39,875.20 |
| 6028752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6028759 | SUPPLY IMPLANT | Supply/Implant | $193.66 |
| 6028763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6028764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $427.14 |
| 6028765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,329.60 |
| 6028767 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6028776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,892.80 |
| 6028778 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6028779 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6028784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6028785 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6028795 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $12,569.73 |
| 6028796 | GRAFT, VASCULAR | Supply/Implant | $3,072.00 |
| 6028804 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6028806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,659.90 |
| 6028807 | ADHESION BARRIER | Supply/Implant | $3,546.50 |
| 6028814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6028832 | SUPPLY IMPLANT | Supply/Implant | $485.50 |
| 6028833 | SUPPLY IMPLANT | Supply/Implant | $2,641.92 |
| 6028834 | SUPPLY IMPLANT | Supply/Implant | $6,982.40 |
| 6028841 | SUPPLY IMPLANT | Supply/Implant | $1,312.64 |
| 6028846 | ALLODERM SKIN SUB | Supply/Implant | $7,769.60 |
| 6028847 | GENERAL SUPPLY | Supply/Implant | $462.08 |
| 6028849 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6028851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6028852 | ALLODERM SKIN SUB | Supply/Implant | $5,888.00 |
| 6028853 | ALLODERM SKIN SUB | Supply/Implant | $9,945.60 |
| 6028858 | SUPPLY IMPLANT | Supply/Implant | $23,936.00 |
| 6028859 | SUPPLY IMPLANT | Supply/Implant | $3,143.68 |
| 6028863 | SUPPLY IMPLANT | Supply/Implant | $3,475.97 |
| 6028864 | CONN TISS, NON-HUMAN | Supply/Implant | $1,415.04 |
| 6028871 | SUPPLY IMPLANT | Supply/Implant | $1,257.18 |
| 6028872 | SUPPLY IMPLANT | Supply/Implant | $3,407.49 |
| 6028873 | SUPPLY IMPLANT | Supply/Implant | $6,832.64 |
| 6028876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,563.20 |
| 6028877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,611.20 |
| 6028879 | SUPPLY IMPLANT | Supply/Implant | $4,334.68 |
| 6028881 | SUPPLY IMPLANT | Supply/Implant | $4,395.39 |
| 6028883 | SUPPLY IMPLANT | Supply/Implant | $2,461.22 |
| 6028884 | SUPPLY IMPLANT | Supply/Implant | $1,972.39 |
| 6028885 | SUPPLY IMPLANT | Supply/Implant | $4,101.25 |
| 6028886 | SUPPLY IMPLANT | Supply/Implant | $2,124.16 |
| 6028887 | SUPPLY IMPLANT | Supply/Implant | $5,944.32 |
| 6028888 | SUPPLY IMPLANT | Supply/Implant | $2,050.56 |
| 6028889 | SUPPLY IMPLANT | Supply/Implant | $4,064.13 |
| 6028890 | SUPPLY IMPLANT | Supply/Implant | $1,165.57 |
| 6028897 | SUPPLY IMPLANT | Supply/Implant | $10,470.40 |
| 6028898 | SUPPLY IMPLANT | Supply/Implant | $1,441.54 |
| 6028900 | SUPPLY IMPLANT | Supply/Implant | $4,300.80 |
| 6028901 | SUPPLY IMPLANT | Supply/Implant | $378.75 |
| 6028906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,164.80 |
| 6028907 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,580.48 |
| 6028908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,755.20 |
| 6028911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,494.40 |
| 6028912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,539.20 |
| 6028915 | STERILE SUPPLY | Supply/Implant | $262.78 |
| 6028917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,540.80 |
| 6028919 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6028920 | STERILE SUPPLY | Supply/Implant | $3,002.88 |
| 6028921 | SUPPLY IMPLANT | Supply/Implant | $1,951.62 |
| 6028924 | MESH (IMPLANTABLE) | Supply/Implant | $28,992.00 |
| 6028925 | SUPPLY IMPLANT | Supply/Implant | $2,923.78 |
| 6028926 | SUPPLY IMPLANT | Supply/Implant | $7,983.36 |
| 6028927 | SUPPLY IMPLANT | Supply/Implant | $139.20 |
| 6028928 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6028931 | SUPPLY IMPLANT | Supply/Implant | $160.32 |
| 6028932 | SUPPLY IMPLANT | Supply/Implant | $663.81 |
| 6028940 | GENERAL SUPPLY | Supply/Implant | $14,689.02 |
| 6028945 | SUPPLY IMPLANT | Supply/Implant | $1,698.69 |
| 6028946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6028947 | ALLODERM SKIN SUB | Supply/Implant | $2,956.80 |
| 6028951 | SUPPLY IMPLANT | Supply/Implant | $1,774.08 |
| 6028952 | GENERAL SUPPLY | Supply/Implant | $132.22 |
| 6028954 | STERILE SUPPLY | Supply/Implant | $213.12 |
| 6028957 | STERILE SUPPLY | Supply/Implant | $9,228.80 |
| 6028961 | SUPPLY IMPLANT | Supply/Implant | $1,648.64 |
| 6028963 | SUPPLY IMPLANT | Supply/Implant | $31,529.79 |
| 6028966 | SUPPLY IMPLANT | Supply/Implant | $26,337.54 |
| 6028968 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6028969 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6028970 | SUPPLY IMPLANT | Supply/Implant | $1,153.54 |
| 6028972 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,407.17 |
| 6028973 | SUPPLY IMPLANT | Supply/Implant | $1,312.90 |
| 6028985 | SUPPLY IMPLANT | Supply/Implant | $6,844.67 |
| 6028987 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6028990 | SUPPLY IMPLANT | Supply/Implant | $417.54 |
| 6028993 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6028994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,274.94 |
| 6028995 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6028997 | SUPPLY IMPLANT | Supply/Implant | $9,146.37 |
| 6029006 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,035.26 |
| 6029013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6029015 | SUPPLY IMPLANT | Supply/Implant | $3,538.56 |
| 6029016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,274.94 |
| 6029019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6029022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6029023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,671.30 |
| 6029024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,150.40 |
| 6029027 | SUPPLY IMPLANT | Supply/Implant | $1,430.53 |
| 6029028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,153.73 |
| 6029030 | STERILE SUPPLY | Supply/Implant | $547.58 |
| 6029031 | SUPPLY IMPLANT | Supply/Implant | $276.10 |
| 6029032 | GENERAL SUPPLY | Supply/Implant | $404.10 |
| 6029033 | GENERAL SUPPLY | Supply/Implant | $520.32 |
| 6029035 | SUPPLY IMPLANT | Supply/Implant | $75,648.00 |
| 6029038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,671.30 |
| 6029039 | SUPPLY IMPLANT | Supply/Implant | $258.56 |
| 6029040 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029041 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029042 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029043 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6029044 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6029045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6029047 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,407.17 |
| 6029050 | SUPPLY IMPLANT | Supply/Implant | $8,256.00 |
| 6029052 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029053 | SUPPLY IMPLANT | Supply/Implant | $4,101.25 |
| 6029054 | SUPPLY IMPLANT | Supply/Implant | $783.10 |
| 6029055 | STERILE SUPPLY | Supply/Implant | $1,813.35 |
| 6029056 | SUPPLY IMPLANT | Supply/Implant | $1,813.35 |
| 6029057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6029065 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6029066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,987.90 |
| 6029069 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6029079 | SUPPLY IMPLANT | Supply/Implant | $1,202.56 |
| 6029081 | SUPPLY IMPLANT | Supply/Implant | $743.71 |
| 6029082 | SUPPLY IMPLANT | Supply/Implant | $23,936.00 |
| 6029083 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6029085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,760.00 |
| 6029086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6029093 | SUPPLY IMPLANT | Supply/Implant | $1,092.57 |
| 6029094 | SUPPLY IMPLANT | Supply/Implant | $22,540.80 |
| 6029097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029106 | ADHESION BARRIER | Supply/Implant | $4,290.82 |
| 6029108 | SUPPLY IMPLANT | Supply/Implant | $176.00 |
| 6029111 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6029113 | SUPPLY IMPLANT | Supply/Implant | $3,110.40 |
| 6029116 | SUPPLY IMPLANT | Supply/Implant | $1,687.04 |
| 6029120 | SUPPLY IMPLANT | Supply/Implant | $2,398.57 |
| 6029121 | SUPPLY IMPLANT | Supply/Implant | $2,398.57 |
| 6029130 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6029138 | PROSTHESIS, BREAST, IMP | Supply/Implant | $7,360.00 |
| 6029140 | SUPPLY IMPLANT | Supply/Implant | $2,835.84 |
| 6029141 | SUPPLY IMPLANT | Supply/Implant | $550.66 |
| 6029143 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6029146 | SUPPLY IMPLANT | Supply/Implant | $11,712.00 |
| 6029147 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029148 | CATH, DRAINAGE | Supply/Implant | $10,057.98 |
| 6029149 | SUPPLY IMPLANT | Supply/Implant | $16,000.10 |
| 6029150 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6029151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,760.00 |
| 6029158 | SUPPLY IMPLANT | Supply/Implant | $3,153.92 |
| 6029160 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029162 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029163 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029164 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029166 | SUPPLY IMPLANT | Supply/Implant | $2,866.56 |
| 6029169 | SUPPLY IMPLANT | Supply/Implant | $1,925.12 |
| 6029170 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6029172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6029173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6029178 | ALLODERM SKIN SUB | Supply/Implant | $26,585.60 |
| 6029180 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6029183 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6029184 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6029185 | CATHETER, GUIDING | Supply/Implant | $5,440.00 |
| 6029191 | SUPPLY IMPLANT | Supply/Implant | $742.40 |
| 6029193 | SUPPLY IMPLANT | Supply/Implant | $588.80 |
| 6029195 | SUPPLY IMPLANT | Supply/Implant | $1,092.57 |
| 6029199 | MESH (IMPLANTABLE) | Supply/Implant | $5,248.00 |
| 6029200 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $9,344.00 |
| 6029207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,369.92 |
| 6029212 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029220 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6029221 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6029222 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6029223 | SUPPLY IMPLANT | Supply/Implant | $1,497.60 |
| 6029227 | CLOSURE DEV, VASC | Supply/Implant | $3,520.00 |
| 6029228 | SUPPLY IMPLANT | Supply/Implant | $48,704.00 |
| 6029231 | SUPPLY IMPLANT | Supply/Implant | $7,001.60 |
| 6029232 | SUPPLY IMPLANT | Supply/Implant | $4,211.20 |
| 6029233 | SUPPLY IMPLANT | Supply/Implant | $4,428.29 |
| 6029234 | SUPPLY IMPLANT | Supply/Implant | $1,624.32 |
| 6029235 | SUPPLY IMPLANT | Supply/Implant | $4,507.78 |
| 6029245 | INTEGRA BMWD SKIN SUB | Supply/Implant | $61,089.79 |
| 6029248 | SUPPLY IMPLANT | Supply/Implant | $582.40 |
| 6029252 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,624.00 |
| 6029254 | MESH (IMPLANTABLE) | Supply/Implant | $9,689.60 |
| 6029255 | MESH (IMPLANTABLE) | Supply/Implant | $35,089.34 |
| 6029257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6029258 | SUPPLY IMPLANT | Supply/Implant | $38,912.00 |
| 6029260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6029274 | SUPPLY IMPLANT | Supply/Implant | $13,141.76 |
| 6029276 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029284 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029285 | PROSTHETIC IMPLANT NOS | Supply/Implant | $37,964.80 |
| 6029287 | SUPPLY IMPLANT | Supply/Implant | $5,669.47 |
| 6029288 | SUPPLY IMPLANT | Supply/Implant | $766.11 |
| 6029289 | SUPPLY IMPLANT | Supply/Implant | $651.26 |
| 6029295 | PROSTHETIC IMPLANT NOS | Supply/Implant | $37,964.80 |
| 6029296 | SUPPLY IMPLANT | Supply/Implant | $4,963.97 |
| 6029297 | SUPPLY IMPLANT | Supply/Implant | $4,427.78 |
| 6029303 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $59,939.84 |
| 6029304 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029305 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029306 | SUPPLY IMPLANT | Supply/Implant | $2,461.57 |
| 6029310 | SUPPLY IMPLANT | Supply/Implant | $620.84 |
| 6029311 | SUPPLY IMPLANT | Supply/Implant | $907.67 |
| 6029312 | SUPPLY IMPLANT | Supply/Implant | $611.84 |
| 6029313 | SUPPLY IMPLANT | Supply/Implant | $907.67 |
| 6029314 | SUPPLY IMPLANT | Supply/Implant | $1,181.22 |
| 6029315 | SUPPLY IMPLANT | Supply/Implant | $1,740.71 |
| 6029316 | SUPPLY IMPLANT | Supply/Implant | $2,208.90 |
| 6029317 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6029319 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,070.59 |
| 6029323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6029324 | GRAFT, VASCULAR | Supply/Implant | $16,153.60 |
| 6029327 | STERILE SUPPLY | Supply/Implant | $15,086.08 |
| 6029330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6029331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.80 |
| 6029333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029335 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029342 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $3,697.92 |
| 6029343 | SUPPLY IMPLANT | Supply/Implant | $3,698.05 |
| 6029344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6029354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,139.20 |
| 6029355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029362 | SUPPLY IMPLANT | Supply/Implant | $6,179.58 |
| 6029366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6029369 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6029371 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6029372 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6029373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6029374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6029378 | MESH (IMPLANTABLE) | Supply/Implant | $5,670.40 |
| 6029379 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6029380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,966.72 |
| 6029385 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,152.00 |
| 6029387 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6029389 | INTRO/SHEATH, NON-LASER | Supply/Implant | $668.16 |
| 6029390 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,315.20 |
| 6029396 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,547.20 |
| 6029403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6029413 | MESH (IMPLANTABLE) | Supply/Implant | $6,310.40 |
| 6029415 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $52,915.20 |
| 6029418 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6029422 | GENERAL SUPPLY | Supply/Implant | $358.27 |
| 6029424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6029430 | SUPPLY IMPLANT | Supply/Implant | $14,720.00 |
| 6029434 | SUPPLY IMPLANT | Supply/Implant | $3,975.94 |
| 6029436 | SUPPLY IMPLANT | Supply/Implant | $1,308.16 |
| 6029439 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6029444 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6029446 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $31,744.00 |
| 6029447 | SUPPLY IMPLANT | Supply/Implant | $3,975.94 |
| 6029448 | SUPPLY IMPLANT | Supply/Implant | $3,911.04 |
| 6029457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,572.80 |
| 6029460 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $91,468.80 |
| 6029464 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029466 | SUPPLY IMPLANT | Supply/Implant | $4,000.64 |
| 6029468 | INTRO/SHEATH, NON-LASER | Supply/Implant | $476.93 |
| 6029472 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029473 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029474 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $6,336.00 |
| 6029476 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029477 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,660.42 |
| 6029484 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6029485 | GUIDE WIRE | Supply/Implant | $1,088.00 |
| 6029487 | SUPPLY IMPLANT | Supply/Implant | $5,470.72 |
| 6029488 | EMBOLIZATION PROTECT SYST | Supply/Implant | $23,680.00 |
| 6029494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,945.60 |
| 6029496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6029498 | INTRO/SHEATH, NON-LASER | Supply/Implant | $268.80 |
| 6029517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6029521 | LEAD, NEUROSTIMULATOR | Supply/Implant | $33,024.00 |
| 6029527 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $34,560.00 |
| 6029567 | SUPPLY IMPLANT | Supply/Implant | $490.42 |
| 6029580 | GENERAL SUPPLY | Supply/Implant | $1,353.60 |
| 6029582 | GENERAL SUPPLY | Supply/Implant | $1,039.74 |
| 6029583 | GENERAL SUPPLY | Supply/Implant | $1,307.14 |
| 6029584 | GENERAL SUPPLY | Supply/Implant | $1,795.58 |
| 6029585 | STERILE SUPPLY | Supply/Implant | $1,860.10 |
| 6029588 | STERILE SUPPLY | Supply/Implant | $535.04 |
| 6029592 | SUPPLY IMPLANT | Supply/Implant | $3,279.36 |
| 6029593 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6029594 | SUPPLY IMPLANT | Supply/Implant | $1,666.56 |
| 6029595 | SUPPLY IMPLANT | Supply/Implant | $1,666.56 |
| 6029597 | INTRO/SHEATH, NON-LASER | Supply/Implant | $559.10 |
| 6029623 | GENERAL SUPPLY | Supply/Implant | $220.42 |
| 6029627 | STERILE SUPPLY | Supply/Implant | $260.10 |
| 6029631 | GENERAL SUPPLY | Supply/Implant | $873.34 |
| 6029632 | GENERAL SUPPLY | Supply/Implant | $2,795.39 |
| 6029633 | GENERAL SUPPLY | Supply/Implant | $1,027.71 |
| 6029634 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6029635 | SUPPLY IMPLANT | Supply/Implant | $2,343.94 |
| 6029637 | SUPPLY IMPLANT | Supply/Implant | $145.15 |
| 6029638 | SUPPLY IMPLANT | Supply/Implant | $343.94 |
| 6029640 | GENERAL SUPPLY | Supply/Implant | $2,009.86 |
| 6029641 | GENERAL SUPPLY | Supply/Implant | $991.23 |
| 6029642 | GENERAL SUPPLY | Supply/Implant | $2,353.92 |
| 6029643 | GENERAL SUPPLY | Supply/Implant | $1,085.82 |
| 6029645 | STERILE SUPPLY | Supply/Implant | $1,989.63 |
| 6029648 | GENERAL SUPPLY | Supply/Implant | $2,379.01 |
| 6029649 | GENERAL SUPPLY | Supply/Implant | $834.18 |
| 6029650 | STERILE SUPPLY | Supply/Implant | $1,413.25 |
| 6029651 | GENERAL SUPPLY | Supply/Implant | $1,687.55 |
| 6029652 | GENERAL SUPPLY | Supply/Implant | $2,022.27 |
| 6029653 | GENERAL SUPPLY | Supply/Implant | $1,386.50 |
| 6029654 | STERILE SUPPLY | Supply/Implant | $786.18 |
| 6029655 | GENERAL SUPPLY | Supply/Implant | $603.90 |
| 6029656 | GENERAL SUPPLY | Supply/Implant | $507.65 |
| 6029657 | GENERAL SUPPLY | Supply/Implant | $838.27 |
| 6029658 | CATHETER, URETERAL | Supply/Implant | $1,350.02 |
| 6029659 | CATHETER, URETERAL | Supply/Implant | $967.68 |
| 6029664 | GENERAL SUPPLY | Supply/Implant | $1,447.55 |
| 6029670 | SUPPLY IMPLANT | Supply/Implant | $197.89 |
| 6029671 | STERILE SUPPLY | Supply/Implant | $934.40 |
| 6029672 | SUPPLY IMPLANT | Supply/Implant | $971.65 |
| 6029676 | GENERAL SUPPLY | Supply/Implant | $2,094.66 |
| 6029677 | SUPPLY IMPLANT | Supply/Implant | $1,095.33 |
| 6029678 | GENERAL SUPPLY | Supply/Implant | $429.76 |
| 6029679 | SUPPLY IMPLANT | Supply/Implant | $2,744.79 |
| 6029681 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,225.60 |
| 6029682 | STERILE SUPPLY | Supply/Implant | $285.70 |
| 6029689 | SUPPLY IMPLANT | Supply/Implant | $226.00 |
| 6029696 | GENERAL DRUG | Supply/Implant | $270.59 |
| 6029711 | STERILE SUPPLY | Supply/Implant | $169.22 |
| 6029715 | GENERAL SUPPLY | Supply/Implant | $727.42 |
| 6029716 | GENERAL SUPPLY | Supply/Implant | $706.18 |
| 6029721 | STERILE SUPPLY | Supply/Implant | $195.07 |
| 6029738 | GENERAL SUPPLY | Supply/Implant | $282.75 |
| 6029741 | CATHETER, URETERAL | Supply/Implant | $195.84 |
| 6029750 | GENERAL SUPPLY | Supply/Implant | $480.77 |
| 6029765 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6029766 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $721.02 |
| 6029776 | STERILE SUPPLY | Supply/Implant | $155.14 |
| 6029779 | STERILE SUPPLY | Supply/Implant | $177.38 |
| 6029787 | STERILE SUPPLY | Supply/Implant | $163.33 |
| 6029789 | STERILE SUPPLY | Supply/Implant | $166.78 |
| 6029790 | STERILE SUPPLY | Supply/Implant | $180.52 |
| 6029796 | STERILE SUPPLY | Supply/Implant | $181.41 |
| 6029797 | STERILE SUPPLY | Supply/Implant | $197.76 |
| 6029798 | STERILE SUPPLY | Supply/Implant | $198.78 |
| 6029831 | STERILE SUPPLY | Supply/Implant | $249.86 |
| 6029846 | STERILE SUPPLY | Supply/Implant | $192.83 |
| 6029847 | STERILE SUPPLY | Supply/Implant | $238.03 |
| 6029853 | STERILE SUPPLY | Supply/Implant | $317.44 |
| 6029854 | STERILE SUPPLY | Supply/Implant | $228.48 |
| 6029857 | STERILE SUPPLY | Supply/Implant | $129.15 |
| 6029876 | STERILE SUPPLY | Supply/Implant | $135.94 |
| 6029877 | STERILE SUPPLY | Supply/Implant | $234.50 |
| 6029878 | STERILE SUPPLY | Supply/Implant | $183.30 |
| 6029884 | STERILE SUPPLY | Supply/Implant | $150.30 |
| 6029887 | STERILE SUPPLY | Supply/Implant | $396.66 |
| 6029895 | STERILE SUPPLY | Supply/Implant | $162.21 |
| 6029898 | STERILE SUPPLY | Supply/Implant | $331.14 |
| 6029899 | STERILE SUPPLY | Supply/Implant | $338.83 |
| 6029900 | STERILE SUPPLY | Supply/Implant | $259.56 |
| 6029904 | STERILE SUPPLY | Supply/Implant | $307.20 |
| 6029905 | STERILE SUPPLY | Supply/Implant | $300.80 |
| 6029906 | STERILE SUPPLY | Supply/Implant | $332.44 |
| 6029907 | STERILE SUPPLY | Supply/Implant | $307.20 |
| 6029908 | STERILE SUPPLY | Supply/Implant | $2,959.36 |
| 6029910 | STERILE SUPPLY | Supply/Implant | $155.14 |
| 6029929 | STERILE SUPPLY | Supply/Implant | $216.79 |
| 6029932 | STERILE SUPPLY | Supply/Implant | $228.48 |
| 6029933 | STERILE SUPPLY | Supply/Implant | $247.04 |
| 6029935 | STERILE SUPPLY | Supply/Implant | $129.47 |
| 6029936 | STERILE SUPPLY | Supply/Implant | $770.28 |
| 6029937 | STERILE SUPPLY | Supply/Implant | $193.51 |
| 6029938 | STERILE SUPPLY | Supply/Implant | $812.84 |
| 6029939 | STERILE SUPPLY | Supply/Implant | $810.65 |
| 6029940 | STERILE SUPPLY | Supply/Implant | $203.19 |
| 6029941 | STERILE SUPPLY | Supply/Implant | $887.80 |
| 6029942 | STERILE SUPPLY | Supply/Implant | $919.85 |
| 6029943 | STERILE SUPPLY | Supply/Implant | $919.72 |
| 6029944 | STERILE SUPPLY | Supply/Implant | $727.81 |
| 6029945 | STERILE SUPPLY | Supply/Implant | $374.27 |
| 6029952 | SUPPLY IMPLANT | Supply/Implant | $1,902.94 |
| 6029954 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6029960 | STERILE SUPPLY | Supply/Implant | $204.80 |
| 6029962 | STERILE SUPPLY | Supply/Implant | $198.66 |
| 6029963 | STERILE SUPPLY | Supply/Implant | $290.02 |
| 6029975 | STERILE SUPPLY | Supply/Implant | $264.65 |
| 6029981 | SUPPLY IMPLANT | Supply/Implant | $204.16 |
| 6029982 | SUPPLY IMPLANT | Supply/Implant | $219.90 |
| 6029983 | SUPPLY IMPLANT | Supply/Implant | $290.75 |
| 6029984 | SUPPLY IMPLANT | Supply/Implant | $290.82 |
| 6029986 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,419.20 |
| 6029987 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,419.20 |
| 6029989 | GENERAL SUPPLY | Supply/Implant | $243.84 |
| 6029992 | SUPPLY IMPLANT | Supply/Implant | $137.34 |
| 6030006 | SUPPLY IMPLANT | Supply/Implant | $1,459.07 |
| 6030008 | STERILE SUPPLY | Supply/Implant | $149.12 |
| 6030009 | SUPPLY IMPLANT | Supply/Implant | $2,863.85 |
| 6030014 | SUPPLY IMPLANT | Supply/Implant | $309.76 |
| 6030015 | SUPPLY IMPLANT | Supply/Implant | $974.72 |
| 6030016 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6030018 | SUPPLY IMPLANT | Supply/Implant | $232.41 |
| 6030019 | CATHETER, URETERAL | Supply/Implant | $237.18 |
| 6030022 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6030023 | CATHETER, URETERAL | Supply/Implant | $258.20 |
| 6030024 | SUPPLY IMPLANT | Supply/Implant | $241.28 |
| 6030029 | CATHETER, URETERAL | Supply/Implant | $239.36 |
| 6030030 | SUPPLY IMPLANT | Supply/Implant | $11,129.60 |
| 6030031 | CATHETER, URETERAL | Supply/Implant | $146.82 |
| 6030032 | CATHETER, URETERAL | Supply/Implant | $146.82 |
| 6030034 | CATHETER, URETERAL | Supply/Implant | $228.22 |
| 6030035 | CATHETER, URETERAL | Supply/Implant | $228.22 |
| 6030036 | SUPPLY IMPLANT | Supply/Implant | $146.18 |
| 6030037 | SUPPLY IMPLANT | Supply/Implant | $188.03 |
| 6030038 | SUPPLY IMPLANT | Supply/Implant | $188.03 |
| 6030039 | SUPPLY IMPLANT | Supply/Implant | $159.62 |
| 6030042 | CATHETER, URETERAL | Supply/Implant | $391.68 |
| 6030043 | SUPPLY IMPLANT | Supply/Implant | $391.68 |
| 6030044 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6030045 | CATHETER, URETERAL | Supply/Implant | $294.91 |
| 6030046 | CATHETER, URETERAL | Supply/Implant | $282.75 |
| 6030048 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6030049 | CATH, DRAINAGE | Supply/Implant | $291.33 |
| 6030050 | CATHETER, URETERAL | Supply/Implant | $152.32 |
| 6030067 | LOCM 100-199MG/ML IODINE,1ML | Supply/Implant | $517.50 |
| 6030082 | SUPPLY IMPLANT | Supply/Implant | $440.65 |
| 6030083 | GENERAL SUPPLY | Supply/Implant | $2,844.29 |
| 6030104 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6030105 | GENERAL SUPPLY | Supply/Implant | $231.68 |
| 6030108 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6030115 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6030116 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6030119 | SUPPLY IMPLANT | Supply/Implant | $605.16 |
| 6030121 | SUPPLY IMPLANT | Supply/Implant | $1,833.34 |
| 6030122 | SUPPLY IMPLANT | Supply/Implant | $489.89 |
| 6030123 | GENERAL SUPPLY | Supply/Implant | $678.40 |
| 6030125 | GENERAL SUPPLY | Supply/Implant | $186.88 |
| 6030126 | SUPPLY IMPLANT | Supply/Implant | $3,001.22 |
| 6030137 | SUPPLY IMPLANT | Supply/Implant | $378.62 |
| 6030143 | GENERAL SUPPLY | Supply/Implant | $141.82 |
| 6030153 | SUPPLY IMPLANT | Supply/Implant | $298.24 |
| 6030159 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6030160 | GENERAL SUPPLY | Supply/Implant | $829.39 |
| 6030161 | GENERAL SUPPLY | Supply/Implant | $700.86 |
| 6030164 | SUPPLY IMPLANT | Supply/Implant | $133.38 |
| 6030169 | CATHETER, URETERAL | Supply/Implant | $319.36 |
| 6030170 | SUPPLY IMPLANT | Supply/Implant | $160.38 |
| 6030174 | SUPPLY IMPLANT | Supply/Implant | $723.97 |
| 6030176 | SUPPLY IMPLANT | Supply/Implant | $249.22 |
| 6030178 | SUPPLY IMPLANT | Supply/Implant | $511.36 |
| 6030179 | GENERAL SUPPLY | Supply/Implant | $177.60 |
| 6030180 | CATHETER, URETERAL | Supply/Implant | $181.76 |
| 6030185 | STERILE SUPPLY | Supply/Implant | $140.42 |
| 6030194 | SUPPLY IMPLANT | Supply/Implant | $852.74 |
| 6030195 | STERILE SUPPLY | Supply/Implant | $540.16 |
| 6030196 | STERILE SUPPLY | Supply/Implant | $1,228.29 |
| 6030197 | STERILE SUPPLY | Supply/Implant | $1,066.11 |
| 6030199 | SUPPLY IMPLANT | Supply/Implant | $1,553.72 |
| 6030204 | STERILE SUPPLY | Supply/Implant | $1,413.89 |
| 6030205 | STERILE SUPPLY | Supply/Implant | $748.42 |
| 6030207 | STERILE SUPPLY | Supply/Implant | $3,504.90 |
| 6030210 | STERILE SUPPLY | Supply/Implant | $170.98 |
| 6030211 | GENERAL SUPPLY | Supply/Implant | $152.58 |
| 6030216 | SUPPLY IMPLANT | Supply/Implant | $652.80 |
| 6030217 | SUPPLY IMPLANT | Supply/Implant | $359.04 |
| 6030218 | SUPPLY IMPLANT | Supply/Implant | $563.20 |
| 6030219 | SUPPLY IMPLANT | Supply/Implant | $330.24 |
| 6030220 | SUPPLY IMPLANT | Supply/Implant | $321.15 |
| 6030223 | GENERAL SUPPLY | Supply/Implant | $225.98 |
| 6030232 | STERILE SUPPLY | Supply/Implant | $234.11 |
| 6030233 | STERILE SUPPLY | Supply/Implant | $179.20 |
| 6030251 | SUPPLY IMPLANT | Supply/Implant | $789.50 |
| 6030253 | GENERAL SUPPLY | Supply/Implant | $252.29 |
| 6030255 | SUPPLY IMPLANT | Supply/Implant | $666.62 |
| 6030256 | SUPPLY IMPLANT | Supply/Implant | $338.69 |
| 6030260 | SUPPLY IMPLANT | Supply/Implant | $633.98 |
| 6030262 | SUPPLY IMPLANT | Supply/Implant | $556.80 |
| 6030263 | SUPPLY IMPLANT | Supply/Implant | $282.75 |
| 6030264 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6030270 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6030271 | SUPPLY IMPLANT | Supply/Implant | $376.32 |
| 6030272 | SUPPLY IMPLANT | Supply/Implant | $376.32 |
| 6030274 | SUPPLY IMPLANT | Supply/Implant | $1,217.28 |
| 6030276 | SUPPLY IMPLANT | Supply/Implant | $1,304.06 |
| 6030282 | SUPPLY IMPLANT | Supply/Implant | $484.22 |
| 6030282 | SUPPLY IMPLANT | Supply/Implant | $547.66 |
| 6030283 | CATHETER, URETERAL | Supply/Implant | $177.05 |
| 6030293 | SUPPLY IMPLANT | Supply/Implant | $830.85 |
| 6030294 | GENERAL SUPPLY | Supply/Implant | $211.20 |
| 6030298 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6030301 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6030306 | GENERAL SUPPLY | Supply/Implant | $134.53 |
| 6030312 | STERILE SUPPLY | Supply/Implant | $416.03 |
| 6030313 | SUPPLY IMPLANT | Supply/Implant | $775.68 |
| 6030317 | GENERAL SUPPLY | Supply/Implant | $180.99 |
| 6030321 | SUPPLY IMPLANT | Supply/Implant | $2,549.09 |
| 6030323 | SUPPLY IMPLANT | Supply/Implant | $2,662.14 |
| 6030328 | STERILE SUPPLY | Supply/Implant | $496.00 |
| 6030333 | SUPPLY IMPLANT | Supply/Implant | $633.98 |
| 6030334 | SUPPLY IMPLANT | Supply/Implant | $2,605.82 |
| 6030338 | SUPPLY IMPLANT | Supply/Implant | $2,290.23 |
| 6030339 | SUPPLY IMPLANT | Supply/Implant | $2,754.18 |
| 6030340 | STERILE SUPPLY | Supply/Implant | $244.06 |
| 6030343 | STERILE SUPPLY | Supply/Implant | $129.09 |
| 6030347 | STERILE SUPPLY | Supply/Implant | $1,587.84 |
| 6030348 | STERILE SUPPLY | Supply/Implant | $1,606.78 |
| 6030349 | STERILE SUPPLY | Supply/Implant | $1,987.97 |
| 6030350 | STERILE SUPPLY | Supply/Implant | $855.42 |
| 6030351 | STERILE SUPPLY | Supply/Implant | $1,151.74 |
| 6030352 | STERILE SUPPLY | Supply/Implant | $1,231.62 |
| 6030354 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030355 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030356 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030357 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030359 | SUPPLY IMPLANT | Supply/Implant | $1,304.06 |
| 6030362 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6030364 | SUPPLY IMPLANT | Supply/Implant | $569.09 |
| 6030365 | STERILE SUPPLY | Supply/Implant | $1,349.89 |
| 6030368 | SUPPLY IMPLANT | Supply/Implant | $825.34 |
| 6030370 | STERILE SUPPLY | Supply/Implant | $222.08 |
| 6030372 | SUPPLY IMPLANT | Supply/Implant | $290.82 |
| 6030373 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6030374 | SUPPLY IMPLANT | Supply/Implant | $3,820.80 |
| 6030376 | GENERAL SUPPLY | Supply/Implant | $228.48 |
| 6030377 | SUPPLY IMPLANT | Supply/Implant | $273.64 |
| 6030379 | STERILE SUPPLY | Supply/Implant | $246.40 |
| 6030381 | STERILE SUPPLY | Supply/Implant | $165.70 |
| 6030383 | SUPPLY IMPLANT | Supply/Implant | $566.14 |
| 6030388 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6030390 | SUPPLY IMPLANT | Supply/Implant | $259.84 |
| 6030391 | SUPPLY IMPLANT | Supply/Implant | $152.32 |
| 6030395 | SUPPLY IMPLANT | Supply/Implant | $511.63 |
| 6030397 | SUPPLY IMPLANT | Supply/Implant | $211.46 |
| 6030400 | STERILE SUPPLY | Supply/Implant | $136.83 |
| 6030402 | GENERAL SUPPLY | Supply/Implant | $275.20 |
| 6030403 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6030408 | SUPPLY IMPLANT | Supply/Implant | $1,149.31 |
| 6030410 | SUPPLY IMPLANT | Supply/Implant | $507.52 |
| 6030414 | SUPPLY IMPLANT | Supply/Implant | $476.29 |
| 6030415 | GENERAL SUPPLY | Supply/Implant | $247.42 |
| 6030416 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6030418 | SUPPLY IMPLANT | Supply/Implant | $2,228.60 |
| 6030420 | STERILE SUPPLY | Supply/Implant | $157.82 |
| 6030421 | STERILE SUPPLY | Supply/Implant | $249.86 |
| 6030422 | STERILE SUPPLY | Supply/Implant | $2,134.40 |
| 6030423 | STERILE SUPPLY | Supply/Implant | $472.32 |
| 6030427 | STERILE SUPPLY | Supply/Implant | $1,407.74 |
| 6030430 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6030437 | STERILE SUPPLY | Supply/Implant | $290.05 |
| 6030439 | SUPPLY IMPLANT | Supply/Implant | $1,167.36 |
| 6030442 | STERILE SUPPLY | Supply/Implant | $2,104.19 |
| 6030445 | GENERAL SUPPLY | Supply/Implant | $876.80 |
| 6030446 | STERILE SUPPLY | Supply/Implant | $1,260.67 |
| 6030447 | GENERAL SUPPLY | Supply/Implant | $323.75 |
| 6030448 | STERILE SUPPLY | Supply/Implant | $1,428.65 |
| 6030450 | CATHETER, URETERAL | Supply/Implant | $137.73 |
| 6030452 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6030454 | SUPPLY IMPLANT | Supply/Implant | $2,965.63 |
| 6030457 | SUPPLY IMPLANT | Supply/Implant | $2,577.66 |
| 6030458 | SUPPLY IMPLANT | Supply/Implant | $228.48 |
| 6030462 | SUPPLY IMPLANT | Supply/Implant | $1,576.45 |
| 6030465 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $176.60 |
| 6030466 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6030468 | INTRO/SHEATH, NON-LASER | Supply/Implant | $304.64 |
| 6030469 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030470 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030472 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6030481 | SUPPLY IMPLANT | Supply/Implant | $4,772.01 |
| 6030483 | GENERAL SUPPLY | Supply/Implant | $257.86 |
| 6030488 | GENERAL SUPPLY | Supply/Implant | $135.17 |
| 6030490 | SUPPLY IMPLANT | Supply/Implant | $209.79 |
| 6030492 | INTRO/SHEATH, NON-LASER | Supply/Implant | $870.40 |
| 6030493 | SUPPLY IMPLANT | Supply/Implant | $412.03 |
| 6030495 | STERILE SUPPLY | Supply/Implant | $1,005.02 |
| 6030497 | CATHETER, URETERAL | Supply/Implant | $252.16 |
| 6030502 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6030504 | SUPPLY IMPLANT | Supply/Implant | $9,830.40 |
| 6030505 | SUPPLY IMPLANT | Supply/Implant | $797.70 |
| 6030507 | RET DEV, INSERTABLE | Supply/Implant | $5,056.00 |
| 6030508 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030509 | SUPPLY IMPLANT | Supply/Implant | $736.13 |
| 6030516 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6030517 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030518 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030519 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030526 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6030529 | SUPPLY IMPLANT | Supply/Implant | $2,739.20 |
| 6030533 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6030535 | STERILE SUPPLY | Supply/Implant | $130.56 |
| 6030536 | SUPPLY IMPLANT | Supply/Implant | $1,389.44 |
| 6030538 | SUPPLY IMPLANT | Supply/Implant | $214.66 |
| 6030539 | STERILE SUPPLY | Supply/Implant | $130.56 |
| 6030541 | STERILE SUPPLY | Supply/Implant | $232.83 |
| 6030542 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6030543 | SUPPLY IMPLANT | Supply/Implant | $1,131.14 |
| 6030548 | SUPPLY IMPLANT | Supply/Implant | $649.92 |
| 6030551 | SUPPLY IMPLANT | Supply/Implant | $146.94 |
| 6030552 | SUPPLY IMPLANT | Supply/Implant | $5,090.69 |
| 6030556 | STERILE SUPPLY | Supply/Implant | $1,273.09 |
| 6030557 | STERILE SUPPLY | Supply/Implant | $705.66 |
| 6030561 | SUPPLY IMPLANT | Supply/Implant | $1,952.06 |
| 6030562 | GENERAL SUPPLY | Supply/Implant | $727.81 |
| 6030564 | STERILE SUPPLY | Supply/Implant | $887.80 |
| 6030571 | SUPPLY IMPLANT | Supply/Implant | $3,238.02 |
| 6030572 | SUPPLY IMPLANT | Supply/Implant | $2,368.68 |
| 6030575 | STERILE SUPPLY | Supply/Implant | $358.40 |
| 6030576 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030578 | SUPPLY IMPLANT | Supply/Implant | $686.46 |
| 6030582 | SUPPLY IMPLANT | Supply/Implant | $833.28 |
| 6030583 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030584 | SUPPLY IMPLANT | Supply/Implant | $174.72 |
| 6030585 | STERILE SUPPLY | Supply/Implant | $170.62 |
| 6030586 | SUPPLY IMPLANT | Supply/Implant | $682.62 |
| 6030587 | SUPPLY IMPLANT | Supply/Implant | $619.52 |
| 6030590 | SUPPLY IMPLANT | Supply/Implant | $1,517.82 |
| 6030592 | SUPPLY IMPLANT | Supply/Implant | $334.72 |
| 6030593 | SUPPLY IMPLANT | Supply/Implant | $302.08 |
| 6030598 | SUPPLY IMPLANT | Supply/Implant | $974.46 |
| 6030600 | STERILE SUPPLY | Supply/Implant | $364.16 |
| 6030602 | SUPPLY IMPLANT | Supply/Implant | $283.39 |
| 6030604 | GENERAL SUPPLY | Supply/Implant | $129.79 |
| 6030608 | GENERAL SUPPLY | Supply/Implant | $219.90 |
| 6030613 | SUPPLY IMPLANT | Supply/Implant | $5,249.66 |
| 6030615 | SUPPLY IMPLANT | Supply/Implant | $5,249.66 |
| 6030617 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030618 | SUPPLY IMPLANT | Supply/Implant | $316.80 |
| 6030619 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6030620 | GENERAL SUPPLY | Supply/Implant | $476.03 |
| 6030622 | SUPPLY IMPLANT | Supply/Implant | $2,916.10 |
| 6030624 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030626 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030627 | SUPPLY IMPLANT | Supply/Implant | $598.14 |
| 6030634 | SUPPLY IMPLANT | Supply/Implant | $2,522.34 |
| 6030637 | GENERAL SUPPLY | Supply/Implant | $801.66 |
| 6030639 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6030640 | SUPPLY IMPLANT | Supply/Implant | $2,922.11 |
| 6030643 | SUPPLY IMPLANT | Supply/Implant | $1,081.09 |
| 6030652 | SUPPLY IMPLANT | Supply/Implant | $241.41 |
| 6030653 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $189.95 |
| 6030656 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6030658 | SUPPLY IMPLANT | Supply/Implant | $737.41 |
| 6030661 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6030663 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,989.06 |
| 6030664 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6030665 | SUPPLY IMPLANT | Supply/Implant | $1,903.87 |
| 6030667 | STERILE SUPPLY | Supply/Implant | $1,079.33 |
| 6030668 | STERILE SUPPLY | Supply/Implant | $308.99 |
| 6030669 | SUPPLY IMPLANT | Supply/Implant | $444.42 |
| 6030681 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030682 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030683 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030684 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030686 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030687 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030688 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030690 | STERILE SUPPLY | Supply/Implant | $288.90 |
| 6030691 | GENERAL SUPPLY | Supply/Implant | $360.06 |
| 6030692 | SUPPLY IMPLANT | Supply/Implant | $2,316.80 |
| 6030693 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6030695 | SUPPLY IMPLANT | Supply/Implant | $5,126.66 |
| 6030701 | STERILE SUPPLY | Supply/Implant | $584.58 |
| 6030703 | CATHETER, GUIDING | Supply/Implant | $1,648.38 |
| 6030707 | SUPPLY IMPLANT | Supply/Implant | $8,585.47 |
| 6030709 | SUPPLY IMPLANT | Supply/Implant | $747.78 |
| 6030711 | GENERAL SUPPLY | Supply/Implant | $373.12 |
| 6030713 | SUPPLY IMPLANT | Supply/Implant | $1,881.60 |
| 6030714 | SUPPLY IMPLANT | Supply/Implant | $1,089.15 |
| 6030715 | SUPPLY IMPLANT | Supply/Implant | $2,283.01 |
| 6030716 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6030718 | SUPPLY IMPLANT | Supply/Implant | $1,243.52 |
| 6030721 | SUPPLY IMPLANT | Supply/Implant | $961.54 |
| 6030722 | SUPPLY IMPLANT | Supply/Implant | $4,560.00 |
| 6030724 | SUPPLY IMPLANT | Supply/Implant | $995.33 |
| 6030725 | STERILE SUPPLY | Supply/Implant | $382.59 |
| 6030730 | STERILE SUPPLY | Supply/Implant | $207.74 |
| 6030733 | SUPPLY IMPLANT | Supply/Implant | $316.88 |
| 6030734 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6030738 | SUPPLY IMPLANT | Supply/Implant | $199.30 |
| 6030739 | SUPPLY IMPLANT | Supply/Implant | $4,851.84 |
| 6030740 | SUPPLY IMPLANT | Supply/Implant | $1,404.54 |
| 6030742 | GENERAL SUPPLY | Supply/Implant | $308.99 |
| 6030746 | STERILE SUPPLY | Supply/Implant | $380.01 |
| 6030747 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6030748 | STERILE SUPPLY | Supply/Implant | $453.95 |
| 6030749 | GENERAL SUPPLY | Supply/Implant | $211.20 |
| 6030750 | SUPPLY IMPLANT | Supply/Implant | $1,434.37 |
| 6030751 | SUPPLY IMPLANT | Supply/Implant | $1,434.37 |
| 6030752 | SUPPLY IMPLANT | Supply/Implant | $361.34 |
| 6030752 | SUPPLY IMPLANT | Supply/Implant | $461.57 |
| 6030755 | STERILE SUPPLY | Supply/Implant | $158.21 |
| 6030756 | STERILE SUPPLY | Supply/Implant | $157.44 |
| 6030757 | GENERAL SUPPLY | Supply/Implant | $155.14 |
| 6030758 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6030759 | STERILE SUPPLY | Supply/Implant | $140.65 |
| 6030762 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6030763 | CATHETER, URETERAL | Supply/Implant | $162.15 |
| 6030764 | GENERAL SUPPLY | Supply/Implant | $711.68 |
| 6030766 | SUPPLY IMPLANT | Supply/Implant | $195.56 |
| 6030769 | STERILE SUPPLY | Supply/Implant | $482.82 |
| 6030772 | STERILE SUPPLY | Supply/Implant | $165.93 |
| 6030775 | GENERAL SUPPLY | Supply/Implant | $619.01 |
| 6030777 | SUPPLY IMPLANT | Supply/Implant | $393.60 |
| 6030778 | SUPPLY IMPLANT | Supply/Implant | $1,767.59 |
| 6030783 | STERILE SUPPLY | Supply/Implant | $262.66 |
| 6030784 | STERILE SUPPLY | Supply/Implant | $250.88 |
| 6030787 | SUPPLY IMPLANT | Supply/Implant | $160.90 |
| 6030792 | SUPPLY IMPLANT | Supply/Implant | $212.74 |
| 6030795 | SUPPLY IMPLANT | Supply/Implant | $1,079.96 |
| 6030802 | SUPPLY IMPLANT | Supply/Implant | $224.90 |
| 6030803 | SUPPLY IMPLANT | Supply/Implant | $154.62 |
| 6030804 | GENERAL SUPPLY | Supply/Implant | $751.87 |
| 6030805 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6030807 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,279.36 |
| 6030818 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6030820 | SUPPLY IMPLANT | Supply/Implant | $5,241.60 |
| 6030822 | SUPPLY IMPLANT | Supply/Implant | $799.62 |
| 6030832 | SUPPLY IMPLANT | Supply/Implant | $1,355.01 |
| 6030836 | SUPPLY IMPLANT | Supply/Implant | $1,434.37 |
| 6030839 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6030840 | STERILE SUPPLY | Supply/Implant | $229.95 |
| 6030857 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6030860 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6030861 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6030862 | GENERAL SUPPLY | Supply/Implant | $1,301.25 |
| 6030863 | STERILE SUPPLY | Supply/Implant | $681.34 |
| 6030872 | SUPPLY IMPLANT | Supply/Implant | $273.97 |
| 6030873 | SUPPLY IMPLANT | Supply/Implant | $273.97 |
| 6030874 | SUPPLY IMPLANT | Supply/Implant | $5,902.08 |
| 6030877 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6030878 | SUPPLY IMPLANT | Supply/Implant | $547.58 |
| 6030879 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6030883 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6030884 | SUPPLY IMPLANT | Supply/Implant | $541.31 |
| 6030900 | SUPPLY IMPLANT | Supply/Implant | $3,298.43 |
| 6030908 | GENERAL SUPPLY | Supply/Implant | $2,816.00 |
| 6030910 | SUPPLY IMPLANT | Supply/Implant | $3,047.63 |
| 6030913 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6030916 | SUPPLY IMPLANT | Supply/Implant | $258.56 |
| 6030918 | STERILE SUPPLY | Supply/Implant | $170.50 |
| 6030919 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $265.09 |
| 6030922 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $353.66 |
| 6030923 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $314.62 |
| 6030932 | GENERAL SUPPLY | Supply/Implant | $2,880.00 |
| 6030933 | SUPPLY IMPLANT | Supply/Implant | $258.56 |
| 6030935 | STERILE SUPPLY | Supply/Implant | $244.99 |
| 6030940 | GENERAL SUPPLY | Supply/Implant | $375.17 |
| 6030942 | CATHETER, URETERAL | Supply/Implant | $185.60 |
| 6030943 | CATHETER, URETERAL | Supply/Implant | $185.60 |
| 6030948 | SUPPLY IMPLANT | Supply/Implant | $9,369.60 |
| 6030949 | SUPPLY IMPLANT | Supply/Implant | $1,122.82 |
| 6030968 | STERILE SUPPLY | Supply/Implant | $5,132.16 |
| 6030970 | GENERAL SUPPLY | Supply/Implant | $608.26 |
| 6030973 | STERILE SUPPLY | Supply/Implant | $252.80 |
| 6030975 | SUPPLY IMPLANT | Supply/Implant | $4,098.05 |
| 6030976 | SUPPLY IMPLANT | Supply/Implant | $4,025.31 |
| 6030981 | STERILE SUPPLY | Supply/Implant | $248.06 |
| 6030985 | STERILE SUPPLY | Supply/Implant | $4,418.94 |
| 6030987 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6030992 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6030999 | INTRO/SHEATH, NON-LASER | Supply/Implant | $591.36 |
| 6031009 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6031011 | GENERAL SUPPLY | Supply/Implant | $152.55 |
| 6031015 | SUPPLY IMPLANT | Supply/Implant | $145.79 |
| 6031016 | SUPPLY IMPLANT | Supply/Implant | $169.22 |
| 6031018 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6031023 | SUPPLY IMPLANT | Supply/Implant | $1,033.34 |
| 6031024 | SUPPLY IMPLANT | Supply/Implant | $283.39 |
| 6031025 | CATHETER, URETERAL | Supply/Implant | $129.41 |
| 6031030 | SUPPLY IMPLANT | Supply/Implant | $374.14 |
| 6031031 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031032 | ADHESION BARRIER | Supply/Implant | $9,991.68 |
| 6031034 | GENERAL SUPPLY | Supply/Implant | $729.60 |
| 6031039 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031040 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031041 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031042 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031043 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031052 | SUPPLY IMPLANT | Supply/Implant | $6,170.11 |
| 6031062 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6031065 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6031070 | SUPPLY IMPLANT | Supply/Implant | $841.93 |
| 6031080 | SUPPLY IMPLANT | Supply/Implant | $7,456.00 |
| 6031082 | SUPPLY IMPLANT | Supply/Implant | $977.73 |
| 6031086 | STERILE SUPPLY | Supply/Implant | $574.67 |
| 6031087 | SUPPLY IMPLANT | Supply/Implant | $642.56 |
| 6031088 | SUPPLY IMPLANT | Supply/Implant | $1,058.23 |
| 6031089 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031093 | SUPPLY IMPLANT | Supply/Implant | $316.80 |
| 6031096 | SUPPLY IMPLANT | Supply/Implant | $619.52 |
| 6031098 | SUPPLY IMPLANT | Supply/Implant | $3,820.80 |
| 6031108 | GUIDE WIRE | Supply/Implant | $3,387.78 |
| 6031112 | STERILE SUPPLY | Supply/Implant | $656.19 |
| 6031114 | SUPPLY IMPLANT | Supply/Implant | $2,789.18 |
| 6031117 | STERILE SUPPLY | Supply/Implant | $214.34 |
| 6031118 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6031119 | GENERAL SUPPLY | Supply/Implant | $620.80 |
| 6031123 | STERILE SUPPLY | Supply/Implant | $422.40 |
| 6031126 | SUPPLY IMPLANT | Supply/Implant | $367.87 |
| 6031127 | SUPPLY IMPLANT | Supply/Implant | $166.57 |
| 6031128 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6031130 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6031132 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031135 | GENERAL SUPPLY | Supply/Implant | $1,024.00 |
| 6031136 | SUPPLY IMPLANT | Supply/Implant | $3,257.86 |
| 6031141 | SUPPLY IMPLANT | Supply/Implant | $572.03 |
| 6031143 | SUPPLY IMPLANT | Supply/Implant | $956.01 |
| 6031144 | SUPPLY IMPLANT | Supply/Implant | $1,839.10 |
| 6031149 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6031150 | SUPPLY IMPLANT | Supply/Implant | $5,738.66 |
| 6031155 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6031159 | STERILE SUPPLY | Supply/Implant | $134.14 |
| 6031168 | STERILE SUPPLY | Supply/Implant | $734.72 |
| 6031171 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6031172 | SUPPLY IMPLANT | Supply/Implant | $917.38 |
| 6031173 | SUPPLY IMPLANT | Supply/Implant | $128.00 |
| 6031175 | STERILE SUPPLY | Supply/Implant | $1,676.80 |
| 6031181 | STERILE SUPPLY | Supply/Implant | $156.54 |
| 6031184 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6031185 | STERILE SUPPLY | Supply/Implant | $972.42 |
| 6031190 | SUPPLY IMPLANT | Supply/Implant | $1,635.84 |
| 6031192 | SUPPLY IMPLANT | Supply/Implant | $1,653.06 |
| 6031195 | SUPPLY IMPLANT | Supply/Implant | $3,644.48 |
| 6031196 | SUPPLY IMPLANT | Supply/Implant | $2,655.36 |
| 6031198 | STERILE SUPPLY | Supply/Implant | $204.16 |
| 6031201 | SUPPLY IMPLANT | Supply/Implant | $1,202.05 |
| 6031205 | SUPPLY IMPLANT | Supply/Implant | $3,993.60 |
| 6031206 | SUPPLY IMPLANT | Supply/Implant | $4,070.40 |
| 6031207 | GENERAL SUPPLY | Supply/Implant | $217.97 |
| 6031208 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6031209 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6031210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6031211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6031212 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6031215 | SUPPLY IMPLANT | Supply/Implant | $904.96 |
| 6031219 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031225 | SUPPLY IMPLANT | Supply/Implant | $4,565.34 |
| 6031227 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6031228 | SUPPLY IMPLANT | Supply/Implant | $353.15 |
| 6031231 | STERILE SUPPLY | Supply/Implant | $357.12 |
| 6031234 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6031235 | GENERAL SUPPLY | Supply/Implant | $360.96 |
| 6031236 | GENERAL SUPPLY | Supply/Implant | $499.20 |
| 6031238 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $182.02 |
| 6031244 | GENERAL SUPPLY | Supply/Implant | $187.39 |
| 6031249 | STERILE SUPPLY | Supply/Implant | $273.97 |
| 6031251 | STERILE SUPPLY | Supply/Implant | $430.08 |
| 6031252 | SUPPLY IMPLANT | Supply/Implant | $50,585.60 |
| 6031253 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6031259 | STERILE SUPPLY | Supply/Implant | $150.18 |
| 6031263 | SUPPLY IMPLANT | Supply/Implant | $336.00 |
| 6031267 | GENERAL SUPPLY | Supply/Implant | $279.68 |
| 6031269 | SUPPLY IMPLANT | Supply/Implant | $7,677.06 |
| 6031272 | SUPPLY IMPLANT | Supply/Implant | $568.63 |
| 6031273 | SUPPLY IMPLANT | Supply/Implant | $568.63 |
| 6031274 | SUPPLY IMPLANT | Supply/Implant | $619.01 |
| 6031276 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,894.40 |
| 6031278 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,894.40 |
| 6031280 | SUPPLY IMPLANT | Supply/Implant | $1,753.60 |
| 6031283 | STERILE SUPPLY | Supply/Implant | $343.94 |
| 6031284 | LEAD, NEUROSTIMULATOR | Supply/Implant | $87,398.40 |
| 6031288 | SUPPLY IMPLANT | Supply/Implant | $1,434.11 |
| 6031289 | SUPPLY IMPLANT | Supply/Implant | $2,380.80 |
| 6031290 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6031291 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6031292 | STERILE SUPPLY | Supply/Implant | $984.52 |
| 6031297 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6031300 | STERILE SUPPLY | Supply/Implant | $193.15 |
| 6031302 | GENERAL SUPPLY | Supply/Implant | $1,164.80 |
| 6031303 | SUPPLY IMPLANT | Supply/Implant | $1,587.20 |
| 6031305 | SUPPLY IMPLANT | Supply/Implant | $445.18 |
| 6031307 | SUPPLY IMPLANT | Supply/Implant | $4,318.34 |
| 6031310 | STERILE SUPPLY | Supply/Implant | $172.29 |
| 6031312 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6031318 | STERILE SUPPLY | Supply/Implant | $756.61 |
| 6031320 | STERILE SUPPLY | Supply/Implant | $976.90 |
| 6031321 | SUPPLY IMPLANT | Supply/Implant | $2,736.64 |
| 6031322 | SUPPLY IMPLANT | Supply/Implant | $6,715.90 |
| 6031325 | SUPPLY IMPLANT | Supply/Implant | $3,233.82 |
| 6031339 | SUPPLY IMPLANT | Supply/Implant | $938.62 |
| 6031344 | GENERAL SUPPLY | Supply/Implant | $364.80 |
| 6031348 | SUPPLY IMPLANT | Supply/Implant | $1,196.93 |
| 6031351 | SUPPLY IMPLANT | Supply/Implant | $1,931.01 |
| 6031353 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6031354 | SUPPLY IMPLANT | Supply/Implant | $5,735.42 |
| 6031355 | SUPPLY IMPLANT | Supply/Implant | $649.98 |
| 6031358 | SUPPLY IMPLANT | Supply/Implant | $863.74 |
| 6031359 | SUPPLY IMPLANT | Supply/Implant | $710.14 |
| 6031360 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6031361 | SUPPLY IMPLANT | Supply/Implant | $1,587.20 |
| 6031368 | GENERAL SUPPLY | Supply/Implant | $1,344.00 |
| 6031372 | SUPPLY IMPLANT | Supply/Implant | $668.42 |
| 6031373 | SUPPLY IMPLANT | Supply/Implant | $1,178.75 |
| 6031376 | SUPPLY IMPLANT | Supply/Implant | $1,405.57 |
| 6031382 | SUPPLY IMPLANT | Supply/Implant | $297.60 |
| 6031385 | SUPPLY IMPLANT | Supply/Implant | $338.39 |
| 6031387 | STERILE SUPPLY | Supply/Implant | $281.60 |
| 6031388 | GENERAL SUPPLY | Supply/Implant | $564.22 |
| 6031391 | SUPPLY IMPLANT | Supply/Implant | $146.48 |
| 6031391 | SUPPLY IMPLANT | Supply/Implant | $149.58 |
| 6031393 | STERILE SUPPLY | Supply/Implant | $456.06 |
| 6031396 | SUPPLY IMPLANT | Supply/Implant | $188.42 |
| 6031398 | SUPPLY IMPLANT | Supply/Implant | $1,375.00 |
| 6031399 | STERILE SUPPLY | Supply/Implant | $214.66 |
| 6031401 | SUPPLY IMPLANT | Supply/Implant | $336.13 |
| 6031402 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6031409 | SUPPLY IMPLANT | Supply/Implant | $809.86 |
| 6031414 | SUPPLY IMPLANT | Supply/Implant | $135.81 |
| 6031415 | SUPPLY IMPLANT | Supply/Implant | $4,642.56 |
| 6031417 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,881.54 |
| 6031418 | STERILE SUPPLY | Supply/Implant | $493.95 |
| 6031419 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6031421 | SUPPLY IMPLANT | Supply/Implant | $302.08 |
| 6031422 | SUPPLY IMPLANT | Supply/Implant | $719.87 |
| 6031424 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6031426 | SUPPLY IMPLANT | Supply/Implant | $2,590.08 |
| 6031429 | STERILE SUPPLY | Supply/Implant | $303.36 |
| 6031433 | STERILE SUPPLY | Supply/Implant | $1,408.00 |
| 6031437 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6031438 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6031441 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6031442 | STERILE SUPPLY | Supply/Implant | $1,943.42 |
| 6031443 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $29,440.00 |
| 6031444 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $34,560.00 |
| 6031445 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6031446 | STERILE SUPPLY | Supply/Implant | $691.20 |
| 6031452 | SUPPLY IMPLANT | Supply/Implant | $5,165.44 |
| 6031453 | SUPPLY IMPLANT | Supply/Implant | $5,165.44 |
| 6031454 | SUPPLY IMPLANT | Supply/Implant | $2,378.11 |
| 6031456 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $6,813.76 |
| 6031463 | SUPPLY IMPLANT | Supply/Implant | $1,653.50 |
| 6031467 | SUPPLY IMPLANT | Supply/Implant | $1,095.33 |
| 6031468 | SUPPLY IMPLANT | Supply/Implant | $584.17 |
| 6031471 | SUPPLY IMPLANT | Supply/Implant | $4,984.96 |
| 6031482 | SUPPLY IMPLANT | Supply/Implant | $11,175.91 |
| 6031483 | SUPPLY IMPLANT | Supply/Implant | $10,476.06 |
| 6031494 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6031497 | STERILE SUPPLY | Supply/Implant | $293.25 |
| 6031500 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6031506 | STERILE SUPPLY | Supply/Implant | $550.40 |
| 6031510 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6031511 | SUPPLY IMPLANT | Supply/Implant | $5,067.01 |
| 6031512 | STERILE SUPPLY | Supply/Implant | $145.15 |
| 6031513 | GENERAL DRUG | Supply/Implant | $893.44 |
| 6031515 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,350.40 |
| 6031520 | STERILE SUPPLY | Supply/Implant | $761.34 |
| 6031524 | STERILE SUPPLY | Supply/Implant | $257.15 |
| 6031531 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6031536 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6031539 | SUPPLY IMPLANT | Supply/Implant | $606.67 |
| 6031545 | STERILE SUPPLY | Supply/Implant | $627.84 |
| 6031550 | CATHETER, URETERAL | Supply/Implant | $240.00 |
| 6031558 | SUPPLY IMPLANT | Supply/Implant | $158.46 |
| 6031559 | SUPPLY IMPLANT | Supply/Implant | $158.46 |
| 6031560 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6031566 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6031568 | CATHETER, URETERAL | Supply/Implant | $137.73 |
| 6031572 | SUPPLY IMPLANT | Supply/Implant | $1,551.36 |
| 6031573 | SUPPLY IMPLANT | Supply/Implant | $1,551.36 |
| 6031575 | GENERAL SUPPLY | Supply/Implant | $183.42 |
| 6031576 | SUPPLY IMPLANT | Supply/Implant | $2,019.58 |
| 6031580 | SUPPLY IMPLANT | Supply/Implant | $595.58 |
| 6031588 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6031592 | SUPPLY IMPLANT | Supply/Implant | $4,328.19 |
| 6031593 | SUPPLY IMPLANT | Supply/Implant | $4,328.19 |
| 6031601 | SUPPLY IMPLANT | Supply/Implant | $11,888.68 |
| 6031602 | SUPPLY IMPLANT | Supply/Implant | $267.65 |
| 6031605 | SUPPLY IMPLANT | Supply/Implant | $1,957.76 |
| 6031606 | MESH (IMPLANTABLE) | Supply/Implant | $2,086.40 |
| 6031608 | STERILE SUPPLY | Supply/Implant | $312.54 |
| 6031609 | GENERAL SUPPLY | Supply/Implant | $137.34 |
| 6031610 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6031613 | SUPPLY IMPLANT | Supply/Implant | $1,142.78 |
| 6031620 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6031622 | SUPPLY IMPLANT | Supply/Implant | $384.03 |
| 6031624 | STERILE SUPPLY | Supply/Implant | $530.66 |
| 6031627 | STERILE SUPPLY | Supply/Implant | $219.39 |
| 6031628 | SUPPLY IMPLANT | Supply/Implant | $2,252.80 |
| 6031630 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6031631 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6031639 | GENERAL SUPPLY | Supply/Implant | $524.80 |
| 6031641 | SUPPLY IMPLANT | Supply/Implant | $405.38 |
| 6031644 | STERILE SUPPLY | Supply/Implant | $537.60 |
| 6031647 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6031652 | SUPPLY IMPLANT | Supply/Implant | $954.24 |
| 6031654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6031655 | SUPPLY IMPLANT | Supply/Implant | $5,165.44 |
| 6031663 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6031666 | PROS, URINARY SPH, IMP | Supply/Implant | $74,967.04 |
| 6031668 | STERILE SUPPLY | Supply/Implant | $198.91 |
| 6031669 | MESH (IMPLANTABLE) | Supply/Implant | $4,809.09 |
| 6031670 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6031671 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6031672 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6031676 | GENERAL SUPPLY | Supply/Implant | $1,834.88 |
| 6031677 | SUPPLY IMPLANT | Supply/Implant | $322.94 |
| 6031678 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6031680 | STERILE SUPPLY | Supply/Implant | $284.67 |
| 6031685 | SUPPLY IMPLANT | Supply/Implant | $782.08 |
| 6031686 | STERILE SUPPLY | Supply/Implant | $883.20 |
| 6031691 | CATHETER, URETERAL | Supply/Implant | $308.19 |
| 6031692 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6031696 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6031697 | SUPPLY IMPLANT | Supply/Implant | $2,799.74 |
| 6031701 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6031703 | STERILE SUPPLY | Supply/Implant | $259.56 |
| 6031706 | STERILE SUPPLY | Supply/Implant | $5,789.44 |
| 6031707 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6031711 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6031712 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6031713 | SUPPLY IMPLANT | Supply/Implant | $322.56 |
| 6031722 | SUPPLY IMPLANT | Supply/Implant | $441.98 |
| 6031724 | SUPPLY IMPLANT | Supply/Implant | $2,199.17 |
| 6031725 | SUPPLY IMPLANT | Supply/Implant | $2,844.16 |
| 6031726 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6031728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6031729 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6031730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6031737 | SUPPLY IMPLANT | Supply/Implant | $2,188.54 |
| 6031738 | SUPPLY IMPLANT | Supply/Implant | $2,124.80 |
| 6031739 | SUPPLY IMPLANT | Supply/Implant | $2,503.94 |
| 6031742 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6031753 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6031759 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6031762 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,520.00 |
| 6031768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6031769 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6031770 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6031772 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6031775 | SUPPLY IMPLANT | Supply/Implant | $11,992.19 |
| 6031776 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6031779 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6031780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,915.20 |
| 6031787 | SUPPLY IMPLANT | Supply/Implant | $6,921.60 |
| 6031795 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6031797 | SUPPLY IMPLANT | Supply/Implant | $323.20 |
| 6031803 | SUPPLY IMPLANT | Supply/Implant | $2,992.79 |
| 6031805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $947.20 |
| 6031807 | SUPPLY IMPLANT | Supply/Implant | $313.60 |
| 6031808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6031809 | SUPPLY IMPLANT | Supply/Implant | $3,697.02 |
| 6031810 | SUPPLY IMPLANT | Supply/Implant | $314.24 |
| 6031811 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6031812 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6031813 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6031814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6031815 | SUPPLY IMPLANT | Supply/Implant | $67,840.00 |
| 6031816 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6031817 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6031820 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6031821 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6031822 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6031826 | SUPPLY IMPLANT | Supply/Implant | $7,028.74 |
| 6031829 | SUPPLY IMPLANT | Supply/Implant | $672.13 |
| 6031841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6031844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,563.20 |
| 6031845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,732.80 |
| 6031848 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6031849 | SUPPLY IMPLANT | Supply/Implant | $1,042.05 |
| 6031852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6031853 | SUPPLY IMPLANT | Supply/Implant | $28,655.49 |
| 6031858 | SUPPLY IMPLANT | Supply/Implant | $940.80 |
| 6031859 | SUPPLY IMPLANT | Supply/Implant | $590.59 |
| 6031862 | SUPPLY IMPLANT | Supply/Implant | $20,106.75 |
| 6031866 | GENERAL SUPPLY | Supply/Implant | $468.35 |
| 6031867 | SUPPLY IMPLANT | Supply/Implant | $13,104.90 |
| 6031868 | SUPPLY IMPLANT | Supply/Implant | $14,090.37 |
| 6031877 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6031878 | STERILE SUPPLY | Supply/Implant | $206.98 |
| 6031879 | GENERAL SUPPLY | Supply/Implant | $277.63 |
| 6031880 | SUPPLY IMPLANT | Supply/Implant | $270.08 |
| 6031882 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6031886 | SUPPLY IMPLANT | Supply/Implant | $226.05 |
| 6031888 | SUPPLY IMPLANT | Supply/Implant | $1,256.81 |
| 6031890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6031891 | SUPPLY IMPLANT | Supply/Implant | $632.70 |
| 6031897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6031899 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,169.60 |
| 6031900 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,520.00 |
| 6031901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,664.00 |
| 6031905 | STERILE SUPPLY | Supply/Implant | $1,671.68 |
| 6031907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6031909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,993.60 |
| 6031913 | GUIDE WIRE | Supply/Implant | $1,331.20 |
| 6031916 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6031920 | SUPPLY IMPLANT | Supply/Implant | $317.44 |
| 6031921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6031922 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6031926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6031927 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6031931 | SUPPLY IMPLANT | Supply/Implant | $317.44 |
| 6031932 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6031935 | SUPPLY IMPLANT | Supply/Implant | $591.26 |
| 6031936 | SUPPLY IMPLANT | Supply/Implant | $591.26 |
| 6031937 | SUPPLY IMPLANT | Supply/Implant | $548.48 |
| 6031939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,643.14 |
| 6031940 | SUPPLY IMPLANT | Supply/Implant | $570.88 |
| 6031942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6031944 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6031945 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6031949 | SUPPLY IMPLANT | Supply/Implant | $13,184.00 |
| 6031958 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6031960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6031968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6031970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6031971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6031978 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6031981 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,977.60 |
| 6031986 | SUPPLY IMPLANT | Supply/Implant | $362.88 |
| 6031988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6031989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6031992 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $627.20 |
| 6031993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6031994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $632.32 |
| 6032002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6032003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6032004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6032006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6032018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6032020 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6032024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6032025 | SUPPLY IMPLANT | Supply/Implant | $524.54 |
| 6032026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6032027 | SUPPLY IMPLANT | Supply/Implant | $4,544.00 |
| 6032029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,614.40 |
| 6032032 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6032033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,977.60 |
| 6032035 | SUPPLY IMPLANT | Supply/Implant | $11,233.02 |
| 6032041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,682.37 |
| 6032043 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032046 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6032048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6032050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032058 | SUPPLY IMPLANT | Supply/Implant | $19,111.55 |
| 6032059 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6032060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6032068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6032069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6032073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,932.80 |
| 6032074 | SUPPLY IMPLANT | Supply/Implant | $1,932.80 |
| 6032076 | STERILE SUPPLY | Supply/Implant | $518.40 |
| 6032077 | STERILE SUPPLY | Supply/Implant | $518.40 |
| 6032078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6032086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $825.60 |
| 6032091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6032092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6032112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032118 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6032120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,105.92 |
| 6032124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,454.08 |
| 6032125 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032126 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6032130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032135 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6032138 | STERILE SUPPLY | Supply/Implant | $213.12 |
| 6032143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032145 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6032152 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6032162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6032165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,561.60 |
| 6032167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,878.40 |
| 6032168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6032171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032172 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6032173 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6032174 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6032175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6032184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,925.50 |
| 6032185 | STERILE SUPPLY | Supply/Implant | $486.40 |
| 6032189 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6032195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,105.92 |
| 6032197 | STERILE SUPPLY | Supply/Implant | $15,360.00 |
| 6032203 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6032208 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6032212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,150.40 |
| 6032219 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6032220 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6032224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,028.80 |
| 6032227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6032228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6032229 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6032240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6032242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6032245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,499.84 |
| 6032246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6032250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6032253 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6032254 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6032258 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6032259 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6032260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,924.74 |
| 6032261 | GUIDE WIRE | Supply/Implant | $669.57 |
| 6032266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $517.12 |
| 6032267 | SUPPLY IMPLANT | Supply/Implant | $779.60 |
| 6032268 | SUPPLY IMPLANT | Supply/Implant | $852.56 |
| 6032271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032272 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,377.60 |
| 6032284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6032285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032288 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6032289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6032293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032299 | SUPPLY IMPLANT | Supply/Implant | $8,534.40 |
| 6032300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,984.64 |
| 6032310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032312 | GENERAL SUPPLY | Supply/Implant | $3,686.40 |
| 6032313 | GENERAL SUPPLY | Supply/Implant | $3,955.20 |
| 6032319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032329 | SUPPLY IMPLANT | Supply/Implant | $5,977.60 |
| 6032334 | SUPPLY IMPLANT | Supply/Implant | $3,697.02 |
| 6032343 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6032344 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6032345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6032346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032347 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6032348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032350 | STERILE SUPPLY | Supply/Implant | $529.92 |
| 6032353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,089.60 |
| 6032354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032357 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6032365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6032369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6032382 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6032384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6032389 | SUPPLY IMPLANT | Supply/Implant | $52,838.40 |
| 6032397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6032402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6032406 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6032407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6032408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,030.40 |
| 6032410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6032415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6032416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6032417 | SUPPLY IMPLANT | Supply/Implant | $4,218.88 |
| 6032418 | GUIDE WIRE | Supply/Implant | $407.81 |
| 6032419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6032426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6032427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6032429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6032430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6032431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6032432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,089.60 |
| 6032433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6032435 | GENERAL SUPPLY | Supply/Implant | $148.48 |
| 6032438 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $762.62 |
| 6032439 | GENERAL SUPPLY | Supply/Implant | $275.46 |
| 6032442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032461 | SUPPLY IMPLANT | Supply/Implant | $2,214.40 |
| 6032466 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6032468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6032470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032478 | GENERAL SUPPLY | Supply/Implant | $130.56 |
| 6032480 | SUPPLY IMPLANT | Supply/Implant | $373.63 |
| 6032484 | GENERAL SUPPLY | Supply/Implant | $151.68 |
| 6032496 | STERILE SUPPLY | Supply/Implant | $172.03 |
| 6032500 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,043.20 |
| 6032501 | GENERAL SUPPLY | Supply/Implant | $138.24 |
| 6032512 | GENERAL SUPPLY | Supply/Implant | $819.20 |
| 6032515 | SUPPLY IMPLANT | Supply/Implant | $533.12 |
| 6032518 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6032522 | SUPPLY IMPLANT | Supply/Implant | $633.98 |
| 6032523 | SUPPLY IMPLANT | Supply/Implant | $150.53 |
| 6032524 | SUPPLY IMPLANT | Supply/Implant | $146.18 |
| 6032525 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6032529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,643.14 |
| 6032541 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $190.59 |
| 6032544 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6032549 | STERILE SUPPLY | Supply/Implant | $210.94 |
| 6032554 | SUPPLY IMPLANT | Supply/Implant | $2,232.83 |
| 6032556 | STERILE SUPPLY | Supply/Implant | $217.47 |
| 6032561 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6032563 | STERILE SUPPLY | Supply/Implant | $962.30 |
| 6032568 | SUPPLY IMPLANT | Supply/Implant | $1,931.01 |
| 6032569 | STERILE SUPPLY | Supply/Implant | $252.42 |
| 6032571 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6032572 | STERILE SUPPLY | Supply/Implant | $148.48 |
| 6032574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $315.01 |
| 6032579 | STERILE SUPPLY | Supply/Implant | $824.06 |
| 6032582 | STERILE SUPPLY | Supply/Implant | $499.07 |
| 6032583 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6032587 | SUPPLY IMPLANT | Supply/Implant | $2,151.68 |
| 6032592 | STERILE SUPPLY | Supply/Implant | $203.19 |
| 6032593 | GENERAL SUPPLY | Supply/Implant | $254.34 |
| 6032596 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6032597 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6032598 | STERILE SUPPLY | Supply/Implant | $199.26 |
| 6032600 | STERILE SUPPLY | Supply/Implant | $130.05 |
| 6032603 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6032604 | STERILE SUPPLY | Supply/Implant | $380.16 |
| 6032608 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6032611 | SUPPLY IMPLANT | Supply/Implant | $489.09 |
| 6032616 | SUPPLY IMPLANT | Supply/Implant | $6,921.60 |
| 6032617 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6032620 | SUPPLY IMPLANT | Supply/Implant | $836.48 |
| 6032624 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6032626 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6032633 | SUPPLY IMPLANT | Supply/Implant | $440.83 |
| 6032635 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6032636 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6032641 | SUPPLY IMPLANT | Supply/Implant | $1,795.20 |
| 6032644 | GUIDE WIRE | Supply/Implant | $2,841.60 |
| 6032646 | SUPPLY IMPLANT | Supply/Implant | $1,161.60 |
| 6032647 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6032652 | SUPPLY IMPLANT | Supply/Implant | $165.76 |
| 6032658 | STERILE SUPPLY | Supply/Implant | $636.80 |
| 6032659 | STERILE SUPPLY | Supply/Implant | $414.98 |
| 6032661 | SUPPLY IMPLANT | Supply/Implant | $1,363.58 |
| 6032662 | SUPPLY IMPLANT | Supply/Implant | $1,074.69 |
| 6032665 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6032667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6032669 | STERILE SUPPLY | Supply/Implant | $221.25 |
| 6032675 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6032676 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032677 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032678 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032679 | STERILE SUPPLY | Supply/Implant | $330.75 |
| 6032680 | SUPPLY IMPLANT | Supply/Implant | $1,074.69 |
| 6032683 | GUIDE WIRE | Supply/Implant | $1,267.20 |
| 6032688 | SUPPLY IMPLANT | Supply/Implant | $4,825.60 |
| 6032690 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6032692 | SUPPLY IMPLANT | Supply/Implant | $1,886.72 |
| 6032693 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6032695 | STERILE SUPPLY | Supply/Implant | $297.42 |
| 6032696 | SUPPLY IMPLANT | Supply/Implant | $445.18 |
| 6032697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032699 | SUPPLY IMPLANT | Supply/Implant | $633.47 |
| 6032704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032706 | STERILE SUPPLY | Supply/Implant | $215.81 |
| 6032707 | STERILE SUPPLY | Supply/Implant | $224.00 |
| 6032713 | SUPPLY IMPLANT | Supply/Implant | $713.60 |
| 6032717 | SUPPLY IMPLANT | Supply/Implant | $391.68 |
| 6032719 | STERILE SUPPLY | Supply/Implant | $4,088.90 |
| 6032720 | SUPPLY IMPLANT | Supply/Implant | $5,437.44 |
| 6032721 | SUPPLY IMPLANT | Supply/Implant | $426.75 |
| 6032722 | STERILE SUPPLY | Supply/Implant | $1,774.08 |
| 6032726 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6032729 | SUPPLY IMPLANT | Supply/Implant | $6,514.43 |
| 6032733 | STERILE SUPPLY | Supply/Implant | $200.32 |
| 6032737 | STERILE SUPPLY | Supply/Implant | $195.84 |
| 6032743 | SUPPLY IMPLANT | Supply/Implant | $815.81 |
| 6032744 | SUPPLY IMPLANT | Supply/Implant | $524.54 |
| 6032745 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6032753 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6032754 | SUPPLY IMPLANT | Supply/Implant | $1,167.36 |
| 6032761 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6032763 | SUPPLY IMPLANT | Supply/Implant | $1,237.34 |
| 6032764 | SUPPLY IMPLANT | Supply/Implant | $1,105.92 |
| 6032766 | SUPPLY IMPLANT | Supply/Implant | $2,188.80 |
| 6032767 | STERILE SUPPLY | Supply/Implant | $435.20 |
| 6032770 | STERILE SUPPLY | Supply/Implant | $3,915.52 |
| 6032772 | SUPPLY IMPLANT | Supply/Implant | $398.08 |
| 6032775 | STERILE SUPPLY | Supply/Implant | $514.18 |
| 6032776 | STERILE SUPPLY | Supply/Implant | $830.98 |
| 6032778 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6032780 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6032781 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6032783 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6032790 | STERILE SUPPLY | Supply/Implant | $274.94 |
| 6032798 | SUPPLY IMPLANT | Supply/Implant | $5,312.00 |
| 6032813 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6032814 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6032815 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6032816 | GENERAL SUPPLY | Supply/Implant | $137.60 |
| 6032817 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6032822 | STERILE SUPPLY | Supply/Implant | $1,026.56 |
| 6032824 | STERILE SUPPLY | Supply/Implant | $415.49 |
| 6032825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6032826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,825.60 |
| 6032828 | GUIDE WIRE | Supply/Implant | $947.20 |
| 6032829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,073.60 |
| 6032832 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6032836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,225.60 |
| 6032838 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $675.33 |
| 6032839 | GENERAL SUPPLY | Supply/Implant | $355.71 |
| 6032840 | GENERAL SUPPLY | Supply/Implant | $346.62 |
| 6032843 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6032849 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6032853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,399.04 |
| 6032854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6032861 | SUPPLY IMPLANT | Supply/Implant | $175.62 |
| 6032863 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032873 | STERILE SUPPLY | Supply/Implant | $1,023.36 |
| 6032895 | STERILE SUPPLY | Supply/Implant | $216.97 |
| 6032903 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $672.38 |
| 6032904 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $683.26 |
| 6032905 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $233.60 |
| 6032909 | SUPPLY IMPLANT | Supply/Implant | $1,186.56 |
| 6032910 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6032911 | SUPPLY IMPLANT | Supply/Implant | $737.79 |
| 6032912 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6032916 | STERILE SUPPLY | Supply/Implant | $1,144.32 |
| 6032918 | SUPPLY IMPLANT | Supply/Implant | $4,185.60 |
| 6032924 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $270.08 |
| 6032925 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $270.08 |
| 6032932 | STERILE SUPPLY | Supply/Implant | $428.99 |
| 6032934 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $670.85 |
| 6032939 | SUPPLY IMPLANT | Supply/Implant | $6,537.60 |
| 6032941 | SUPPLY IMPLANT | Supply/Implant | $1,128.70 |
| 6032942 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6032944 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6032950 | STERILE SUPPLY | Supply/Implant | $1,732.01 |
| 6032951 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6032953 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6032956 | STERILE SUPPLY | Supply/Implant | $429.76 |
| 6032975 | STERILE SUPPLY | Supply/Implant | $476.66 |
| 6032976 | STERILE SUPPLY | Supply/Implant | $452.86 |
| 6032981 | SUPPLY IMPLANT | Supply/Implant | $291.33 |
| 6032982 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6033008 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6033009 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6033010 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6033011 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6033014 | GENERAL SUPPLY | Supply/Implant | $574.85 |
| 6033015 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6033016 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6033021 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6033023 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6033025 | STERILE SUPPLY | Supply/Implant | $147.20 |
| 6033026 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6033027 | SUPPLY IMPLANT | Supply/Implant | $437.76 |
| 6033031 | STERILE SUPPLY | Supply/Implant | $276.35 |
| 6033032 | STERILE SUPPLY | Supply/Implant | $301.16 |
| 6033033 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6033043 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6033053 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6033055 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,132.80 |
| 6033056 | SUPPLY IMPLANT | Supply/Implant | $1,082.75 |
| 6033063 | STERILE SUPPLY | Supply/Implant | $852.56 |
| 6033067 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6033070 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6033073 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6033089 | SUPPLY IMPLANT | Supply/Implant | $3,338.88 |
| 6033097 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6033103 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6033105 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6033106 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6033107 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6033108 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6033109 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6033112 | SUPPLY IMPLANT | Supply/Implant | $230.40 |
| 6033113 | SUPPLY IMPLANT | Supply/Implant | $5,080.19 |
| 6033116 | GENERAL SUPPLY | Supply/Implant | $515.71 |
| 6033118 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6033133 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6033138 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6033139 | GUIDE WIRE | Supply/Implant | $512.00 |
| 6033140 | GUIDE WIRE | Supply/Implant | $512.00 |
| 6033146 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6033157 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6033163 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6033164 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6033181 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6033185 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6033188 | GRAFT, VASCULAR | Supply/Implant | $11,061.12 |
| 6033189 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033214 | SUPPLY IMPLANT | Supply/Implant | $2,181.12 |
| 6033215 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,772.48 |
| 6033232 | SUPPLY IMPLANT | Supply/Implant | $12,172.80 |
| 6033237 | SUPPLY IMPLANT | Supply/Implant | $14,374.40 |
| 6033240 | SUPPLY IMPLANT | Supply/Implant | $4,736.00 |
| 6033241 | SUPPLY IMPLANT | Supply/Implant | $4,736.00 |
| 6033247 | SUPPLY IMPLANT | Supply/Implant | $11,303.04 |
| 6033248 | GRAFT, VASCULAR | Supply/Implant | $11,303.04 |
| 6033249 | GRAFT, VASCULAR | Supply/Implant | $11,303.04 |
| 6033250 | GRAFT, VASCULAR | Supply/Implant | $11,057.79 |
| 6033251 | GRAFT, VASCULAR | Supply/Implant | $8,079.36 |
| 6033252 | GRAFT, VASCULAR | Supply/Implant | $9,009.15 |
| 6033255 | GRAFT, VASCULAR | Supply/Implant | $8,646.02 |
| 6033256 | GRAFT, VASCULAR | Supply/Implant | $8,983.68 |
| 6033264 | SUPPLY IMPLANT | Supply/Implant | $8,669.06 |
| 6033266 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033267 | GRAFT, VASCULAR | Supply/Implant | $6,361.60 |
| 6033271 | GRAFT, VASCULAR | Supply/Implant | $21,580.80 |
| 6033273 | GRAFT, VASCULAR | Supply/Implant | $5,286.40 |
| 6033281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6033282 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $38,182.40 |
| 6033283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,430.40 |
| 6033301 | SUPPLY IMPLANT | Supply/Implant | $7,232.00 |
| 6033302 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6033303 | SUPPLY IMPLANT | Supply/Implant | $3,975.04 |
| 6033304 | SUPPLY IMPLANT | Supply/Implant | $6,048.64 |
| 6033306 | SUPPLY IMPLANT | Supply/Implant | $8,396.80 |
| 6033307 | SUPPLY IMPLANT | Supply/Implant | $12,979.20 |
| 6033308 | SUPPLY IMPLANT | Supply/Implant | $1,356.67 |
| 6033309 | SUPPLY IMPLANT | Supply/Implant | $15,991.94 |
| 6033312 | SUPPLY IMPLANT | Supply/Implant | $4,338.56 |
| 6033314 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6033315 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6033320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6033329 | GRAFT, VASCULAR | Supply/Implant | $20,851.20 |
| 6033330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033332 | GRAFT, VASCULAR | Supply/Implant | $17,766.40 |
| 6033334 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6033335 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033357 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $427.14 |
| 6033372 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,464.00 |
| 6033374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6033386 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6033392 | SUPPLY IMPLANT | Supply/Implant | $522.50 |
| 6033393 | SUPPLY IMPLANT | Supply/Implant | $37,854.59 |
| 6033407 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,959.55 |
| 6033408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,959.55 |
| 6033412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,394.05 |
| 6033430 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033431 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033432 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033436 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6033437 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6033438 | SUPPLY IMPLANT | Supply/Implant | $1,316.99 |
| 6033448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6033450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6033452 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6033453 | ALLODERM SKIN SUB | Supply/Implant | $2,956.80 |
| 6033454 | GRAFT, VASCULAR | Supply/Implant | $2,136.96 |
| 6033457 | SUPPLY IMPLANT | Supply/Implant | $3,829.34 |
| 6033464 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $17,827.84 |
| 6033468 | SUPPLY IMPLANT | Supply/Implant | $2,377.47 |
| 6033469 | SUPPLY IMPLANT | Supply/Implant | $4,764.29 |
| 6033470 | SUPPLY IMPLANT | Supply/Implant | $1,638.02 |
| 6033472 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033473 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033474 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033475 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6033491 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033492 | SUPPLY IMPLANT | Supply/Implant | $56,960.00 |
| 6033493 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033495 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033496 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033497 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033498 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033499 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033508 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6033512 | SUPPLY IMPLANT | Supply/Implant | $3,597.70 |
| 6033513 | SUPPLY IMPLANT | Supply/Implant | $2,461.22 |
| 6033514 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $17,827.84 |
| 6033525 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033526 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033527 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033528 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033529 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033530 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033531 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6033536 | SUPPLY IMPLANT | Supply/Implant | $17,864.70 |
| 6033547 | SUPPLY IMPLANT | Supply/Implant | $10,897.92 |
| 6033548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6033551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $898.56 |
| 6033552 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6033563 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6033577 | SUPPLY IMPLANT | Supply/Implant | $3,829.38 |
| 6033578 | SUPPLY IMPLANT | Supply/Implant | $3,829.38 |
| 6033579 | SUPPLY IMPLANT | Supply/Implant | $3,829.38 |
| 6033582 | SUPPLY IMPLANT | Supply/Implant | $6,553.60 |
| 6033586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $124,225.50 |
| 6033601 | SUPPLY IMPLANT | Supply/Implant | $1,770.11 |
| 6033603 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6033604 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6033605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6033606 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6033607 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6033611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6033612 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033613 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033614 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033615 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033616 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033617 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6033619 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6033620 | SUPPLY IMPLANT | Supply/Implant | $47,020.80 |
| 6033621 | SUPPLY IMPLANT | Supply/Implant | $47,020.80 |
| 6033639 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6033643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,176.70 |
| 6033644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,311.10 |
| 6033646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,020.80 |
| 6033652 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6033657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,750.40 |
| 6033658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,755.20 |
| 6033659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,851.20 |
| 6033660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,555.20 |
| 6033662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,158.40 |
| 6033669 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6033672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6033674 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6033678 | GUIDE WIRE | Supply/Implant | $2,931.20 |
| 6033681 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033688 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,770.30 |
| 6033689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,610.43 |
| 6033690 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,822.59 |
| 6033693 | SUPPLY IMPLANT | Supply/Implant | $2,108.93 |
| 6033702 | SUPPLY IMPLANT | Supply/Implant | $7,180.80 |
| 6033703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6033704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6033706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,090.37 |
| 6033707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,964.48 |
| 6033708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,390.34 |
| 6033710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,381.70 |
| 6033712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,031.04 |
| 6033714 | SUPPLY IMPLANT | Supply/Implant | $5,427.20 |
| 6033716 | SUPPLY IMPLANT | Supply/Implant | $11,635.20 |
| 6033735 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6033736 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,341.44 |
| 6033738 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,407.17 |
| 6033743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,364.42 |
| 6033745 | SUPPLY IMPLANT | Supply/Implant | $5,319.55 |
| 6033746 | SUPPLY IMPLANT | Supply/Implant | $40,320.00 |
| 6033751 | GRAFT, VASCULAR | Supply/Implant | $4,428.80 |
| 6033752 | SUPPLY IMPLANT | Supply/Implant | $883.20 |
| 6033764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6033765 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,395.26 |
| 6033766 | SUPPLY IMPLANT | Supply/Implant | $18,395.26 |
| 6033779 | GRAFT, VASCULAR | Supply/Implant | $6,361.60 |
| 6033780 | SUPPLY IMPLANT | Supply/Implant | $5,280.77 |
| 6033782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,920.00 |
| 6033793 | INTRO/SHEATH, NON-LASER | Supply/Implant | $658.69 |
| 6033794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,411.01 |
| 6033796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $102,728.96 |
| 6033797 | STERILE SUPPLY | Supply/Implant | $2,981.12 |
| 6033803 | SUPPLY IMPLANT | Supply/Implant | $5,280.77 |
| 6033812 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $561.02 |
| 6033814 | SUPPLY IMPLANT | Supply/Implant | $3,417.60 |
| 6033816 | SUPPLY IMPLANT | Supply/Implant | $5,977.60 |
| 6033818 | SUPPLY IMPLANT | Supply/Implant | $12,518.40 |
| 6033820 | SUPPLY IMPLANT | Supply/Implant | $9,674.24 |
| 6033830 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6033831 | SUPPLY IMPLANT | Supply/Implant | $18,299.39 |
| 6033835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6033837 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6033848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,592.00 |
| 6033853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,265.98 |
| 6033876 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,689.60 |
| 6033877 | INTERSPINOUS IMPLANT | Supply/Implant | $15,360.00 |
| 6033878 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6033890 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6033892 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6033896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,207.62 |
| 6033897 | SUPPLY IMPLANT | Supply/Implant | $3,648.00 |
| 6033898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,207.62 |
| 6033899 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6033900 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6033901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,633.47 |
| 6033903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,255.17 |
| 6033904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,555.01 |
| 6033905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6033906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,420.61 |
| 6033907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,392.83 |
| 6033908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,311.10 |
| 6033909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,070.59 |
| 6033910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,972.35 |
| 6033911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,342.14 |
| 6033921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,352.90 |
| 6033923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,393.60 |
| 6033933 | SUPPLY IMPLANT | Supply/Implant | $10,448.51 |
| 6033942 | SUPPLY IMPLANT | Supply/Implant | $1,042.05 |
| 6033944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,631.17 |
| 6033956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6033958 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6033959 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,689.60 |
| 6033967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,132.48 |
| 6033993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6033998 | SUPPLY IMPLANT | Supply/Implant | $741.50 |
| 6034007 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6034010 | SUPPLY IMPLANT | Supply/Implant | $564.90 |
| 6034011 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6034013 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6034018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6034023 | SUPPLY IMPLANT | Supply/Implant | $1,464.32 |
| 6034031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6034032 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034033 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034035 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6034036 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $970.37 |
| 6034037 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $970.37 |
| 6034049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6034055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,689.60 |
| 6034056 | SUPPLY IMPLANT | Supply/Implant | $2,982.40 |
| 6034059 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6034061 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,312.90 |
| 6034062 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6034078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034090 | INFUSION PUMP, PROGRAMMABLE | Supply/Implant | $123,900.00 |
| 6034096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,394.05 |
| 6034113 | SUPPLY IMPLANT | Supply/Implant | $8,668.80 |
| 6034115 | SUPPLY IMPLANT | Supply/Implant | $1,186.56 |
| 6034133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6034135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6034140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6034141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6034143 | SUPPLY IMPLANT | Supply/Implant | $7,238.40 |
| 6034153 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,683.65 |
| 6034155 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6034163 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6034166 | SUPPLY IMPLANT | Supply/Implant | $1,603.20 |
| 6034167 | SUPPLY IMPLANT | Supply/Implant | $3,360.00 |
| 6034168 | SUPPLY IMPLANT | Supply/Implant | $3,974.40 |
| 6034182 | SUPPLY IMPLANT | Supply/Implant | $14,025.60 |
| 6034186 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6034192 | SUPPLY IMPLANT | Supply/Implant | $176.00 |
| 6034193 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6034194 | SUPPLY IMPLANT | Supply/Implant | $2,398.59 |
| 6034197 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034205 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6034207 | SUPPLY IMPLANT | Supply/Implant | $7,420.80 |
| 6034210 | SUPPLY IMPLANT | Supply/Implant | $7,001.60 |
| 6034211 | SUPPLY IMPLANT | Supply/Implant | $5,646.98 |
| 6034215 | SUPPLY IMPLANT | Supply/Implant | $5,396.48 |
| 6034225 | SUPPLY IMPLANT | Supply/Implant | $17,274.88 |
| 6034227 | SUPPLY IMPLANT | Supply/Implant | $17,274.88 |
| 6034228 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6034247 | SUPPLY IMPLANT | Supply/Implant | $31,294.08 |
| 6034258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6034264 | SUPPLY IMPLANT | Supply/Implant | $69,966.34 |
| 6034265 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6034268 | SUPPLY IMPLANT | Supply/Implant | $965.89 |
| 6034271 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6034277 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034278 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034287 | SUPPLY IMPLANT | Supply/Implant | $2,038.53 |
| 6034288 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6034291 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034292 | SUPPLY IMPLANT | Supply/Implant | $2,296.19 |
| 6034293 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6034307 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034308 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034309 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6034318 | MESH (IMPLANTABLE) | Supply/Implant | $54,835.20 |
| 6034320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034324 | SUPPLY IMPLANT | Supply/Implant | $2,421.95 |
| 6034336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034352 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6034363 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6034364 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6034366 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,508.54 |
| 6034368 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6034373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6034377 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,859.20 |
| 6034395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,184.00 |
| 6034416 | SUPPLY IMPLANT | Supply/Implant | $8,691.20 |
| 6034417 | SUPPLY IMPLANT | Supply/Implant | $5,593.47 |
| 6034418 | SUPPLY IMPLANT | Supply/Implant | $3,829.34 |
| 6034426 | SUPPLY IMPLANT | Supply/Implant | $1,352.45 |
| 6034429 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6034431 | SUPPLY IMPLANT | Supply/Implant | $6,809.60 |
| 6034440 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,495.23 |
| 6034443 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6034444 | SUPPLY IMPLANT | Supply/Implant | $6,131.20 |
| 6034447 | SUPPLY IMPLANT | Supply/Implant | $25,169.92 |
| 6034448 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6034452 | SUPPLY IMPLANT | Supply/Implant | $3,829.34 |
| 6034454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034459 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6034460 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6034462 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034463 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034473 | SUPPLY IMPLANT | Supply/Implant | $14,899.71 |
| 6034476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,413.18 |
| 6034478 | SUPPLY IMPLANT | Supply/Implant | $3,110.40 |
| 6034483 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034488 | SUPPLY IMPLANT | Supply/Implant | $11,712.00 |
| 6034489 | SUPPLY IMPLANT | Supply/Implant | $10,009.60 |
| 6034497 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034501 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,058.24 |
| 6034507 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6034508 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6034517 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034518 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034527 | MESH (IMPLANTABLE) | Supply/Implant | $9,561.60 |
| 6034528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6034533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,228.22 |
| 6034538 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034540 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034542 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034544 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034545 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034547 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034548 | SUPPLY IMPLANT | Supply/Implant | $1,074.69 |
| 6034551 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034552 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6034561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6034566 | SUPPLY IMPLANT | Supply/Implant | $9,076.48 |
| 6034568 | SUPPLY IMPLANT | Supply/Implant | $1,250.24 |
| 6034572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6034574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6034575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034576 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034577 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034578 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034580 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034581 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,693.06 |
| 6034595 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034596 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034597 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034598 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034599 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6034604 | SUPPLY IMPLANT | Supply/Implant | $1,860.22 |
| 6034605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034606 | SUPPLY IMPLANT | Supply/Implant | $1,568.90 |
| 6034607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034611 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034612 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,069.82 |
| 6034615 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.98 |
| 6034621 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034625 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034626 | SUPPLY IMPLANT | Supply/Implant | $25,169.92 |
| 6034627 | SUPPLY IMPLANT | Supply/Implant | $19,948.31 |
| 6034628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6034630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034635 | SUPPLY IMPLANT | Supply/Implant | $5,255.55 |
| 6034636 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034637 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034642 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034643 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034649 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034657 | SUPPLY IMPLANT | Supply/Implant | $2,350.08 |
| 6034658 | SUPPLY IMPLANT | Supply/Implant | $4,218.88 |
| 6034661 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,693.06 |
| 6034662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034664 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6034665 | SUPPLY IMPLANT | Supply/Implant | $49,746.05 |
| 6034666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $37,259.52 |
| 6034668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034670 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6034673 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034676 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034681 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034683 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034685 | SUPPLY IMPLANT | Supply/Implant | $3,968.00 |
| 6034690 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034691 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034692 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034694 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034696 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6034706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034708 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034710 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034712 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034722 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034723 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6034728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6034729 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6034730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6034742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6034758 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6034759 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6034760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034766 | SUPPLY IMPLANT | Supply/Implant | $112,576.00 |
| 6034768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034779 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,574.40 |
| 6034797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6034798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034799 | SUPPLY IMPLANT | Supply/Implant | $2,774.40 |
| 6034802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034806 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6034814 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6034815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,966.72 |
| 6034817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6034822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,375.68 |
| 6034826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,053.31 |
| 6034829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,192.96 |
| 6034830 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6034851 | SUPPLY IMPLANT | Supply/Implant | $6,148.99 |
| 6034852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $840.45 |
| 6034854 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034860 | SUPPLY IMPLANT | Supply/Implant | $10,321.92 |
| 6034863 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034864 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,188.22 |
| 6034869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,085.95 |
| 6034885 | SUPPLY IMPLANT | Supply/Implant | $318.72 |
| 6034893 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,433.60 |
| 6034894 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6034897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6034898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034912 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6034919 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034921 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6034922 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6034925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,266.30 |
| 6034934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6034935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6034937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,187.33 |
| 6034939 | SUPPLY IMPLANT | Supply/Implant | $668.03 |
| 6034940 | SUPPLY IMPLANT | Supply/Implant | $1,181.22 |
| 6034941 | SUPPLY IMPLANT | Supply/Implant | $1,740.71 |
| 6034942 | SUPPLY IMPLANT | Supply/Implant | $535.08 |
| 6034943 | SUPPLY IMPLANT | Supply/Implant | $535.08 |
| 6034944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,117.76 |
| 6034949 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,008.00 |
| 6034954 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,808.00 |
| 6034955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6034957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6034962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6034964 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034965 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6034966 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6034967 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6034977 | SUPPLY IMPLANT | Supply/Implant | $768.64 |
| 6034984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6034991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6034992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,226.43 |
| 6034996 | SUPPLY IMPLANT | Supply/Implant | $1,698.69 |
| 6034997 | SUPPLY IMPLANT | Supply/Implant | $1,123.71 |
| 6034998 | SUPPLY IMPLANT | Supply/Implant | $193.13 |
| 6034999 | SUPPLY IMPLANT | Supply/Implant | $1,086.46 |
| 6035000 | SUPPLY IMPLANT | Supply/Implant | $1,123.71 |
| 6035001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,401.22 |
| 6035007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,401.22 |
| 6035009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,053.31 |
| 6035019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6035030 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6035044 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035047 | SUPPLY IMPLANT | Supply/Implant | $21,056.00 |
| 6035053 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035054 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035055 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035056 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035059 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $73,776.00 |
| 6035066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,292.99 |
| 6035078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6035089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6035094 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6035103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6035112 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6035113 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035114 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6035118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6035120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6035135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $883.20 |
| 6035151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6035152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,952.00 |
| 6035153 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6035154 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6035158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,460.80 |
| 6035159 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6035165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6035179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,353.92 |
| 6035187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6035188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6035191 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6035202 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6035207 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,984.64 |
| 6035217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6035219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6035222 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6035223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6035231 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,729.66 |
| 6035240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6035244 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,808.64 |
| 6035248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6035253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6035260 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6035285 | INTRO/SHEATH, NON-LASER | Supply/Implant | $742.40 |
| 6035289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6035293 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $35,840.00 |
| 6035302 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035311 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,453.44 |
| 6035317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6035320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6035323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,546.50 |
| 6035324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6035326 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,776.00 |
| 6035337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6035345 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6035346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,914.37 |
| 6035347 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035348 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035349 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035350 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035351 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035353 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $10,368.00 |
| 6035354 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $9,600.00 |
| 6035367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6035368 | SUPPLY IMPLANT | Supply/Implant | $43,187.71 |
| 6035369 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6035378 | SUPPLY IMPLANT | Supply/Implant | $252,500.00 |
| 6035379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,477.70 |
| 6035381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6035394 | SUPPLY IMPLANT | Supply/Implant | $48,872.70 |
| 6035395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6035396 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6035403 | SUPPLY IMPLANT | Supply/Implant | $225.28 |
| 6035431 | SUPPLY IMPLANT | Supply/Implant | $1,885.06 |
| 6035442 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6035447 | SUPPLY IMPLANT | Supply/Implant | $4,966.40 |
| 6035461 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6035472 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035496 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $36,352.00 |
| 6035500 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6035528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,572.80 |
| 6035529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6035530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6035531 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6035532 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6035535 | SUPPLY IMPLANT | Supply/Implant | $147,000.00 |
| 6035537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,414.72 |
| 6035541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6035548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035551 | SUPPLY IMPLANT | Supply/Implant | $105,843.20 |
| 6035567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,414.72 |
| 6035569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.81 |
| 6035570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.81 |
| 6035571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.81 |
| 6035573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,165.50 |
| 6035576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6035577 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6035585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6035586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6035589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6035597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6035627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035632 | SUPPLY IMPLANT | Supply/Implant | $652.80 |
| 6035633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035639 | SUPPLY IMPLANT | Supply/Implant | $3,494.40 |
| 6035641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6035642 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,535.94 |
| 6035647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6035670 | GRAFT, VASCULAR | Supply/Implant | $35,737.60 |
| 6035671 | GRAFT, VASCULAR | Supply/Implant | $23,244.80 |
| 6035672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6035677 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6035705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035722 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035733 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6035734 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6035735 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6035744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,139.20 |
| 6035760 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6035773 | SUPPLY IMPLANT | Supply/Implant | $13,632.00 |
| 6035777 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $66,560.00 |
| 6035779 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $66,560.00 |
| 6035782 | MESH (IMPLANTABLE) | Supply/Implant | $13,580.80 |
| 6035799 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6035801 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6035812 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6035820 | SUPPLY IMPLANT | Supply/Implant | $5,593.47 |
| 6035839 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6035840 | GUIDE WIRE | Supply/Implant | $1,478.40 |
| 6035846 | SUPPLY IMPLANT | Supply/Implant | $24,701.57 |
| 6035862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6035863 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6035865 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6035867 | GRAFT, VASCULAR | Supply/Implant | $10,265.60 |
| 6035869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6035874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6035875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6035878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035880 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6035886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,052.80 |
| 6035887 | SUPPLY IMPLANT | Supply/Implant | $3,254.40 |
| 6035894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6035896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6035897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035899 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6035901 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6035904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6035906 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6035909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6035911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6035912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6035914 | CATH, DRAINAGE | Supply/Implant | $1,042.69 |
| 6035925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6035927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6035944 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6035947 | SUPPLY IMPLANT | Supply/Implant | $2,755.20 |
| 6035952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035967 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6035972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,266.30 |
| 6035974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.29 |
| 6035975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6035976 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6035977 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6035978 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6036001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6036003 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6036006 | SUPPLY IMPLANT | Supply/Implant | $11,712.00 |
| 6036014 | SUPPLY IMPLANT | Supply/Implant | $9,676.80 |
| 6036016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6036023 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6036029 | SUPPLY IMPLANT | Supply/Implant | $16,947.20 |
| 6036050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6036057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6036058 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6036067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6036075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6036096 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6036096 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036100 | STERILE SUPPLY | Supply/Implant | $212.48 |
| 6036101 | STERILE SUPPLY | Supply/Implant | $727.81 |
| 6036103 | STERILE SUPPLY | Supply/Implant | $430.55 |
| 6036104 | STERILE SUPPLY | Supply/Implant | $144.90 |
| 6036106 | STERILE SUPPLY | Supply/Implant | $160.13 |
| 6036110 | SUPPLY IMPLANT | Supply/Implant | $429.18 |
| 6036112 | SUPPLY IMPLANT | Supply/Implant | $366.59 |
| 6036114 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6036115 | SUPPLY IMPLANT | Supply/Implant | $366.59 |
| 6036116 | SUPPLY IMPLANT | Supply/Implant | $366.59 |
| 6036117 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036118 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036119 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036120 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036126 | CATHETER, GUIDING | Supply/Implant | $326.02 |
| 6036127 | STERILE SUPPLY | Supply/Implant | $1,636.86 |
| 6036128 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036129 | SUPPLY IMPLANT | Supply/Implant | $374.02 |
| 6036130 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6036131 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6036138 | SUPPLY IMPLANT | Supply/Implant | $343.94 |
| 6036140 | CATH, DRAINAGE | Supply/Implant | $913.92 |
| 6036141 | CATH, DRAINAGE | Supply/Implant | $967.68 |
| 6036143 | CATHETER, URETERAL | Supply/Implant | $239.36 |
| 6036144 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6036146 | CATH, DRAINAGE | Supply/Implant | $177.92 |
| 6036147 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6036148 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6036151 | STERILE SUPPLY | Supply/Implant | $157.25 |
| 6036152 | GENERAL SUPPLY | Supply/Implant | $191.36 |
| 6036158 | STERILE SUPPLY | Supply/Implant | $1,151.36 |
| 6036159 | STERILE SUPPLY | Supply/Implant | $1,142.53 |
| 6036163 | CATH, DRAINAGE | Supply/Implant | $291.33 |
| 6036164 | CATH, DRAINAGE | Supply/Implant | $325.63 |
| 6036168 | SUPPLY IMPLANT | Supply/Implant | $219.90 |
| 6036173 | SUPPLY IMPLANT | Supply/Implant | $524.93 |
| 6036174 | SUPPLY IMPLANT | Supply/Implant | $524.93 |
| 6036175 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036176 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6036177 | SUPPLY IMPLANT | Supply/Implant | $402.43 |
| 6036178 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036179 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6036183 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036184 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036186 | SUPPLY IMPLANT | Supply/Implant | $1,854.85 |
| 6036187 | GENERAL SUPPLY | Supply/Implant | $160.90 |
| 6036188 | SUPPLY IMPLANT | Supply/Implant | $247.42 |
| 6036189 | SUPPLY IMPLANT | Supply/Implant | $247.30 |
| 6036190 | SUPPLY IMPLANT | Supply/Implant | $202.75 |
| 6036191 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6036192 | CATH, DRAINAGE | Supply/Implant | $153.60 |
| 6036193 | CATH, DRAINAGE | Supply/Implant | $153.60 |
| 6036194 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,419.20 |
| 6036200 | SUPPLY IMPLANT | Supply/Implant | $7,872.51 |
| 6036202 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6036205 | CATH, DRAINAGE | Supply/Implant | $177.10 |
| 6036206 | CATH, DRAINAGE | Supply/Implant | $179.71 |
| 6036211 | SUPPLY IMPLANT | Supply/Implant | $583.17 |
| 6036212 | STERILE SUPPLY | Supply/Implant | $298.24 |
| 6036221 | SUPPLY IMPLANT | Supply/Implant | $459.52 |
| 6036228 | STERILE SUPPLY | Supply/Implant | $273.79 |
| 6036229 | STERILE SUPPLY | Supply/Implant | $281.96 |
| 6036230 | STERILE SUPPLY | Supply/Implant | $293.34 |
| 6036239 | SUPPLY IMPLANT | Supply/Implant | $137.98 |
| 6036242 | SUPPLY IMPLANT | Supply/Implant | $1,257.73 |
| 6036244 | CATHETER, URETERAL | Supply/Implant | $244.86 |
| 6036245 | CATHETER, URETERAL | Supply/Implant | $244.86 |
| 6036251 | SUPPLY IMPLANT | Supply/Implant | $204.16 |
| 6036252 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036257 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6036258 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6036260 | STERILE SUPPLY | Supply/Implant | $1,360.26 |
| 6036268 | SUPPLY IMPLANT | Supply/Implant | $657.02 |
| 6036269 | SUPPLY IMPLANT | Supply/Implant | $132.22 |
| 6036272 | STERILE SUPPLY | Supply/Implant | $452.16 |
| 6036279 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6036289 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6036293 | SUPPLY IMPLANT | Supply/Implant | $2,965.63 |
| 6036296 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $247.30 |
| 6036298 | SUPPLY IMPLANT | Supply/Implant | $281.86 |
| 6036301 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6036302 | GENERAL SUPPLY | Supply/Implant | $277.34 |
| 6036311 | SUPPLY IMPLANT | Supply/Implant | $1,228.16 |
| 6036314 | SUPPLY IMPLANT | Supply/Implant | $768.64 |
| 6036318 | STERILE SUPPLY | Supply/Implant | $4,966.55 |
| 6036320 | SUPPLY IMPLANT | Supply/Implant | $10,876.52 |
| 6036321 | SUPPLY IMPLANT | Supply/Implant | $24,931.97 |
| 6036330 | SUPPLY IMPLANT | Supply/Implant | $197.63 |
| 6036337 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036338 | SUPPLY IMPLANT | Supply/Implant | $2,201.73 |
| 6036339 | SUPPLY IMPLANT | Supply/Implant | $272.26 |
| 6036341 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6036344 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6036347 | STERILE SUPPLY | Supply/Implant | $4,861.93 |
| 6036349 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6036350 | STERILE SUPPLY | Supply/Implant | $4,032.00 |
| 6036351 | SUPPLY IMPLANT | Supply/Implant | $571.53 |
| 6036352 | STERILE SUPPLY | Supply/Implant | $2,965.63 |
| 6036357 | SUPPLY IMPLANT | Supply/Implant | $3,233.79 |
| 6036362 | SUPPLY IMPLANT | Supply/Implant | $167.68 |
| 6036364 | SUPPLY IMPLANT | Supply/Implant | $793.83 |
| 6036370 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6036371 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6036372 | CATHETER, URETERAL | Supply/Implant | $170.98 |
| 6036374 | SUPPLY IMPLANT | Supply/Implant | $2,992.00 |
| 6036375 | SUPPLY IMPLANT | Supply/Implant | $1,679.36 |
| 6036376 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6036377 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6036378 | STERILE SUPPLY | Supply/Implant | $159.90 |
| 6036380 | SUPPLY IMPLANT | Supply/Implant | $1,329.28 |
| 6036381 | SUPPLY IMPLANT | Supply/Implant | $2,333.18 |
| 6036384 | SUPPLY IMPLANT | Supply/Implant | $1,200.64 |
| 6036385 | SUPPLY IMPLANT | Supply/Implant | $1,680.90 |
| 6036386 | SUPPLY IMPLANT | Supply/Implant | $1,455.49 |
| 6036392 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6036394 | STERILE SUPPLY | Supply/Implant | $1,062.78 |
| 6036395 | SUPPLY IMPLANT | Supply/Implant | $3,057.28 |
| 6036396 | SUPPLY IMPLANT | Supply/Implant | $375.68 |
| 6036406 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6036407 | CATH OCCLUSION | Supply/Implant | $2,631.42 |
| 6036412 | SUPPLY IMPLANT | Supply/Implant | $598.40 |
| 6036414 | CATH, DRAINAGE | Supply/Implant | $449.92 |
| 6036415 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6036418 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $197.76 |
| 6036419 | SUPPLY IMPLANT | Supply/Implant | $2,015.62 |
| 6036422 | STERILE SUPPLY | Supply/Implant | $2,321.28 |
| 6036423 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6036431 | STERILE SUPPLY | Supply/Implant | $412.03 |
| 6036432 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6036433 | SUPPLY IMPLANT | Supply/Implant | $2,483.71 |
| 6036434 | SUPPLY IMPLANT | Supply/Implant | $1,294.98 |
| 6036439 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6036440 | TISSUE LOCALIZATION EXCISION | Supply/Implant | $23,987.20 |
| 6036447 | GUIDE WIRE | Supply/Implant | $1,336.32 |
| 6036453 | STERILE SUPPLY | Supply/Implant | $1,299.20 |
| 6036454 | INTRO/SHEATH, NON-LASER | Supply/Implant | $496.77 |
| 6036457 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6036459 | SUPPLY IMPLANT | Supply/Implant | $808.58 |
| 6036461 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6036462 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6036467 | SUPPLY IMPLANT | Supply/Implant | $1,294.98 |
| 6036468 | SUPPLY IMPLANT | Supply/Implant | $1,587.75 |
| 6036474 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6036477 | SUPPLY IMPLANT | Supply/Implant | $3,041.28 |
| 6036480 | STERILE SUPPLY | Supply/Implant | $2,713.60 |
| 6036483 | SUPPLY IMPLANT | Supply/Implant | $1,569.41 |
| 6036484 | GENERAL SUPPLY | Supply/Implant | $142.08 |
| 6036485 | GENERAL SUPPLY | Supply/Implant | $1,024.51 |
| 6036492 | SUPPLY IMPLANT | Supply/Implant | $1,663.74 |
| 6036495 | SUPPLY IMPLANT | Supply/Implant | $1,535.10 |
| 6036496 | SUPPLY IMPLANT | Supply/Implant | $1,130.88 |
| 6036501 | SUPPLY IMPLANT | Supply/Implant | $2,437.12 |
| 6036505 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6036508 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6036509 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6036513 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6036515 | SUPPLY IMPLANT | Supply/Implant | $234.66 |
| 6036524 | SUPPLY IMPLANT | Supply/Implant | $634.88 |
| 6036528 | SUPPLY IMPLANT | Supply/Implant | $659.20 |
| 6036529 | STERILE SUPPLY | Supply/Implant | $487.09 |
| 6036535 | SUPPLY IMPLANT | Supply/Implant | $1,320.96 |
| 6036538 | SUPPLY IMPLANT | Supply/Implant | $1,234.94 |
| 6036542 | STERILE SUPPLY | Supply/Implant | $2,475.64 |
| 6036543 | STERILE SUPPLY | Supply/Implant | $238.03 |
| 6036546 | SUPPLY IMPLANT | Supply/Implant | $6,787.20 |
| 6036548 | SUPPLY IMPLANT | Supply/Implant | $590.59 |
| 6036549 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6036550 | SUPPLY IMPLANT | Supply/Implant | $2,908.80 |
| 6036551 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6036553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,536.77 |
| 6036555 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6036556 | SUPPLY IMPLANT | Supply/Implant | $1,466.50 |
| 6036559 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6036560 | SUPPLY IMPLANT | Supply/Implant | $2,294.40 |
| 6036561 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6036567 | SUPPLY IMPLANT | Supply/Implant | $1,893.89 |
| 6036568 | SUPPLY IMPLANT | Supply/Implant | $1,468.03 |
| 6036572 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6036573 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6036575 | SUPPLY IMPLANT | Supply/Implant | $1,692.16 |
| 6036577 | CATH OCCLUSION | Supply/Implant | $5,142.40 |
| 6036579 | SUPPLY IMPLANT | Supply/Implant | $213.25 |
| 6036590 | SUPPLY IMPLANT | Supply/Implant | $133.45 |
| 6036591 | SUPPLY IMPLANT | Supply/Implant | $224.90 |
| 6036593 | SUPPLY IMPLANT | Supply/Implant | $426.75 |
| 6036612 | SUPPLY IMPLANT | Supply/Implant | $731.78 |
| 6036614 | SUPPLY IMPLANT | Supply/Implant | $32,416.90 |
| 6036623 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6036625 | STERILE SUPPLY | Supply/Implant | $449.79 |
| 6036628 | SUPPLY IMPLANT | Supply/Implant | $8,439.42 |
| 6036630 | SUPPLY IMPLANT | Supply/Implant | $1,395.84 |
| 6036631 | SUPPLY IMPLANT | Supply/Implant | $951.04 |
| 6036632 | SUPPLY IMPLANT | Supply/Implant | $11,270.66 |
| 6036635 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6036639 | SUPPLY IMPLANT | Supply/Implant | $708.35 |
| 6036641 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6036643 | GUIDE WIRE | Supply/Implant | $1,024.00 |
| 6036649 | STERILE SUPPLY | Supply/Implant | $134.14 |
| 6036651 | STERILE SUPPLY | Supply/Implant | $400.51 |
| 6036657 | SUPPLY IMPLANT | Supply/Implant | $8,988.42 |
| 6036658 | SUPPLY IMPLANT | Supply/Implant | $1,473.66 |
| 6036660 | SUPPLY IMPLANT | Supply/Implant | $5,043.20 |
| 6036661 | SUPPLY IMPLANT | Supply/Implant | $4,550.02 |
| 6036662 | CATH, DRAINAGE | Supply/Implant | $5,396.48 |
| 6036663 | GENERAL SUPPLY | Supply/Implant | $302.08 |
| 6036664 | SUPPLY IMPLANT | Supply/Implant | $143.71 |
| 6036667 | CATH, SUPRAPUBIC/CYSTOSCOPIC | Supply/Implant | $3,454.98 |
| 6036668 | STERILE SUPPLY | Supply/Implant | $2,150.40 |
| 6036674 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6036675 | STERILE SUPPLY | Supply/Implant | $290.64 |
| 6036677 | SUPPLY IMPLANT | Supply/Implant | $4,876.80 |
| 6036679 | SUPPLY IMPLANT | Supply/Implant | $658.82 |
| 6036680 | SUPPLY IMPLANT | Supply/Implant | $8,988.42 |
| 6036681 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6036681 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6036682 | SUPPLY IMPLANT | Supply/Implant | $533.62 |
| 6036683 | SUPPLY IMPLANT | Supply/Implant | $1,142.78 |
| 6036685 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036686 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6036687 | SUPPLY IMPLANT | Supply/Implant | $46,592.00 |
| 6036688 | SUPPLY IMPLANT | Supply/Implant | $5,148.45 |
| 6036689 | STERILE SUPPLY | Supply/Implant | $3,628.29 |
| 6036694 | SUPPLY IMPLANT | Supply/Implant | $3,094.02 |
| 6036697 | SUPPLY IMPLANT | Supply/Implant | $731.01 |
| 6036698 | SUPPLY IMPLANT | Supply/Implant | $3,842.05 |
| 6036705 | SUPPLY IMPLANT | Supply/Implant | $929.28 |
| 6036709 | STERILE SUPPLY | Supply/Implant | $6,461.44 |
| 6036710 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6036717 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,696.00 |
| 6036723 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6036729 | SUPPLY IMPLANT | Supply/Implant | $2,187.87 |
| 6036731 | SUPPLY IMPLANT | Supply/Implant | $14,899.71 |
| 6036732 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036733 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6036734 | SUPPLY IMPLANT | Supply/Implant | $5,438.46 |
| 6036738 | SUPPLY IMPLANT | Supply/Implant | $1,653.76 |
| 6036741 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6036742 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6036744 | SUPPLY IMPLANT | Supply/Implant | $3,417.73 |
| 6036745 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036746 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036747 | SUPPLY IMPLANT | Supply/Implant | $3,983.36 |
| 6036753 | SUPPLY IMPLANT | Supply/Implant | $1,186.39 |
| 6036754 | SUPPLY IMPLANT | Supply/Implant | $1,169.41 |
| 6036755 | SUPPLY IMPLANT | Supply/Implant | $545.54 |
| 6036756 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,420.80 |
| 6036757 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,420.80 |
| 6036758 | SUPPLY IMPLANT | Supply/Implant | $993.28 |
| 6036781 | SUPPLY IMPLANT | Supply/Implant | $863.74 |
| 6036782 | SUPPLY IMPLANT | Supply/Implant | $668.42 |
| 6036785 | RET DEV, INSERTABLE | Supply/Implant | $457.59 |
| 6036786 | SUPPLY IMPLANT | Supply/Implant | $605.57 |
| 6036787 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6036790 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6036791 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6036792 | SUPPLY IMPLANT | Supply/Implant | $15,948.80 |
| 6036793 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6036799 | SUPPLY IMPLANT | Supply/Implant | $768.64 |
| 6036803 | SUPPLY IMPLANT | Supply/Implant | $2,664.19 |
| 6036806 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6036807 | SUPPLY IMPLANT | Supply/Implant | $1,178.75 |
| 6036808 | SUPPLY IMPLANT | Supply/Implant | $1,208.96 |
| 6036809 | SUPPLY IMPLANT | Supply/Implant | $4,863.62 |
| 6036811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6036814 | SUPPLY IMPLANT | Supply/Implant | $2,321.28 |
| 6036815 | SUPPLY IMPLANT | Supply/Implant | $1,294.98 |
| 6036818 | SUPPLY IMPLANT | Supply/Implant | $7,246.46 |
| 6036819 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,800.81 |
| 6036825 | SUPPLY IMPLANT | Supply/Implant | $11,328.00 |
| 6036826 | SUPPLY IMPLANT | Supply/Implant | $1,156.57 |
| 6036829 | SUPPLY IMPLANT | Supply/Implant | $6,774.02 |
| 6036835 | SUPPLY IMPLANT | Supply/Implant | $772.48 |
| 6036836 | SUPPLY IMPLANT | Supply/Implant | $772.48 |
| 6036842 | SUPPLY IMPLANT | Supply/Implant | $13,058.18 |
| 6036844 | SUPPLY IMPLANT | Supply/Implant | $3,430.40 |
| 6036846 | INTRO/SHEATH, NON-LASER | Supply/Implant | $633.60 |
| 6036848 | SUPPLY IMPLANT | Supply/Implant | $1,648.64 |
| 6036856 | SUPPLY IMPLANT | Supply/Implant | $2,979.84 |
| 6036858 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6036859 | STERILE SUPPLY | Supply/Implant | $4,233.60 |
| 6036860 | GENERAL SUPPLY | Supply/Implant | $703.36 |
| 6036861 | SUPPLY IMPLANT | Supply/Implant | $668.42 |
| 6036863 | SUPPLY IMPLANT | Supply/Implant | $3,764.10 |
| 6036864 | SUPPLY IMPLANT | Supply/Implant | $3,764.10 |
| 6036868 | STERILE SUPPLY | Supply/Implant | $3,328.00 |
| 6036875 | STERILE SUPPLY | Supply/Implant | $3,835.90 |
| 6036881 | SUPPLY IMPLANT | Supply/Implant | $475.84 |
| 6036882 | SUPPLY IMPLANT | Supply/Implant | $660.61 |
| 6036885 | SUPPLY IMPLANT | Supply/Implant | $1,887.36 |
| 6036886 | SUPPLY IMPLANT | Supply/Implant | $1,192.96 |
| 6036889 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6036893 | SUPPLY IMPLANT | Supply/Implant | $38,169.60 |
| 6036894 | GRAFT, VASCULAR | Supply/Implant | $23,244.80 |
| 6036902 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6036909 | SUPPLY IMPLANT | Supply/Implant | $2,658.56 |
| 6036914 | SUPPLY IMPLANT | Supply/Implant | $21,478.40 |
| 6036917 | GUIDE WIRE | Supply/Implant | $1,024.00 |
| 6036918 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6036919 | SUPPLY IMPLANT | Supply/Implant | $6,131.20 |
| 6036920 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6036922 | SUPPLY IMPLANT | Supply/Implant | $280.45 |
| 6036925 | STERILE SUPPLY | Supply/Implant | $309.50 |
| 6036926 | GENERAL SUPPLY | Supply/Implant | $153.86 |
| 6036930 | SUPPLY IMPLANT | Supply/Implant | $874.24 |
| 6036931 | SUPPLY IMPLANT | Supply/Implant | $2,086.40 |
| 6036937 | SUPPLY IMPLANT | Supply/Implant | $15,847.55 |
| 6036939 | STERILE SUPPLY | Supply/Implant | $2,816.00 |
| 6036940 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6036945 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,536.77 |
| 6036947 | SUPPLY IMPLANT | Supply/Implant | $66,560.00 |
| 6036950 | SUPPLY IMPLANT | Supply/Implant | $2,697.60 |
| 6036953 | SUPPLY IMPLANT | Supply/Implant | $3,041.28 |
| 6036954 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6036955 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6036960 | STERILE SUPPLY | Supply/Implant | $568.00 |
| 6036964 | SUPPLY IMPLANT | Supply/Implant | $3,004.33 |
| 6036965 | SUPPLY IMPLANT | Supply/Implant | $4,921.47 |
| 6036969 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,520.00 |
| 6036970 | SUPPLY IMPLANT | Supply/Implant | $234.50 |
| 6036971 | SUPPLY IMPLANT | Supply/Implant | $234.50 |
| 6036972 | SUPPLY IMPLANT | Supply/Implant | $234.50 |
| 6036974 | SUPPLY IMPLANT | Supply/Implant | $531.24 |
| 6036975 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6036981 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6036982 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6036983 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6036987 | SUPPLY IMPLANT | Supply/Implant | $2,231.30 |
| 6036988 | SUPPLY IMPLANT | Supply/Implant | $2,512.13 |
| 6036989 | SUPPLY IMPLANT | Supply/Implant | $1,587.75 |
| 6036993 | GRAFT, VASCULAR | Supply/Implant | $38,169.60 |
| 6036994 | SUPPLY IMPLANT | Supply/Implant | $1,561.34 |
| 6036996 | STERILE SUPPLY | Supply/Implant | $524.80 |
| 6037001 | SUPPLY IMPLANT | Supply/Implant | $5,376.00 |
| 6037003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6037009 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $789.38 |
| 6037011 | SUPPLY IMPLANT | Supply/Implant | $6,322.18 |
| 6037013 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6037016 | SUPPLY IMPLANT | Supply/Implant | $3,251.20 |
| 6037023 | SUPPLY IMPLANT | Supply/Implant | $17,523.20 |
| 6037027 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6037030 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6037035 | SUPPLY IMPLANT | Supply/Implant | $6,054.40 |
| 6037038 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037043 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037045 | RET DEV, INSERTABLE | Supply/Implant | $7,253.34 |
| 6037046 | SUPPLY IMPLANT | Supply/Implant | $739.33 |
| 6037056 | RET DEV, INSERTABLE | Supply/Implant | $4,352.00 |
| 6037058 | STERILE SUPPLY | Supply/Implant | $1,166.34 |
| 6037059 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037060 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037062 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037063 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037065 | SUPPLY IMPLANT | Supply/Implant | $234.66 |
| 6037066 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6037067 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6037068 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6037069 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037070 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037071 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037072 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037073 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037074 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037077 | GRAFT, VASCULAR | Supply/Implant | $2,176.00 |
| 6037078 | GRAFT, VASCULAR | Supply/Implant | $3,187.20 |
| 6037081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6037092 | STERILE SUPPLY | Supply/Implant | $174.21 |
| 6037100 | STERILE SUPPLY | Supply/Implant | $151.24 |
| 6037101 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6037102 | STERILE SUPPLY | Supply/Implant | $156.42 |
| 6037103 | STERILE SUPPLY | Supply/Implant | $190.46 |
| 6037106 | SUPPLY IMPLANT | Supply/Implant | $660.48 |
| 6037114 | SUPPLY IMPLANT | Supply/Implant | $604.16 |
| 6037116 | STERILE SUPPLY | Supply/Implant | $396.26 |
| 6037118 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6037119 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6037121 | SUPPLY IMPLANT | Supply/Implant | $251.49 |
| 6037124 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6037125 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6037127 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6037128 | SUPPLY IMPLANT | Supply/Implant | $501.89 |
| 6037130 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6037131 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6037132 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6037133 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6037134 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6037135 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6037136 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6037139 | SUPPLY IMPLANT | Supply/Implant | $570.24 |
| 6037153 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6037155 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6037160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $184.32 |
| 6037165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037171 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6037176 | SUPPLY IMPLANT | Supply/Implant | $402.94 |
| 6037183 | SUPPLY IMPLANT | Supply/Implant | $2,296.96 |
| 6037184 | SUPPLY IMPLANT | Supply/Implant | $2,296.96 |
| 6037185 | SUPPLY IMPLANT | Supply/Implant | $2,296.96 |
| 6037186 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,859.01 |
| 6037188 | STERILE SUPPLY | Supply/Implant | $1,223.77 |
| 6037189 | STERILE SUPPLY | Supply/Implant | $187.90 |
| 6037201 | SUPPLY IMPLANT | Supply/Implant | $8,230.40 |
| 6037202 | GENERAL SUPPLY | Supply/Implant | $224.64 |
| 6037203 | CATHETER, GUIDING | Supply/Implant | $7,680.00 |
| 6037205 | GENERAL SUPPLY | Supply/Implant | $477.44 |
| 6037206 | GENERAL SUPPLY | Supply/Implant | $524.16 |
| 6037207 | SUPPLY IMPLANT | Supply/Implant | $10,432.00 |
| 6037208 | SUPPLY IMPLANT | Supply/Implant | $391.46 |
| 6037209 | GENERAL SUPPLY | Supply/Implant | $304.64 |
| 6037211 | SUPPLY IMPLANT | Supply/Implant | $5,148.45 |
| 6037216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $156.93 |
| 6037218 | SUPPLY IMPLANT | Supply/Implant | $1,866.11 |
| 6037222 | SUPPLY IMPLANT | Supply/Implant | $2,340.10 |
| 6037226 | SUPPLY IMPLANT | Supply/Implant | $2,531.46 |
| 6037235 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,228.80 |
| 6037245 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,854.40 |
| 6037256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,291.20 |
| 6037262 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,961.28 |
| 6037265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6037289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6037298 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037310 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037318 | SUPPLY IMPLANT | Supply/Implant | $9,967.10 |
| 6037319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6037321 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6037323 | SUPPLY IMPLANT | Supply/Implant | $712.96 |
| 6037329 | GENERAL SUPPLY | Supply/Implant | $14,689.02 |
| 6037336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6037343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6037348 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,271.36 |
| 6037353 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,060.80 |
| 6037354 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,060.80 |
| 6037361 | GENERAL SUPPLY | Supply/Implant | $10,198.02 |
| 6037363 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6037365 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037366 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6037367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037368 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037369 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037373 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037375 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037376 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037378 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037380 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037382 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037388 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6037389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,450.24 |
| 6037406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6037407 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6037416 | GENERAL SUPPLY | Supply/Implant | $9,918.59 |
| 6037417 | GENERAL SUPPLY | Supply/Implant | $9,918.59 |
| 6037425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6037426 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6037429 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6037440 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $105,350.40 |
| 6037442 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,867.20 |
| 6037444 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,867.20 |
| 6037448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6037450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,444.80 |
| 6037454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037460 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037461 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037463 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037466 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037468 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037469 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037470 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037471 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037473 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6037475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,137.60 |
| 6037476 | SUPPLY IMPLANT | Supply/Implant | $5,152.00 |
| 6037477 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,793.02 |
| 6037479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6037485 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037506 | SUPPLY IMPLANT | Supply/Implant | $4,579.20 |
| 6037508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,592.00 |
| 6037550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $777.60 |
| 6037554 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6037559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6037578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6037580 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,267.20 |
| 6037596 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6037607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6037611 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6037626 | SUPPLY IMPLANT | Supply/Implant | $8,944.00 |
| 6037643 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037648 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,536.32 |
| 6037657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6037697 | SUPPLY IMPLANT | Supply/Implant | $2,531.46 |
| 6037698 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,291.65 |
| 6037719 | SUPPLY IMPLANT | Supply/Implant | $11,520.38 |
| 6037720 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037725 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,134.40 |
| 6037727 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6037730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6037743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,984.70 |
| 6037744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6037748 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6037762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037769 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037770 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037792 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037793 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6037795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037804 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6037807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6037808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6037809 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6037810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6037811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037812 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6037813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6037816 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,913.66 |
| 6037817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,691.20 |
| 6037818 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037819 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,640.70 |
| 6037822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,342.72 |
| 6037823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6037828 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6037833 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6037835 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6037837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6037838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6037839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037850 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6037853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037854 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,553.86 |
| 6037855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6037856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6037865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6037866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037869 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037870 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,360.00 |
| 6037871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6037872 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6037873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037877 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6037879 | SUPPLY IMPLANT | Supply/Implant | $10,240.13 |
| 6037880 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037881 | SUPPLY IMPLANT | Supply/Implant | $10,240.13 |
| 6037882 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6037883 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6037890 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,342.72 |
| 6037891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,419.20 |
| 6037893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6037894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6037897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6037904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6037905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6037909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6037914 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6037916 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6037922 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037923 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037924 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6037925 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6037926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6037931 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6037932 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6037933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6037935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,697.60 |
| 6037936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6037938 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6037942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6037949 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,129.60 |
| 6037951 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6037964 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037965 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6037966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,542.40 |
| 6037967 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,200.00 |
| 6037968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6037969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6037973 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6037974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6037980 | GENERAL SUPPLY | Supply/Implant | $10,732.80 |
| 6037981 | SUPPLY IMPLANT | Supply/Implant | $19,187.33 |
| 6037983 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,360.00 |
| 6037985 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037989 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,473.09 |
| 6037991 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6037995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6038006 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6038014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,820.74 |
| 6038018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6038027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6038031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6038033 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6038034 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6038037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6038038 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038058 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038060 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6038061 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038068 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6038076 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $116,992.00 |
| 6038078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6038085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6038096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6038106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6038107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6038118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038123 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,580.80 |
| 6038129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038132 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,126.72 |
| 6038141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038142 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6038147 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6038148 | INTERSPINOUS IMPLANT | Supply/Implant | $60,678.40 |
| 6038152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6038157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,977.60 |
| 6038159 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038162 | SUPPLY IMPLANT | Supply/Implant | $1,815.42 |
| 6038166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,687.36 |
| 6038171 | SUPPLY IMPLANT | Supply/Implant | $23,511.68 |
| 6038181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6038182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6038183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,112.00 |
| 6038186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6038188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038189 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6038190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,979.20 |
| 6038191 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6038193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038197 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,993.60 |
| 6038207 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6038221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6038226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6038228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6038229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,556.80 |
| 6038230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6038237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6038240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6038246 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6038256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6038257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6038269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,608.00 |
| 6038270 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038274 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6038282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,267.20 |
| 6038298 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6038299 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6038301 | INTERSPINOUS IMPLANT | Supply/Implant | $79,385.60 |
| 6038303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6038308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6038309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,896.00 |
| 6038320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038326 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6038330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,267.20 |
| 6038331 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,829.31 |
| 6038333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,896.00 |
| 6038336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6038337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038348 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6038356 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,496.00 |
| 6038360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6038362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,747.90 |
| 6038368 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6038373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,384.00 |
| 6038378 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6038384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6038415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038416 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038417 | SUPPLY IMPLANT | Supply/Implant | $550.02 |
| 6038418 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6038426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6038434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6038435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6038436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6038440 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6038443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,686.40 |
| 6038447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6038449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6038451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038452 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,192.64 |
| 6038461 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,463.30 |
| 6038464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,384.00 |
| 6038465 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6038467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,686.40 |
| 6038468 | GUIDE WIRE | Supply/Implant | $2,880.00 |
| 6038470 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,747.90 |
| 6038473 | SUPPLY IMPLANT | Supply/Implant | $10,464.00 |
| 6038481 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6038483 | INTERSPINOUS IMPLANT | Supply/Implant | $60,678.40 |
| 6038489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,448.00 |
| 6038493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,224.00 |
| 6038496 | GUIDE WIRE | Supply/Implant | $2,944.00 |
| 6038497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,448.00 |
| 6038502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6038505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038507 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6038508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6038509 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038511 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6038525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038527 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6038528 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038533 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,793.02 |
| 6038534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6038535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,259.20 |
| 6038536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,705.60 |
| 6038543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,448.00 |
| 6038546 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038547 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038553 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038556 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6038557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6038573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,223.81 |
| 6038575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6038579 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6038585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6038586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038591 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6038592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6038599 | GUIDE WIRE | Supply/Implant | $1,584.00 |
| 6038605 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6038613 | SUPPLY IMPLANT | Supply/Implant | $13,946.88 |
| 6038620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6038624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6038632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6038634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6038635 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,223.81 |
| 6038641 | INTERSPINOUS IMPLANT | Supply/Implant | $25,159.68 |
| 6038647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038652 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038654 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6038670 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,472.96 |
| 6038673 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038675 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6038678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,797.38 |
| 6038700 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,463.30 |
| 6038703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038716 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038719 | INTERSPINOUS IMPLANT | Supply/Implant | $75,648.00 |
| 6038733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6038735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6038744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038748 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6038749 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6038750 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038754 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038756 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6038760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6038763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,606.40 |
| 6038771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6038773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038776 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038777 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,049.47 |
| 6038803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038821 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6038822 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6038829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6038836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6038838 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6038841 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6038850 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038851 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038855 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038858 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6038884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,473.09 |
| 6038888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038889 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6038894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,138.82 |
| 6038897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038901 | SUPPLY IMPLANT | Supply/Implant | $373.63 |
| 6038908 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6038909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6038916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6038917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,758.40 |
| 6038922 | SUPPLY IMPLANT | Supply/Implant | $329.09 |
| 6038923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,516.80 |
| 6038926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6038930 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038940 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,702.40 |
| 6038942 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,735.62 |
| 6038943 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6038947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6038951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,976.00 |
| 6038961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6038973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6038974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6038975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6038977 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,328.00 |
| 6038979 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6038988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,640.70 |
| 6038993 | SUPPLY IMPLANT | Supply/Implant | $1,971.20 |
| 6038995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,746.24 |
| 6038996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6039000 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6039008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,392.00 |
| 6039009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6039012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6039018 | SUPPLY IMPLANT | Supply/Implant | $8,192.00 |
| 6039021 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6039023 | SUPPLY IMPLANT | Supply/Implant | $4,881.28 |
| 6039030 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6039045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,256.06 |
| 6039046 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6039055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,477.70 |
| 6039063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6039064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6039100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039115 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6039120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6039129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039132 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,960.00 |
| 6039146 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6039164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6039166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6039190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6039193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039207 | SUPPLY IMPLANT | Supply/Implant | $993.28 |
| 6039211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,347.20 |
| 6039219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6039227 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039232 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6039242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6039247 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,241.60 |
| 6039249 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6039253 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6039254 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6039255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,912.00 |
| 6039258 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039259 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039264 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,262.27 |
| 6039281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6039284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,553.60 |
| 6039290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039297 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6039300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039303 | SUPPLY IMPLANT | Supply/Implant | $34,240.00 |
| 6039308 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6039309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,939.20 |
| 6039316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,676.80 |
| 6039323 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6039331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039358 | GENERAL SUPPLY | Supply/Implant | $2,607.74 |
| 6039359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6039368 | SUPPLY IMPLANT | Supply/Implant | $619.14 |
| 6039371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039381 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039382 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6039387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,814.40 |
| 6039391 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,544.06 |
| 6039404 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039405 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6039410 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6039413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6039415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6039422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6039423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,952.00 |
| 6039426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,477.70 |
| 6039430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,548.80 |
| 6039436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039441 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039444 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6039453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6039456 | SUPPLY IMPLANT | Supply/Implant | $23,488.00 |
| 6039467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6039468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6039473 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6039501 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039503 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039504 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039506 | SUPPLY IMPLANT | Supply/Implant | $10,895.23 |
| 6039507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6039512 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6039521 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6039522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6039526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6039531 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6039532 | SUPPLY IMPLANT | Supply/Implant | $18,304.00 |
| 6039533 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039534 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6039541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039551 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6039552 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6039589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6039590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,262.27 |
| 6039591 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039606 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6039623 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6039641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6039644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039649 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6039651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6039653 | SUPPLY IMPLANT | Supply/Implant | $1,141.89 |
| 6039659 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,203.52 |
| 6039661 | SUPPLY IMPLANT | Supply/Implant | $4,803.20 |
| 6039686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039687 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,088.00 |
| 6039689 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $14,118.40 |
| 6039702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6039705 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,752.00 |
| 6039706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,944.00 |
| 6039707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,944.00 |
| 6039712 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6039713 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039716 | SUPPLY IMPLANT | Supply/Implant | $43,520.00 |
| 6039732 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6039750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,766.40 |
| 6039753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6039760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,588.80 |
| 6039770 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,544.00 |
| 6039782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6039783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6039784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6039785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,735.62 |
| 6039796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,760.00 |
| 6039798 | SUPPLY IMPLANT | Supply/Implant | $6,461.44 |
| 6039803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6039807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6039808 | SUPPLY IMPLANT | Supply/Implant | $806.40 |
| 6039809 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6039836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039840 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6039846 | SUPPLY IMPLANT | Supply/Implant | $7,936.00 |
| 6039847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6039853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,262.27 |
| 6039858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6039859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6039866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6039867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,392.00 |
| 6039872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6039873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6039876 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,032.00 |
| 6039885 | SUPPLY IMPLANT | Supply/Implant | $7,430.40 |
| 6039887 | SUPPLY IMPLANT | Supply/Implant | $36,595.20 |
| 6039891 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6039898 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039900 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039902 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039905 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,866.88 |
| 6039906 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6039907 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039908 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6039910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6039913 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6039914 | STERILE SUPPLY | Supply/Implant | $5,760.00 |
| 6039918 | SUPPLY IMPLANT | Supply/Implant | $9,987.71 |
| 6039936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6039948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $116,992.00 |
| 6039961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039963 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6039981 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039982 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6039984 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6039985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039999 | GENERAL SUPPLY | Supply/Implant | $278.02 |
| 6040002 | SUPPLY IMPLANT | Supply/Implant | $3,914.02 |
| 6040005 | SUPPLY IMPLANT | Supply/Implant | $1,411.20 |
| 6040006 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6040011 | SUPPLY IMPLANT | Supply/Implant | $2,333.18 |
| 6040015 | SUPPLY IMPLANT | Supply/Implant | $1,243.52 |
| 6040022 | STERILE SUPPLY | Supply/Implant | $1,480.58 |
| 6040026 | SUPPLY IMPLANT | Supply/Implant | $1,415.04 |
| 6040036 | SUPPLY IMPLANT | Supply/Implant | $172.80 |
| 6040042 | GUIDE WIRE | Supply/Implant | $2,931.20 |
| 6040043 | SUPPLY IMPLANT | Supply/Implant | $2,640.00 |
| 6040044 | SUPPLY IMPLANT | Supply/Implant | $1,903.87 |
| 6040047 | SUPPLY IMPLANT | Supply/Implant | $2,015.62 |
| 6040055 | STERILE SUPPLY | Supply/Implant | $7,257.60 |
| 6040060 | SUPPLY IMPLANT | Supply/Implant | $11,123.97 |
| 6040061 | SUPPLY IMPLANT | Supply/Implant | $1,682.56 |
| 6040062 | SUPPLY IMPLANT | Supply/Implant | $682.38 |
| 6040065 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040066 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6040067 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040071 | SUPPLY IMPLANT | Supply/Implant | $10,009.60 |
| 6040072 | SUPPLY IMPLANT | Supply/Implant | $17,619.07 |
| 6040073 | SUPPLY IMPLANT | Supply/Implant | $3,016.45 |
| 6040080 | SUPPLY IMPLANT | Supply/Implant | $1,741.48 |
| 6040098 | SUPPLY IMPLANT | Supply/Implant | $4,410.15 |
| 6040099 | STERILE SUPPLY | Supply/Implant | $595.32 |
| 6040101 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6040105 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6040107 | STERILE SUPPLY | Supply/Implant | $243.71 |
| 6040108 | STERILE SUPPLY | Supply/Implant | $1,635.33 |
| 6040109 | GENERAL SUPPLY | Supply/Implant | $397.82 |
| 6040111 | SUPPLY IMPLANT | Supply/Implant | $862.85 |
| 6040119 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6040121 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6040127 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6040128 | SUPPLY IMPLANT | Supply/Implant | $210.37 |
| 6040130 | STERILE SUPPLY | Supply/Implant | $739.07 |
| 6040131 | SUPPLY IMPLANT | Supply/Implant | $195.56 |
| 6040134 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6040135 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6040136 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6040137 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6040139 | SUPPLY IMPLANT | Supply/Implant | $514.18 |
| 6040142 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6040145 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040146 | SUPPLY IMPLANT | Supply/Implant | $1,197.70 |
| 6040163 | CATHETER, URETERAL | Supply/Implant | $142.72 |
| 6040165 | GENERAL SUPPLY | Supply/Implant | $141.18 |
| 6040166 | SUPPLY IMPLANT | Supply/Implant | $2,640.00 |
| 6040167 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6040169 | STERILE SUPPLY | Supply/Implant | $253.31 |
| 6040178 | SUPPLY IMPLANT | Supply/Implant | $2,687.00 |
| 6040179 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6040180 | STERILE SUPPLY | Supply/Implant | $438.66 |
| 6040181 | STERILE SUPPLY | Supply/Implant | $512.13 |
| 6040191 | SUPPLY IMPLANT | Supply/Implant | $2,204.33 |
| 6040195 | STERILE SUPPLY | Supply/Implant | $370.56 |
| 6040196 | STERILE SUPPLY | Supply/Implant | $276.35 |
| 6040198 | SUPPLY IMPLANT | Supply/Implant | $3,497.73 |
| 6040200 | GENERAL SUPPLY | Supply/Implant | $206.21 |
| 6040201 | GENERAL SUPPLY | Supply/Implant | $376.06 |
| 6040202 | GENERAL SUPPLY | Supply/Implant | $138.24 |
| 6040206 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040207 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040210 | SUPPLY IMPLANT | Supply/Implant | $1,041.54 |
| 6040213 | STERILE SUPPLY | Supply/Implant | $643.58 |
| 6040216 | SUPPLY IMPLANT | Supply/Implant | $10,176.00 |
| 6040217 | SUPPLY IMPLANT | Supply/Implant | $15,936.00 |
| 6040221 | SUPPLY IMPLANT | Supply/Implant | $2,437.76 |
| 6040222 | STERILE SUPPLY | Supply/Implant | $1,700.86 |
| 6040223 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6040224 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6040233 | SUPPLY IMPLANT | Supply/Implant | $3,705.60 |
| 6040238 | SUPPLY IMPLANT | Supply/Implant | $931.84 |
| 6040239 | SUPPLY IMPLANT | Supply/Implant | $45,209.60 |
| 6040243 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6040244 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6040245 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6040253 | SUPPLY IMPLANT | Supply/Implant | $5,247.10 |
| 6040255 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6040256 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6040260 | SUPPLY IMPLANT | Supply/Implant | $977.92 |
| 6040267 | SUPPLY IMPLANT | Supply/Implant | $741.50 |
| 6040268 | SUPPLY IMPLANT | Supply/Implant | $3,338.88 |
| 6040270 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6040276 | STERILE SUPPLY | Supply/Implant | $522.24 |
| 6040277 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6040278 | SUPPLY IMPLANT | Supply/Implant | $3,338.88 |
| 6040279 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6040309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $281.47 |
| 6040341 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6040390 | GRAFT, VASCULAR | Supply/Implant | $5,286.40 |
| 6040433 | GRAFT, VASCULAR | Supply/Implant | $8,646.02 |
| 6040457 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6040478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,460.80 |
| 6040504 | SUPPLY IMPLANT | Supply/Implant | $53,644.80 |
| 6040506 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6040546 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $11,543.04 |
| 6040549 | SUPPLY IMPLANT | Supply/Implant | $4,264.45 |
| 6040623 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6040679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6040680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,450.24 |
| 6040718 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6040734 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,722.75 |
| 6040802 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6040847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6040857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $82,240.00 |
| 6040898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6040899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,036.80 |
| 6040902 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6040903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6041026 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $4,160.00 |
| 6041096 | SUPPLY IMPLANT | Supply/Implant | $41,484.80 |
| 6041143 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,832.00 |
| 6041177 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,120.00 |
| 6041188 | SUPPLY IMPLANT | Supply/Implant | $5,606.40 |
| 6041197 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6041217 | SUPPLY IMPLANT | Supply/Implant | $15,704.67 |
| 6041224 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6041232 | SUPPLY IMPLANT | Supply/Implant | $870.40 |
| 6041235 | SUPPLY IMPLANT | Supply/Implant | $9,210.62 |
| 6041247 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,832.00 |
| 6041253 | SUPPLY IMPLANT | Supply/Implant | $160.38 |
| 6041264 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $66,577.28 |
| 6041272 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041273 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041275 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041307 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041316 | SUPPLY IMPLANT | Supply/Implant | $13,056.00 |
| 6041323 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,707.20 |
| 6041345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,292.80 |
| 6041356 | SUPPLY IMPLANT | Supply/Implant | $2,962.56 |
| 6041360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,828.16 |
| 6041412 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6041422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,707.20 |
| 6041428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $124,225.50 |
| 6041444 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041483 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6041484 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6041488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6041497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041498 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041517 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6041518 | VENA CAVA FILTER | Supply/Implant | $13,619.07 |
| 6041520 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041524 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041536 | SUPPLY IMPLANT | Supply/Implant | $17,446.40 |
| 6041540 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6041541 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6041544 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6041561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,380.80 |
| 6041612 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6041614 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6041729 | SUPPLY IMPLANT | Supply/Implant | $4,313.60 |
| 6041739 | GENERAL SUPPLY | Supply/Implant | $2,243.46 |
| 6041784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,593.60 |
| 6041844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,888.00 |
| 6041866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,910.40 |
| 6041869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,537.60 |
| 6041897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,510.40 |
| 6041902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,236.03 |
| 6041916 | SUPPLY IMPLANT | Supply/Implant | $8,944.00 |
| 6041927 | SUPPLY IMPLANT | Supply/Implant | $5,280.77 |
| 6041947 | SUPPLY IMPLANT | Supply/Implant | $9,497.60 |
| 6041975 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,580.48 |
| 6041986 | SUPPLY IMPLANT | Supply/Implant | $10,073.60 |
| 6042005 | PROSTHETIC IMPLANT NOS | Supply/Implant | $22,540.80 |
| 6042051 | SUPPLY IMPLANT | Supply/Implant | $3,432.70 |
| 6042055 | INTERSPINOUS IMPLANT | Supply/Implant | $58,240.00 |
| 6042063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6042085 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6042085 | SUPPLY IMPLANT | Supply/Implant | $191.62 |
| 6042099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6042108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $947.20 |
| 6042110 | SUPPLY IMPLANT | Supply/Implant | $15,595.52 |
| 6042120 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6042136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,613.70 |
| 6042161 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6042248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,603.20 |
| 6042252 | SUPPLY IMPLANT | Supply/Implant | $973.44 |
| 6042265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6042289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,555.01 |
| 6042348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,476.67 |
| 6042361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $734.98 |
| 6042367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,437.12 |
| 6042385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,487.81 |
| 6042388 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6042399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,633.47 |
| 6042414 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6042415 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6042483 | SUPPLY IMPLANT | Supply/Implant | $973.44 |
| 6042499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6042512 | SUPPLY IMPLANT | Supply/Implant | $5,116.80 |
| 6042611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,181.12 |
| 6042627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6042653 | GUIDE WIRE | Supply/Implant | $2,995.20 |
| 6042681 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6042764 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6042780 | SUPPLY IMPLANT | Supply/Implant | $2,274.30 |
| 6042858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,676.80 |
| 6042873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6042874 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6042918 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,580.48 |
| 6042941 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6042963 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6043010 | GENERAL SUPPLY | Supply/Implant | $526.34 |
| 6043031 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6043034 | SUPPLY IMPLANT | Supply/Implant | $326.40 |
| 6043045 | SUPPLY IMPLANT | Supply/Implant | $1,352.45 |
| 6043085 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6043148 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6043257 | SUPPLY IMPLANT | Supply/Implant | $323.20 |
| 6043285 | SUPPLY IMPLANT | Supply/Implant | $231.17 |
| 6043287 | SUPPLY IMPLANT | Supply/Implant | $231.17 |
| 6043300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6043323 | SUPPLY IMPLANT | Supply/Implant | $6,988.80 |
| 6043358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,984.70 |
| 6043366 | SUPPLY IMPLANT | Supply/Implant | $1,352.45 |
| 6043387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6043409 | GRAFT, VASCULAR | Supply/Implant | $31,294.08 |
| 6043513 | SUPPLY IMPLANT | Supply/Implant | $324.61 |
| 6043531 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6043576 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $23,667.20 |
| 6043661 | SUPPLY IMPLANT | Supply/Implant | $668.80 |
| 6043674 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6043686 | SUPPLY IMPLANT | Supply/Implant | $4,000.64 |
| 6043689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,704.00 |
| 6043690 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6043704 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6043760 | SUPPLY IMPLANT | Supply/Implant | $23,828.48 |
| 6043770 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6043832 | ALLODERM SKIN SUB | Supply/Implant | $37,465.60 |
| 6043865 | GRAFT, VASCULAR | Supply/Implant | $2,315.26 |
| 6043925 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6043938 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6043947 | SUPPLY IMPLANT | Supply/Implant | $62,933.76 |
| 6043951 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6043954 | SUPPLY IMPLANT | Supply/Implant | $30,087.68 |
| 6043971 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6043979 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,774.40 |
| 6043992 | SUPPLY IMPLANT | Supply/Implant | $1,663.49 |
| 6044000 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6044086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6044087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6044092 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6044096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6044111 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6044117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6044125 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6044133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6044163 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6044167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6044168 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6044180 | SUPPLY IMPLANT | Supply/Implant | $19,403.52 |
| 6044188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,828.48 |
| 6044203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,407.49 |
| 6044237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $784.51 |
| 6044256 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6044269 | SUPPLY IMPLANT | Supply/Implant | $2,754.56 |
| 6044280 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6044294 | SUPPLY IMPLANT | Supply/Implant | $541.27 |
| 6044299 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,588.80 |
| 6044315 | GENERAL SUPPLY | Supply/Implant | $180.48 |
| 6044320 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6044331 | GENERAL SUPPLY | Supply/Implant | $288.26 |
| 6044342 | GENERAL SUPPLY | Supply/Implant | $154.50 |
| 6044345 | GENERAL SUPPLY | Supply/Implant | $419.58 |
| 6044351 | GENERAL SUPPLY | Supply/Implant | $957.80 |
| 6044353 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $798.46 |
| 6044367 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6044374 | GENERAL SUPPLY | Supply/Implant | $327.04 |
| 6044384 | GENERAL SUPPLY | Supply/Implant | $214.14 |
| 6044401 | GENERAL SUPPLY | Supply/Implant | $133.12 |
| 6044403 | STERILE SUPPLY | Supply/Implant | $181.80 |
| 6044407 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6044410 | GENERAL SUPPLY | Supply/Implant | $377.60 |
| 6044418 | SUPPLY IMPLANT | Supply/Implant | $3,123.20 |
| 6044419 | SUPPLY IMPLANT | Supply/Implant | $3,030.14 |
| 6044420 | SUPPLY IMPLANT | Supply/Implant | $3,030.14 |
| 6044429 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6044437 | CATHETER, URETERAL | Supply/Implant | $209.02 |
| 6044438 | CATH, DRAINAGE | Supply/Implant | $291.33 |
| 6044439 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6044440 | CATH, DRAINAGE | Supply/Implant | $325.63 |
| 6044441 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6044442 | SUPPLY IMPLANT | Supply/Implant | $328.45 |
| 6044459 | SUPPLY IMPLANT | Supply/Implant | $219.90 |
| 6044475 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6044510 | SUPPLY IMPLANT | Supply/Implant | $1,679.87 |
| 6044534 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6044535 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6044547 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6044557 | GENERAL SUPPLY | Supply/Implant | $149.76 |
| 6044558 | SUPPLY IMPLANT | Supply/Implant | $178.94 |
| 6044559 | GENERAL SUPPLY | Supply/Implant | $171.65 |
| 6044571 | SUPPLY IMPLANT | Supply/Implant | $1,438.08 |
| 6044615 | STERILE SUPPLY | Supply/Implant | $515.84 |
| 6044616 | STERILE SUPPLY | Supply/Implant | $476.16 |
| 6044633 | GENERAL SUPPLY | Supply/Implant | $185.86 |
| 6044634 | GENERAL SUPPLY | Supply/Implant | $132.48 |
| 6044635 | GENERAL SUPPLY | Supply/Implant | $223.74 |
| 6044647 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $314.24 |
| 6044653 | SUPPLY IMPLANT | Supply/Implant | $2,965.63 |
| 6044672 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,786.18 |
| 6044700 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $2,368.00 |
| 6044720 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6044726 | SUPPLY IMPLANT | Supply/Implant | $457.09 |
| 6044728 | SUPPLY IMPLANT | Supply/Implant | $457.09 |
| 6044730 | SUPPLY IMPLANT | Supply/Implant | $524.29 |
| 6044734 | SUPPLY IMPLANT | Supply/Implant | $566.27 |
| 6044743 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6044813 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6044823 | GENERAL SUPPLY | Supply/Implant | $303.49 |
| 6044857 | SUPPLY IMPLANT | Supply/Implant | $211.58 |
| 6044863 | CATHETER, URETERAL | Supply/Implant | $135.55 |
| 6044902 | CATH, DRAINAGE | Supply/Implant | $449.92 |
| 6044903 | SUPPLY IMPLANT | Supply/Implant | $492.93 |
| 6044911 | GENERAL SUPPLY | Supply/Implant | $271.36 |
| 6044912 | SUPPLY IMPLANT | Supply/Implant | $1,505.28 |
| 6044919 | SUPPLY IMPLANT | Supply/Implant | $6,785.66 |
| 6044921 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6044925 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,126.58 |
| 6044945 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6044947 | SUPPLY IMPLANT | Supply/Implant | $3,199.36 |
| 6044995 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6045000 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6045004 | TRANS ANGIOPLASTY CATH | Supply/Implant | $12,160.00 |
| 6045027 | STERILE SUPPLY | Supply/Implant | $245.16 |
| 6045028 | STERILE SUPPLY | Supply/Implant | $152.18 |
| 6045050 | SUPPLY IMPLANT | Supply/Implant | $5,542.40 |
| 6045051 | SUPPLY IMPLANT | Supply/Implant | $6,825.60 |
| 6045059 | GENERAL SUPPLY | Supply/Implant | $178.82 |
| 6045068 | STERILE SUPPLY | Supply/Implant | $311.62 |
| 6045094 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6045096 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6045103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6045108 | GENERAL SUPPLY | Supply/Implant | $254.34 |
| 6045117 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6045121 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6045122 | SUPPLY IMPLANT | Supply/Implant | $1,276.80 |
| 6045125 | SUPPLY IMPLANT | Supply/Implant | $1,862.40 |
| 6045134 | SUPPLY IMPLANT | Supply/Implant | $209.54 |
| 6045149 | SUPPLY IMPLANT | Supply/Implant | $1,852.80 |
| 6045177 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6045178 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6045179 | STERILE SUPPLY | Supply/Implant | $3,027.46 |
| 6045182 | SUPPLY IMPLANT | Supply/Implant | $4,134.40 |
| 6045186 | STERILE SUPPLY | Supply/Implant | $5,824.00 |
| 6045212 | CATHETER, GUIDING | Supply/Implant | $275.20 |
| 6045213 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6045227 | SUPPLY IMPLANT | Supply/Implant | $1,244.29 |
| 6045243 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6045246 | SUPPLY IMPLANT | Supply/Implant | $3,600.00 |
| 6045247 | SUPPLY IMPLANT | Supply/Implant | $3,891.20 |
| 6045257 | SUPPLY IMPLANT | Supply/Implant | $4,172.80 |
| 6045269 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,523.20 |
| 6045271 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6045275 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6045331 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6045333 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6045505 | SUPPLY IMPLANT | Supply/Implant | $973.44 |
| 6045534 | GENERAL SUPPLY | Supply/Implant | $547.84 |
| 6045553 | CATHETER, GUIDING | Supply/Implant | $275.20 |
| 6045557 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $588.80 |
| 6045587 | STERILE SUPPLY | Supply/Implant | $1,862.14 |
| 6045598 | RET DEV, INSERTABLE | Supply/Implant | $8,960.00 |
| 6045635 | SUPPLY IMPLANT | Supply/Implant | $10,176.00 |
| 6045665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $473.60 |
| 6045666 | SUPPLY IMPLANT | Supply/Implant | $2,585.09 |
| 6045671 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6045672 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6045678 | CATH, DRAINAGE | Supply/Implant | $962.43 |
| 6045680 | GENERAL SUPPLY | Supply/Implant | $363.52 |
| 6045721 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6045725 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6045726 | SUPPLY IMPLANT | Supply/Implant | $460.16 |
| 6045727 | SUPPLY IMPLANT | Supply/Implant | $3,842.05 |
| 6045763 | SUPPLY IMPLANT | Supply/Implant | $175.87 |
| 6045767 | GENERAL SUPPLY | Supply/Implant | $599.04 |
| 6045769 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6045770 | SUPPLY IMPLANT | Supply/Implant | $1,264.64 |
| 6045777 | SUPPLY IMPLANT | Supply/Implant | $362.88 |
| 6045779 | SUPPLY IMPLANT | Supply/Implant | $3,226.34 |
| 6045799 | INTRO/SHEATH, NON-LASER | Supply/Implant | $591.36 |
| 6045800 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6045811 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6045817 | SUPPLY IMPLANT | Supply/Implant | $1,078.27 |
| 6045818 | SUPPLY IMPLANT | Supply/Implant | $3,315.39 |
| 6045822 | SUPPLY IMPLANT | Supply/Implant | $523.49 |
| 6045837 | GENERAL SUPPLY | Supply/Implant | $342.78 |
| 6045843 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6045852 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6045859 | SUPPLY IMPLANT | Supply/Implant | $437.63 |
| 6045863 | SUPPLY IMPLANT | Supply/Implant | $3,315.39 |
| 6045865 | GENERAL SUPPLY | Supply/Implant | $131.58 |
| 6045870 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6045878 | SUPPLY IMPLANT | Supply/Implant | $3,040.00 |
| 6045882 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6045884 | SUPPLY IMPLANT | Supply/Implant | $875.52 |
| 6045897 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,024.90 |
| 6045899 | STERILE SUPPLY | Supply/Implant | $145.02 |
| 6045923 | SUPPLY IMPLANT | Supply/Implant | $406.43 |
| 6045928 | GENERAL SUPPLY | Supply/Implant | $154.37 |
| 6045929 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6045942 | SUPPLY IMPLANT | Supply/Implant | $551.30 |
| 6045944 | CATHETER, GUIDING | Supply/Implant | $4,467.20 |
| 6045947 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6045957 | SUPPLY IMPLANT | Supply/Implant | $1,238.53 |
| 6045958 | SUPPLY IMPLANT | Supply/Implant | $2,802.56 |
| 6045964 | STERILE SUPPLY | Supply/Implant | $906.37 |
| 6045966 | STERILE SUPPLY | Supply/Implant | $914.56 |
| 6045974 | STERILE SUPPLY | Supply/Implant | $214.40 |
| 6045975 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6045976 | GENERAL SUPPLY | Supply/Implant | $172.19 |
| 6045978 | SUPPLY IMPLANT | Supply/Implant | $427.78 |
| 6045985 | STERILE SUPPLY | Supply/Implant | $513.79 |
| 6045999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6046016 | SUPPLY IMPLANT | Supply/Implant | $653.31 |
| 6046017 | STERILE SUPPLY | Supply/Implant | $1,113.60 |
| 6046021 | SUPPLY IMPLANT | Supply/Implant | $406.43 |
| 6046026 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6046034 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6046039 | GENERAL SUPPLY | Supply/Implant | $263.68 |
| 6046039 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6046041 | SUPPLY IMPLANT | Supply/Implant | $8,925.31 |
| 6046049 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6046050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,345.60 |
| 6046054 | STERILE SUPPLY | Supply/Implant | $494.46 |
| 6046055 | MISC SUP/ACC IMP VAD | Supply/Implant | $704.00 |
| 6046065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,640.70 |
| 6046066 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6046082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6046101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6046133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,594.37 |
| 6046137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6046148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6046149 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6046150 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6046153 | SUPPLY IMPLANT | Supply/Implant | $25,110.53 |
| 6046159 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6046188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6046198 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,032.58 |
| 6046234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6046236 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6046244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,425.60 |
| 6046268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6046272 | SUPPLY IMPLANT | Supply/Implant | $122,367.00 |
| 6046281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,407.49 |
| 6046289 | SUPPLY IMPLANT | Supply/Implant | $2,992.64 |
| 6046294 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,360.00 |
| 6046297 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6046324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6046335 | SUPPLY IMPLANT | Supply/Implant | $4,146.56 |
| 6046359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6046386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6046394 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6046405 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6046411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6046412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6046423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6046434 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6046453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6046467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6046477 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6046478 | SUPPLY IMPLANT | Supply/Implant | $14,566.40 |
| 6046488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,336.00 |
| 6046489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,336.00 |
| 6046491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6046492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6046494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,336.00 |
| 6046495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,336.00 |
| 6046506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046518 | SUPPLY IMPLANT | Supply/Implant | $853.50 |
| 6046522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6046559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6046593 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6046614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6046644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6046657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6046658 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6046666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6046672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6046680 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $37,760.00 |
| 6046712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6046728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6046733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6046752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6046753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6046772 | GUIDE WIRE | Supply/Implant | $604.16 |
| 6046780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6046792 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,876.35 |
| 6046798 | SUPPLY IMPLANT | Supply/Implant | $884.35 |
| 6046799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,888.00 |
| 6046808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6046823 | GENERAL SUPPLY | Supply/Implant | $10,946.56 |
| 6046826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6046837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6046843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6046877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6046900 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,157.12 |
| 6046904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6046905 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6046906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,398.40 |
| 6046914 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,686.40 |
| 6046916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,949.12 |
| 6046933 | GUIDE WIRE | Supply/Implant | $2,944.00 |
| 6046940 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6046948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,517.76 |
| 6046957 | SUPPLY IMPLANT | Supply/Implant | $13,286.40 |
| 6046958 | SUPPLY IMPLANT | Supply/Implant | $10,939.65 |
| 6046981 | SUPPLY IMPLANT | Supply/Implant | $3,763.20 |
| 6046982 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,294.08 |
| 6046983 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046988 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6047000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.80 |
| 6047001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6047011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6047018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,556.80 |
| 6047031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6047048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,687.36 |
| 6047050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $440.32 |
| 6047069 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6047075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,580.80 |
| 6047093 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6047130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6047147 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6047151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6047167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6047172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6047178 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6047198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6047199 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6047219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6047221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047228 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,716.80 |
| 6047238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,544.06 |
| 6047241 | SUPPLY IMPLANT | Supply/Implant | $2,754.56 |
| 6047243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6047246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6047251 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6047252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6047253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,072.77 |
| 6047260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6047267 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6047277 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6047282 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6047285 | GUIDE WIRE | Supply/Implant | $524.80 |
| 6047286 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6047300 | SUPPLY IMPLANT | Supply/Implant | $1,080.27 |
| 6047301 | STERILE SUPPLY | Supply/Implant | $7,553.28 |
| 6047303 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6047315 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6047316 | SUPPLY IMPLANT | Supply/Implant | $17,452.29 |
| 6047319 | SUPPLY IMPLANT | Supply/Implant | $2,467.20 |
| 6047334 | GUIDE WIRE | Supply/Implant | $366.46 |
| 6047338 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6047342 | SUPPLY IMPLANT | Supply/Implant | $2,416.64 |
| 6047343 | SUPPLY IMPLANT | Supply/Implant | $3,705.60 |
| 6047353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6047362 | GUIDE WIRE | Supply/Implant | $2,611.20 |
| 6047371 | SUPPLY IMPLANT | Supply/Implant | $2,163.84 |
| 6047376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,318.40 |
| 6047425 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6047426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6047436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6047437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6047448 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6047449 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6047450 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6047452 | STERILE SUPPLY | Supply/Implant | $1,066.75 |
| 6047457 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6047462 | SUPPLY IMPLANT | Supply/Implant | $160.90 |
| 6047480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6047481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6047483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6047517 | STERILE SUPPLY | Supply/Implant | $1,433.60 |
| 6047519 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6047532 | STERILE SUPPLY | Supply/Implant | $210.30 |
| 6047533 | STERILE SUPPLY | Supply/Implant | $1,094.40 |
| 6047540 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,766.40 |
| 6047557 | GRAFT, VASCULAR | Supply/Implant | $79,360.00 |
| 6047564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6047600 | GUIDE WIRE | Supply/Implant | $1,126.27 |
| 6047601 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6047614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,065.02 |
| 6047627 | GENERAL SUPPLY | Supply/Implant | $399.10 |
| 6047641 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6047663 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $8,960.00 |
| 6047666 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6047671 | SUPPLY IMPLANT | Supply/Implant | $1,594.24 |
| 6047672 | SUPPLY IMPLANT | Supply/Implant | $660.61 |
| 6047690 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6047691 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6047692 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6047701 | GENERAL SUPPLY | Supply/Implant | $6,696.32 |
| 6047714 | STERILE SUPPLY | Supply/Implant | $497.61 |
| 6047726 | SUPPLY IMPLANT | Supply/Implant | $3,090.18 |
| 6047733 | STERILE SUPPLY | Supply/Implant | $237.31 |
| 6047736 | SUPPLY IMPLANT | Supply/Implant | $171.14 |
| 6047759 | GENERAL SUPPLY | Supply/Implant | $6,336.00 |
| 6047760 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6047778 | SUPPLY IMPLANT | Supply/Implant | $2,639.03 |
| 6047784 | SUPPLY IMPLANT | Supply/Implant | $300.80 |
| 6047789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047804 | SUPPLY IMPLANT | Supply/Implant | $10,672.00 |
| 6047811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,394.05 |
| 6047820 | SUPPLY IMPLANT | Supply/Implant | $544.00 |
| 6047824 | SUPPLY IMPLANT | Supply/Implant | $12,172.80 |
| 6047826 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6047827 | CATHETER, GUIDING | Supply/Implant | $1,984.00 |
| 6047828 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6047829 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6047830 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6047834 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6047855 | STERILE SUPPLY | Supply/Implant | $223.87 |
| 6047861 | SUPPLY IMPLANT | Supply/Implant | $2,287.49 |
| 6047870 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6047958 | GENERAL SUPPLY | Supply/Implant | $1,526.40 |
| 6047962 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6047963 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6047964 | SUPPLY IMPLANT | Supply/Implant | $5,462.40 |
| 6047965 | SUPPLY IMPLANT | Supply/Implant | $5,462.40 |
| 6047977 | SUPPLY IMPLANT | Supply/Implant | $1,161.60 |
| 6047996 | STERILE SUPPLY | Supply/Implant | $760.32 |
| 6048000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,118.21 |
| 6048041 | STERILE SUPPLY | Supply/Implant | $137.22 |
| 6048047 | SUPPLY IMPLANT | Supply/Implant | $231.83 |
| 6048051 | GENERAL SUPPLY | Supply/Implant | $433.66 |
| 6048070 | STERILE SUPPLY | Supply/Implant | $880.26 |
| 6048083 | GENERAL SUPPLY | Supply/Implant | $514.43 |
| 6048112 | GENERAL SUPPLY | Supply/Implant | $150.22 |
| 6048128 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6048138 | STERILE SUPPLY | Supply/Implant | $166.78 |
| 6048143 | STERILE SUPPLY | Supply/Implant | $200.06 |
| 6048143 | STERILE SUPPLY | Supply/Implant | $203.78 |
| 6048151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,534.40 |
| 6048152 | INTEGRA BMWD SKIN SUB | Supply/Implant | $100,317.31 |
| 6048156 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6048167 | GUIDE WIRE | Supply/Implant | $2,534.40 |
| 6048183 | STERILE SUPPLY | Supply/Implant | $183.04 |
| 6048205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,185.60 |
| 6048213 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6048233 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,199.42 |
| 6048245 | GENERAL SUPPLY | Supply/Implant | $306.18 |
| 6048286 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6048289 | CATHETER, GUIDING | Supply/Implant | $8,755.20 |
| 6048294 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6048301 | STERILE SUPPLY | Supply/Implant | $140.42 |
| 6048303 | SUPPLY IMPLANT | Supply/Implant | $5,067.01 |
| 6048305 | SUPPLY IMPLANT | Supply/Implant | $782.08 |
| 6048314 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $343.42 |
| 6048316 | GENERAL SUPPLY | Supply/Implant | $190.46 |
| 6048317 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6048318 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6048319 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6048387 | STERILE SUPPLY | Supply/Implant | $147.60 |
| 6048388 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,298.37 |
| 6048407 | SUPPLY IMPLANT | Supply/Implant | $275.97 |
| 6048414 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6048467 | STERILE SUPPLY | Supply/Implant | $4,377.60 |
| 6048475 | GUIDE WIRE | Supply/Implant | $8,755.20 |
| 6048478 | SUPPLY IMPLANT | Supply/Implant | $307.33 |
| 6048492 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6048497 | STERILE SUPPLY | Supply/Implant | $4,800.00 |
| 6048520 | GENERAL SUPPLY | Supply/Implant | $161.28 |
| 6048521 | GENERAL SUPPLY | Supply/Implant | $161.28 |
| 6048522 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6048523 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6048525 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $153.60 |
| 6048529 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6048548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6048554 | SUPPLY IMPLANT | Supply/Implant | $27,522.69 |
| 6048559 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6048560 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6048561 | GENERAL SUPPLY | Supply/Implant | $234.66 |
| 6048569 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6048595 | GUIDE WIRE | Supply/Implant | $1,024.00 |
| 6048596 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6048597 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6048615 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,520.00 |
| 6048624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6048640 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $27,522.69 |
| 6048641 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6048643 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6048674 | SUPPLY IMPLANT | Supply/Implant | $2,879.36 |
| 6048676 | SUPPLY IMPLANT | Supply/Implant | $487.30 |
| 6048694 | SUPPLY IMPLANT | Supply/Implant | $3,427.20 |
| 6048697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6048724 | STERILE SUPPLY | Supply/Implant | $690.05 |
| 6048734 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6048742 | SUPPLY IMPLANT | Supply/Implant | $13,760.00 |
| 6048759 | SUPPLY IMPLANT | Supply/Implant | $273.97 |
| 6048767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6048777 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6048780 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6048791 | SUPPLY IMPLANT | Supply/Implant | $260.20 |
| 6048795 | SUPPLY IMPLANT | Supply/Implant | $1,930.24 |
| 6048811 | STERILE SUPPLY | Supply/Implant | $162.82 |
| 6048821 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6048823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,784.32 |
| 6048824 | STERILE SUPPLY | Supply/Implant | $264.77 |
| 6048894 | VENA CAVA FILTER | Supply/Implant | $1,536.00 |
| 6048898 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6048903 | INTRO/SHEATH, NON-LASER | Supply/Implant | $506.24 |
| 6048928 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6048929 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6048931 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6048934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $49,470.98 |
| 6048978 | SUPPLY IMPLANT | Supply/Implant | $6,338.56 |
| 6048979 | SUPPLY IMPLANT | Supply/Implant | $5,468.16 |
| 6048980 | SUPPLY IMPLANT | Supply/Implant | $5,376.00 |
| 6048981 | SUPPLY IMPLANT | Supply/Implant | $6,215.68 |
| 6048992 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,395.26 |
| 6049008 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6049009 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6049040 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6049067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,369.92 |
| 6049071 | GENERAL SUPPLY | Supply/Implant | $6,387.20 |
| 6049111 | STERILE SUPPLY | Supply/Implant | $1,594.88 |
| 6049158 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6049159 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6049160 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6049178 | SUPPLY IMPLANT | Supply/Implant | $2,313.60 |
| 6049231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $840.45 |
| 6049249 | GUIDE WIRE | Supply/Implant | $135.42 |
| 6049266 | STERILE SUPPLY | Supply/Implant | $231.85 |
| 6049275 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6049293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6049332 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6049340 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6049357 | STERILE SUPPLY | Supply/Implant | $448.32 |
| 6049358 | GENERAL SUPPLY | Supply/Implant | $1,218.05 |
| 6049359 | GENERAL SUPPLY | Supply/Implant | $981.50 |
| 6049422 | SUPPLY IMPLANT | Supply/Implant | $3,635.20 |
| 6049464 | SUPPLY IMPLANT | Supply/Implant | $672.26 |
| 6049477 | GENERAL SUPPLY | Supply/Implant | $147.33 |
| 6049501 | SUPPLY IMPLANT | Supply/Implant | $19,826.05 |
| 6049508 | GENERAL SUPPLY | Supply/Implant | $330.69 |
| 6049526 | SUPPLY IMPLANT | Supply/Implant | $2,935.81 |
| 6049557 | STERILE SUPPLY | Supply/Implant | $304.88 |
| 6049590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6049605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6049655 | SUPPLY IMPLANT | Supply/Implant | $1,055.49 |
| 6049726 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6049727 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6049738 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,944.00 |
| 6049770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6049795 | SUPPLY IMPLANT | Supply/Implant | $2,015.62 |
| 6049802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6049862 | GENERAL SUPPLY | Supply/Implant | $409.15 |
| 6049872 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049873 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049874 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049875 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049876 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049891 | GENERAL SUPPLY | Supply/Implant | $221.18 |
| 6049892 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6049893 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6049894 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6049895 | GENERAL SUPPLY | Supply/Implant | $217.09 |
| 6049896 | GENERAL SUPPLY | Supply/Implant | $217.09 |
| 6049949 | STERILE SUPPLY | Supply/Implant | $8,704.00 |
| 6050023 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6050024 | GENERAL SUPPLY | Supply/Implant | $374.66 |
| 6050056 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6050083 | GENERAL SUPPLY | Supply/Implant | $314.11 |
| 6050139 | GENERAL SUPPLY | Supply/Implant | $652.80 |
| 6050170 | STERILE SUPPLY | Supply/Implant | $174.81 |
| 6050225 | STERILE SUPPLY | Supply/Implant | $1,629.70 |
| 6050249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6050250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6050271 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6050272 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6050287 | CATH, DRAINAGE | Supply/Implant | $1,021.44 |
| 6050315 | STERILE SUPPLY | Supply/Implant | $273.15 |
| 6050333 | STERILE SUPPLY | Supply/Implant | $511.36 |
| 6050353 | GENERAL SUPPLY | Supply/Implant | $883.20 |
| 6050354 | SUPPLY IMPLANT | Supply/Implant | $1,591.30 |
| 6050419 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,920.00 |
| 6050432 | GENERAL SUPPLY | Supply/Implant | $732.93 |
| 6050490 | SUPPLY IMPLANT | Supply/Implant | $534.27 |
| 6050491 | SUPPLY IMPLANT | Supply/Implant | $605.57 |
| 6050501 | SUPPLY IMPLANT | Supply/Implant | $2,050.30 |
| 6050502 | SUPPLY IMPLANT | Supply/Implant | $2,050.30 |
| 6050504 | SUPPLY IMPLANT | Supply/Implant | $1,114.24 |
| 6050505 | SUPPLY IMPLANT | Supply/Implant | $1,114.24 |
| 6050506 | SUPPLY IMPLANT | Supply/Implant | $1,114.24 |
| 6050551 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6050552 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6050553 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6050554 | SUPPLY IMPLANT | Supply/Implant | $534.27 |
| 6050563 | GENERAL SUPPLY | Supply/Implant | $12,921.60 |
| 6050564 | GENERAL SUPPLY | Supply/Implant | $23,936.00 |
| 6050565 | GENERAL SUPPLY | Supply/Implant | $12,921.60 |
| 6050603 | GENERAL SUPPLY | Supply/Implant | $148.79 |
| 6050621 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6050665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6050673 | SUPPLY IMPLANT | Supply/Implant | $4,257.59 |
| 6050688 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6050702 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6050703 | STERILE SUPPLY | Supply/Implant | $1,585.15 |
| 6050824 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6050828 | GENERAL SUPPLY | Supply/Implant | $273.02 |
| 6050847 | GENERAL SUPPLY | Supply/Implant | $3,360.00 |
| 6050881 | SUPPLY IMPLANT | Supply/Implant | $184.32 |
| 6050883 | SUPPLY IMPLANT | Supply/Implant | $184.32 |
| 6050920 | STERILE SUPPLY | Supply/Implant | $839.81 |
| 6050921 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $1,575.94 |
| 6050922 | STERILE SUPPLY | Supply/Implant | $270.72 |
| 6050923 | SUPPLY IMPLANT | Supply/Implant | $8,768.00 |
| 6050976 | GENERAL SUPPLY | Supply/Implant | $4,198.40 |
| 6051012 | GENERAL SUPPLY | Supply/Implant | $336.00 |
| 6051058 | STERILE SUPPLY | Supply/Implant | $187.90 |
| 6051072 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6051073 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6051075 | STERILE SUPPLY | Supply/Implant | $1,202.05 |
| 6051083 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6051084 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6051103 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6051165 | STERILE SUPPLY | Supply/Implant | $555.07 |
| 6051166 | SUPPLY IMPLANT | Supply/Implant | $469.25 |
| 6051172 | SUPPLY IMPLANT | Supply/Implant | $5,286.40 |
| 6051173 | GENERAL SUPPLY | Supply/Implant | $5,286.40 |
| 6051199 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6051200 | OSSICULAR IMPLANT | Supply/Implant | $4,963.97 |
| 6051282 | SUPPLY IMPLANT | Supply/Implant | $342.78 |
| 6051299 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,395.20 |
| 6051341 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6051342 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6051357 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6051373 | WOUND FILLER GEL/PASTE /OZ | Supply/Implant | $596.48 |
| 6051403 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6051433 | STERILE SUPPLY | Supply/Implant | $1,818.62 |
| 6051434 | STERILE SUPPLY | Supply/Implant | $1,341.82 |
| 6051437 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6051438 | SUPPLY IMPLANT | Supply/Implant | $143.87 |
| 6051439 | INTRO/SHEATH, NON-LASER | Supply/Implant | $136.03 |
| 6051447 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $3,210.24 |
| 6051494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $784.51 |
| 6051495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.85 |
| 6051496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,633.47 |
| 6051499 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6051507 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6051523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6051524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6051553 | STERILE SUPPLY | Supply/Implant | $1,600.51 |
| 6051557 | STERILE SUPPLY | Supply/Implant | $441.60 |
| 6051566 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6051590 | GRAFT, VASCULAR | Supply/Implant | $36,812.80 |
| 6051604 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6051660 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6051666 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6051681 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6051705 | STERILE SUPPLY | Supply/Implant | $1,094.40 |
| 6051711 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6051716 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6051736 | SUPPLY IMPLANT | Supply/Implant | $357.89 |
| 6051739 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6051749 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6051773 | SUPPLY IMPLANT | Supply/Implant | $16,192.00 |
| 6051774 | SUPPLY IMPLANT | Supply/Implant | $5,652.48 |
| 6051779 | SUPPLY IMPLANT | Supply/Implant | $246.78 |
| 6051781 | SUPPLY IMPLANT | Supply/Implant | $1,086.46 |
| 6051782 | SUPPLY IMPLANT | Supply/Implant | $1,207.21 |
| 6051792 | SUPPLY IMPLANT | Supply/Implant | $192.26 |
| 6051794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6051797 | SUPPLY IMPLANT | Supply/Implant | $529.28 |
| 6051798 | SUPPLY IMPLANT | Supply/Implant | $475.84 |
| 6051817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6051818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6051820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6051913 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,718.40 |
| 6051951 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6051989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6051991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,826.62 |
| 6051993 | SUPPLY IMPLANT | Supply/Implant | $4,852.35 |
| 6052050 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6052051 | GENERAL SUPPLY | Supply/Implant | $285.95 |
| 6052058 | SUPPLY IMPLANT | Supply/Implant | $713.60 |
| 6052091 | SUPPLY IMPLANT | Supply/Implant | $210.05 |
| 6052099 | STERILE SUPPLY | Supply/Implant | $1,127.04 |
| 6052101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $632.32 |
| 6052113 | GENERAL SUPPLY | Supply/Implant | $181.89 |
| 6052135 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6052173 | SUPPLY IMPLANT | Supply/Implant | $199.17 |
| 6052174 | SUPPLY IMPLANT | Supply/Implant | $333.18 |
| 6052209 | GENERAL SUPPLY | Supply/Implant | $974.59 |
| 6052231 | GRAFT, VASCULAR | Supply/Implant | $23,244.80 |
| 6052234 | SUPPLY IMPLANT | Supply/Implant | $1,719.17 |
| 6052242 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6052259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,062.59 |
| 6052272 | CATHETER, GUIDING | Supply/Implant | $14,080.00 |
| 6052280 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6052313 | SUPPLY IMPLANT | Supply/Implant | $3,342.21 |
| 6052357 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6052375 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6052389 | SUPPLY IMPLANT | Supply/Implant | $24,384.00 |
| 6052395 | SUPPLY IMPLANT | Supply/Implant | $7,088.00 |
| 6052401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.85 |
| 6052413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,830.78 |
| 6052415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6052418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6052434 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $33,851.78 |
| 6052466 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6052476 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6052477 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6052482 | SUPPLY IMPLANT | Supply/Implant | $140.16 |
| 6052483 | SUPPLY IMPLANT | Supply/Implant | $140.16 |
| 6052488 | STERILE SUPPLY | Supply/Implant | $915.20 |
| 6052505 | STERILE SUPPLY | Supply/Implant | $165.43 |
| 6052531 | STERILE SUPPLY | Supply/Implant | $3,028.48 |
| 6052555 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6052556 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6052557 | SUPPLY IMPLANT | Supply/Implant | $131.07 |
| 6052570 | CATHETER, GUIDING | Supply/Implant | $9,344.00 |
| 6052573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,498.62 |
| 6052648 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.64 |
| 6052656 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6052658 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6052659 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6052660 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6052663 | GUIDE WIRE | Supply/Implant | $4,787.20 |
| 6052664 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6052665 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6052666 | GUIDE WIRE | Supply/Implant | $2,035.20 |
| 6052680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6052683 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6052705 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6052737 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6052741 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6052784 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052788 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052790 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052796 | SUPPLY IMPLANT | Supply/Implant | $2,711.42 |
| 6052797 | SUPPLY IMPLANT | Supply/Implant | $2,711.42 |
| 6052805 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052822 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6052826 | GENERAL SUPPLY | Supply/Implant | $1,512.19 |
| 6052830 | GENERAL SUPPLY | Supply/Implant | $294.66 |
| 6052845 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6052896 | GENERAL SUPPLY | Supply/Implant | $1,385.60 |
| 6052950 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6052952 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6052974 | MESH (IMPLANTABLE) | Supply/Implant | $86,937.60 |
| 6052988 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6052989 | GENERAL SUPPLY | Supply/Implant | $547.84 |
| 6052998 | GENERAL SUPPLY | Supply/Implant | $296.32 |
| 6053002 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $13,760.00 |
| 6053006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6053015 | GUIDE WIRE | Supply/Implant | $3,712.00 |
| 6053039 | SUPPLY IMPLANT | Supply/Implant | $3,379.20 |
| 6053041 | SUPPLY IMPLANT | Supply/Implant | $2,252.80 |
| 6053056 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,960.00 |
| 6053094 | GENERAL SUPPLY | Supply/Implant | $1,924.35 |
| 6053095 | SUPPLY IMPLANT | Supply/Implant | $2,293.76 |
| 6053103 | GUIDE WIRE | Supply/Implant | $2,240.00 |
| 6053106 | SUPPLY IMPLANT | Supply/Implant | $364.80 |
| 6053111 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6053126 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6053131 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6053134 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6053137 | SUPPLY IMPLANT | Supply/Implant | $3,459.43 |
| 6053180 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6053183 | STERILE SUPPLY | Supply/Implant | $1,152.00 |
| 6053200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,937.92 |
| 6053208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6053229 | SUPPLY IMPLANT | Supply/Implant | $2,580.48 |
| 6053254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,981.89 |
| 6053261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053267 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053272 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6053274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6053277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6053281 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6053343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,905.60 |
| 6053354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6053355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6053373 | STERILE SUPPLY | Supply/Implant | $5,068.80 |
| 6053393 | SUPPLY IMPLANT | Supply/Implant | $1,080.32 |
| 6053398 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6053409 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6053413 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6053417 | CATHETER, URETERAL | Supply/Implant | $266.62 |
| 6053422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6053423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,072.77 |
| 6053424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,463.87 |
| 6053430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6053464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6053469 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6053470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,558.40 |
| 6053481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6053482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6053490 | STERILE SUPPLY | Supply/Implant | $142.98 |
| 6053491 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $588.80 |
| 6053524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,463.87 |
| 6053548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,393.60 |
| 6053588 | SUPPLY IMPLANT | Supply/Implant | $2,134.40 |
| 6053600 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6053608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6053664 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6053665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,913.66 |
| 6053705 | GENERAL SUPPLY | Supply/Implant | $360.96 |
| 6053706 | GENERAL SUPPLY | Supply/Implant | $474.62 |
| 6053707 | STERILE SUPPLY | Supply/Implant | $158.21 |
| 6053744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,509.12 |
| 6053746 | SUPPLY IMPLANT | Supply/Implant | $7,027.20 |
| 6053752 | SUPPLY IMPLANT | Supply/Implant | $48,869.63 |
| 6053756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6053757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6053770 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6053771 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6053788 | GENERAL SUPPLY | Supply/Implant | $28,160.00 |
| 6053810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,348.80 |
| 6053817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,072.77 |
| 6053818 | GUIDE WIRE | Supply/Implant | $1,238.40 |
| 6053823 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6053836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6053837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6053840 | GENERAL SUPPLY | Supply/Implant | $160.17 |
| 6053842 | SUPPLY IMPLANT | Supply/Implant | $266.50 |
| 6053844 | SUPPLY IMPLANT | Supply/Implant | $3,320.32 |
| 6053880 | WHFO,NO JOINT, PREFABRICATED | Supply/Implant | $281.60 |
| 6053908 | SUPPLY IMPLANT | Supply/Implant | $1,081.22 |
| 6053911 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6053921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6053941 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6053947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6053950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,878.40 |
| 6053951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6053952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6053960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,220.42 |
| 6053965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6054024 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $34,835.84 |
| 6054031 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6054032 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6054033 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6054047 | SUPPLY IMPLANT | Supply/Implant | $3,421.44 |
| 6054064 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,751.17 |
| 6054083 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6054088 | STERILE SUPPLY | Supply/Implant | $5,013.50 |
| 6054114 | GUIDE WIRE | Supply/Implant | $7,155.20 |
| 6054126 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6054127 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6054128 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6054145 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6054153 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6054154 | SUPPLY IMPLANT | Supply/Implant | $6,054.40 |
| 6054159 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6054160 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6054169 | CATHETER, GUIDING | Supply/Implant | $1,632.00 |
| 6054186 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6054192 | GENERAL SUPPLY | Supply/Implant | $7,324.80 |
| 6054197 | STERILE SUPPLY | Supply/Implant | $5,843.20 |
| 6054199 | STERILE SUPPLY | Supply/Implant | $4,608.00 |
| 6054200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,398.40 |
| 6054207 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6054208 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6054209 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,624.00 |
| 6054210 | SUPPLY IMPLANT | Supply/Implant | $42,560.00 |
| 6054211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,062.59 |
| 6054218 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $90,457.60 |
| 6054253 | SUPPLY IMPLANT | Supply/Implant | $3,571.20 |
| 6054264 | SUPPLY IMPLANT | Supply/Implant | $34,568.45 |
| 6054293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6054300 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6054328 | SUPPLY IMPLANT | Supply/Implant | $823.68 |
| 6054335 | SUPPLY IMPLANT | Supply/Implant | $945.41 |
| 6054339 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6054351 | SUPPLY IMPLANT | Supply/Implant | $2,130.69 |
| 6054353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,304.00 |
| 6054364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,259.20 |
| 6054365 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6054368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6054376 | SUPPLY IMPLANT | Supply/Implant | $458.11 |
| 6054380 | SUPPLY IMPLANT | Supply/Implant | $1,088.26 |
| 6054383 | SUPPLY IMPLANT | Supply/Implant | $160.77 |
| 6054407 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6054421 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6054423 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6054430 | SUPPLY IMPLANT | Supply/Implant | $446.98 |
| 6054432 | SUPPLY IMPLANT | Supply/Implant | $453.76 |
| 6054439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,411.39 |
| 6054442 | STERILE SUPPLY | Supply/Implant | $1,660.80 |
| 6054472 | STERILE SUPPLY | Supply/Implant | $3,264.00 |
| 6054477 | SUPPLY IMPLANT | Supply/Implant | $3,030.14 |
| 6054492 | STERILE SUPPLY | Supply/Implant | $1,536.00 |
| 6054520 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6054522 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6054534 | GENERAL SUPPLY | Supply/Implant | $188.75 |
| 6054543 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054544 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054546 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054547 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054548 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054549 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054550 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6054606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6054608 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6054638 | SUPPLY IMPLANT | Supply/Implant | $402.43 |
| 6054645 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,587.20 |
| 6054681 | GENERAL SUPPLY | Supply/Implant | $666.37 |
| 6054682 | GENERAL SUPPLY | Supply/Implant | $785.54 |
| 6054709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,697.60 |
| 6054711 | CATHETER, GUIDING | Supply/Implant | $1,935.36 |
| 6054775 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6054794 | SUPPLY IMPLANT | Supply/Implant | $1,971.20 |
| 6054813 | GENERAL SUPPLY | Supply/Implant | $203.52 |
| 6054845 | STERILE SUPPLY | Supply/Implant | $450.56 |
| 6054850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,124.80 |
| 6054889 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,000.00 |
| 6054925 | STERILE SUPPLY | Supply/Implant | $3,315.20 |
| 6054946 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6055036 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6055037 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6055073 | GENERAL SUPPLY | Supply/Implant | $12,221.95 |
| 6055074 | GENERAL SUPPLY | Supply/Implant | $11,640.70 |
| 6055075 | STERILE SUPPLY | Supply/Implant | $13,210.24 |
| 6055076 | GENERAL SUPPLY | Supply/Implant | $12,338.69 |
| 6055117 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $309.50 |
| 6055123 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $309.50 |
| 6055162 | GENERAL SUPPLY | Supply/Implant | $1,073.79 |
| 6055167 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6055174 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6055175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $727.04 |
| 6055217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,304.00 |
| 6055293 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,072.00 |
| 6055330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055337 | SUPPLY IMPLANT | Supply/Implant | $4,515.84 |
| 6055340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055385 | GUIDE WIRE | Supply/Implant | $2,134.40 |
| 6055389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6055392 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6055435 | SUPPLY IMPLANT | Supply/Implant | $52,416.00 |
| 6055455 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $560.00 |
| 6055489 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6055496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6055514 | GENERAL SUPPLY | Supply/Implant | $646.66 |
| 6055532 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6055535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6055540 | SUPPLY IMPLANT | Supply/Implant | $13,120.00 |
| 6055543 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,663.74 |
| 6055544 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6055548 | GENERAL SUPPLY | Supply/Implant | $1,209.60 |
| 6055562 | SUPPLY IMPLANT | Supply/Implant | $4,963.97 |
| 6055568 | CATH, DRAINAGE | Supply/Implant | $935.68 |
| 6055619 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6055620 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6055638 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6055639 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6055640 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $37,381.38 |
| 6055688 | CATH, DRAINAGE | Supply/Implant | $1,042.69 |
| 6055777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6055825 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6055862 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6055890 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6055895 | SUPPLY IMPLANT | Supply/Implant | $46,016.00 |
| 6055911 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,552.00 |
| 6055917 | CATH, DRAINAGE | Supply/Implant | $2,204.16 |
| 6056017 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,859.01 |
| 6056050 | GENERAL SUPPLY | Supply/Implant | $221.06 |
| 6056055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,117.76 |
| 6056064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,280.00 |
| 6056071 | GENERAL SUPPLY | Supply/Implant | $366.08 |
| 6056073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6056082 | GENERAL SUPPLY | Supply/Implant | $2,573.31 |
| 6056118 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6056120 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6056149 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056150 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056151 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056156 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $3,769.60 |
| 6056158 | SUPPLY IMPLANT | Supply/Implant | $526.34 |
| 6056160 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056162 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6056217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,060.80 |
| 6056231 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6056285 | SUPPLY IMPLANT | Supply/Implant | $1,703.55 |
| 6056287 | STERILE SUPPLY | Supply/Implant | $4,470.02 |
| 6056295 | SUPPLY IMPLANT | Supply/Implant | $3,257.47 |
| 6056296 | GENERAL SUPPLY | Supply/Implant | $1,550.46 |
| 6056307 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $273,609.00 |
| 6056310 | STERILE SUPPLY | Supply/Implant | $635.40 |
| 6056327 | GENERAL SUPPLY | Supply/Implant | $358.66 |
| 6056354 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6056364 | GENERAL SUPPLY | Supply/Implant | $942.98 |
| 6056368 | GENERAL SUPPLY | Supply/Implant | $131.20 |
| 6056378 | GENERAL SUPPLY | Supply/Implant | $952.32 |
| 6056379 | SUPPLY IMPLANT | Supply/Implant | $143.62 |
| 6056450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6056453 | SUPPLY IMPLANT | Supply/Implant | $381.82 |
| 6056459 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6056460 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6056461 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6056507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6056520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6056537 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6056547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.29 |
| 6056554 | SUPPLY IMPLANT | Supply/Implant | $3,764.10 |
| 6056568 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6056571 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6056573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6056576 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6056616 | SUPPLY IMPLANT | Supply/Implant | $12,224.00 |
| 6056617 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,509.12 |
| 6056619 | GENERAL DRUG | Supply/Implant | $263.68 |
| 6056636 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6056659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6056665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6056667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6056691 | CATHETER, GUIDING | Supply/Implant | $5,158.40 |
| 6056692 | CATHETER, GUIDING | Supply/Implant | $5,158.40 |
| 6056694 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6056695 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6056696 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6056723 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6056741 | SUPPLY IMPLANT | Supply/Implant | $10,432.00 |
| 6056760 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6056771 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6056790 | SUPPLY IMPLANT | Supply/Implant | $5,624.32 |
| 6056791 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6056792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,099.20 |
| 6056799 | SUPPLY IMPLANT | Supply/Implant | $1,760.00 |
| 6056812 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6056814 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6056815 | GENERAL SUPPLY | Supply/Implant | $472.32 |
| 6056816 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6056834 | STERILE SUPPLY | Supply/Implant | $133.25 |
| 6056907 | SUPPLY IMPLANT | Supply/Implant | $959.36 |
| 6056912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6056943 | INTRO/SHEATH, NON-LASER | Supply/Implant | $560.00 |
| 6056944 | INTRO/SHEATH, NON-LASER | Supply/Implant | $560.00 |
| 6056945 | GENERAL SUPPLY | Supply/Implant | $128.38 |
| 6056949 | SUPPLY IMPLANT | Supply/Implant | $5,702.02 |
| 6056961 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6056975 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $13,555.20 |
| 6056976 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $13,555.20 |
| 6057031 | SUPPLY IMPLANT | Supply/Implant | $3,025.66 |
| 6057044 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6057055 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6057061 | STERILE SUPPLY | Supply/Implant | $2,099.97 |
| 6057067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6057079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6057086 | SUPPLY IMPLANT | Supply/Implant | $509.18 |
| 6057103 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6057112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6057113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6057132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6057139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6057144 | SUPPLY IMPLANT | Supply/Implant | $1,484.42 |
| 6057151 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6057152 | SUPPLY IMPLANT | Supply/Implant | $4,121.60 |
| 6057154 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6057155 | SUPPLY IMPLANT | Supply/Implant | $634.50 |
| 6057156 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6057158 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6057161 | SUPPLY IMPLANT | Supply/Implant | $4,318.34 |
| 6057166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6057168 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6057171 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6057181 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6057189 | SUPPLY IMPLANT | Supply/Implant | $669.44 |
| 6057190 | SUPPLY IMPLANT | Supply/Implant | $422.40 |
| 6057191 | SUPPLY IMPLANT | Supply/Implant | $422.40 |
| 6057207 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057209 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057222 | GENERAL SUPPLY | Supply/Implant | $329.73 |
| 6057227 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057229 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057230 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057231 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057232 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057233 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057262 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057283 | SUPPLY IMPLANT | Supply/Implant | $13,060.10 |
| 6057286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6057287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6057289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,825.60 |
| 6057296 | DEXTRANOMER/HYALURONIC ACID 1 ML | Supply/Implant | $24,312.96 |
| 6057298 | SUPPLY IMPLANT | Supply/Implant | $3,010.62 |
| 6057306 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6057309 | GENERAL SUPPLY | Supply/Implant | $855.04 |
| 6057312 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6057313 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6057316 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,748.10 |
| 6057318 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6057319 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,404.93 |
| 6057321 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $32,000.00 |
| 6057338 | RET DEV, INSERTABLE | Supply/Implant | $7,253.34 |
| 6057358 | ALLODERM SKIN SUB | Supply/Implant | $123,891.20 |
| 6057368 | SUPPLY IMPLANT | Supply/Implant | $2,539.52 |
| 6057370 | SUPPLY IMPLANT | Supply/Implant | $3,061.76 |
| 6057371 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6057373 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $1,941.38 |
| 6057379 | GUIDE WIRE | Supply/Implant | $715.14 |
| 6057382 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6057390 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,003.58 |
| 6057391 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6057392 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,204.67 |
| 6057393 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,062.59 |
| 6057402 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,113.60 |
| 6057403 | SUPPLY IMPLANT | Supply/Implant | $3,980.80 |
| 6057407 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6057409 | INTRO/SHEATH, NON-LASER | Supply/Implant | $985.60 |
| 6057410 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6057430 | SUPPLY IMPLANT | Supply/Implant | $19,129.60 |
| 6057431 | SUPPLY IMPLANT | Supply/Implant | $19,129.60 |
| 6057437 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.38 |
| 6057441 | GUIDE WIRE | Supply/Implant | $247.04 |
| 6057443 | SUPPLY IMPLANT | Supply/Implant | $1,446.40 |
| 6057448 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $8,896.00 |
| 6057463 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,808.00 |
| 6057468 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6057469 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6057489 | ALLODERM SKIN SUB | Supply/Implant | $123,891.20 |
| 6057521 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6057526 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6057527 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6057533 | GUIDE WIRE | Supply/Implant | $2,005.18 |
| 6057534 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6057535 | GUIDE WIRE | Supply/Implant | $4,369.92 |
| 6057536 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6057539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,640.00 |
| 6057550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6057567 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6057568 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6057583 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,424.00 |
| 6057600 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,352.45 |
| 6057614 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6057616 | SUPPLY IMPLANT | Supply/Implant | $108,517.50 |
| 6057618 | SUPPLY IMPLANT | Supply/Implant | $3,955.20 |
| 6057623 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6057624 | SUPPLY IMPLANT | Supply/Implant | $2,240.51 |
| 6057626 | SUPPLY IMPLANT | Supply/Implant | $526.34 |
| 6057628 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6057629 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6057630 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6057631 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6057640 | GENERAL SUPPLY | Supply/Implant | $4,296.70 |
| 6057642 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6057657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.26 |
| 6057658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.26 |
| 6057659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $713.60 |
| 6057664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,715.20 |
| 6057665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6057671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,872.70 |
| 6057673 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6057678 | SUPPLY IMPLANT | Supply/Implant | $3,212.80 |
| 6057680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6057681 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6057689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,188.80 |
| 6057690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6057691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6057701 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6057704 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6057705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $736.90 |
| 6057706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6057707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6057710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,520.00 |
| 6057718 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6057719 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6057734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6057735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,993.60 |
| 6057741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6057743 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6057761 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6057787 | GENERAL SUPPLY | Supply/Implant | $3,955.20 |
| 6057794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,501.89 |
| 6057795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,501.89 |
| 6057801 | SUPPLY IMPLANT | Supply/Implant | $2,451.71 |
| 6057802 | SUPPLY IMPLANT | Supply/Implant | $2,948.10 |
| 6057803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6057814 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6057818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $736.90 |
| 6057823 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6057846 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,328.00 |
| 6057848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6057850 | GENERAL SUPPLY | Supply/Implant | $2,547.46 |
| 6057857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6057859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6057860 | SUPPLY IMPLANT | Supply/Implant | $8,322.05 |
| 6057861 | GUIDE WIRE | Supply/Implant | $502.66 |
| 6057894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6057901 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6057902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6057903 | APLIGRAF SKIN SUB | Supply/Implant | $22,989.70 |
| 6057913 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,838.40 |
| 6057915 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,199.42 |
| 6057918 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,344.00 |
| 6057920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6057922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6057940 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,581.57 |
| 6057942 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6057944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $119,795.20 |
| 6057949 | MESH (IMPLANTABLE) | Supply/Implant | $12,089.47 |
| 6057950 | VENA CAVA FILTER | Supply/Implant | $14,438.40 |
| 6057954 | SEPTAL DEFECT IMP SYS | Supply/Implant | $10,649.60 |
| 6057956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6057966 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057971 | SUPPLY IMPLANT | Supply/Implant | $1,031.55 |
| 6057975 | SUPPLY IMPLANT | Supply/Implant | $80,768.00 |
| 6057976 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6057978 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6057980 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6057982 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6057988 | SUPPLY IMPLANT | Supply/Implant | $368.64 |
| 6058000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6058008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,328.00 |
| 6058011 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6058012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6058031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,344.32 |
| 6058039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,344.32 |
| 6058040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,344.32 |
| 6058051 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6058053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $162.56 |
| 6058069 | SUPPLY IMPLANT | Supply/Implant | $3,474.05 |
| 6058073 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6058074 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6058077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $455.04 |
| 6058105 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,715.01 |
| 6058110 | SUPPLY IMPLANT | Supply/Implant | $1,356.80 |
| 6058114 | STERILE SUPPLY | Supply/Implant | $729.60 |
| 6058158 | GUIDE WIRE | Supply/Implant | $1,510.40 |
| 6058159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,459.20 |
| 6058178 | STERILE SUPPLY | Supply/Implant | $882.05 |
| 6058184 | GUIDE WIRE | Supply/Implant | $588.80 |
| 6058197 | SUPPLY IMPLANT | Supply/Implant | $2,469.25 |
| 6058198 | STERILE SUPPLY | Supply/Implant | $140.42 |
| 6058206 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6058209 | GENERAL SUPPLY | Supply/Implant | $450.69 |
| 6058211 | GENERAL SUPPLY | Supply/Implant | $246.02 |
| 6058224 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058225 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058227 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058228 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058229 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058248 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,763.90 |
| 6058263 | SUPPLY IMPLANT | Supply/Implant | $199.10 |
| 6058264 | STERILE SUPPLY | Supply/Implant | $527.87 |
| 6058266 | GUIDE WIRE | Supply/Implant | $1,920.00 |
| 6058267 | SUPPLY IMPLANT | Supply/Implant | $489.09 |
| 6058278 | STERILE SUPPLY | Supply/Implant | $839.94 |
| 6058279 | STERILE SUPPLY | Supply/Implant | $839.94 |
| 6058283 | GENERAL SUPPLY | Supply/Implant | $477.82 |
| 6058287 | SUPPLY IMPLANT | Supply/Implant | $596.35 |
| 6058288 | SUPPLY IMPLANT | Supply/Implant | $441.98 |
| 6058296 | STERILE SUPPLY | Supply/Implant | $285.70 |
| 6058297 | STERILE SUPPLY | Supply/Implant | $347.78 |
| 6058298 | STERILE SUPPLY | Supply/Implant | $434.82 |
| 6058301 | GENERAL SUPPLY | Supply/Implant | $1,678.98 |
| 6058323 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058324 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058325 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058326 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058329 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058330 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058331 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058335 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058336 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058338 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058339 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058342 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058343 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058345 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058346 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058348 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058349 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058350 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058352 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058353 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058354 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058355 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058356 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058358 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058359 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058362 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058366 | STERILE SUPPLY | Supply/Implant | $686.59 |
| 6058367 | STERILE SUPPLY | Supply/Implant | $375.94 |
| 6058369 | PORT, INDWELLING, IMP | Supply/Implant | $9,792.00 |
| 6058386 | SUPPLY IMPLANT | Supply/Implant | $2,223.85 |
| 6058407 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6058421 | SUPPLY IMPLANT | Supply/Implant | $2,407.49 |
| 6058432 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058433 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058434 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058435 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058444 | STERILE SUPPLY | Supply/Implant | $1,131.78 |
| 6058461 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6058462 | GENERAL SUPPLY | Supply/Implant | $1,062.40 |
| 6058471 | STERILE SUPPLY | Supply/Implant | $1,387.39 |
| 6058482 | STERILE SUPPLY | Supply/Implant | $4,636.80 |
| 6058483 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6058484 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6058488 | SUPPLY IMPLANT | Supply/Implant | $9,113.34 |
| 6058492 | STERILE SUPPLY | Supply/Implant | $576.77 |
| 6058495 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6058497 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6058513 | SUPPLY IMPLANT | Supply/Implant | $4,511.36 |
| 6058519 | GENERAL SUPPLY | Supply/Implant | $244.99 |
| 6058526 | GENERAL SUPPLY | Supply/Implant | $333.18 |
| 6058529 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058530 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058531 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058540 | CATHETER, GUIDING | Supply/Implant | $8,947.20 |
| 6058542 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058543 | GENERAL SUPPLY | Supply/Implant | $267.65 |
| 6058550 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6058555 | SUPPLY IMPLANT | Supply/Implant | $136.96 |
| 6058556 | STERILE SUPPLY | Supply/Implant | $1,604.99 |
| 6058560 | STERILE SUPPLY | Supply/Implant | $484.48 |
| 6058572 | SUPPLY IMPLANT | Supply/Implant | $3,705.60 |
| 6058594 | SUPPLY IMPLANT | Supply/Implant | $1,276.42 |
| 6058596 | STERILE SUPPLY | Supply/Implant | $303.55 |
| 6058597 | SUPPLY IMPLANT | Supply/Implant | $368.90 |
| 6058598 | SUPPLY IMPLANT | Supply/Implant | $387.33 |
| 6058599 | SUPPLY IMPLANT | Supply/Implant | $368.90 |
| 6058603 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6058605 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6058610 | SUPPLY IMPLANT | Supply/Implant | $2,344.96 |
| 6058612 | SUPPLY IMPLANT | Supply/Implant | $1,751.04 |
| 6058615 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058638 | SUPPLY IMPLANT | Supply/Implant | $10,570.88 |
| 6058639 | SUPPLY IMPLANT | Supply/Implant | $10,570.88 |
| 6058640 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6058643 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6058644 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,126.58 |
| 6058646 | SUPPLY IMPLANT | Supply/Implant | $1,164.80 |
| 6058647 | GUIDE WIRE | Supply/Implant | $2,134.40 |
| 6058650 | SUPPLY IMPLANT | Supply/Implant | $544.26 |
| 6058652 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6058659 | SUPPLY IMPLANT | Supply/Implant | $157.18 |
| 6058661 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $63,936.00 |
| 6058668 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6058671 | SUPPLY IMPLANT | Supply/Implant | $1,450.88 |
| 6058752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,355.20 |
| 6058865 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,568.77 |
| 6058866 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6058867 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6058868 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6058875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,036.80 |
| 6059014 | SUPPLY IMPLANT | Supply/Implant | $9,518.85 |
| 6059202 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6059210 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6059261 | GENERAL SUPPLY | Supply/Implant | $3,139.07 |
| 6059326 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6059328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6059337 | GENERAL SUPPLY | Supply/Implant | $5,888.00 |
| 6059338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,263.36 |
| 6059339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6059341 | GUIDE WIRE | Supply/Implant | $2,571.52 |
| 6059346 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,632.00 |
| 6059503 | SUPPLY IMPLANT | Supply/Implant | $458.37 |
| 6059675 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6059676 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6059788 | SUPPLY IMPLANT | Supply/Implant | $1,561.60 |
| 6059798 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6059815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6059821 | SUPPLY IMPLANT | Supply/Implant | $1,341.82 |
| 6059822 | SUPPLY IMPLANT | Supply/Implant | $958.46 |
| 6059870 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6059874 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6059875 | GRAFT, VASCULAR | Supply/Implant | $7,078.40 |
| 6059932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6059934 | SUPPLY IMPLANT | Supply/Implant | $7,156.99 |
| 6059992 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6060007 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6060009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6060037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,998.40 |
| 6060039 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,268.80 |
| 6060041 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,268.80 |
| 6060071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,321.60 |
| 6060104 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6060108 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6060111 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6060120 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6060121 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6060143 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6060146 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6060153 | CATHETER, GUIDING | Supply/Implant | $8,768.00 |
| 6060157 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6060158 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6060161 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6060182 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6060184 | SUPPLY IMPLANT | Supply/Implant | $16,128.00 |
| 6060198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6060210 | STERILE SUPPLY | Supply/Implant | $4,736.00 |
| 6060218 | SUPPLY IMPLANT | Supply/Implant | $20,480.00 |
| 6060219 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6060228 | SUPPLY IMPLANT | Supply/Implant | $1,843.20 |
| 6060229 | SUPPLY IMPLANT | Supply/Implant | $8,184.58 |
| 6060231 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $122,535.00 |
| 6060233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $862.85 |
| 6060235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,537.60 |
| 6060255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6060256 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6060257 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060258 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6060261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6060263 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6060318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,411.97 |
| 6060322 | SUPPLY IMPLANT | Supply/Implant | $62,933.76 |
| 6060353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,495.68 |
| 6060375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $629.76 |
| 6060384 | SUPPLY IMPLANT | Supply/Implant | $1,004.80 |
| 6060395 | GUIDE WIRE | Supply/Implant | $640.00 |
| 6060423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,304.00 |
| 6060427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,909.50 |
| 6060437 | SUPPLY IMPLANT | Supply/Implant | $852.56 |
| 6060444 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6060445 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6060448 | SUPPLY IMPLANT | Supply/Implant | $6,003.20 |
| 6060449 | SUPPLY IMPLANT | Supply/Implant | $10,048.00 |
| 6060450 | SUPPLY IMPLANT | Supply/Implant | $6,622.72 |
| 6060451 | SUPPLY IMPLANT | Supply/Implant | $4,055.04 |
| 6060461 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,290.24 |
| 6060463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,129.60 |
| 6060466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,300.80 |
| 6060495 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6060504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6060507 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6060521 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6060524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6060538 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6060542 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,993.60 |
| 6060543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6060546 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6060547 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6060557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,984.00 |
| 6060569 | SUPPLY IMPLANT | Supply/Implant | $11,840.00 |
| 6060570 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,433.60 |
| 6060571 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,472.00 |
| 6060576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,280.00 |
| 6060579 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6060590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6060603 | GRAFT, VASCULAR | Supply/Implant | $21,263.23 |
| 6060604 | GRAFT, VASCULAR | Supply/Implant | $5,184.00 |
| 6060605 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6060608 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060609 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060610 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060611 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,048.00 |
| 6060628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6060635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6060646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,076.48 |
| 6060652 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6060659 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6060663 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6060696 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,306.24 |
| 6060699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060700 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060706 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6060708 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6060709 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6060713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6060730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,535.94 |
| 6060739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6060740 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6060742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,643.14 |
| 6060746 | SUPPLY IMPLANT | Supply/Implant | $9,981.06 |
| 6060748 | PROSTHESIS, BREAST, IMP | Supply/Implant | $7,680.00 |
| 6060755 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6060757 | STERILE SUPPLY | Supply/Implant | $7,270.40 |
| 6060802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $793.60 |
| 6060814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,553.60 |
| 6060819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,032.00 |
| 6060822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6060823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6060825 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6060852 | SUPPLY IMPLANT | Supply/Implant | $643.71 |
| 6060863 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6060868 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060871 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060884 | VENA CAVA FILTER | Supply/Implant | $11,840.00 |
| 6060889 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060890 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060891 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060892 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,539.20 |
| 6060899 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $32,000.00 |
| 6060914 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060916 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060917 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060919 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6060933 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6060935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6060954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6060956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,392.00 |
| 6060962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,307.20 |
| 6060969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6061009 | SUPPLY IMPLANT | Supply/Implant | $2,088.96 |
| 6061017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6061018 | SUPPLY IMPLANT | Supply/Implant | $475.78 |
| 6061025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,437.38 |
| 6061034 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6061035 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6061036 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6061039 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6061040 | SUPPLY IMPLANT | Supply/Implant | $19,968.00 |
| 6061041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6061042 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6061043 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6061052 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6061055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6061056 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,255.68 |
| 6061058 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,050.69 |
| 6061072 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6061073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6061078 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6061089 | SUPPLY IMPLANT | Supply/Implant | $19,430.40 |
| 6061096 | SUPPLY IMPLANT | Supply/Implant | $135,649.50 |
| 6061106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,353.60 |
| 6061108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,675.20 |
| 6061112 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6061130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6061132 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,185.60 |
| 6061137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,864.00 |
| 6061138 | GENERAL SUPPLY | Supply/Implant | $2,119.42 |
| 6061142 | SUPPLY IMPLANT | Supply/Implant | $2,577.66 |
| 6061151 | SUPPLY IMPLANT | Supply/Implant | $9,088.00 |
| 6061164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,203.52 |
| 6061165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6061173 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,872.13 |
| 6061176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6061181 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,892.80 |
| 6061183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6061190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6061193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6061196 | REP DEV, URINARY, W/SLING | Supply/Implant | $16,496.64 |
| 6061200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6061201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6061212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6061216 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,863.36 |
| 6061217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,288.00 |
| 6061219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6061224 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6061242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6061243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6061250 | SUPPLY IMPLANT | Supply/Implant | $17,024.00 |
| 6061256 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6061293 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6061313 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6061338 | STERILE SUPPLY | Supply/Implant | $214.27 |
| 6061347 | SUPPLY IMPLANT | Supply/Implant | $492.03 |
| 6061372 | SUPPLY IMPLANT | Supply/Implant | $4,339.20 |
| 6061382 | SUPPLY IMPLANT | Supply/Implant | $1,165.06 |
| 6061419 | RET DEV, INSERTABLE | Supply/Implant | $384.61 |
| 6061420 | GENERAL SUPPLY | Supply/Implant | $614.40 |
| 6061431 | SUPPLY IMPLANT | Supply/Implant | $211.46 |
| 6061438 | SUPPLY IMPLANT | Supply/Implant | $2,342.40 |
| 6061442 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6061443 | CATHETER, GUIDING | Supply/Implant | $2,086.40 |
| 6061444 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6061446 | CATHETER, GUIDING | Supply/Implant | $832.00 |
| 6061449 | CATHETER, GUIDING | Supply/Implant | $465.92 |
| 6061450 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6061451 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6061452 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6061453 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6061454 | GUIDE WIRE | Supply/Implant | $620.16 |
| 6061466 | SUPPLY IMPLANT | Supply/Implant | $2,201.73 |
| 6061468 | SUPPLY IMPLANT | Supply/Implant | $2,201.73 |
| 6061499 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,965.63 |
| 6061501 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,786.18 |
| 6061502 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,786.18 |
| 6061560 | SUPPLY IMPLANT | Supply/Implant | $585.34 |
| 6061561 | SUPPLY IMPLANT | Supply/Implant | $582.14 |
| 6061562 | SUPPLY IMPLANT | Supply/Implant | $506.24 |
| 6061583 | STERILE SUPPLY | Supply/Implant | $438.53 |
| 6061589 | SUPPLY IMPLANT | Supply/Implant | $534.27 |
| 6061590 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6061592 | SUPPLY IMPLANT | Supply/Implant | $4,487.87 |
| 6061596 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6061633 | SUPPLY IMPLANT | Supply/Implant | $2,580.48 |
| 6061639 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6061640 | SUPPLY IMPLANT | Supply/Implant | $323.20 |
| 6061685 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6061693 | SUPPLY IMPLANT | Supply/Implant | $658.33 |
| 6061704 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6061712 | SUPPLY IMPLANT | Supply/Implant | $5,363.20 |
| 6061717 | GUIDE WIRE | Supply/Implant | $712.96 |
| 6061718 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6061726 | CATH, DRAINAGE | Supply/Implant | $873.98 |
| 6061751 | SUPPLY IMPLANT | Supply/Implant | $4,467.20 |
| 6061756 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6061757 | STERILE SUPPLY | Supply/Implant | $230.05 |
| 6061775 | GENERAL SUPPLY | Supply/Implant | $140.58 |
| 6061784 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6061795 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6061822 | SUPPLY IMPLANT | Supply/Implant | $371.33 |
| 6061933 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6061937 | SUPPLY IMPLANT | Supply/Implant | $440.70 |
| 6061942 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6061955 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6061958 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6061964 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6061965 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6061970 | CATH, DRAINAGE | Supply/Implant | $1,182.72 |
| 6061977 | GENERAL SUPPLY | Supply/Implant | $243.20 |
| 6061978 | GENERAL SUPPLY | Supply/Implant | $245.76 |
| 6061979 | GENERAL SUPPLY | Supply/Implant | $204.42 |
| 6061985 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6061992 | STERILE SUPPLY | Supply/Implant | $2,176.00 |
| 6062000 | STERILE SUPPLY | Supply/Implant | $978.59 |
| 6062013 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6062017 | STERILE SUPPLY | Supply/Implant | $304.90 |
| 6062023 | SUPPLY IMPLANT | Supply/Implant | $20,160.00 |
| 6062029 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,483.78 |
| 6062056 | SUPPLY IMPLANT | Supply/Implant | $309.76 |
| 6062063 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6062068 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6062070 | SUPPLY IMPLANT | Supply/Implant | $4,352.00 |
| 6062073 | STERILE SUPPLY | Supply/Implant | $7,828.48 |
| 6062076 | STERILE SUPPLY | Supply/Implant | $723.46 |
| 6062087 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6062105 | SUPPLY IMPLANT | Supply/Implant | $489.09 |
| 6062106 | STERILE SUPPLY | Supply/Implant | $164.61 |
| 6062120 | SUPPLY IMPLANT | Supply/Implant | $6,148.74 |
| 6062126 | STERILE SUPPLY | Supply/Implant | $3,314.43 |
| 6062127 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6062138 | STERILE SUPPLY | Supply/Implant | $156.80 |
| 6062141 | STERILE SUPPLY | Supply/Implant | $2,204.16 |
| 6062147 | GUIDE WIRE | Supply/Implant | $3,136.00 |
| 6062148 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6062149 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6062151 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6062180 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6062200 | SUPPLY IMPLANT | Supply/Implant | $588.29 |
| 6062207 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6062210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6062214 | SUPPLY IMPLANT | Supply/Implant | $590.59 |
| 6062219 | SUPPLY IMPLANT | Supply/Implant | $742.40 |
| 6062222 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6062223 | SUPPLY IMPLANT | Supply/Implant | $1,647.49 |
| 6062227 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6062233 | STERILE SUPPLY | Supply/Implant | $3,008.00 |
| 6062248 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6062259 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6062261 | GENERAL SUPPLY | Supply/Implant | $772.86 |
| 6062281 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6062302 | SUPPLY IMPLANT | Supply/Implant | $8,576.00 |
| 6062316 | GENERAL SUPPLY | Supply/Implant | $17,480.06 |
| 6062343 | GENERAL SUPPLY | Supply/Implant | $476.16 |
| 6062344 | GENERAL SUPPLY | Supply/Implant | $476.16 |
| 6062362 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6062363 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6062395 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6062403 | GENERAL SUPPLY | Supply/Implant | $1,864.96 |
| 6062406 | STERILE SUPPLY | Supply/Implant | $613.89 |
| 6062425 | STERILE SUPPLY | Supply/Implant | $275.84 |
| 6062465 | STERILE SUPPLY | Supply/Implant | $915.58 |
| 6062468 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6062472 | STERILE SUPPLY | Supply/Implant | $765.31 |
| 6062482 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062484 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062487 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062488 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062489 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062490 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062492 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062493 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062494 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062495 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062500 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062501 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062502 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062511 | STERILE SUPPLY | Supply/Implant | $159.10 |
| 6062512 | STERILE SUPPLY | Supply/Implant | $210.05 |
| 6062520 | SUPPLY IMPLANT | Supply/Implant | $381.82 |
| 6062521 | SUPPLY IMPLANT | Supply/Implant | $318.34 |
| 6062523 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6062524 | SUPPLY IMPLANT | Supply/Implant | $619.14 |
| 6062525 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6062533 | STERILE SUPPLY | Supply/Implant | $4,443.01 |
| 6062537 | RET DEV, INSERTABLE | Supply/Implant | $281.60 |
| 6062556 | SUPPLY IMPLANT | Supply/Implant | $2,431.74 |
| 6062565 | STERILE SUPPLY | Supply/Implant | $2,496.00 |
| 6062568 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062569 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062570 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062571 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062574 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062575 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062576 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062589 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6062606 | GENERAL SUPPLY | Supply/Implant | $1,564.80 |
| 6062608 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6062622 | SUPPLY IMPLANT | Supply/Implant | $138.50 |
| 6062657 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062667 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $268.80 |
| 6062669 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6062670 | GENERAL SUPPLY | Supply/Implant | $698.75 |
| 6062671 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6062680 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6062681 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6062695 | CATHETER, GUIDING | Supply/Implant | $14,310.40 |
| 6062700 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,088.00 |
| 6062701 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,088.00 |
| 6062722 | STERILE SUPPLY | Supply/Implant | $411.01 |
| 6062728 | SUPPLY IMPLANT | Supply/Implant | $598.40 |
| 6062729 | GUIDE WIRE | Supply/Implant | $5,312.00 |
| 6062733 | GENERAL SUPPLY | Supply/Implant | $2,889.47 |
| 6062735 | SUPPLY IMPLANT | Supply/Implant | $218.24 |
| 6062746 | SUPPLY IMPLANT | Supply/Implant | $1,100.80 |
| 6062756 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6062757 | SUPPLY IMPLANT | Supply/Implant | $524.80 |
| 6062759 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6062760 | SUPPLY IMPLANT | Supply/Implant | $143.62 |
| 6062771 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6062778 | SUPPLY IMPLANT | Supply/Implant | $2,841.06 |
| 6062780 | SUPPLY IMPLANT | Supply/Implant | $5,831.68 |
| 6062798 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6062799 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6062801 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6062805 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062809 | CATH, DRAINAGE | Supply/Implant | $5,589.38 |
| 6062833 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6062851 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6062875 | GENERAL SUPPLY | Supply/Implant | $840.96 |
| 6062876 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6062886 | STERILE SUPPLY | Supply/Implant | $486.78 |
| 6062890 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6062895 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6062897 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6062898 | STERILE SUPPLY | Supply/Implant | $287.62 |
| 6062899 | STERILE SUPPLY | Supply/Implant | $258.98 |
| 6062916 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6063308 | SUPPLY IMPLANT | Supply/Implant | $4,264.45 |
| 6063353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6063358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,221.70 |
| 6063379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6063606 | SUPPLY IMPLANT | Supply/Implant | $4,928.77 |
| 6063611 | SUPPLY IMPLANT | Supply/Implant | $4,928.77 |
| 6063689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,550.40 |
| 6063699 | MESH (IMPLANTABLE) | Supply/Implant | $18,434.56 |
| 6063700 | MESH (IMPLANTABLE) | Supply/Implant | $12,439.17 |
| 6063888 | MESH (IMPLANTABLE) | Supply/Implant | $18,434.56 |
| 6063903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,981.12 |
| 6063904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,846.46 |
| 6063905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,149.06 |
| 6063920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,671.30 |
| 6063953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,619.84 |
| 6063954 | MESH (IMPLANTABLE) | Supply/Implant | $1,019.52 |
| 6064017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6064074 | SUPPLY IMPLANT | Supply/Implant | $759.81 |
| 6064084 | SUPPLY IMPLANT | Supply/Implant | $1,760.00 |
| 6064090 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6064135 | SUPPLY IMPLANT | Supply/Implant | $717.18 |
| 6064145 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6064152 | GENERAL SUPPLY | Supply/Implant | $883.20 |
| 6064175 | GENERAL SUPPLY | Supply/Implant | $6,784.00 |
| 6064186 | STERILE SUPPLY | Supply/Implant | $316.80 |
| 6064213 | ALLODERM SKIN SUB | Supply/Implant | $10,355.20 |
| 6064276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064285 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6064342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,561.60 |
| 6064351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6064370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,998.40 |
| 6064423 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6064448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6064474 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6064478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,065.60 |
| 6064479 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6064481 | SUPPLY IMPLANT | Supply/Implant | $889.22 |
| 6064484 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6064491 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064494 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064495 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064496 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064497 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064498 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064499 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064500 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064501 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064502 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064503 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,432.00 |
| 6064504 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064505 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064506 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064507 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064508 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064509 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,432.00 |
| 6064510 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064511 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064513 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064515 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064516 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064517 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6064537 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6064539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6064540 | SUPPLY IMPLANT | Supply/Implant | $6,461.44 |
| 6064550 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064555 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064559 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6064574 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6064576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6064577 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064578 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064580 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064581 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064584 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064585 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064606 | GUIDE WIRE | Supply/Implant | $1,648.64 |
| 6064608 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6064624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6064632 | SUPPLY IMPLANT | Supply/Implant | $1,275.99 |
| 6064637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,353.60 |
| 6064672 | SUPPLY IMPLANT | Supply/Implant | $3,638.78 |
| 6064684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6064709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,849.28 |
| 6064711 | SUPPLY IMPLANT | Supply/Implant | $18,391.68 |
| 6064746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6064751 | SUPPLY IMPLANT | Supply/Implant | $965.89 |
| 6064755 | GENERAL SUPPLY | Supply/Implant | $7,067.14 |
| 6064784 | INTEGRA BMWD SKIN SUB | Supply/Implant | $78,272.00 |
| 6064798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6064806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064809 | SUPPLY IMPLANT | Supply/Implant | $7,906.18 |
| 6064825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,203.52 |
| 6064908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,544.00 |
| 6064909 | CONN TISS, NON-HUMAN | Supply/Implant | $7,644.16 |
| 6064910 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6064917 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6064940 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6064941 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6064942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6064947 | SUPPLY IMPLANT | Supply/Implant | $12,228.48 |
| 6064951 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,120.00 |
| 6064956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $516.99 |
| 6064981 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6064986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6064987 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,663.74 |
| 6064988 | SUPPLY IMPLANT | Supply/Implant | $25,663.74 |
| 6064994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6064997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6064999 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6065001 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,242.37 |
| 6065010 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,328.00 |
| 6065011 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6065013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6065015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6065017 | SUPPLY IMPLANT | Supply/Implant | $13,754.88 |
| 6065038 | SUPPLY IMPLANT | Supply/Implant | $2,344.96 |
| 6065044 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6065057 | SUPPLY IMPLANT | Supply/Implant | $7,334.40 |
| 6065065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.20 |
| 6065067 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6065075 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6065078 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6065086 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,400.00 |
| 6065087 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,400.00 |
| 6065095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6065096 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $15,603.20 |
| 6065104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.18 |
| 6065110 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6065115 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6065117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6065120 | STERILE SUPPLY | Supply/Implant | $263.68 |
| 6065121 | STERILE SUPPLY | Supply/Implant | $270.41 |
| 6065127 | SUPPLY IMPLANT | Supply/Implant | $15,565.44 |
| 6065133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6065135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,006.40 |
| 6065184 | SUPPLY IMPLANT | Supply/Implant | $14,630.40 |
| 6065191 | STERILE SUPPLY | Supply/Implant | $230.05 |
| 6065192 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6065198 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6065199 | SUPPLY IMPLANT | Supply/Implant | $6,262.40 |
| 6065206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6065254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,425.60 |
| 6065261 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6065264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6065265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6065272 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6065279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6065284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,758.40 |
| 6065288 | SUPPLY IMPLANT | Supply/Implant | $12,697.60 |
| 6065289 | SUPPLY IMPLANT | Supply/Implant | $25,574.40 |
| 6065290 | SUPPLY IMPLANT | Supply/Implant | $41,574.40 |
| 6065293 | CONN TISS, NON-HUMAN | Supply/Implant | $2,635.01 |
| 6065294 | CONN TISS, NON-HUMAN | Supply/Implant | $2,635.01 |
| 6065306 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,880.00 |
| 6065307 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,880.00 |
| 6065308 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,880.00 |
| 6065312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6065317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6065318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6065320 | PORT, INDWELLING, IMP | Supply/Implant | $6,262.40 |
| 6065331 | SUPPLY IMPLANT | Supply/Implant | $228.61 |
| 6065352 | SUPPLY IMPLANT | Supply/Implant | $759.68 |
| 6065353 | SUPPLY IMPLANT | Supply/Implant | $547.33 |
| 6065360 | GENERAL SUPPLY | Supply/Implant | $200.96 |
| 6065394 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6065398 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6065414 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6065420 | GENERAL SUPPLY | Supply/Implant | $10,996.99 |
| 6065429 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6065436 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6065437 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6065441 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6065464 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6065467 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6065468 | SUPPLY IMPLANT | Supply/Implant | $10,570.88 |
| 6065469 | SUPPLY IMPLANT | Supply/Implant | $1,203.20 |
| 6065479 | INTEGRA BMWD SKIN SUB | Supply/Implant | $35,035.90 |
| 6065499 | SUPPLY IMPLANT | Supply/Implant | $1,403.65 |
| 6065508 | IMPL EXT ACCESS CATH | Supply/Implant | $9,708.42 |
| 6065523 | GENERAL SUPPLY | Supply/Implant | $592.90 |
| 6065524 | GENERAL SUPPLY | Supply/Implant | $663.42 |
| 6065526 | GENERAL SUPPLY | Supply/Implant | $2,137.60 |
| 6065531 | SUPPLY IMPLANT | Supply/Implant | $2,245.82 |
| 6065532 | SUPPLY IMPLANT | Supply/Implant | $3,139.58 |
| 6065533 | SUPPLY IMPLANT | Supply/Implant | $3,316.48 |
| 6065534 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6065541 | STERILE SUPPLY | Supply/Implant | $1,094.53 |
| 6065542 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6065543 | STERILE SUPPLY | Supply/Implant | $746.62 |
| 6065544 | SUPPLY IMPLANT | Supply/Implant | $181.45 |
| 6065546 | SUPPLY IMPLANT | Supply/Implant | $584.96 |
| 6065551 | SUPPLY IMPLANT | Supply/Implant | $3,330.43 |
| 6065552 | SUPPLY IMPLANT | Supply/Implant | $2,256.51 |
| 6065556 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065557 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065558 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065559 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065560 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065561 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065562 | STERILE SUPPLY | Supply/Implant | $633.86 |
| 6065563 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065580 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6065596 | SUPPLY IMPLANT | Supply/Implant | $2,620.67 |
| 6065597 | SUPPLY IMPLANT | Supply/Implant | $3,685.63 |
| 6065598 | SUPPLY IMPLANT | Supply/Implant | $2,739.29 |
| 6065599 | SUPPLY IMPLANT | Supply/Implant | $3,859.16 |
| 6065606 | SUPPLY IMPLANT | Supply/Implant | $3,902.89 |
| 6065607 | SUPPLY IMPLANT | Supply/Implant | $4,025.31 |
| 6065613 | SUPPLY IMPLANT | Supply/Implant | $5,056.00 |
| 6065615 | SUPPLY IMPLANT | Supply/Implant | $5,056.00 |
| 6065616 | SUPPLY IMPLANT | Supply/Implant | $5,056.00 |
| 6065618 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,120.64 |
| 6065622 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6065640 | SUPPLY IMPLANT | Supply/Implant | $1,744.77 |
| 6065645 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6065647 | GENERAL SUPPLY | Supply/Implant | $301.79 |
| 6065648 | GENERAL SUPPLY | Supply/Implant | $305.02 |
| 6065649 | CATHETER, URETERAL | Supply/Implant | $316.88 |
| 6065650 | STERILE SUPPLY | Supply/Implant | $316.93 |
| 6065653 | SUPPLY IMPLANT | Supply/Implant | $1,366.78 |
| 6065670 | SUPPLY IMPLANT | Supply/Implant | $575.87 |
| 6065673 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6065674 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6065690 | SUPPLY IMPLANT | Supply/Implant | $6,747.52 |
| 6065718 | STERILE SUPPLY | Supply/Implant | $152.06 |
| 6065720 | STERILE SUPPLY | Supply/Implant | $1,250.24 |
| 6065721 | STERILE SUPPLY | Supply/Implant | $212.94 |
| 6065734 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6065736 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6065741 | SUPPLY IMPLANT | Supply/Implant | $2,092.80 |
| 6065744 | SUPPLY IMPLANT | Supply/Implant | $6,785.66 |
| 6065747 | SUPPLY IMPLANT | Supply/Implant | $6,008.58 |
| 6065751 | SUPPLY IMPLANT | Supply/Implant | $8,978.30 |
| 6065757 | CATHETER, GUIDING | Supply/Implant | $465.92 |
| 6065758 | SUPPLY IMPLANT | Supply/Implant | $246.40 |
| 6065760 | STERILE SUPPLY | Supply/Implant | $231.94 |
| 6065765 | STERILE SUPPLY | Supply/Implant | $5,362.56 |
| 6065768 | SUPPLY IMPLANT | Supply/Implant | $2,870.27 |
| 6065776 | STERILE SUPPLY | Supply/Implant | $170.11 |
| 6065777 | STERILE SUPPLY | Supply/Implant | $164.74 |
| 6065780 | STERILE SUPPLY | Supply/Implant | $1,468.16 |
| 6065781 | SUPPLY IMPLANT | Supply/Implant | $185.47 |
| 6065783 | STERILE SUPPLY | Supply/Implant | $220.56 |
| 6065787 | SUPPLY IMPLANT | Supply/Implant | $1,406.46 |
| 6065788 | STERILE SUPPLY | Supply/Implant | $219.39 |
| 6065789 | STERILE SUPPLY | Supply/Implant | $219.26 |
| 6065811 | STERILE SUPPLY | Supply/Implant | $147.33 |
| 6065812 | STERILE SUPPLY | Supply/Implant | $202.79 |
| 6065813 | STERILE SUPPLY | Supply/Implant | $232.33 |
| 6065816 | STERILE SUPPLY | Supply/Implant | $197.64 |
| 6065828 | SUPPLY IMPLANT | Supply/Implant | $529.56 |
| 6065829 | GENERAL SUPPLY | Supply/Implant | $678.91 |
| 6065836 | SUPPLY IMPLANT | Supply/Implant | $152.70 |
| 6065837 | SUPPLY IMPLANT | Supply/Implant | $129.92 |
| 6065838 | STERILE SUPPLY | Supply/Implant | $245.63 |
| 6065840 | GENERAL SUPPLY | Supply/Implant | $174.36 |
| 6065841 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6065847 | STERILE SUPPLY | Supply/Implant | $245.63 |
| 6065861 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6065879 | SUPPLY IMPLANT | Supply/Implant | $695.17 |
| 6065885 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6065886 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6065887 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6065896 | SUPPLY IMPLANT | Supply/Implant | $1,432.19 |
| 6065900 | GENERAL SUPPLY | Supply/Implant | $27,456.00 |
| 6065906 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6065921 | SUPPLY IMPLANT | Supply/Implant | $216.96 |
| 6065927 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6065931 | SUPPLY IMPLANT | Supply/Implant | $13,211.48 |
| 6065932 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6065934 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6065935 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6065936 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6065953 | STERILE SUPPLY | Supply/Implant | $1,094.53 |
| 6065977 | SUPPLY IMPLANT | Supply/Implant | $241.41 |
| 6065978 | GENERAL SUPPLY | Supply/Implant | $928.51 |
| 6065996 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $435.20 |
| 6066009 | STERILE SUPPLY | Supply/Implant | $790.05 |
| 6066018 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $793.60 |
| 6066020 | STERILE SUPPLY | Supply/Implant | $1,055.87 |
| 6066021 | STERILE SUPPLY | Supply/Implant | $532.35 |
| 6066026 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6066027 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6066031 | SUPPLY IMPLANT | Supply/Implant | $302.72 |
| 6066070 | SUPPLY IMPLANT | Supply/Implant | $8,522.24 |
| 6066071 | SUPPLY IMPLANT | Supply/Implant | $5,061.12 |
| 6066072 | STERILE SUPPLY | Supply/Implant | $7,667.20 |
| 6066073 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6066074 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6066076 | SUPPLY IMPLANT | Supply/Implant | $1,839.10 |
| 6066081 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6066086 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6066089 | GENERAL SUPPLY | Supply/Implant | $595.20 |
| 6066104 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066105 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066106 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066107 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6066148 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6066151 | SUPPLY IMPLANT | Supply/Implant | $288.96 |
| 6066160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6066163 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6066168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $736.90 |
| 6066169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6066170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6066187 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6066195 | SUPPLY IMPLANT | Supply/Implant | $19,276.80 |
| 6066196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6066197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6066207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6066208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6066220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6066224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6066225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6066227 | SUPPLY IMPLANT | Supply/Implant | $2,713.60 |
| 6066235 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6066236 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6066237 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6066241 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6066244 | SUPPLY IMPLANT | Supply/Implant | $659.20 |
| 6066247 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066248 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6066260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,423.23 |
| 6066261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,689.54 |
| 6066262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,423.23 |
| 6066271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,492.48 |
| 6066275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6066294 | SUPPLY IMPLANT | Supply/Implant | $3,729.02 |
| 6066295 | SUPPLY IMPLANT | Supply/Implant | $4,987.01 |
| 6066296 | SUPPLY IMPLANT | Supply/Implant | $4,552.70 |
| 6066301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,493.50 |
| 6066310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6066311 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6066341 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6066351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,048.00 |
| 6066358 | SUPPLY IMPLANT | Supply/Implant | $195.84 |
| 6066362 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066363 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066372 | SUPPLY IMPLANT | Supply/Implant | $12,531.20 |
| 6066417 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6066418 | GENERAL SUPPLY | Supply/Implant | $998.40 |
| 6066420 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6066421 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6066430 | SUPPLY IMPLANT | Supply/Implant | $8,697.60 |
| 6066436 | INTRO/SHEATH, NON-LASER | Supply/Implant | $777.86 |
| 6066440 | SUPPLY IMPLANT | Supply/Implant | $3,199.74 |
| 6066441 | SUPPLY IMPLANT | Supply/Implant | $5,158.91 |
| 6066445 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066459 | SUPPLY IMPLANT | Supply/Implant | $1,661.44 |
| 6066462 | STERILE SUPPLY | Supply/Implant | $4,397.06 |
| 6066464 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6066465 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6066466 | GUIDE WIRE | Supply/Implant | $8,531.20 |
| 6066473 | STERILE SUPPLY | Supply/Implant | $2,050.05 |
| 6066478 | SUPPLY IMPLANT | Supply/Implant | $3,059.20 |
| 6066485 | SUPPLY IMPLANT | Supply/Implant | $4,536.06 |
| 6066495 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066499 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6066501 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6066504 | SUPPLY IMPLANT | Supply/Implant | $7,244.80 |
| 6066518 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,600.00 |
| 6066544 | GENERAL SUPPLY | Supply/Implant | $130.05 |
| 6066545 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6066546 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6066547 | SUPPLY IMPLANT | Supply/Implant | $6,262.40 |
| 6066566 | STERILE SUPPLY | Supply/Implant | $334.34 |
| 6066574 | SUPPLY IMPLANT | Supply/Implant | $1,175.55 |
| 6066576 | SUPPLY IMPLANT | Supply/Implant | $1,175.55 |
| 6066580 | STERILE SUPPLY | Supply/Implant | $1,514.37 |
| 6066582 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6066600 | STERILE SUPPLY | Supply/Implant | $514.56 |
| 6066610 | STERILE SUPPLY | Supply/Implant | $6,336.00 |
| 6066611 | STERILE SUPPLY | Supply/Implant | $3,776.00 |
| 6066615 | STERILE SUPPLY | Supply/Implant | $6,888.96 |
| 6066616 | SUPPLY IMPLANT | Supply/Implant | $9,853.44 |
| 6066617 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6066618 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6066619 | GENERAL SUPPLY | Supply/Implant | $998.40 |
| 6066633 | STERILE SUPPLY | Supply/Implant | $336.00 |
| 6066640 | SUPPLY IMPLANT | Supply/Implant | $30,720.00 |
| 6066660 | GENERAL SUPPLY | Supply/Implant | $558.21 |
| 6066668 | SUPPLY IMPLANT | Supply/Implant | $3,818.88 |
| 6066669 | SUPPLY IMPLANT | Supply/Implant | $3,729.02 |
| 6066670 | STERILE SUPPLY | Supply/Implant | $5,166.72 |
| 6066674 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066675 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066678 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066679 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066680 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066690 | SUPPLY IMPLANT | Supply/Implant | $387.33 |
| 6066692 | GUIDE WIRE | Supply/Implant | $423.68 |
| 6066693 | GUIDE WIRE | Supply/Implant | $568.32 |
| 6066694 | GUIDE WIRE | Supply/Implant | $423.68 |
| 6066697 | SUPPLY IMPLANT | Supply/Implant | $5,438.46 |
| 6066699 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,827.20 |
| 6066704 | SUPPLY IMPLANT | Supply/Implant | $5,728.00 |
| 6066712 | SUPPLY IMPLANT | Supply/Implant | $6,381.82 |
| 6066714 | STERILE SUPPLY | Supply/Implant | $5,634.94 |
| 6066715 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $435.20 |
| 6066738 | LITH-ION BATT ELEC/PNEUM VAD | Supply/Implant | $8,000.00 |
| 6066739 | BAT CLPS ELEC/COMBO VAD REP | Supply/Implant | $7,040.00 |
| 6066741 | CHARGER ELEC/COMBO VAD REP | Supply/Implant | $92,160.00 |
| 6066777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,124.80 |
| 6066863 | SUPPLY IMPLANT | Supply/Implant | $30,087.68 |
| 6066864 | CONN TISS, NON-HUMAN | Supply/Implant | $4,587.52 |
| 6066865 | MESH (IMPLANTABLE) | Supply/Implant | $6,291.46 |
| 6066866 | CONN TISS, NON-HUMAN | Supply/Implant | $13,957.50 |
| 6066873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6066892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6066896 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6066915 | SUPPLY IMPLANT | Supply/Implant | $1,464.32 |
| 6066918 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6066922 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6066929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6066952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,689.54 |
| 6066961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $806.91 |
| 6066968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6066978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6066980 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,211.20 |
| 6066982 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6067039 | CONN TISS, NON-HUMAN | Supply/Implant | $4,664.83 |
| 6067060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6067063 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6067066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,927.55 |
| 6067069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,390.08 |
| 6067073 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6067074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6067076 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6067105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $780.80 |
| 6067113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6067117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6067122 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,272.00 |
| 6067133 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6067158 | SUPPLY IMPLANT | Supply/Implant | $30,087.68 |
| 6067161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6067163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6067166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6067169 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6067171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6067181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6067182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6067188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6067226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,913.66 |
| 6067233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,847.30 |
| 6067234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,847.30 |
| 6067247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6067249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6067250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6067252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,837.44 |
| 6067269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6067283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6067284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6067288 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6067297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,502.40 |
| 6067299 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6067331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6067360 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6067362 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6067363 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $45,568.00 |
| 6067364 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $51,417.60 |
| 6067365 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6067366 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6067368 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $51,417.60 |
| 6067370 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,651.20 |
| 6067371 | SUPPLY IMPLANT | Supply/Implant | $46,144.00 |
| 6067372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $51,417.60 |
| 6067374 | SUPPLY IMPLANT | Supply/Implant | $42,944.00 |
| 6067375 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $46,144.00 |
| 6067380 | GENERAL SUPPLY | Supply/Implant | $421.89 |
| 6067388 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6067390 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6067391 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6067393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6067394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6067397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,094.40 |
| 6067409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6067410 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6067426 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6067437 | SUPPLY IMPLANT | Supply/Implant | $439.17 |
| 6067442 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067443 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067447 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067449 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067450 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067452 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067467 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067472 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067473 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067475 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067478 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067480 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067507 | STERILE SUPPLY | Supply/Implant | $184.69 |
| 6067513 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6067514 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6067538 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $37,760.00 |
| 6067552 | GENERAL SUPPLY | Supply/Implant | $386.56 |
| 6067582 | SUPPLY IMPLANT | Supply/Implant | $8,522.24 |
| 6067611 | GENERAL SUPPLY | Supply/Implant | $277.89 |
| 6067616 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6067622 | STERILE SUPPLY | Supply/Implant | $312.42 |
| 6067629 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067630 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067631 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067632 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067633 | SUPPLY IMPLANT | Supply/Implant | $4,096.00 |
| 6067635 | SUPPLY IMPLANT | Supply/Implant | $6,706.56 |
| 6067636 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067637 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6067638 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6067639 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067640 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067641 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067642 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067649 | SUPPLY IMPLANT | Supply/Implant | $20,278.91 |
| 6067650 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067651 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067652 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067654 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067655 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067656 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067658 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067660 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067664 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067668 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,146.88 |
| 6067674 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6067676 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6067677 | SUPPLY IMPLANT | Supply/Implant | $1,417.60 |
| 6067678 | STERILE SUPPLY | Supply/Implant | $263.42 |
| 6067679 | SUPPLY IMPLANT | Supply/Implant | $1,418.37 |
| 6067680 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6067682 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6067707 | GENERAL SUPPLY | Supply/Implant | $247.55 |
| 6067710 | STERILE SUPPLY | Supply/Implant | $452.99 |
| 6067712 | SUPPLY IMPLANT | Supply/Implant | $16,576.00 |
| 6067715 | SUPPLY IMPLANT | Supply/Implant | $3,020.80 |
| 6067724 | SUPPLY IMPLANT | Supply/Implant | $1,884.16 |
| 6067730 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $10,368.00 |
| 6067740 | RET DEV, INSERTABLE | Supply/Implant | $13,478.40 |
| 6067760 | STERILE SUPPLY | Supply/Implant | $1,356.80 |
| 6067761 | STERILE SUPPLY | Supply/Implant | $273.09 |
| 6067766 | SUPPLY IMPLANT | Supply/Implant | $314.88 |
| 6067812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6067823 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6067824 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6067904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,693.06 |
| 6067910 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6067918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6067929 | SUPPLY IMPLANT | Supply/Implant | $88,960.00 |
| 6067985 | AMNIOTIC MEMBRANE | Supply/Implant | $7,616.00 |
| 6068000 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6068017 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6068030 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6068032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6068057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,777.60 |
| 6068076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6068078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6068084 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6068085 | INTRO/SHEATH, NON-LASER | Supply/Implant | $760.32 |
| 6068086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6068087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6068088 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6068091 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6068092 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,457.34 |
| 6068097 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6068100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6068101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6068102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6068111 | POWER MODULE COMBO VAD REP | Supply/Implant | $132,300.00 |
| 6068115 | SUPPLY IMPLANT | Supply/Implant | $12,228.48 |
| 6068125 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6068134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6068146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6068147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,419.84 |
| 6068181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6068196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,422.08 |
| 6068203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,422.08 |
| 6068205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,422.08 |
| 6068268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6068269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6068273 | SUPPLY IMPLANT | Supply/Implant | $441.70 |
| 6068275 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6068277 | SUPPLY IMPLANT | Supply/Implant | $438.53 |
| 6068287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $67,200.00 |
| 6068289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6068323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068343 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068348 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6068355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068382 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,171.20 |
| 6068385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6068413 | CATHETER, GUIDING | Supply/Implant | $8,614.40 |
| 6068423 | GUIDE WIRE | Supply/Implant | $334.72 |
| 6068424 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6068430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6068435 | STERILE SUPPLY | Supply/Implant | $264.58 |
| 6068437 | SUPPLY IMPLANT | Supply/Implant | $2,519.04 |
| 6068439 | STERILE SUPPLY | Supply/Implant | $314.25 |
| 6068442 | SUPPLY IMPLANT | Supply/Implant | $1,986.56 |
| 6068443 | SUPPLY IMPLANT | Supply/Implant | $1,884.16 |
| 6068448 | STERILE SUPPLY | Supply/Implant | $652.80 |
| 6068454 | SUPPLY IMPLANT | Supply/Implant | $4,556.80 |
| 6068458 | STERILE SUPPLY | Supply/Implant | $9,088.51 |
| 6068462 | SUPPLY IMPLANT | Supply/Implant | $458.24 |
| 6068485 | SUPPLY IMPLANT | Supply/Implant | $138.62 |
| 6068491 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6068499 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6068500 | STERILE SUPPLY | Supply/Implant | $285.57 |
| 6068501 | SUPPLY IMPLANT | Supply/Implant | $8,522.24 |
| 6068502 | STERILE SUPPLY | Supply/Implant | $225.88 |
| 6068506 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6068511 | STERILE SUPPLY | Supply/Implant | $12,736.00 |
| 6068514 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6068520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,833.60 |
| 6068526 | STERILE SUPPLY | Supply/Implant | $13,145.60 |
| 6068530 | SUPPLY IMPLANT | Supply/Implant | $6,067.20 |
| 6068531 | SUPPLY IMPLANT | Supply/Implant | $6,278.40 |
| 6068534 | SUPPLY IMPLANT | Supply/Implant | $11,596.80 |
| 6068540 | SHWR COV ELECT/COMBO VAD REP | Supply/Implant | $2,880.00 |
| 6068552 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6068558 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6068601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6068611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6068613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6068626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,596.80 |
| 6068668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,272.00 |
| 6068674 | SUPPLY IMPLANT | Supply/Implant | $23,526.40 |
| 6068678 | SUPPLY IMPLANT | Supply/Implant | $6,388.48 |
| 6070055 | SUPPLY IMPLANT | Supply/Implant | $120,750.00 |
| 6070068 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,457.34 |
| 6070069 | GENERAL SUPPLY | Supply/Implant | $233.09 |
| 6070078 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6070079 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6070086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6070088 | SUPPLY IMPLANT | Supply/Implant | $2,593.28 |
| 6070089 | SUPPLY IMPLANT | Supply/Implant | $1,383.81 |
| 6070090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6070093 | SUPPLY IMPLANT | Supply/Implant | $2,665.60 |
| 6070094 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6070095 | GENERAL SUPPLY | Supply/Implant | $441.70 |
| 6070109 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6070110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6070114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6070122 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6070123 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,564.80 |
| 6070128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6070129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6070131 | GRAFT, VASCULAR | Supply/Implant | $31,294.08 |
| 6070132 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6070133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6070142 | GENERAL SUPPLY | Supply/Implant | $2,424.19 |
| 6070143 | GENERAL SUPPLY | Supply/Implant | $2,157.18 |
| 6070161 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6070162 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6070175 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6070180 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6070181 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6070183 | GUIDE WIRE | Supply/Implant | $412.80 |
| 6070184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,247.49 |
| 6070185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6070190 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,502.40 |
| 6070194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6070197 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6070212 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070222 | GUIDE WIRE | Supply/Implant | $436.74 |
| 6070236 | STERILE SUPPLY | Supply/Implant | $2,368.00 |
| 6070244 | CONN TISS, NON-HUMAN | Supply/Implant | $19,738.62 |
| 6070248 | CONN TISS, NON-HUMAN | Supply/Implant | $26,985.73 |
| 6070257 | STERILE SUPPLY | Supply/Implant | $307.20 |
| 6070263 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070271 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070281 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070285 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070295 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070311 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6070313 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6070315 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070317 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070334 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $37,760.00 |
| 6070337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6070339 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,560.00 |
| 6070340 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6070341 | SUPPLY IMPLANT | Supply/Implant | $130.82 |
| 6070344 | SUPPLY IMPLANT | Supply/Implant | $5,273.47 |
| 6070345 | SUPPLY IMPLANT | Supply/Implant | $5,017.34 |
| 6070351 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6070360 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6070363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,988.80 |
| 6070376 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6070382 | SUPPLY IMPLANT | Supply/Implant | $4,705.66 |
| 6070412 | STERILE SUPPLY | Supply/Implant | $352.00 |
| 6070413 | STERILE SUPPLY | Supply/Implant | $318.94 |
| 6070425 | SUPPLY IMPLANT | Supply/Implant | $466.18 |
| 6070428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6070430 | SUPPLY IMPLANT | Supply/Implant | $70,976.00 |
| 6070438 | SUPPLY IMPLANT | Supply/Implant | $381.57 |
| 6070439 | SUPPLY IMPLANT | Supply/Implant | $2,521.60 |
| 6070441 | GENERAL SUPPLY | Supply/Implant | $389.12 |
| 6070448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6070451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070460 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $122,880.00 |
| 6070462 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6070468 | SUPPLY IMPLANT | Supply/Implant | $1,120.64 |
| 6070469 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6070470 | STERILE SUPPLY | Supply/Implant | $1,545.09 |
| 6070483 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6070488 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6070504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6070510 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6070535 | SUPPLY IMPLANT | Supply/Implant | $28,060.16 |
| 6070548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6070551 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070553 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070554 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070555 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070557 | SUPPLY IMPLANT | Supply/Implant | $2,445.57 |
| 6070560 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070561 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070581 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6070582 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6070583 | SUPPLY IMPLANT | Supply/Implant | $230.91 |
| 6070586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,929.41 |
| 6070591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,130.69 |
| 6070592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,130.69 |
| 6070593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,130.69 |
| 6070605 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $4,416.00 |
| 6070612 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $4,416.00 |
| 6070618 | SUPPLY IMPLANT | Supply/Implant | $19,276.80 |
| 6070623 | PWR MODULE PT CABLE LVAD RPL | Supply/Implant | $16,000.00 |
| 6070624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6070653 | SUPPLY IMPLANT | Supply/Implant | $18,624.00 |
| 6070657 | SUPPLY IMPLANT | Supply/Implant | $18,624.00 |
| 6070660 | SUPPLY IMPLANT | Supply/Implant | $17,630.72 |
| 6070666 | INTEGRA MATRIX SKIN SUB | Supply/Implant | $65,854.46 |
| 6070667 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6070672 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $82,675.20 |
| 6070673 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6070682 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $724.22 |
| 6070685 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070689 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070696 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6070697 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6070706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6070716 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6070718 | SUPPLY IMPLANT | Supply/Implant | $356.35 |
| 6070720 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6070728 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6070732 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6070736 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,586.37 |
| 6070739 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,784.58 |
| 6070758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,712.00 |
| 6070762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070767 | GENERAL SUPPLY | Supply/Implant | $477.34 |
| 6070769 | GUIDE WIRE | Supply/Implant | $793.60 |
| 6070781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6070782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6070783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6070787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6070814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6070817 | PORT, INDWELLING, IMP | Supply/Implant | $9,907.20 |
| 6070818 | PORT, INDWELLING, IMP | Supply/Implant | $9,907.20 |
| 6070821 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6070822 | SUPPLY IMPLANT | Supply/Implant | $7,961.60 |
| 6070824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,070.40 |
| 6070835 | GUIDE WIRE | Supply/Implant | $3,238.40 |
| 6070836 | GUIDE WIRE | Supply/Implant | $3,532.80 |
| 6070837 | GUIDE WIRE | Supply/Implant | $3,238.40 |
| 6070838 | SUPPLY IMPLANT | Supply/Implant | $34,240.00 |
| 6070839 | SUPPLY IMPLANT | Supply/Implant | $34,240.00 |
| 6070840 | CATHETER, GUIDING | Supply/Implant | $9,331.20 |
| 6070841 | CATHETER, GUIDING | Supply/Implant | $9,331.20 |
| 6070844 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070848 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070849 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070850 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070851 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070852 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070855 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070857 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070858 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070859 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070860 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070861 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070862 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070863 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070864 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070865 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070866 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070867 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070868 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070869 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070874 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070875 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070890 | SUPPLY IMPLANT | Supply/Implant | $487.30 |
| 6070895 | INTEGRA MATRIX SKIN SUB | Supply/Implant | $62,973.57 |
| 6070896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,048.00 |
| 6070901 | SUPPLY IMPLANT | Supply/Implant | $18,304.00 |
| 6070942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6070944 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6070978 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6070979 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6070980 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6070989 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6070990 | SUPPLY IMPLANT | Supply/Implant | $7,961.60 |
| 6071001 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $576.00 |
| 6071002 | SUPPLY IMPLANT | Supply/Implant | $870.40 |
| 6071003 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6071019 | GUIDE WIRE | Supply/Implant | $6,054.40 |
| 6071021 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6071022 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,080.00 |
| 6071030 | GENERAL SUPPLY | Supply/Implant | $285.44 |
| 6071034 | CLOSURE DEV, VASC | Supply/Implant | $2,432.00 |
| 6071035 | CLOSURE DEV, VASC | Supply/Implant | $2,432.00 |
| 6071036 | CLOSURE DEV, VASC | Supply/Implant | $2,432.00 |
| 6071037 | SUPPLY IMPLANT | Supply/Implant | $3,280.18 |
| 6071042 | SUPPLY IMPLANT | Supply/Implant | $2,078.72 |
| 6071045 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6071046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,520.00 |
| 6071049 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6071050 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6071053 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6071056 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6071067 | SUPPLY IMPLANT | Supply/Implant | $293.89 |
| 6071074 | SUPPLY IMPLANT | Supply/Implant | $205.70 |
| 6071079 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6071080 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6071082 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6071113 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6071122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6071123 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071124 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071125 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071126 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6071138 | SUPPLY IMPLANT | Supply/Implant | $4,684.80 |
| 6071143 | STERILE SUPPLY | Supply/Implant | $21,596.16 |
| 6071161 | SUPPLY IMPLANT | Supply/Implant | $2,492.80 |
| 6071166 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071168 | SUPPLY IMPLANT | Supply/Implant | $8,460.80 |
| 6071175 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $31,993.60 |
| 6071176 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $127,692.80 |
| 6071186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $60,895.36 |
| 6071187 | SUPPLY IMPLANT | Supply/Implant | $8,870.40 |
| 6071189 | GENERAL SUPPLY | Supply/Implant | $465.92 |
| 6071197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6071198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6071202 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6071206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,025.73 |
| 6071209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6071219 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,247.49 |
| 6071220 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6071228 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6071230 | SUPPLY IMPLANT | Supply/Implant | $16,569.65 |
| 6071233 | SUPPLY IMPLANT | Supply/Implant | $65,534.98 |
| 6071235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6071242 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6071250 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071251 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6071252 | SUPPLY IMPLANT | Supply/Implant | $4,363.65 |
| 6071253 | SUPPLY IMPLANT | Supply/Implant | $3,274.59 |
| 6071254 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6071256 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6071277 | STERILE SUPPLY | Supply/Implant | $294.40 |
| 6071280 | STERILE SUPPLY | Supply/Implant | $170.24 |
| 6071281 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6071310 | SUPPLY IMPLANT | Supply/Implant | $4,427.26 |
| 6071311 | STERILE SUPPLY | Supply/Implant | $193.02 |
| 6071322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6071371 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071372 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071373 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071374 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071375 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071376 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071377 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071378 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6071394 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6071398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,680.00 |
| 6071408 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071409 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071410 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071411 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071412 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6071414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6071416 | SUPPLY IMPLANT | Supply/Implant | $1,202.05 |
| 6071417 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071419 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071420 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071422 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071423 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071424 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071425 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071426 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071427 | SUPPLY IMPLANT | Supply/Implant | $1,617.66 |
| 6071428 | SUPPLY IMPLANT | Supply/Implant | $1,617.66 |
| 6071430 | SUPPLY IMPLANT | Supply/Implant | $2,582.53 |
| 6071435 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6071438 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6071439 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6071451 | SUPPLY IMPLANT | Supply/Implant | $306.69 |
| 6071453 | CATHETER, GUIDING | Supply/Implant | $9,331.20 |
| 6071458 | GENERAL SUPPLY | Supply/Implant | $154.91 |
| 6071459 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,457.34 |
| 6071462 | CATHETER, GUIDING | Supply/Implant | $838.91 |
| 6071467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,662.40 |
| 6071472 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6071473 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6071479 | SUPPLY IMPLANT | Supply/Implant | $2,526.72 |
| 6071480 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6071481 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6071482 | SUPPLY IMPLANT | Supply/Implant | $13,171.20 |
| 6071486 | SUPPLY IMPLANT | Supply/Implant | $31,294.08 |
| 6071489 | SUPPLY IMPLANT | Supply/Implant | $1,720.32 |
| 6071494 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6071501 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6071502 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6071504 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071505 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071506 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071507 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071508 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6071509 | SUPPLY IMPLANT | Supply/Implant | $5,235.20 |
| 6071512 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071522 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,164.80 |
| 6071526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,357.76 |
| 6071535 | GUIDE WIRE | Supply/Implant | $8,641.28 |
| 6071539 | CATHETER, GUIDING | Supply/Implant | $20,467.20 |
| 6071540 | CATHETER, GUIDING | Supply/Implant | $16,000.00 |
| 6071542 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6071564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6071565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,187.84 |
| 6071569 | CATHETER, GUIDING | Supply/Implant | $6,336.00 |
| 6071570 | CATHETER, GUIDING | Supply/Implant | $6,336.00 |
| 6071571 | CATHETER, GUIDING | Supply/Implant | $6,272.00 |
| 6071572 | CATHETER, GUIDING | Supply/Implant | $6,272.00 |
| 6071573 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $42,176.00 |
| 6071584 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6071588 | GUIDE WIRE | Supply/Implant | $3,712.00 |
| 6071592 | SUPPLY IMPLANT | Supply/Implant | $7,091.20 |
| 6071594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,235.20 |
| 6071595 | SUPPLY IMPLANT | Supply/Implant | $7,923.20 |
| 6071596 | SUPPLY IMPLANT | Supply/Implant | $7,808.00 |
| 6071597 | SUPPLY IMPLANT | Supply/Implant | $7,539.20 |
| 6071598 | SUPPLY IMPLANT | Supply/Implant | $6,950.40 |
| 6071599 | SUPPLY IMPLANT | Supply/Implant | $5,606.40 |
| 6071602 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6071603 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6071607 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6071614 | GENERAL SUPPLY | Supply/Implant | $974.34 |
| 6071615 | STERILE SUPPLY | Supply/Implant | $902.78 |
| 6071616 | GENERAL SUPPLY | Supply/Implant | $979.33 |
| 6071619 | SUPPLY IMPLANT | Supply/Implant | $1,579.52 |
| 6071621 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071622 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071623 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071624 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071660 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6071664 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6071665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071671 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $205,030.00 |
| 6071674 | SUPPLY IMPLANT | Supply/Implant | $4,508.42 |
| 6071687 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6071694 | STERILE SUPPLY | Supply/Implant | $260.86 |
| 6071698 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6071700 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6071701 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6071702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6071703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,636.80 |
| 6071707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6071708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,080.00 |
| 6071709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071710 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,840.00 |
| 6071711 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6071712 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6071713 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,120.00 |
| 6071717 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071718 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,840.00 |
| 6071719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,369.60 |
| 6071727 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $78,848.00 |
| 6071734 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,247.23 |
| 6071751 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6071761 | SUPPLY IMPLANT | Supply/Implant | $1,202.30 |
| 6071763 | SUPPLY IMPLANT | Supply/Implant | $2,086.40 |
| 6071764 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6071765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,909.50 |
| 6071770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6071778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6071790 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $140.80 |
| 6071804 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,793.02 |
| 6071805 | CATHETER, URETERAL | Supply/Implant | $244.86 |
| 6071807 | CATHETER, URETERAL | Supply/Implant | $395.14 |
| 6071812 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071813 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,384.00 |
| 6071816 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6071824 | SUPPLY IMPLANT | Supply/Implant | $4,697.60 |
| 6071825 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071832 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6071841 | SUPPLY IMPLANT | Supply/Implant | $1,423.36 |
| 6071842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6071845 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6071848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6071852 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6071853 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6071854 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6071855 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6071859 | SUPPLY IMPLANT | Supply/Implant | $1,748.48 |
| 6071860 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6071861 | SUPPLY IMPLANT | Supply/Implant | $1,573.50 |
| 6071864 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6071884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6071887 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6071891 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6071893 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6071904 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071905 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,864.00 |
| 6071906 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071907 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071923 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $42,176.00 |
| 6071927 | SUPPLY IMPLANT | Supply/Implant | $209.79 |
| 6071931 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6071932 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6071939 | SUPPLY IMPLANT | Supply/Implant | $119,962.50 |
| 6071940 | SUPPLY IMPLANT | Supply/Implant | $4,289.02 |
| 6071946 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6071948 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,295.49 |
| 6071949 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6071961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6071962 | SUPPLY IMPLANT | Supply/Implant | $118,053.39 |
| 6071963 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6071969 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6071970 | SUPPLY IMPLANT | Supply/Implant | $645.89 |
| 6071979 | STERILE SUPPLY | Supply/Implant | $12,736.00 |
| 6071981 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6071995 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6071996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.70 |
| 6071997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.70 |
| 6072000 | SUPPLY IMPLANT | Supply/Implant | $2,451.71 |
| 6072001 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6072003 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6072006 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,792.00 |
| 6072007 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,892.80 |
| 6072008 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6072009 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6072012 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $42,112.00 |
| 6072027 | STERILE SUPPLY | Supply/Implant | $2,426.75 |
| 6072029 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6072036 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6072039 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6072040 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6072046 | SUPPLY IMPLANT | Supply/Implant | $418.69 |
| 6072047 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6072071 | PORT, INDWELLING, IMP | Supply/Implant | $6,720.00 |
| 6072077 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,408.00 |
| 6072084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,566.08 |
| 6072086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,397.50 |
| 6072092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,988.80 |
| 6072099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,566.08 |
| 6072102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6072103 | SUPPLY IMPLANT | Supply/Implant | $573.44 |
| 6072121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,428.80 |
| 6072123 | SUPPLY IMPLANT | Supply/Implant | $120,532.48 |
| 6072126 | GENERAL SUPPLY | Supply/Implant | $330.75 |
| 6072129 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6072130 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6072131 | STERILE SUPPLY | Supply/Implant | $519.68 |
| 6072142 | NEURAWRAP NERVE PROTECTOR,CM | Supply/Implant | $25,123.20 |
| 6072148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072170 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6072172 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6072173 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6072181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6072184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6072193 | SUPPLY IMPLANT | Supply/Implant | $7,730.56 |
| 6072195 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072196 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072197 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072198 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072199 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072200 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072201 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072202 | GENERAL SUPPLY | Supply/Implant | $181.38 |
| 6072204 | GENERAL SUPPLY | Supply/Implant | $1,314.05 |
| 6072209 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072212 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072215 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6072219 | SUPPLY IMPLANT | Supply/Implant | $1,325.44 |
| 6072220 | SUPPLY IMPLANT | Supply/Implant | $1,192.90 |
| 6072260 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6072274 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6072276 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6072277 | GENERAL SUPPLY | Supply/Implant | $658.69 |
| 6072279 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $116,992.00 |
| 6072283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6072302 | CORNEAL TISSUE PROCESSING | Supply/Implant | $48,640.00 |
| 6072307 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.20 |
| 6072314 | GENERAL SUPPLY | Supply/Implant | $296.45 |
| 6072323 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072333 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072336 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072365 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072366 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072377 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6072378 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6072379 | SUPPLY IMPLANT | Supply/Implant | $883.20 |
| 6072381 | SUPPLY IMPLANT | Supply/Implant | $10,142.34 |
| 6072382 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6072383 | SUPPLY IMPLANT | Supply/Implant | $1,862.53 |
| 6072384 | SUPPLY IMPLANT | Supply/Implant | $958.21 |
| 6072387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6072390 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6072391 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6072393 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6072397 | GENERAL SUPPLY | Supply/Implant | $1,425.66 |
| 6072398 | GENERAL SUPPLY | Supply/Implant | $2,162.10 |
| 6072403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,703.42 |
| 6072405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6072407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6072412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6072424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,863.36 |
| 6072432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6072433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6072435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,979.52 |
| 6072438 | GENERAL SUPPLY | Supply/Implant | $2,948.10 |
| 6072440 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6072442 | SUPPLY IMPLANT | Supply/Implant | $140,955.89 |
| 6072444 | CATH OCCLUSION | Supply/Implant | $17,920.00 |
| 6072446 | GUIDE WIRE | Supply/Implant | $2,188.80 |
| 6072448 | GENERAL SUPPLY | Supply/Implant | $336.90 |
| 6072450 | SUPPLY IMPLANT | Supply/Implant | $2,268.25 |
| 6072451 | SUPPLY IMPLANT | Supply/Implant | $9,379.33 |
| 6072456 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072457 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072458 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072459 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072460 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072461 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072469 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072470 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072471 | SUPPLY IMPLANT | Supply/Implant | $6,648.32 |
| 6072472 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072473 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072474 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072481 | STERILE SUPPLY | Supply/Implant | $1,728.38 |
| 6072494 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6072498 | GENERAL SUPPLY | Supply/Implant | $293.12 |
| 6072499 | GENERAL SUPPLY | Supply/Implant | $267.52 |
| 6072510 | CATHETER, GUIDING | Supply/Implant | $512.00 |
| 6072511 | CATHETER, GUIDING | Supply/Implant | $1,408.00 |
| 6072512 | CATHETER, GUIDING | Supply/Implant | $307.20 |
| 6072535 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6072536 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6072537 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6072544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,067.20 |
| 6072546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,969.73 |
| 6072547 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $660.74 |
| 6072548 | SUPPLY IMPLANT | Supply/Implant | $604.80 |
| 6072554 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6072568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,038.50 |
| 6072569 | SUPPLY IMPLANT | Supply/Implant | $7,728.00 |
| 6072572 | GRAFT, VASCULAR | Supply/Implant | $39,499.26 |
| 6072576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,958.40 |
| 6072577 | SUPPLY IMPLANT | Supply/Implant | $5,958.40 |
| 6072580 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6072583 | GENERAL SUPPLY | Supply/Implant | $257.54 |
| 6072585 | GRAFT, VASCULAR | Supply/Implant | $39,499.26 |
| 6072590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6072591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6072598 | SUPPLY IMPLANT | Supply/Implant | $10,854.40 |
| 6072606 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,137.28 |
| 6072616 | SUPPLY IMPLANT | Supply/Implant | $306.82 |
| 6072617 | SUPPLY IMPLANT | Supply/Implant | $246.02 |
| 6072618 | SUPPLY IMPLANT | Supply/Implant | $246.02 |
| 6072636 | SUPPLY IMPLANT | Supply/Implant | $1,152.26 |
| 6072637 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6072638 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6072639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6072640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,150.72 |
| 6072642 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6072648 | GENERAL SUPPLY | Supply/Implant | $645.12 |
| 6072649 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6072651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6072653 | SUPPLY IMPLANT | Supply/Implant | $1,270.14 |
| 6072655 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6072656 | SUPPLY IMPLANT | Supply/Implant | $1,270.14 |
| 6072657 | SUPPLY IMPLANT | Supply/Implant | $589.57 |
| 6072658 | SUPPLY IMPLANT | Supply/Implant | $649.98 |
| 6072659 | SUPPLY IMPLANT | Supply/Implant | $589.57 |
| 6072661 | SUPPLY IMPLANT | Supply/Implant | $2,947.84 |
| 6072662 | SUPPLY IMPLANT | Supply/Implant | $1,434.11 |
| 6072669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6072675 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,706.69 |
| 6072684 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6072688 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,408.13 |
| 6072689 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,408.13 |
| 6072696 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072697 | SUPPLY IMPLANT | Supply/Implant | $1,012.74 |
| 6072699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6072700 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.20 |
| 6072701 | ALLODERM SKIN SUB | Supply/Implant | $3,660.80 |
| 6072702 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6072704 | STERILE SUPPLY | Supply/Implant | $499.20 |
| 6072715 | LEAD, CORONARY VENOUS | Supply/Implant | $120,640.00 |
| 6072716 | LEAD, CORONARY VENOUS | Supply/Implant | $120,640.00 |
| 6072719 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6072732 | SUPPLY IMPLANT | Supply/Implant | $1,184.00 |
| 6072733 | SUPPLY IMPLANT | Supply/Implant | $1,184.00 |
| 6072734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6072748 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,267.20 |
| 6072750 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6072754 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6072755 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6072757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6072760 | STERILE SUPPLY | Supply/Implant | $332.80 |
| 6072767 | MESH (IMPLANTABLE) | Supply/Implant | $8,010.50 |
| 6072770 | SUPPLY IMPLANT | Supply/Implant | $598.53 |
| 6072776 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6072815 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6072827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,136.00 |
| 6072828 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6072838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,209.60 |
| 6072840 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6072844 | STERILE SUPPLY | Supply/Implant | $488.32 |
| 6072846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6072848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6072856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,352.00 |
| 6072860 | GENERAL SUPPLY | Supply/Implant | $271.36 |
| 6072869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6072872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6072873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6072876 | SUPPLY IMPLANT | Supply/Implant | $4,648.96 |
| 6072878 | SUPPLY IMPLANT | Supply/Implant | $2,997.89 |
| 6072886 | SUPPLY IMPLANT | Supply/Implant | $3,297.79 |
| 6072891 | SUPPLY IMPLANT | Supply/Implant | $2,539.52 |
| 6072901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,881.60 |
| 6072915 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,328.00 |
| 6072917 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6072929 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $119,680.00 |
| 6072937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6072946 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $14,470.40 |
| 6072947 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $184,432.50 |
| 6072948 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $116,249.60 |
| 6072949 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $116,249.60 |
| 6072975 | SUPPLY IMPLANT | Supply/Implant | $223.36 |
| 6072979 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $8,268.80 |
| 6072999 | SUPPLY IMPLANT | Supply/Implant | $606.72 |
| 6073009 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6073012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6073017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6073023 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6073026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6073027 | CATHETER, GUIDING | Supply/Implant | $2,112.00 |
| 6073028 | SUPPLY IMPLANT | Supply/Implant | $3,267.07 |
| 6073032 | SUPPLY IMPLANT | Supply/Implant | $883.33 |
| 6073036 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $3,551.74 |
| 6073055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6073083 | GENERAL SUPPLY | Supply/Implant | $419.97 |
| 6073120 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6073122 | SUPPLY IMPLANT | Supply/Implant | $59,776.00 |
| 6073123 | SUPPLY IMPLANT | Supply/Implant | $7,689.60 |
| 6073124 | SUPPLY IMPLANT | Supply/Implant | $7,689.60 |
| 6073125 | SUPPLY IMPLANT | Supply/Implant | $7,555.20 |
| 6073126 | SUPPLY IMPLANT | Supply/Implant | $7,555.20 |
| 6073129 | INTERSPINOUS IMPLANT | Supply/Implant | $37,888.00 |
| 6073133 | INTERSPINOUS IMPLANT | Supply/Implant | $60,806.40 |
| 6073152 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6073153 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6073174 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,897.60 |
| 6073175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6073176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6073178 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6073179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6073182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,772.16 |
| 6073184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073187 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6073190 | GENERAL SUPPLY | Supply/Implant | $672.00 |
| 6073210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,929.41 |
| 6073211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6073230 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $1,886.85 |
| 6073231 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $1,806.08 |
| 6073232 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,806.08 |
| 6073237 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,806.08 |
| 6073239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,840.00 |
| 6073240 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6073245 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6073246 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6073263 | GENERAL SUPPLY | Supply/Implant | $600.06 |
| 6073278 | IMPLT NEUROSTIM ELCTR EACH | Supply/Implant | $30,592.00 |
| 6073286 | GENERAL SUPPLY | Supply/Implant | $253.31 |
| 6073307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,369.60 |
| 6073309 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6073311 | CATH, DRAINAGE | Supply/Implant | $2,944.00 |
| 6073317 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073320 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073321 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073328 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6073349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,088.96 |
| 6073350 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6073352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6073356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,318.72 |
| 6073357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,318.72 |
| 6073358 | CATHETER, GUIDING | Supply/Implant | $2,206.85 |
| 6073359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6073372 | GENERAL SUPPLY | Supply/Implant | $316.03 |
| 6073398 | SUPPLY IMPLANT | Supply/Implant | $87,360.00 |
| 6073404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $318.72 |
| 6073408 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6073421 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $25,523.20 |
| 6073429 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,867.01 |
| 6073436 | GENERAL SUPPLY | Supply/Implant | $288.51 |
| 6073442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,814.40 |
| 6073443 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6073450 | SUPPLY IMPLANT | Supply/Implant | $6,649.60 |
| 6073465 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6073474 | GENERAL SUPPLY | Supply/Implant | $395.78 |
| 6073475 | STERILE SUPPLY | Supply/Implant | $8,481.79 |
| 6073485 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6073490 | MESH (IMPLANTABLE) | Supply/Implant | $71,616.00 |
| 6073491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6073497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6073498 | SUPPLY IMPLANT | Supply/Implant | $23,203.84 |
| 6073504 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,664.00 |
| 6073505 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6073506 | GENERAL SUPPLY | Supply/Implant | $216.96 |
| 6073510 | SUPPLY IMPLANT | Supply/Implant | $1,556.48 |
| 6073513 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073514 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073517 | SUPPLY IMPLANT | Supply/Implant | $2,011.48 |
| 6073518 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073522 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073523 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073526 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073527 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073530 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073531 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073537 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073539 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073541 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073542 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,048.00 |
| 6073543 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073544 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073546 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073547 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073548 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073549 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073550 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073551 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073552 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073554 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073556 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073558 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073559 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073560 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073563 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6073565 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6073569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6073580 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $94,707.20 |
| 6073582 | RET DEV, INSERTABLE | Supply/Implant | $94,707.20 |
| 6073583 | RET DEV, INSERTABLE | Supply/Implant | $94,707.20 |
| 6073591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6073592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6073604 | SUPPLY IMPLANT | Supply/Implant | $2,221.44 |
| 6073605 | SUPPLY IMPLANT | Supply/Implant | $3,826.43 |
| 6073609 | SUPPLY IMPLANT | Supply/Implant | $15,552.00 |
| 6073630 | INTRO/SHEATH, NON-LASER | Supply/Implant | $10,585.60 |
| 6073632 | INTRO/SHEATH, NON-LASER | Supply/Implant | $10,585.60 |
| 6073638 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073639 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073641 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073642 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073643 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073644 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073647 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073648 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073650 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073651 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073652 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073653 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073654 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073656 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073658 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073662 | SUPPLY IMPLANT | Supply/Implant | $257,550.00 |
| 6073670 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073671 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073672 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073673 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073680 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6073690 | SUPPLY IMPLANT | Supply/Implant | $1,021.44 |
| 6073694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,920.06 |
| 6073703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,804.48 |
| 6073709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6073716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073724 | SUPPLY IMPLANT | Supply/Implant | $23,500.80 |
| 6073725 | SUPPLY IMPLANT | Supply/Implant | $66,585.60 |
| 6073741 | SUPPLY IMPLANT | Supply/Implant | $2,734.08 |
| 6073743 | SUPPLY IMPLANT | Supply/Implant | $2,836.48 |
| 6073744 | SUPPLY IMPLANT | Supply/Implant | $931.84 |
| 6073752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6073756 | STERILE SUPPLY | Supply/Implant | $246.53 |
| 6073757 | STERILE SUPPLY | Supply/Implant | $199.17 |
| 6073759 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,348.80 |
| 6073766 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6073768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6073772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,742.40 |
| 6073774 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6073782 | SUPPLY IMPLANT | Supply/Implant | $148.74 |
| 6073783 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6073794 | GRAFT, VASCULAR | Supply/Implant | $87,360.00 |
| 6073795 | GRAFT, VASCULAR | Supply/Implant | $42,560.00 |
| 6073811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6073813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6073814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6073824 | INTRO/SHEATH, NON-LASER | Supply/Implant | $556.80 |
| 6073847 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6073861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073865 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,720.00 |
| 6073876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6073879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,065.60 |
| 6073881 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $63,936.00 |
| 6073884 | SUPPLY IMPLANT | Supply/Implant | $1,054.72 |
| 6073906 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6073907 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6073911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,121.22 |
| 6073913 | SUPPLY IMPLANT | Supply/Implant | $575.87 |
| 6073921 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6073935 | SUPPLY IMPLANT | Supply/Implant | $1,182.72 |
| 6073940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073973 | SUPPLY IMPLANT | Supply/Implant | $495.10 |
| 6073990 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6073991 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6073992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6073999 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6074002 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6074007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,736.00 |
| 6074008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,651.20 |
| 6074012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6074013 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6074014 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6074017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6074020 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074024 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6074025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6074026 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6074029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6074030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,736.00 |
| 6074032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,467.20 |
| 6074034 | GENERAL SUPPLY | Supply/Implant | $5,712.00 |
| 6074047 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6074052 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6074054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074064 | SUPPLY IMPLANT | Supply/Implant | $3,302.40 |
| 6074080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6074081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,668.54 |
| 6074102 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6074104 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,471.74 |
| 6074106 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,480.19 |
| 6074107 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6074108 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6074113 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6074118 | SUPPLY IMPLANT | Supply/Implant | $1,182.72 |
| 6074120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,651.20 |
| 6074129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074131 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6074133 | SUPPLY IMPLANT | Supply/Implant | $3,827.20 |
| 6074134 | SUPPLY IMPLANT | Supply/Implant | $645.89 |
| 6074136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6074145 | LEAD, NEUROSTIMULATOR | Supply/Implant | $100,480.00 |
| 6074150 | GENERAL SUPPLY | Supply/Implant | $1,399.17 |
| 6074151 | GENERAL SUPPLY | Supply/Implant | $1,372.42 |
| 6074157 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6074158 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6074159 | STERILE SUPPLY | Supply/Implant | $601.34 |
| 6074160 | STERILE SUPPLY | Supply/Implant | $835.58 |
| 6074161 | STERILE SUPPLY | Supply/Implant | $360.19 |
| 6074166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6074167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6074169 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074171 | STERILE SUPPLY | Supply/Implant | $467.42 |
| 6074172 | INTERSPINOUS IMPLANT | Supply/Implant | $48,114.56 |
| 6074173 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6074186 | SUPPLY IMPLANT | Supply/Implant | $216.45 |
| 6074188 | SUPPLY IMPLANT | Supply/Implant | $149.12 |
| 6074189 | STERILE SUPPLY | Supply/Implant | $301.31 |
| 6074190 | STERILE SUPPLY | Supply/Implant | $301.31 |
| 6074194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6074195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6074202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6074214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6074217 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6074225 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074234 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $52,467.20 |
| 6074235 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $52,467.20 |
| 6074240 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074242 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074249 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074250 | SUPPLY IMPLANT | Supply/Implant | $26,307.07 |
| 6074252 | MISC SUP/ACC IMP VAD | Supply/Implant | $139.14 |
| 6074255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074256 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074258 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074262 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074263 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074264 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6074267 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074268 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074269 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074270 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074271 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074276 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,945.60 |
| 6074277 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074278 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074279 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074281 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6074284 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074285 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074286 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074287 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074289 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6074293 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074294 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074295 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074298 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6074300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074304 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074327 | GENERAL SUPPLY | Supply/Implant | $461.70 |
| 6074328 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6074333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074335 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,817.60 |
| 6074336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6074338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,146.88 |
| 6074341 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $63,254.40 |
| 6074350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6074356 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6074357 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6074359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,802.88 |
| 6074361 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6074362 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6074363 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6074371 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6074375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6074378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074381 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6074386 | GUIDE WIRE | Supply/Implant | $7,508.86 |
| 6074387 | GUIDE WIRE | Supply/Implant | $7,508.86 |
| 6074390 | GENERAL SUPPLY | Supply/Implant | $1,039.74 |
| 6074397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6074398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6074404 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074405 | SUPPLY IMPLANT | Supply/Implant | $6,412.29 |
| 6074406 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074407 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074408 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074409 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074410 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074411 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074412 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074414 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074415 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074416 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6074429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6074430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6074464 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6074465 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6074466 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6074469 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6074472 | GENERAL SUPPLY | Supply/Implant | $7,616.00 |
| 6074473 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6074487 | ALLODERM SKIN SUB | Supply/Implant | $2,956.80 |
| 6074490 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $14,018.69 |
| 6074491 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,576.45 |
| 6074499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,124.80 |
| 6074505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6074509 | SUPPLY IMPLANT | Supply/Implant | $5,990.40 |
| 6074522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,566.08 |
| 6074533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074534 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6074535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6074536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074538 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074542 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6074543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6074544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6074545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,790.40 |
| 6074546 | RET DEV, INSERTABLE | Supply/Implant | $1,407.05 |
| 6074550 | CORNEAL TISSUE PROCESSING | Supply/Implant | $51,200.00 |
| 6074551 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $10,579.20 |
| 6074552 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $10,579.20 |
| 6074563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074577 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074580 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6074585 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6074587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,790.40 |
| 6074588 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $32,000.00 |
| 6074592 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074593 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074594 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074595 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074596 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074597 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074598 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074603 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074604 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074606 | GUIDE WIRE | Supply/Implant | $332.80 |
| 6074608 | GUIDE WIRE | Supply/Implant | $268.80 |
| 6074610 | GUIDE WIRE | Supply/Implant | $419.61 |
| 6074611 | SUPPLY IMPLANT | Supply/Implant | $3,357.70 |
| 6074615 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6074617 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6074638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6074639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6074640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6074647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6074648 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6074653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,017.22 |
| 6074665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6074681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6074683 | GUIDE WIRE | Supply/Implant | $601.60 |
| 6074740 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,960.00 |
| 6074749 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6074761 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $119,680.00 |
| 6074764 | GRAFT, VASCULAR | Supply/Implant | $119,680.00 |
| 6074766 | GENERAL SUPPLY | Supply/Implant | $1,628.03 |
| 6074770 | SUPPLY IMPLANT | Supply/Implant | $108,736.00 |
| 6074774 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $119,680.00 |
| 6074779 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $704.00 |
| 6074780 | GRAFT, VASCULAR | Supply/Implant | $119,680.00 |
| 6074782 | GRAFT, VASCULAR | Supply/Implant | $108,736.00 |
| 6074786 | GRAFT, VASCULAR | Supply/Implant | $108,736.00 |
| 6074788 | GRAFT, VASCULAR | Supply/Implant | $115,500.00 |
| 6074791 | SUPPLY IMPLANT | Supply/Implant | $15,595.52 |
| 6074796 | GRAFT, VASCULAR | Supply/Implant | $44,736.00 |
| 6074810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,872.13 |
| 6074814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074817 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6074822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074836 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6074845 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074846 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074847 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074848 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074863 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074864 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074865 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074867 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074868 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074870 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074871 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6074878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6074879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,548.80 |
| 6074887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6074890 | SUPPLY IMPLANT | Supply/Implant | $548.35 |
| 6074892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6074893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6074894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $652.80 |
| 6074895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6074899 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6074903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6074912 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,872.13 |
| 6074916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074919 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,587.84 |
| 6074921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,187.20 |
| 6074922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074928 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6074929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074934 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6074942 | SUPPLY IMPLANT | Supply/Implant | $6,345.22 |
| 6074962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6074963 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $36,480.00 |
| 6074964 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $36,480.00 |
| 6074965 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $36,480.00 |
| 6074966 | SUPPLY IMPLANT | Supply/Implant | $368.64 |
| 6074973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074980 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6074981 | GUIDE WIRE | Supply/Implant | $1,740.80 |
| 6074982 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $3,200.00 |
| 6074983 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6074988 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6074990 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,328.00 |
| 6074994 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,328.00 |
| 6074997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,006.40 |
| 6075007 | LEAD, CORONARY VENOUS | Supply/Implant | $35,840.00 |
| 6075012 | GRAFT, VASCULAR | Supply/Implant | $63,680.00 |
| 6075013 | SUPPLY IMPLANT | Supply/Implant | $59,520.00 |
| 6075014 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6075018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6075019 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6075020 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6075021 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6075029 | GRAFT, VASCULAR | Supply/Implant | $61,440.00 |
| 6075041 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6075042 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075043 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075044 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075045 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075046 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075048 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075049 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075054 | STERILE SUPPLY | Supply/Implant | $1,375.87 |
| 6075063 | GRAFT, VASCULAR | Supply/Implant | $60,496.00 |
| 6075064 | GRAFT, VASCULAR | Supply/Implant | $58,976.00 |
| 6075067 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,776.00 |
| 6075070 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075080 | GENERAL SUPPLY | Supply/Implant | $142.85 |
| 6075081 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6075082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075085 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6075086 | SUPPLY IMPLANT | Supply/Implant | $30,720.00 |
| 6075093 | STERILE SUPPLY | Supply/Implant | $318.85 |
| 6075103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6075107 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $271,690.00 |
| 6075108 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $28,160.00 |
| 6075111 | CATHETER, GUIDING | Supply/Implant | $1,779.20 |
| 6075121 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,036.80 |
| 6075137 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6075139 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $1,186.56 |
| 6075157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6075164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,395.52 |
| 6075168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075174 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,305.60 |
| 6075186 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075187 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075188 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075189 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075190 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075191 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075192 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075194 | CATHETER, GUIDING | Supply/Implant | $448.00 |
| 6075199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6075201 | STERILE SUPPLY | Supply/Implant | $177.28 |
| 6075224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075225 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6075229 | GENERAL SUPPLY | Supply/Implant | $147.58 |
| 6075230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075232 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075238 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6075239 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6075248 | GENERAL SUPPLY | Supply/Implant | $542.46 |
| 6075250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6075259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6075260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6075261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6075264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6075265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6075266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,835.20 |
| 6075277 | SUPPLY IMPLANT | Supply/Implant | $4,427.26 |
| 6075284 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6075288 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6075291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6075297 | ADHESION BARRIER | Supply/Implant | $4,490.78 |
| 6075300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,279.36 |
| 6075302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6075307 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6075310 | SUPPLY IMPLANT | Supply/Implant | $1,049.86 |
| 6075311 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6075313 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6075314 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $47,769.60 |
| 6075315 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $45,683.20 |
| 6075317 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $54,016.00 |
| 6075319 | SUPPLY IMPLANT | Supply/Implant | $306.56 |
| 6075329 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6075335 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,529.60 |
| 6075336 | STERILE SUPPLY | Supply/Implant | $863.36 |
| 6075342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6075347 | SUPPLY IMPLANT | Supply/Implant | $60,496.00 |
| 6075361 | SUPPLY IMPLANT | Supply/Implant | $1,839.10 |
| 6075362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6075385 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075386 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075388 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075389 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6075416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075429 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075432 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075435 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075439 | LEAD, NEUROSTIMULATOR | Supply/Implant | $27,200.00 |
| 6075442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6075447 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6075448 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075460 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6075461 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,867.01 |
| 6075465 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6075472 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6075479 | LEAD, NEUROSTIMULATOR | Supply/Implant | $11,456.00 |
| 6075482 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6075487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6075495 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6075509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075510 | GENERAL SUPPLY | Supply/Implant | $181.38 |
| 6075518 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6075520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,635.20 |
| 6075524 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $52,736.00 |
| 6075526 | SUPPLY IMPLANT | Supply/Implant | $2,534.40 |
| 6075529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6075534 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6075538 | CATH EP COOL-TIP | Supply/Implant | $20,480.00 |
| 6075542 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6075543 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6075545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6075548 | MESH (IMPLANTABLE) | Supply/Implant | $33,945.60 |
| 6075550 | SUPPLY IMPLANT | Supply/Implant | $2,870.78 |
| 6075551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6075556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6075557 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6075558 | STERILE SUPPLY | Supply/Implant | $1,491.46 |
| 6075559 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $13,542.40 |
| 6075560 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $13,542.40 |
| 6075562 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $16,089.60 |
| 6075565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6075582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6075584 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,531.20 |
| 6075585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6075587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6075590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6075594 | GENERAL SUPPLY | Supply/Implant | $508.51 |
| 6075597 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6075600 | SUPPLY IMPLANT | Supply/Implant | $11,184.64 |
| 6075605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6075607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,034.24 |
| 6075608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6075610 | SUPPLY IMPLANT | Supply/Implant | $3,744.00 |
| 6075612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6075613 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6075615 | SUPPLY IMPLANT | Supply/Implant | $31,680.00 |
| 6075618 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6075622 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6075623 | GENERAL SUPPLY | Supply/Implant | $926.85 |
| 6075625 | SUPPLY IMPLANT | Supply/Implant | $38,272.00 |
| 6075626 | CATHETER, GUIDING | Supply/Implant | $21,376.00 |
| 6075627 | SUPPLY IMPLANT | Supply/Implant | $38,272.00 |
| 6075628 | CATHETER, GUIDING | Supply/Implant | $21,376.00 |
| 6075629 | SUPPLY IMPLANT | Supply/Implant | $38,272.00 |
| 6075631 | GENERAL SUPPLY | Supply/Implant | $4,736.00 |
| 6075632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6075633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6075636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,068.80 |
| 6075640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6075641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075643 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6075645 | GENERAL SUPPLY | Supply/Implant | $147.58 |
| 6075647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075650 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6075654 | INTRO/SHEATH, NON-LASER | Supply/Implant | $261.63 |
| 6075655 | INTRO/SHEATH, NON-LASER | Supply/Implant | $261.63 |
| 6075662 | SUPPLY IMPLANT | Supply/Implant | $9,244.93 |
| 6075663 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6075664 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6075665 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $21,440.00 |
| 6075670 | SUPPLY IMPLANT | Supply/Implant | $296.58 |
| 6075673 | SUPPLY IMPLANT | Supply/Implant | $5,388.80 |
| 6075674 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,035.20 |
| 6075680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,080.64 |
| 6075683 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6075684 | CATH, DRAINAGE | Supply/Implant | $13,162.11 |
| 6075693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075697 | CATHETER, GUIDING | Supply/Implant | $1,216.00 |
| 6075698 | SUPPLY IMPLANT | Supply/Implant | $35,472.64 |
| 6075699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6075701 | SUPPLY IMPLANT | Supply/Implant | $309.76 |
| 6075702 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6075707 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $52,467.20 |
| 6075708 | SUPPLY IMPLANT | Supply/Implant | $2,905.60 |
| 6075722 | SUPPLY IMPLANT | Supply/Implant | $52,044.80 |
| 6075723 | SUPPLY IMPLANT | Supply/Implant | $20,608.00 |
| 6075731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,948.54 |
| 6075733 | INTRO/SHEATH, NON-LASER | Supply/Implant | $43,712.00 |
| 6075734 | INTRO/SHEATH, NON-LASER | Supply/Implant | $43,712.00 |
| 6075736 | INTRO/SHEATH, NON-LASER | Supply/Implant | $43,712.00 |
| 6075740 | SUPPLY IMPLANT | Supply/Implant | $58,976.00 |
| 6075741 | GENERAL SUPPLY | Supply/Implant | $203.01 |
| 6075744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075748 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6075765 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6075766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075771 | SUPPLY IMPLANT | Supply/Implant | $674.59 |
| 6075782 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,347.20 |
| 6075783 | SUPPLY IMPLANT | Supply/Implant | $380.67 |
| 6075784 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,426.94 |
| 6075793 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6075797 | STERILE SUPPLY | Supply/Implant | $387.20 |
| 6075800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,283.52 |
| 6075801 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,276.99 |
| 6075803 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,369.60 |
| 6075807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6075865 | SUPPLY IMPLANT | Supply/Implant | $1,440.00 |
| 6075868 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6075869 | GENERAL SUPPLY | Supply/Implant | $6,963.20 |
| 6075870 | GENERAL SUPPLY | Supply/Implant | $10,905.60 |
| 6075871 | GENERAL SUPPLY | Supply/Implant | $12,659.20 |
| 6075872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6075873 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6075877 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6075880 | SUPPLY IMPLANT | Supply/Implant | $9,666.56 |
| 6075881 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6075884 | SUPPLY IMPLANT | Supply/Implant | $3,654.40 |
| 6075891 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,531.20 |
| 6075895 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6075902 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6075903 | STERILE SUPPLY | Supply/Implant | $211.20 |
| 6075908 | STERILE SUPPLY | Supply/Implant | $134.53 |
| 6075915 | SUPPLY IMPLANT | Supply/Implant | $12,710.40 |
| 6075916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6075918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075928 | CATH OCCLUSION | Supply/Implant | $17,920.00 |
| 6075929 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6075931 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6075946 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,721.60 |
| 6075947 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,531.20 |
| 6075950 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,226.43 |
| 6075958 | SUPPLY IMPLANT | Supply/Implant | $21,478.40 |
| 6075960 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6075961 | CLOSURE DEV, VASC | Supply/Implant | $5,120.00 |
| 6075964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6075971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6075975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6075978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6075979 | SUPPLY IMPLANT | Supply/Implant | $309.91 |
| 6075980 | SUPPLY IMPLANT | Supply/Implant | $865.14 |
| 6075981 | SUPPLY IMPLANT | Supply/Implant | $415.36 |
| 6075982 | SUPPLY IMPLANT | Supply/Implant | $3,258.44 |
| 6075994 | CLOSURE DEV, VASC | Supply/Implant | $5,120.00 |
| 6075998 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $60,147.20 |
| 6076004 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6076005 | GUIDE WIRE | Supply/Implant | $286.72 |
| 6076027 | GUIDE WIRE | Supply/Implant | $903.17 |
| 6076028 | GENERAL SUPPLY | Supply/Implant | $623.91 |
| 6076031 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $41,344.00 |
| 6076036 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6076040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6076049 | CATH OCCLUSION | Supply/Implant | $18,278.40 |
| 6076052 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6076053 | INTERSPINOUS IMPLANT | Supply/Implant | $48,114.56 |
| 6076056 | SUPPLY IMPLANT | Supply/Implant | $5,593.47 |
| 6076057 | GENERAL SUPPLY | Supply/Implant | $5,958.40 |
| 6076060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076062 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,152.00 |
| 6076065 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,608.00 |
| 6076068 | SUPPLY IMPLANT | Supply/Implant | $10,738.56 |
| 6076073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,262.40 |
| 6076074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076080 | GENERAL SUPPLY | Supply/Implant | $478.59 |
| 6076081 | GENERAL SUPPLY | Supply/Implant | $478.59 |
| 6076082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6076083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6076084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6076086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,318.72 |
| 6076087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,157.12 |
| 6076091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.81 |
| 6076102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,155.39 |
| 6076107 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6076113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6076138 | SUPPLY IMPLANT | Supply/Implant | $48,114.56 |
| 6076150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6076156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6076166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6076168 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6076172 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6076182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,649.28 |
| 6076183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076187 | GENERAL SUPPLY | Supply/Implant | $179.58 |
| 6076192 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $11,456.00 |
| 6076195 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6076196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6076198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,470.40 |
| 6076199 | ALLODERM SKIN SUB | Supply/Implant | $49,945.60 |
| 6076203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,049.47 |
| 6076209 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6076212 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $115,447.50 |
| 6076219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6076222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076230 | SUPPLY IMPLANT | Supply/Implant | $573.44 |
| 6076232 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6076241 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6076246 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6076255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6076256 | SUPPLY IMPLANT | Supply/Implant | $547.71 |
| 6076258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6076259 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,484.80 |
| 6076260 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6076274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6076277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6076278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6076290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6076292 | GENERAL SUPPLY | Supply/Implant | $6,233.60 |
| 6076293 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6076294 | GENERAL SUPPLY | Supply/Implant | $10,905.60 |
| 6076295 | GENERAL SUPPLY | Supply/Implant | $12,659.20 |
| 6076305 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6076307 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6076308 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $13,376.00 |
| 6076312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $743.94 |
| 6076313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $743.94 |
| 6076316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6076317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6076331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6076332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6076337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,561.60 |
| 6076342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,888.00 |
| 6076350 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076351 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076352 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076353 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076354 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076355 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076356 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076357 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076372 | GENERAL SUPPLY | Supply/Implant | $450.56 |
| 6076389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6076390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,107.33 |
| 6076403 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076404 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076405 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076406 | SUPPLY IMPLANT | Supply/Implant | $1,635.84 |
| 6076407 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6076410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6076411 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6076417 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6076421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,756.54 |
| 6076428 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6076430 | GENERAL SUPPLY | Supply/Implant | $5,056.00 |
| 6076435 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6076436 | CATHETER, INTRASPINAL | Supply/Implant | $13,376.00 |
| 6076446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6076447 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6076448 | TRACHEOSTOMY SPEAKING VALVE | Supply/Implant | $1,050.50 |
| 6076474 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6076475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076478 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6076487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6076495 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $208.00 |
| 6076497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6076500 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6076502 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6076504 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076505 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076506 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076510 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076514 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076516 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076517 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076518 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076519 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076520 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076521 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076523 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076524 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076525 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076526 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076527 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076528 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076529 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076530 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076531 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076532 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076533 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076534 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076536 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076537 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076538 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076539 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076540 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076541 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076543 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076544 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076546 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076547 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076548 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076549 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076554 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076556 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076558 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076559 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076560 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076561 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076562 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076563 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,651.20 |
| 6076565 | GENERAL SUPPLY | Supply/Implant | $1,497.60 |
| 6076566 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,497.60 |
| 6076567 | SUPPLY IMPLANT | Supply/Implant | $515.84 |
| 6076568 | GUIDE WIRE | Supply/Implant | $2,459.52 |
| 6076569 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,695.49 |
| 6076575 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6076584 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6076596 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,529.60 |
| 6076597 | STERILE SUPPLY | Supply/Implant | $254.72 |
| 6076599 | STERILE SUPPLY | Supply/Implant | $254.72 |
| 6076605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,797.76 |
| 6076608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6076617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6076618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6076625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076643 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6076644 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6076654 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6076656 | CONN TISS, NON-HUMAN | Supply/Implant | $31,040.00 |
| 6076669 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076674 | SUPPLY IMPLANT | Supply/Implant | $2,969.73 |
| 6076675 | MESH (IMPLANTABLE) | Supply/Implant | $6,200.32 |
| 6076676 | SUPPLY IMPLANT | Supply/Implant | $3,468.80 |
| 6076679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6076680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,830.78 |
| 6076686 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6076687 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6076690 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,723.20 |
| 6076702 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6076704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6076705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6076706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6076714 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6076715 | CONN TISS, NON-HUMAN | Supply/Implant | $30,400.00 |
| 6076724 | GRAFT, VASCULAR | Supply/Implant | $31,040.00 |
| 6076727 | SUPPLY IMPLANT | Supply/Implant | $1,395.20 |
| 6076729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6076730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6076734 | SUPPLY IMPLANT | Supply/Implant | $656.64 |
| 6076737 | STERILE SUPPLY | Supply/Implant | $187.26 |
| 6076739 | SUPPLY IMPLANT | Supply/Implant | $277.50 |
| 6076746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,684.61 |
| 6076748 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6076749 | GENERAL SUPPLY | Supply/Implant | $7,186.18 |
| 6076762 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076764 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6076774 | REP DEV, URINARY, W/O SLING | Supply/Implant | $7,349.76 |
| 6076776 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6076782 | MESH (IMPLANTABLE) | Supply/Implant | $24,883.20 |
| 6076795 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6076801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,397.50 |
| 6076810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6076822 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6076843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,283.52 |
| 6076850 | SUPPLY IMPLANT | Supply/Implant | $1,305.60 |
| 6076853 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6076857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6076862 | SUPPLY IMPLANT | Supply/Implant | $9,140.74 |
| 6076865 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6076874 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6076876 | SUPPLY IMPLANT | Supply/Implant | $18,752.00 |
| 6076877 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6076878 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6076879 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076881 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076887 | GUIDE WIRE | Supply/Implant | $2,448.00 |
| 6076891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6076898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6076899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6076900 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6076904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6076907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6076912 | STERILE SUPPLY | Supply/Implant | $2,419.20 |
| 6076916 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6076920 | SUPPLY IMPLANT | Supply/Implant | $9,856.00 |
| 6076927 | PORT, INDWELLING, IMP | Supply/Implant | $1,536.00 |
| 6076928 | PORT, INDWELLING, IMP | Supply/Implant | $3,225.60 |
| 6076929 | PORT, INDWELLING, IMP | Supply/Implant | $1,830.40 |
| 6076930 | PORT, INDWELLING, IMP | Supply/Implant | $1,830.40 |
| 6076931 | PORT, INDWELLING, IMP | Supply/Implant | $1,536.00 |
| 6076932 | GUIDE WIRE | Supply/Implant | $2,368.00 |
| 6076944 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076952 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,817.60 |
| 6076958 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6076976 | GENERAL SUPPLY | Supply/Implant | $479.10 |
| 6076977 | GENERAL SUPPLY | Supply/Implant | $355.84 |
| 6076978 | GENERAL SUPPLY | Supply/Implant | $342.66 |
| 6076979 | GENERAL SUPPLY | Supply/Implant | $262.40 |
| 6076980 | GENERAL SUPPLY | Supply/Implant | $328.96 |
| 6076981 | STERILE SUPPLY | Supply/Implant | $144.38 |
| 6076982 | GENERAL SUPPLY | Supply/Implant | $382.08 |
| 6076983 | SUPPLY IMPLANT | Supply/Implant | $296.42 |
| 6076984 | SUPPLY IMPLANT | Supply/Implant | $141.18 |
| 6076985 | SUPPLY IMPLANT | Supply/Implant | $558.08 |
| 6077022 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6077033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6077036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077051 | SUPPLY IMPLANT | Supply/Implant | $170,898.00 |
| 6077052 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6077065 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6077072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6077073 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6077078 | SUPPLY IMPLANT | Supply/Implant | $6,225.66 |
| 6077079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6077085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,588.48 |
| 6077088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6077089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,472.00 |
| 6077090 | GUIDE WIRE | Supply/Implant | $844.80 |
| 6077091 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6077104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077117 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6077118 | STERILE SUPPLY | Supply/Implant | $1,215.10 |
| 6077120 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6077122 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6077125 | SUPPLY IMPLANT | Supply/Implant | $7,872.00 |
| 6077126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,985.60 |
| 6077129 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6077130 | SUPPLY IMPLANT | Supply/Implant | $8,870.40 |
| 6077131 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6077134 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077136 | SUPPLY IMPLANT | Supply/Implant | $19,955.71 |
| 6077137 | SUPPLY IMPLANT | Supply/Implant | $12,803.49 |
| 6077140 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6077143 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077144 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077145 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077146 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6077147 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6077149 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6077151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6077153 | SUPPLY IMPLANT | Supply/Implant | $1,830.40 |
| 6077154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6077155 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6077158 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,384.00 |
| 6077160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6077172 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6077173 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6077182 | SUPPLY IMPLANT | Supply/Implant | $242.94 |
| 6077187 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6077189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6077194 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6077196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6077197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,923.33 |
| 6077199 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $425.09 |
| 6077201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6077216 | CATHETER, GUIDING | Supply/Implant | $7,680.00 |
| 6077217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,017.22 |
| 6077220 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077227 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6077228 | SUPPLY IMPLANT | Supply/Implant | $8,857.60 |
| 6077230 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6077232 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077238 | MESH (IMPLANTABLE) | Supply/Implant | $6,389.50 |
| 6077239 | MESH (IMPLANTABLE) | Supply/Implant | $10,048.00 |
| 6077240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077246 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6077253 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6077255 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6077258 | GENERAL SUPPLY | Supply/Implant | $2,099.20 |
| 6077260 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077261 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077262 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6077277 | MESH (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6077278 | MESH (IMPLANTABLE) | Supply/Implant | $24,883.20 |
| 6077285 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077298 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077304 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6077306 | INTERSPINOUS IMPLANT | Supply/Implant | $15,104.00 |
| 6077307 | SUPPLY IMPLANT | Supply/Implant | $465.79 |
| 6077310 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6077318 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6077321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,830.40 |
| 6077322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6077323 | SUPPLY IMPLANT | Supply/Implant | $38,304.00 |
| 6077324 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6077327 | SUPPLY IMPLANT | Supply/Implant | $16,864.00 |
| 6077334 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077335 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077336 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077337 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077338 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077339 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077340 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077341 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077342 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077348 | SUPPLY IMPLANT | Supply/Implant | $11,276.80 |
| 6077354 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6077355 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6077357 | GENERAL SUPPLY | Supply/Implant | $1,740.80 |
| 6077360 | GRAFT, VASCULAR | Supply/Implant | $42,560.00 |
| 6077363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6077365 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6077368 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,984.00 |
| 6077370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,861.50 |
| 6077374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6077379 | STERILE SUPPLY | Supply/Implant | $533.25 |
| 6077380 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6077381 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6077382 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $10,880.00 |
| 6077384 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $15,360.00 |
| 6077385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6077405 | SUPPLY IMPLANT | Supply/Implant | $1,561.60 |
| 6077406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6077408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,819.26 |
| 6077409 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,979.20 |
| 6077419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6077422 | SUPPLY IMPLANT | Supply/Implant | $1,018.50 |
| 6077423 | SUPPLY IMPLANT | Supply/Implant | $1,067.90 |
| 6077424 | SUPPLY IMPLANT | Supply/Implant | $753.79 |
| 6077428 | SUPPLY IMPLANT | Supply/Implant | $1,023.08 |
| 6077429 | SUPPLY IMPLANT | Supply/Implant | $1,023.08 |
| 6077430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077432 | SUPPLY IMPLANT | Supply/Implant | $3,575.68 |
| 6077436 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6077438 | GENERAL SUPPLY | Supply/Implant | $140.80 |
| 6077441 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,336.00 |
| 6077442 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6077444 | GUIDE WIRE | Supply/Implant | $4,032.00 |
| 6077445 | SUPPLY IMPLANT | Supply/Implant | $2,995.20 |
| 6077447 | SUPPLY IMPLANT | Supply/Implant | $14,568.32 |
| 6077450 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6077463 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6077465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077471 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077477 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6077478 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6077484 | STERILE SUPPLY | Supply/Implant | $1,105.92 |
| 6077485 | GENERAL SUPPLY | Supply/Implant | $1,558.66 |
| 6077486 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,889.66 |
| 6077487 | SUPPLY IMPLANT | Supply/Implant | $36,480.00 |
| 6077506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077510 | AUD OSSEO DEV INT/EXT COMP | Supply/Implant | $38,336.00 |
| 6077511 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $88,448.00 |
| 6077514 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6077518 | SUPPLY IMPLANT | Supply/Implant | $6,947.20 |
| 6077521 | GENERAL SUPPLY | Supply/Implant | $3,136.00 |
| 6077524 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077525 | SUPPLY IMPLANT | Supply/Implant | $1,434.11 |
| 6077528 | SUPPLY IMPLANT | Supply/Implant | $16,410.24 |
| 6077530 | SUPPLY IMPLANT | Supply/Implant | $2,099.20 |
| 6077531 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6077532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6077541 | STERILE SUPPLY | Supply/Implant | $10,457.60 |
| 6077548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077549 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6077553 | SUPPLY IMPLANT | Supply/Implant | $241.54 |
| 6077559 | SUPPLY IMPLANT | Supply/Implant | $201.86 |
| 6077571 | SUPPLY IMPLANT | Supply/Implant | $197.89 |
| 6077573 | SUPPLY IMPLANT | Supply/Implant | $258.69 |
| 6077616 | SUPPLY IMPLANT | Supply/Implant | $209.79 |
| 6077621 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6077637 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6077638 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6077639 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6077640 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6077641 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,806.08 |
| 6077642 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $5,806.08 |
| 6077650 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6077651 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6077652 | GENERAL SUPPLY | Supply/Implant | $12,019.20 |
| 6077653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6077655 | GENERAL SUPPLY | Supply/Implant | $698.24 |
| 6077656 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6077660 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077661 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6077673 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6077678 | SUPPLY IMPLANT | Supply/Implant | $4,926.66 |
| 6077679 | SUPPLY IMPLANT | Supply/Implant | $849.54 |
| 6077681 | SUPPLY IMPLANT | Supply/Implant | $13,018.37 |
| 6077690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6077691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6077692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6077694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6077695 | CATHETER, GUIDING | Supply/Implant | $9,185.79 |
| 6077699 | INTEGRA BMWD SKIN SUB | Supply/Implant | $44,876.80 |
| 6077701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6077702 | SUPPLY IMPLANT | Supply/Implant | $12,528.00 |
| 6077703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077707 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6077710 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6077719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,815.10 |
| 6077723 | GENERAL SUPPLY | Supply/Implant | $479.49 |
| 6077726 | GENERAL SUPPLY | Supply/Implant | $621.52 |
| 6077727 | SUPPLY IMPLANT | Supply/Implant | $20,352.00 |
| 6077736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,200.00 |
| 6077738 | SUPPLY IMPLANT | Supply/Implant | $1,830.40 |
| 6077742 | SUPPLY IMPLANT | Supply/Implant | $59,888.00 |
| 6077743 | SUPPLY IMPLANT | Supply/Implant | $51,984.00 |
| 6077745 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,600.00 |
| 6077746 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,600.00 |
| 6077747 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,600.00 |
| 6077749 | STERILE SUPPLY | Supply/Implant | $2,886.40 |
| 6077758 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6077759 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6077767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6077768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6077774 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6077775 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077782 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077793 | CATHETER, GUIDING | Supply/Implant | $140.80 |
| 6077798 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $11,456.00 |
| 6077808 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6077818 | GENERAL SUPPLY | Supply/Implant | $4,377.60 |
| 6077819 | LEAD, CORONARY VENOUS | Supply/Implant | $76,800.00 |
| 6077821 | SUPPLY IMPLANT | Supply/Implant | $59,888.00 |
| 6077841 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6077845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6077852 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,417.60 |
| 6077873 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077874 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077875 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077879 | SUPPLY IMPLANT | Supply/Implant | $2,115.33 |
| 6077889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6077890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6077891 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6077904 | SUPPLY IMPLANT | Supply/Implant | $2,598.40 |
| 6077906 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6077909 | INTRO/SHEATH, NON-LASER | Supply/Implant | $598.27 |
| 6077910 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6077911 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6077913 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,088.96 |
| 6077914 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $890.88 |
| 6077916 | SUPPLY IMPLANT | Supply/Implant | $9,140.74 |
| 6077918 | SUPPLY IMPLANT | Supply/Implant | $59,888.00 |
| 6077920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6077921 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6077922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,158.40 |
| 6077923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6077924 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6077928 | GENERAL SUPPLY | Supply/Implant | $636.92 |
| 6077937 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6077938 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6077969 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6077971 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6077972 | SUPPLY IMPLANT | Supply/Implant | $514.43 |
| 6077973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6077974 | SUPPLY IMPLANT | Supply/Implant | $799,900.00 |
| 6077979 | SUPPLY IMPLANT | Supply/Implant | $63,360.00 |
| 6077980 | MICROPRESR CU ELEC VAD REP | Supply/Implant | $91,520.00 |
| 6077984 | CHARGER ELEC/COMBO VAD REP | Supply/Implant | $78,080.00 |
| 6077986 | MISC SUP/ACC IMP VAD | Supply/Implant | $5,440.00 |
| 6077987 | SHWR COV ELECT/COMBO VAD REP | Supply/Implant | $3,840.00 |
| 6077994 | GENERAL SUPPLY | Supply/Implant | $277.25 |
| 6078001 | SUPPLY IMPLANT | Supply/Implant | $23,549.70 |
| 6078003 | INTERSPINOUS IMPLANT | Supply/Implant | $14,873.60 |
| 6078004 | INTERSPINOUS IMPLANT | Supply/Implant | $14,873.60 |
| 6078005 | SUPPLY IMPLANT | Supply/Implant | $1,411.20 |
| 6078008 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6078013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,392.00 |
| 6078019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078020 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6078023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,382.40 |
| 6078024 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6078027 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,384.00 |
| 6078028 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6078029 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,384.00 |
| 6078030 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6078036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6078037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6078042 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6078043 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6078047 | GENERAL SUPPLY | Supply/Implant | $266.62 |
| 6078048 | GENERAL SUPPLY | Supply/Implant | $266.62 |
| 6078049 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6078050 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,876.35 |
| 6078053 | SUPPLY IMPLANT | Supply/Implant | $1,081.09 |
| 6078054 | SUPPLY IMPLANT | Supply/Implant | $1,044.86 |
| 6078059 | CONN TISS, NON-HUMAN | Supply/Implant | $14,065.92 |
| 6078062 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078070 | CATHETER, URETERAL | Supply/Implant | $376.32 |
| 6078071 | GENERAL SUPPLY | Supply/Implant | $1,346.66 |
| 6078072 | GENERAL SUPPLY | Supply/Implant | $160.00 |
| 6078073 | GENERAL SUPPLY | Supply/Implant | $503.55 |
| 6078080 | SUPPLY IMPLANT | Supply/Implant | $3,274.55 |
| 6078081 | PORT, INDWELLING, IMP | Supply/Implant | $9,907.20 |
| 6078082 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6078084 | SUPPLY IMPLANT | Supply/Implant | $4,569.60 |
| 6078086 | GENERAL SUPPLY | Supply/Implant | $505.47 |
| 6078088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,014.40 |
| 6078102 | SUPPLY IMPLANT | Supply/Implant | $192.90 |
| 6078104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078108 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6078111 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6078114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6078122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,065.60 |
| 6078136 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6078148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,652.80 |
| 6078149 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,301.44 |
| 6078153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6078158 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078167 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6078168 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6078175 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6078182 | GRAFT, VASCULAR | Supply/Implant | $10,897.92 |
| 6078184 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $25,379.20 |
| 6078185 | SKIN SUBSTITUTE, NOS | Supply/Implant | $44,900.86 |
| 6078192 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6078197 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,752.00 |
| 6078201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6078205 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6078206 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6078209 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6078210 | GRAFT, VASCULAR | Supply/Implant | $14,963.20 |
| 6078216 | GENERAL SUPPLY | Supply/Implant | $197.12 |
| 6078225 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6078227 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6078231 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078233 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078234 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078235 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078236 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078237 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078238 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078239 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,800.00 |
| 6078240 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6078241 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078242 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078247 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6078249 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6078262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,044.80 |
| 6078264 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078267 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6078268 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6078275 | GENERAL SUPPLY | Supply/Implant | $156.42 |
| 6078276 | GENERAL SUPPLY | Supply/Implant | $150.22 |
| 6078290 | GENERAL SUPPLY | Supply/Implant | $215.68 |
| 6078291 | GENERAL SUPPLY | Supply/Implant | $205.44 |
| 6078308 | SUPPLY IMPLANT | Supply/Implant | $1,740.80 |
| 6078309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6078310 | INTERSPINOUS IMPLANT | Supply/Implant | $76,800.00 |
| 6078318 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078319 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078320 | PMKR, DUAL, RATE-RESP | Supply/Implant | $66,854.40 |
| 6078321 | AICD, DUAL CHAMBER | Supply/Implant | $194,890.50 |
| 6078345 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078346 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078353 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078357 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078359 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078361 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078362 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078363 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078364 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078365 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078367 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078395 | GENERAL SUPPLY | Supply/Implant | $145.02 |
| 6078396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6078401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,728.00 |
| 6078402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6078403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6078406 | SUPPLY IMPLANT | Supply/Implant | $1,164.80 |
| 6078407 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6078413 | SUPPLY IMPLANT | Supply/Implant | $2,433.28 |
| 6078414 | SUPPLY IMPLANT | Supply/Implant | $2,259.20 |
| 6078420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6078428 | SUPPLY IMPLANT | Supply/Implant | $11,983.36 |
| 6078429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,144.70 |
| 6078432 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6078433 | SUPPLY IMPLANT | Supply/Implant | $2,995.33 |
| 6078437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,379.20 |
| 6078439 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6078443 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6078446 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6078448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6078454 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078455 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078456 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078457 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078464 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $15,910.40 |
| 6078465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6078469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,894.72 |
| 6078471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,227.52 |
| 6078475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078483 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6078485 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6078488 | SUPPLY IMPLANT | Supply/Implant | $1,690.24 |
| 6078491 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6078504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6078505 | SUPPLY IMPLANT | Supply/Implant | $18,112.00 |
| 6078506 | SUPPLY IMPLANT | Supply/Implant | $1,241.60 |
| 6078508 | SUPPLY IMPLANT | Supply/Implant | $1,521.66 |
| 6078510 | INTERSPINOUS IMPLANT | Supply/Implant | $14,656.00 |
| 6078511 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $207,050.00 |
| 6078516 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6078523 | STERILE SUPPLY | Supply/Implant | $266.37 |
| 6078524 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6078548 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6078549 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6078550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6078551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6078552 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6078558 | SUPPLY IMPLANT | Supply/Implant | $7,274.88 |
| 6078559 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6078560 | MISC SUP/ACC IMP VAD | Supply/Implant | $135.58 |
| 6078563 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6078565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6078574 | SUPPLY IMPLANT | Supply/Implant | $889.60 |
| 6078591 | SUPPLY IMPLANT | Supply/Implant | $1,753.60 |
| 6078604 | CATHETER, GUIDING | Supply/Implant | $711.42 |
| 6078605 | CATHETER, GUIDING | Supply/Implant | $711.42 |
| 6078606 | CATHETER, GUIDING | Supply/Implant | $499.20 |
| 6078607 | CATHETER, GUIDING | Supply/Implant | $499.20 |
| 6078611 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $12,736.00 |
| 6078613 | SUPPLY IMPLANT | Supply/Implant | $311.24 |
| 6078615 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6078626 | SUPPLY IMPLANT | Supply/Implant | $3,916.80 |
| 6078627 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6078629 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6078651 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6078652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6078654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6078663 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078682 | SUPPLY IMPLANT | Supply/Implant | $182.40 |
| 6078683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078691 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,253.44 |
| 6078692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6078694 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6078695 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6078698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078700 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6078701 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6078703 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6078705 | SUPPLY IMPLANT | Supply/Implant | $11,515.39 |
| 6078707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,502.40 |
| 6078708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6078712 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6078720 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6078721 | STERILE SUPPLY | Supply/Implant | $8,064.00 |
| 6078723 | STERILE SUPPLY | Supply/Implant | $3,072.00 |
| 6078724 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6078725 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6078726 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6078727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,044.80 |
| 6078728 | GENERAL SUPPLY | Supply/Implant | $4,480.00 |
| 6078730 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078733 | SUPPLY IMPLANT | Supply/Implant | $18,457.60 |
| 6078738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078742 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6078743 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6078744 | STERILE SUPPLY | Supply/Implant | $190.34 |
| 6078746 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,056.00 |
| 6078747 | SUPPLY IMPLANT | Supply/Implant | $831,250.00 |
| 6078748 | MICROPRESR CU ELEC VAD REP | Supply/Implant | $70,400.00 |
| 6078749 | MICROPRESR CU ELEC VAD REP | Supply/Implant | $6,400.00 |
| 6078751 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,056.00 |
| 6078752 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,760.00 |
| 6078753 | HOLSTER ELEC/COMBO VAD REP | Supply/Implant | $5,056.00 |
| 6078758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,644.80 |
| 6078775 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,088.00 |
| 6078777 | SUPPLY IMPLANT | Supply/Implant | $1,215.62 |
| 6078783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6078785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6078788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $962.56 |
| 6078794 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6078795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6078803 | GENERAL SUPPLY | Supply/Implant | $454.40 |
| 6078804 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6078810 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6078819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6078820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6078822 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078823 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078831 | SUPPLY IMPLANT | Supply/Implant | $6,016.00 |
| 6078832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6078837 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6078838 | CATHETER, GUIDING | Supply/Implant | $31,616.00 |
| 6078840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,920.00 |
| 6078842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,920.00 |
| 6078846 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6078847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6078849 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6078855 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078856 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078857 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078859 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078860 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078861 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078862 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078863 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078864 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078865 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078867 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078868 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078869 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078870 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078877 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078878 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078879 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078880 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078882 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078887 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078893 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078902 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6078906 | SUPPLY IMPLANT | Supply/Implant | $17,088.00 |
| 6078907 | SUPPLY IMPLANT | Supply/Implant | $2,905.60 |
| 6078910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,614.08 |
| 6078912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,034.24 |
| 6078920 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6078921 | STERILE SUPPLY | Supply/Implant | $1,232.90 |
| 6078924 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078927 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6078929 | GUIDE WIRE | Supply/Implant | $3,200.00 |
| 6078930 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6078931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078934 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6078940 | LEAD, NEUROSTIMULATOR | Supply/Implant | $36,992.00 |
| 6078941 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $14,464.00 |
| 6078951 | GENERAL SUPPLY | Supply/Implant | $575.97 |
| 6078953 | CATH, DRAINAGE | Supply/Implant | $1,450.76 |
| 6078954 | CATH, DRAINAGE | Supply/Implant | $5,264.00 |
| 6078956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6078957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6078958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6078959 | SUPPLY IMPLANT | Supply/Implant | $477.44 |
| 6078963 | SUPPLY IMPLANT | Supply/Implant | $6,701.18 |
| 6078971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078977 | GENERAL DRUG | Supply/Implant | $143.49 |
| 6078978 | SUPPLY IMPLANT | Supply/Implant | $10,195.62 |
| 6078984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6078986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078989 | SUPPLY IMPLANT | Supply/Implant | $11,246.94 |
| 6078990 | STERILE SUPPLY | Supply/Implant | $881.06 |
| 6078991 | SUPPLY IMPLANT | Supply/Implant | $692.22 |
| 6078997 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6078998 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079002 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079004 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079006 | SUPPLY IMPLANT | Supply/Implant | $2,355.20 |
| 6079007 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6079010 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $152,565.00 |
| 6079013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,009.60 |
| 6079014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6079015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6079021 | SUPPLY IMPLANT | Supply/Implant | $2,876.67 |
| 6079023 | SUPPLY IMPLANT | Supply/Implant | $5,821.57 |
| 6079031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6079038 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6079039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,150.72 |
| 6079043 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6079060 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6079067 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6079072 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $8,859.01 |
| 6079074 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $7,812.99 |
| 6079081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,131.20 |
| 6079086 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6079087 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6079088 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6079091 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,892.80 |
| 6079092 | SUPPLY IMPLANT | Supply/Implant | $355.71 |
| 6079094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,862.40 |
| 6079097 | SUPPLY IMPLANT | Supply/Implant | $234.65 |
| 6079103 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6079115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079123 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $32,972.80 |
| 6079124 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6079126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6079132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6079133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6079135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6079152 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6079153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6079157 | SUPPLY IMPLANT | Supply/Implant | $115,447.50 |
| 6079163 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6079165 | CATHETER, URETERAL | Supply/Implant | $282.75 |
| 6079166 | CATHETER, URETERAL | Supply/Implant | $357.89 |
| 6079167 | CATHETER, URETERAL | Supply/Implant | $357.89 |
| 6079168 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079169 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079170 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079171 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079172 | CATH, DRAINAGE | Supply/Implant | $1,215.87 |
| 6079173 | CATH, DRAINAGE | Supply/Implant | $1,215.87 |
| 6079176 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6079182 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079183 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6079184 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6079185 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079187 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079188 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079189 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079190 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079191 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079193 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079201 | STERILE SUPPLY | Supply/Implant | $471.42 |
| 6079204 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6079214 | INTRO/SHEATH, NON-LASER | Supply/Implant | $755.20 |
| 6079215 | INTRO/SHEATH, NON-LASER | Supply/Implant | $755.20 |
| 6079216 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6079217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079218 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6079222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079226 | IMPL EXT ACCESS CATH | Supply/Implant | $2,388.74 |
| 6079227 | SUPPLY IMPLANT | Supply/Implant | $264.00 |
| 6079229 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6079231 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $15,360.00 |
| 6079236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6079241 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,158.08 |
| 6079243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,468.80 |
| 6079245 | SUPPLY IMPLANT | Supply/Implant | $272,700.00 |
| 6079249 | SUPPLY IMPLANT | Supply/Implant | $5,286.40 |
| 6079250 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $15,360.00 |
| 6079251 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $15,360.00 |
| 6079252 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $15,360.00 |
| 6079255 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,584.00 |
| 6079256 | SUPPLY IMPLANT | Supply/Implant | $1,058.23 |
| 6079259 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6079262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6079268 | SUPPLY IMPLANT | Supply/Implant | $17,260.80 |
| 6079284 | SUPPLY IMPLANT | Supply/Implant | $1,723.65 |
| 6079290 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079292 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079297 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079298 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6079312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6079325 | STERILE SUPPLY | Supply/Implant | $192.00 |
| 6079326 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,729.60 |
| 6079327 | STERILE SUPPLY | Supply/Implant | $468.48 |
| 6079332 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6079334 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6079335 | SUPPLY IMPLANT | Supply/Implant | $4,055.68 |
| 6079339 | SUPPLY IMPLANT | Supply/Implant | $1,318.84 |
| 6079340 | SUPPLY IMPLANT | Supply/Implant | $895.54 |
| 6079342 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6079345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,361.60 |
| 6079354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6079360 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6079361 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6079362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6079363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,044.80 |
| 6079364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079370 | SUPPLY IMPLANT | Supply/Implant | $3,243.43 |
| 6079420 | SUPPLY IMPLANT | Supply/Implant | $206.34 |
| 6079422 | SUPPLY IMPLANT | Supply/Implant | $211.97 |
| 6079423 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6079425 | GENERAL SUPPLY | Supply/Implant | $180.10 |
| 6079426 | GENERAL SUPPLY | Supply/Implant | $191.23 |
| 6079441 | SUPPLY IMPLANT | Supply/Implant | $433.41 |
| 6079443 | REP DEV, URINARY, W/SLING | Supply/Implant | $19,317.76 |
| 6079446 | GUIDE WIRE | Supply/Implant | $1,303.68 |
| 6079447 | SUPPLY IMPLANT | Supply/Implant | $977.02 |
| 6079451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,278.40 |
| 6079452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,532.80 |
| 6079456 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6079457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,283.20 |
| 6079467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,809.60 |
| 6079468 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079471 | BRACHYTHERAPY NEEDLE | Supply/Implant | $5,235.20 |
| 6079473 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079478 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079487 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6079489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,830.40 |
| 6079491 | SUPPLY IMPLANT | Supply/Implant | $174.08 |
| 6079492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6079493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6079502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6079504 | SUPPLY IMPLANT | Supply/Implant | $7,596.03 |
| 6079516 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079518 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079519 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079521 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079522 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079524 | GENERAL SUPPLY | Supply/Implant | $345.09 |
| 6079525 | GENERAL SUPPLY | Supply/Implant | $347.78 |
| 6079526 | GENERAL SUPPLY | Supply/Implant | $317.44 |
| 6079528 | OASIS TRI-LAYER WND MATRIX PER 1 SQ CM | Supply/Implant | $29,004.85 |
| 6079529 | OASIS TRI-LAYER WND MATRIX PER 1 SQ CM | Supply/Implant | $14,502.89 |
| 6079530 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079531 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079532 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079535 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079536 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079542 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6079586 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6079587 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6079588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6079589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6079590 | SUPPLY IMPLANT | Supply/Implant | $3,417.60 |
| 6079591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,862.40 |
| 6079596 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079601 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079604 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079607 | GENERAL SUPPLY | Supply/Implant | $138.48 |
| 6079609 | GENERAL SUPPLY | Supply/Implant | $4,736.00 |
| 6079612 | SUPPLY IMPLANT | Supply/Implant | $11,059.20 |
| 6079617 | GENERAL SUPPLY | Supply/Implant | $262.40 |
| 6079621 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6079630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6079642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,494.40 |
| 6079649 | SUPPLY IMPLANT | Supply/Implant | $281.22 |
| 6079650 | SUPPLY IMPLANT | Supply/Implant | $145.79 |
| 6079652 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6079654 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6079661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6079662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6079665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,817.60 |
| 6079667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079677 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079678 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079679 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079680 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,404.80 |
| 6079689 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6079690 | SUPPLY IMPLANT | Supply/Implant | $2,818.69 |
| 6079691 | SUPPLY IMPLANT | Supply/Implant | $1,497.60 |
| 6079693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,979.20 |
| 6079708 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6079724 | SUPPLY IMPLANT | Supply/Implant | $1,094.40 |
| 6079727 | SUPPLY IMPLANT | Supply/Implant | $276.35 |
| 6079730 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079731 | GENERAL SUPPLY | Supply/Implant | $1,175.17 |
| 6079735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6079739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,891.20 |
| 6079746 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6079747 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6079750 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $28,096.00 |
| 6079752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6079754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6079761 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6079762 | SUPPLY IMPLANT | Supply/Implant | $1,303.55 |
| 6079763 | STERILE SUPPLY | Supply/Implant | $3,072.00 |
| 6079764 | STERILE SUPPLY | Supply/Implant | $3,737.60 |
| 6079765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6079766 | SUPPLY IMPLANT | Supply/Implant | $2,617.60 |
| 6079783 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6079784 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079785 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079786 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079787 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079788 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079789 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079790 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079791 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079792 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079794 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079796 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079798 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079801 | GUIDE WIRE | Supply/Implant | $482.82 |
| 6079802 | SUPPLY IMPLANT | Supply/Implant | $2,802.43 |
| 6079803 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079804 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079805 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079806 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079809 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079811 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079812 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079813 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079814 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079815 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079816 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079817 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079818 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079819 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079820 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079821 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079823 | GUIDE WIRE | Supply/Implant | $1,326.34 |
| 6079825 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6079831 | STERILE SUPPLY | Supply/Implant | $247.19 |
| 6079833 | OCULAR IMPLANT | Supply/Implant | $5,632.00 |
| 6079838 | SUPPLY IMPLANT | Supply/Implant | $10,155.01 |
| 6079839 | STERILE SUPPLY | Supply/Implant | $312.06 |
| 6079852 | GENERAL SUPPLY | Supply/Implant | $702.72 |
| 6079853 | SUPPLY IMPLANT | Supply/Implant | $4,408.32 |
| 6079854 | GENERAL SUPPLY | Supply/Implant | $6,225.41 |
| 6079856 | CONN TISS, NON-HUMAN | Supply/Implant | $3,296.00 |
| 6079858 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6079859 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6079862 | GENERAL SUPPLY | Supply/Implant | $1,111.46 |
| 6079869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,012.35 |
| 6079870 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6079875 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6079876 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6079879 | GENERAL SUPPLY | Supply/Implant | $12,800.00 |
| 6079881 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $100,517.12 |
| 6079882 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6079897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079900 | GENERAL SUPPLY | Supply/Implant | $422.40 |
| 6079902 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $24,396.80 |
| 6079909 | GUIDE WIRE | Supply/Implant | $1,904.64 |
| 6079910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6079912 | SUPPLY IMPLANT | Supply/Implant | $355.20 |
| 6079916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6079919 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079921 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6079922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6079923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6079925 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6079928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6079938 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6079939 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6079941 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6079942 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6079943 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6079944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,965.89 |
| 6079945 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,747.90 |
| 6079947 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6079952 | SUPPLY IMPLANT | Supply/Implant | $10,942.72 |
| 6079958 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6079968 | SUPPLY IMPLANT | Supply/Implant | $4,467.20 |
| 6079969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6079977 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6079978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,920.00 |
| 6079980 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6079989 | SUPPLY IMPLANT | Supply/Implant | $942.98 |
| 6079992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,896.00 |
| 6079994 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6079996 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6080004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6080011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6080012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6080020 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6080024 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6080025 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6080026 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6080027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6080028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6080030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $915.20 |
| 6080050 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6080052 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6080055 | SUPPLY IMPLANT | Supply/Implant | $10,585.60 |
| 6080057 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080061 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $192.00 |
| 6080063 | SUPPLY IMPLANT | Supply/Implant | $2,578.94 |
| 6080072 | GENERAL DRUG | Supply/Implant | $273.15 |
| 6080073 | SUPPLY IMPLANT | Supply/Implant | $13,491.20 |
| 6080077 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6080080 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6080083 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6080084 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6080085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6080086 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6080087 | SUPPLY IMPLANT | Supply/Implant | $293.12 |
| 6080088 | SUPPLY IMPLANT | Supply/Implant | $593.92 |
| 6080089 | SUPPLY IMPLANT | Supply/Implant | $593.92 |
| 6080090 | SUPPLY IMPLANT | Supply/Implant | $333.18 |
| 6080094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080107 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6080108 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6080109 | GENERAL SUPPLY | Supply/Implant | $1,344.00 |
| 6080123 | STERILE SUPPLY | Supply/Implant | $339.44 |
| 6080124 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6080129 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $8,448.00 |
| 6080132 | GENERAL SUPPLY | Supply/Implant | $3,008.00 |
| 6080133 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6080135 | SUPPLY IMPLANT | Supply/Implant | $2,086.40 |
| 6080136 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6080137 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6080138 | SUPPLY IMPLANT | Supply/Implant | $13,376.00 |
| 6080139 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6080140 | IMPL EXT ACCESS CATH | Supply/Implant | $21,478.40 |
| 6080142 | STERILE SUPPLY | Supply/Implant | $2,816.00 |
| 6080143 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080144 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080147 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080148 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080149 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080150 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080154 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6080156 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6080157 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080158 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6080160 | SUPPLY IMPLANT | Supply/Implant | $624.00 |
| 6080161 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,412.10 |
| 6080174 | SUPPLY IMPLANT | Supply/Implant | $3,818.88 |
| 6080176 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6080183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6080187 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6080188 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6080190 | GUIDE WIRE | Supply/Implant | $5,760.00 |
| 6080192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080196 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6080198 | SUPPLY IMPLANT | Supply/Implant | $1,580.80 |
| 6080199 | INTERSPINOUS IMPLANT | Supply/Implant | $60,678.40 |
| 6080200 | GENERAL SUPPLY | Supply/Implant | $1,090.56 |
| 6080201 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6080202 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6080211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6080212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,096.00 |
| 6080218 | SUPPLY IMPLANT | Supply/Implant | $40,396.80 |
| 6080223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080224 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6080233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6080235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6080236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,320.00 |
| 6080237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6080238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6080244 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6080245 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,052.80 |
| 6080246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6080248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6080254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,496.00 |
| 6080266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,437.76 |
| 6080267 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6080284 | SUPPLY IMPLANT | Supply/Implant | $3,297.05 |
| 6080289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6080290 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6080307 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6080309 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6080312 | SUPPLY IMPLANT | Supply/Implant | $2,491.65 |
| 6080313 | SUPPLY IMPLANT | Supply/Implant | $2,099.20 |
| 6080315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,209.60 |
| 6080316 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6080323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,592.77 |
| 6080327 | CATHETER, GUIDING | Supply/Implant | $20,467.20 |
| 6080332 | ALLODERM SKIN SUB | Supply/Implant | $69,132.80 |
| 6080340 | VENA CAVA FILTER | Supply/Implant | $21,440.00 |
| 6080341 | VENA CAVA FILTER | Supply/Implant | $21,440.00 |
| 6080347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080350 | SUPPLY IMPLANT | Supply/Implant | $2,231.30 |
| 6080353 | CATH OCCLUSION | Supply/Implant | $21,760.00 |
| 6080358 | SUPPLY IMPLANT | Supply/Implant | $3,967.78 |
| 6080361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $52,160.00 |
| 6080367 | SUPPLY IMPLANT | Supply/Implant | $218.24 |
| 6080369 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6080371 | SUPPLY IMPLANT | Supply/Implant | $5,235.20 |
| 6080372 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6080376 | SUPPLY IMPLANT | Supply/Implant | $1,070.08 |
| 6080379 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6080383 | SUPPLY IMPLANT | Supply/Implant | $364.80 |
| 6080387 | GUIDE WIRE | Supply/Implant | $2,790.40 |
| 6080392 | SUPPLY IMPLANT | Supply/Implant | $1,277.82 |
| 6080396 | GENERAL SUPPLY | Supply/Implant | $1,011.20 |
| 6080398 | SUPPLY IMPLANT | Supply/Implant | $149.89 |
| 6080409 | INTRO/SHEATH, NON-LASER | Supply/Implant | $640.00 |
| 6080410 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6080411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,876.35 |
| 6080413 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6080444 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6080448 | STERILE SUPPLY | Supply/Implant | $2,560.00 |
| 6080456 | SUPPLY IMPLANT | Supply/Implant | $348.29 |
| 6080462 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6080467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6080468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6080469 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6080471 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6080473 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6080478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,164.16 |
| 6080479 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,907.20 |
| 6080486 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6080487 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6080488 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6080489 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6080492 | SUPPLY IMPLANT | Supply/Implant | $30,080.00 |
| 6080494 | GENERAL SUPPLY | Supply/Implant | $189.57 |
| 6080498 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,819.26 |
| 6080499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,087.94 |
| 6080503 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6080505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,275.26 |
| 6080507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,300.80 |
| 6080514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6080516 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6080521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6080523 | GENERAL SUPPLY | Supply/Implant | $4,869.89 |
| 6080527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6080532 | GENERAL SUPPLY | Supply/Implant | $16,857.60 |
| 6080533 | GENERAL SUPPLY | Supply/Implant | $2,497.66 |
| 6080534 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6080537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $120,478.46 |
| 6080543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6080548 | SUPPLY IMPLANT | Supply/Implant | $177.31 |
| 6080550 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080551 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080552 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080554 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080558 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080568 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6080574 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6080575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6080576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6080577 | SUPPLY IMPLANT | Supply/Implant | $20,553.60 |
| 6080581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,065.60 |
| 6080582 | CATHETER, GUIDING | Supply/Implant | $5,500.29 |
| 6080589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6080591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6080592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6080595 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6080601 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6080604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6080605 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6080606 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6080625 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,040.00 |
| 6080632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,878.53 |
| 6080636 | SEPTAL DEFECT IMP SYS | Supply/Implant | $58,969.60 |
| 6080637 | SUPPLY IMPLANT | Supply/Implant | $3,788.80 |
| 6080646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $142,075.50 |
| 6080649 | GENERAL SUPPLY | Supply/Implant | $586.83 |
| 6080655 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6080665 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6080672 | RET DEV, INSERTABLE | Supply/Implant | $15,756.80 |
| 6080681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6080685 | GRAFT, VASCULAR | Supply/Implant | $11,123.20 |
| 6080686 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6080691 | SUPPLY IMPLANT | Supply/Implant | $810.24 |
| 6080692 | IMPL EXT ACCESS CATH | Supply/Implant | $2,368.00 |
| 6080696 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6080700 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6080710 | IMPL EXT ACCESS CATH | Supply/Implant | $896.00 |
| 6080714 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,969.60 |
| 6080723 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6080732 | INTRO/SHEATH, NON-LASER | Supply/Implant | $10,585.60 |
| 6080733 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6080734 | SUPPLY IMPLANT | Supply/Implant | $215.54 |
| 6080735 | SUPPLY IMPLANT | Supply/Implant | $2,146.18 |
| 6080736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6080744 | LEAD, NEUROSTIMULATOR | Supply/Implant | $16,896.00 |
| 6080745 | SUPPLY IMPLANT | Supply/Implant | $458.34 |
| 6080750 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6080752 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6080755 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6080760 | GENERAL SUPPLY | Supply/Implant | $1,919.36 |
| 6080764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6080767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6080770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6080774 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,169.60 |
| 6080781 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6080785 | STERILE SUPPLY | Supply/Implant | $1,418.11 |
| 6080786 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6080789 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $35,840.00 |
| 6080790 | GENERAL SUPPLY | Supply/Implant | $1,600.00 |
| 6080791 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6080792 | STERILE SUPPLY | Supply/Implant | $4,800.00 |
| 6080794 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6080796 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080798 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080802 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080803 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080809 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6080811 | STERILE SUPPLY | Supply/Implant | $379.90 |
| 6080815 | EVENT RECORDER CARDIAC | Supply/Implant | $67,776.00 |
| 6080821 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6080827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6080828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,548.80 |
| 6080830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6080832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6080841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080843 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6080846 | SUPPLY IMPLANT | Supply/Implant | $7,849.47 |
| 6080847 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6080849 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,960.00 |
| 6080852 | STERILE SUPPLY | Supply/Implant | $563.20 |
| 6080853 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080854 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080855 | SUPPLY IMPLANT | Supply/Implant | $257.41 |
| 6080857 | SUPPLY IMPLANT | Supply/Implant | $20,685.18 |
| 6080858 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6080869 | SUPPLY IMPLANT | Supply/Implant | $663.64 |
| 6080873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,768.38 |
| 6080876 | GENERAL SUPPLY | Supply/Implant | $6,067.20 |
| 6080877 | SUPPLY IMPLANT | Supply/Implant | $1,474.56 |
| 6080878 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6080879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,863.68 |
| 6080888 | ALLODERM SKIN SUB | Supply/Implant | $65,369.60 |
| 6080889 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6080910 | SUPPLY IMPLANT | Supply/Implant | $1,235.97 |
| 6080911 | INTERSPINOUS IMPLANT | Supply/Implant | $121,600.00 |
| 6080912 | INTERSPINOUS IMPLANT | Supply/Implant | $121,600.00 |
| 6080913 | SUPPLY IMPLANT | Supply/Implant | $5,286.40 |
| 6080920 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6080921 | GENERAL SUPPLY | Supply/Implant | $2,560.00 |
| 6080922 | GENERAL SUPPLY | Supply/Implant | $6,233.60 |
| 6080923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,822.72 |
| 6080924 | GUIDE WIRE | Supply/Implant | $2,201.60 |
| 6080925 | GUIDE WIRE | Supply/Implant | $1,958.40 |
| 6080935 | GENERAL SUPPLY | Supply/Implant | $3,020.80 |
| 6080938 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $77,616.00 |
| 6080939 | SUPPLY IMPLANT | Supply/Implant | $15,459.84 |
| 6080946 | SUPPLY IMPLANT | Supply/Implant | $181.12 |
| 6080948 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $34,560.00 |
| 6080950 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $2,052.10 |
| 6080951 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $8,640.00 |
| 6080973 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6080978 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6080980 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6080989 | SUPPLY IMPLANT | Supply/Implant | $3,107.33 |
| 6080993 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $107,161.60 |
| 6080996 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,387.20 |
| 6080997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6080999 | SUPPLY IMPLANT | Supply/Implant | $2,451.71 |
| 6081000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,401.60 |
| 6081010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6081011 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6081013 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $84,467.20 |
| 6081014 | MESH (IMPLANTABLE) | Supply/Implant | $22,096.38 |
| 6081015 | MESH (IMPLANTABLE) | Supply/Implant | $12,973.06 |
| 6081016 | MESH (IMPLANTABLE) | Supply/Implant | $9,520.64 |
| 6081017 | CATHETER, GUIDING | Supply/Implant | $4,441.60 |
| 6081021 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6081026 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.13 |
| 6081027 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6081028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,387.20 |
| 6081029 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6081032 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6081033 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,387.20 |
| 6081034 | GENERAL SUPPLY | Supply/Implant | $7,308.80 |
| 6081036 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6081042 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6081054 | SUPPLY IMPLANT | Supply/Implant | $10,816.00 |
| 6081062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6081063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6081068 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6081098 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081100 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081101 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081103 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081113 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6081131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6081141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,135.87 |
| 6081142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6081143 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6081149 | GENERAL DRUG | Supply/Implant | $128.00 |
| 6081150 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6081151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.42 |
| 6081156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081160 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6081161 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6081166 | GENERAL SUPPLY | Supply/Implant | $2,756.61 |
| 6081167 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6081168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,038.40 |
| 6081171 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6081178 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6081186 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6081189 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6081201 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6081212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6081213 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6081215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6081219 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,706.69 |
| 6081221 | STERILE SUPPLY | Supply/Implant | $264.83 |
| 6081223 | SUPPLY IMPLANT | Supply/Implant | $2,546.82 |
| 6081226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6081228 | SUPPLY IMPLANT | Supply/Implant | $12,945.92 |
| 6081229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6081236 | SUPPLY IMPLANT | Supply/Implant | $46,080.00 |
| 6081241 | SUPPLY IMPLANT | Supply/Implant | $3,225.60 |
| 6081243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6081252 | GENERAL SUPPLY | Supply/Implant | $1,535.36 |
| 6081254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $625.15 |
| 6081257 | SUPPLY IMPLANT | Supply/Implant | $22,540.80 |
| 6081258 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6081260 | GENERAL SUPPLY | Supply/Implant | $195.33 |
| 6081261 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6081262 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6081263 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6081271 | GENERAL SUPPLY | Supply/Implant | $329.34 |
| 6081278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,800.00 |
| 6081279 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6081282 | SUPPLY IMPLANT | Supply/Implant | $36,839.68 |
| 6081291 | GENERAL SUPPLY | Supply/Implant | $686.72 |
| 6081311 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,387.20 |
| 6081318 | LEAD, NEUROSTIMULATOR | Supply/Implant | $1,280.00 |
| 6081321 | SUPPLY IMPLANT | Supply/Implant | $2,438.94 |
| 6081328 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $1,550.34 |
| 6081332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6081334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6081339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6081350 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6081353 | GUIDE WIRE | Supply/Implant | $2,444.80 |
| 6081354 | STERILE SUPPLY | Supply/Implant | $142.08 |
| 6081365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6081366 | GENERAL SUPPLY | Supply/Implant | $145.02 |
| 6081367 | GENERAL SUPPLY | Supply/Implant | $216.96 |
| 6081368 | GENERAL SUPPLY | Supply/Implant | $285.95 |
| 6081369 | GENERAL SUPPLY | Supply/Implant | $192.51 |
| 6081370 | GENERAL SUPPLY | Supply/Implant | $1,065.86 |
| 6081371 | GENERAL SUPPLY | Supply/Implant | $241.66 |
| 6081372 | GENERAL SUPPLY | Supply/Implant | $297.22 |
| 6081376 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6081380 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6081381 | MESH (IMPLANTABLE) | Supply/Implant | $17,439.62 |
| 6081383 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $107,161.60 |
| 6081384 | SUPPLY IMPLANT | Supply/Implant | $518.40 |
| 6081396 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $28,096.00 |
| 6081397 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $28,096.00 |
| 6081399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,812.48 |
| 6081411 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6081418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $890.88 |
| 6081425 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6081433 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6081434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6081435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6081449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6081452 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6081453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6081455 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6081456 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6081457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6081458 | SUPPLY IMPLANT | Supply/Implant | $311.17 |
| 6081460 | SUPPLY IMPLANT | Supply/Implant | $543.10 |
| 6081463 | STERILE SUPPLY | Supply/Implant | $137.65 |
| 6081464 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6081473 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $66,150.40 |
| 6081478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6081479 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6081481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,817.60 |
| 6081482 | SUPPLY IMPLANT | Supply/Implant | $2,300.03 |
| 6081483 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6081484 | GRAFT, VASCULAR | Supply/Implant | $6,676.35 |
| 6081485 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $157,500.00 |
| 6081490 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6081491 | SUPPLY IMPLANT | Supply/Implant | $311.04 |
| 6081496 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6081497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,965.89 |
| 6081500 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6081501 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $21,440.00 |
| 6081502 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,148.80 |
| 6081503 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6081507 | MESH (IMPLANTABLE) | Supply/Implant | $2,923.26 |
| 6081509 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6081512 | RET DEV, INSERTABLE | Supply/Implant | $88,960.00 |
| 6081514 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,016.00 |
| 6081518 | SUPPLY IMPLANT | Supply/Implant | $43,584.00 |
| 6081522 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081523 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081524 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081526 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $22,976.00 |
| 6081531 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081541 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081542 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081543 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081544 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081555 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $716.80 |
| 6081561 | SUPPLY IMPLANT | Supply/Implant | $80,026.11 |
| 6081562 | CATHETER, INTRASPINAL | Supply/Implant | $320.00 |
| 6081563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6081564 | AICD, DUAL CHAMBER | Supply/Implant | $141,750.00 |
| 6081565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $743.94 |
| 6081567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6081568 | GENERAL SUPPLY | Supply/Implant | $132.10 |
| 6081572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6081586 | SUPPLY IMPLANT | Supply/Implant | $14,118.40 |
| 6081588 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,889.66 |
| 6081589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,819.26 |
| 6081590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,023.94 |
| 6081592 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6081597 | SUPPLY IMPLANT | Supply/Implant | $55,632.00 |
| 6081600 | INTERSPINOUS IMPLANT | Supply/Implant | $25,472.00 |
| 6081608 | SUPPLY IMPLANT | Supply/Implant | $262.46 |
| 6081609 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $93,376.00 |
| 6081614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6081619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081622 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $440.45 |
| 6081624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,880.00 |
| 6081629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6081630 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6081633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.42 |
| 6081634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,287.94 |
| 6081635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.42 |
| 6081644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6081647 | SUPPLY IMPLANT | Supply/Implant | $1,090.56 |
| 6081660 | GENERAL SUPPLY | Supply/Implant | $191.36 |
| 6081663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6081666 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6081668 | STERILE SUPPLY | Supply/Implant | $1,024.00 |
| 6081683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,300.80 |
| 6081685 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $15,360.00 |
| 6081687 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $15,360.00 |
| 6081694 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6081695 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6081696 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6081706 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6081722 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6081738 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $33,500.67 |
| 6081743 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6081745 | STERILE SUPPLY | Supply/Implant | $174.46 |
| 6081748 | SUPPLY IMPLANT | Supply/Implant | $217.37 |
| 6081752 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $768.00 |
| 6081753 | SUPPLY IMPLANT | Supply/Implant | $8,128.00 |
| 6081754 | SUPPLY IMPLANT | Supply/Implant | $1,822.72 |
| 6081786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,132.93 |
| 6081787 | GUIDE WIRE | Supply/Implant | $1,885.31 |
| 6081789 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6081790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6081793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081802 | CATHETER, GUIDING | Supply/Implant | $16,000.00 |
| 6081819 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6081826 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6081827 | ALLODERM SKIN SUB | Supply/Implant | $17,753.60 |
| 6081831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,625.60 |
| 6081839 | CATHETER, GUIDING | Supply/Implant | $8,268.80 |
| 6081852 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6081858 | SUPPLY IMPLANT | Supply/Implant | $6,701.18 |
| 6081859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6081860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6081861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6081862 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $6,336.00 |
| 6081864 | SUPPLY IMPLANT | Supply/Implant | $2,577.66 |
| 6081865 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6081867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6081869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6081872 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6081874 | GENERAL SUPPLY | Supply/Implant | $296.70 |
| 6081875 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6081878 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,387.20 |
| 6081881 | GENERAL SUPPLY | Supply/Implant | $384.00 |
| 6081886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6081888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,204.48 |
| 6081889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,720.00 |
| 6081911 | SUPPLY IMPLANT | Supply/Implant | $15,577.60 |
| 6081915 | SUPPLY IMPLANT | Supply/Implant | $944.64 |
| 6081916 | SUPPLY IMPLANT | Supply/Implant | $232.70 |
| 6081919 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,116.80 |
| 6081921 | GENERAL SUPPLY | Supply/Implant | $283.52 |
| 6081922 | GENERAL SUPPLY | Supply/Implant | $309.89 |
| 6081923 | GENERAL SUPPLY | Supply/Implant | $355.97 |
| 6081924 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6081925 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6081927 | GRAFT, VASCULAR | Supply/Implant | $30,400.00 |
| 6081931 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6081936 | SUPPLY IMPLANT | Supply/Implant | $2,995.20 |
| 6081937 | SUPPLY IMPLANT | Supply/Implant | $9,280.00 |
| 6081938 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6081939 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081940 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081941 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081942 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081943 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081944 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081948 | SUPPLY IMPLANT | Supply/Implant | $17,856.00 |
| 6081958 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081959 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081961 | SUPPLY IMPLANT | Supply/Implant | $14,604.80 |
| 6081964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6081965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6081966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6081969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,170.24 |
| 6081970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6081971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6081977 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6081978 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6081984 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6081986 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $157,500.00 |
| 6081996 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6082001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6082005 | SUPPLY IMPLANT | Supply/Implant | $23,232.00 |
| 6082007 | SUPPLY IMPLANT | Supply/Implant | $3,289.60 |
| 6082009 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6082014 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,921.60 |
| 6082027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,086.08 |
| 6082028 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $39,513.60 |
| 6082031 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6082032 | SUPPLY IMPLANT | Supply/Implant | $8,576.00 |
| 6082035 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6082038 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6082043 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082044 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6082050 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6082053 | SUPPLY IMPLANT | Supply/Implant | $503.68 |
| 6082057 | SUPPLY IMPLANT | Supply/Implant | $4,266.88 |
| 6082058 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6082060 | GENERAL SUPPLY | Supply/Implant | $241.79 |
| 6082061 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6082064 | SUPPLY IMPLANT | Supply/Implant | $54,886.40 |
| 6082066 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6082067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $556.80 |
| 6082072 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,372.80 |
| 6082073 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6082074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6082076 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6082077 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6082079 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6082081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6082082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6082084 | SUPPLY IMPLANT | Supply/Implant | $41,894.40 |
| 6082085 | SUPPLY IMPLANT | Supply/Implant | $17,664.00 |
| 6082086 | SUPPLY IMPLANT | Supply/Implant | $19,737.60 |
| 6082091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6082093 | STERILE SUPPLY | Supply/Implant | $3,628.80 |
| 6082094 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6082104 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6082106 | SUPPLY IMPLANT | Supply/Implant | $931.84 |
| 6082109 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,567.87 |
| 6082118 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6082121 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082122 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,818.11 |
| 6082123 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082124 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082125 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,818.11 |
| 6082128 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082129 | IMPL EXT ACCESS CATH | Supply/Implant | $11,200.00 |
| 6082130 | IMPL EXT ACCESS CATH | Supply/Implant | $11,200.00 |
| 6082131 | IMPL EXT ACCESS CATH | Supply/Implant | $11,200.00 |
| 6082132 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082133 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082138 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $9,868.80 |
| 6082139 | OCULAR IMPLANT | Supply/Implant | $3,520.00 |
| 6082142 | SUPPLY IMPLANT | Supply/Implant | $2,585.60 |
| 6082143 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082145 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082146 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082147 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6082148 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6082149 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082150 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082151 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082154 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6082157 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082164 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082165 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082166 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082167 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,818.11 |
| 6082168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6082175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,149.76 |
| 6082179 | SUPPLY IMPLANT | Supply/Implant | $326.40 |
| 6082183 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6082184 | STERILE SUPPLY | Supply/Implant | $665.60 |
| 6082185 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6082191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6082192 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6082199 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $30,656.00 |
| 6082207 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6082209 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6082211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6082215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6082235 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6082237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082242 | GENERAL SUPPLY | Supply/Implant | $244.15 |
| 6082243 | GENERAL SUPPLY | Supply/Implant | $269.30 |
| 6082244 | GENERAL SUPPLY | Supply/Implant | $284.81 |
| 6082248 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6082250 | SUPPLY IMPLANT | Supply/Implant | $7,692.03 |
| 6082265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,579.20 |
| 6082267 | SUPPLY IMPLANT | Supply/Implant | $23,052.80 |
| 6082268 | SUPPLY IMPLANT | Supply/Implant | $4,893.95 |
| 6082269 | SUPPLY IMPLANT | Supply/Implant | $4,649.34 |
| 6082277 | SUPPLY IMPLANT | Supply/Implant | $2,729.60 |
| 6082279 | SUPPLY IMPLANT | Supply/Implant | $4,244.74 |
| 6082280 | SUPPLY IMPLANT | Supply/Implant | $4,244.74 |
| 6082284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,731.58 |
| 6082285 | STERILE SUPPLY | Supply/Implant | $387.33 |
| 6082289 | SUPPLY IMPLANT | Supply/Implant | $3,097.60 |
| 6082317 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6082327 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,144.32 |
| 6082331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6082332 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6082334 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6082337 | SUPPLY IMPLANT | Supply/Implant | $2,457.22 |
| 6082339 | SUPPLY IMPLANT | Supply/Implant | $2,457.22 |
| 6082348 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $47,462.40 |
| 6082349 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $5,312.13 |
| 6082354 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6082355 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6082358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6082359 | OCULAR IMPLANT | Supply/Implant | $7,232.00 |
| 6082361 | SUPPLY IMPLANT | Supply/Implant | $2,512.13 |
| 6082367 | STERILE SUPPLY | Supply/Implant | $441.98 |
| 6082368 | STERILE SUPPLY | Supply/Implant | $1,789.18 |
| 6082369 | SUPPLY IMPLANT | Supply/Implant | $2,273.28 |
| 6082372 | SUPPLY IMPLANT | Supply/Implant | $354.43 |
| 6082376 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6082379 | SUPPLY IMPLANT | Supply/Implant | $3,676.80 |
| 6082380 | SUPPLY IMPLANT | Supply/Implant | $1,244.16 |
| 6082384 | SUPPLY IMPLANT | Supply/Implant | $4,648.96 |
| 6082387 | SUPPLY IMPLANT | Supply/Implant | $3,744.00 |
| 6082395 | SUPPLY IMPLANT | Supply/Implant | $1,881.60 |
| 6082396 | SUPPLY IMPLANT | Supply/Implant | $2,044.80 |
| 6082397 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6082398 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6082399 | SUPPLY IMPLANT | Supply/Implant | $1,881.60 |
| 6082400 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6082401 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6082402 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082403 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082405 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6082410 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6082413 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6082417 | SUPPLY IMPLANT | Supply/Implant | $3,085.70 |
| 6082418 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6082426 | SUPPLY IMPLANT | Supply/Implant | $2,215.81 |
| 6082427 | SUPPLY IMPLANT | Supply/Implant | $3,044.99 |
| 6082428 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6082429 | SUPPLY IMPLANT | Supply/Implant | $1,868.80 |
| 6082434 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6082437 | SUPPLY IMPLANT | Supply/Implant | $3,085.70 |
| 6082440 | SUPPLY IMPLANT | Supply/Implant | $2,918.40 |
| 6082441 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6082444 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082445 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082446 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082447 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082450 | SUPPLY IMPLANT | Supply/Implant | $365.06 |
| 6082455 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6082456 | SUPPLY IMPLANT | Supply/Implant | $4,803.20 |
| 6082458 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6082459 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6082461 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082463 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082472 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6082478 | SUPPLY IMPLANT | Supply/Implant | $5,634.94 |
| 6082479 | GUIDE WIRE | Supply/Implant | $2,534.40 |
| 6082482 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6082483 | SUPPLY IMPLANT | Supply/Implant | $1,996.80 |
| 6082487 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6082491 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6082492 | SUPPLY IMPLANT | Supply/Implant | $1,505.28 |
| 6082494 | SUPPLY IMPLANT | Supply/Implant | $2,400.00 |
| 6082502 | STERILE SUPPLY | Supply/Implant | $759.08 |
| 6082503 | STERILE SUPPLY | Supply/Implant | $491.78 |
| 6082504 | SUPPLY IMPLANT | Supply/Implant | $15,187.20 |
| 6082522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6082524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6082532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082658 | STERILE SUPPLY | Supply/Implant | $1,417.22 |
| 6082669 | WIRELESS PRESSURE SENSOR | Supply/Implant | $251,995.00 |
| 6082672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,880.00 |
| 6082675 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6082676 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6082680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6082681 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,801.60 |
| 6082682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,801.60 |
| 6082684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,801.60 |
| 6082700 | STERILE SUPPLY | Supply/Implant | $212.61 |
| 6082712 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6082731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6082733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6082734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6082745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6082748 | SUPPLY IMPLANT | Supply/Implant | $33,662.72 |
| 6082750 | SUPPLY IMPLANT | Supply/Implant | $6,992.00 |
| 6082758 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6082759 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6082760 | SUPPLY IMPLANT | Supply/Implant | $472.32 |
| 6082761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6082765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6082768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6082771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,150.72 |
| 6082778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6082784 | STERILE SUPPLY | Supply/Implant | $699.65 |
| 6082785 | SUPPLY IMPLANT | Supply/Implant | $5,030.40 |
| 6082789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6082791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6082792 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $51,699.20 |
| 6082793 | AICD, SINGLE CHAMBER | Supply/Implant | $131,250.00 |
| 6082794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,383.81 |
| 6082795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6082796 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6082798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6082799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6082800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,188.80 |
| 6082801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6082802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6082803 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6082805 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6082806 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6082813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6082817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,049.47 |
| 6082824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,907.20 |
| 6082834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6082835 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,684.80 |
| 6082836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6082837 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,924.80 |
| 6082838 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,491.20 |
| 6082839 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,478.40 |
| 6082846 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6082855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6082857 | REP DEV, URINARY, W/SLING | Supply/Implant | $12,160.00 |
| 6082861 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6082865 | SUPPLY IMPLANT | Supply/Implant | $20,774.40 |
| 6082867 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6082869 | SUPPLY IMPLANT | Supply/Implant | $2,155.52 |
| 6082887 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082906 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082910 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082912 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082913 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082916 | STERILE SUPPLY | Supply/Implant | $216.83 |
| 6082917 | SUPPLY IMPLANT | Supply/Implant | $917.61 |
| 6082918 | SUPPLY IMPLANT | Supply/Implant | $883.20 |
| 6082920 | SUPPLY IMPLANT | Supply/Implant | $480.00 |
| 6082921 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $192.00 |
| 6082923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,262.40 |
| 6082927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6082936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6082941 | IMPL EXT ACCESS CATH | Supply/Implant | $4,467.20 |
| 6082951 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6082960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6082963 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6082964 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6082972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,784.26 |
| 6082978 | SUPPLY IMPLANT | Supply/Implant | $6,105.60 |
| 6082984 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6082995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6082997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,924.80 |
| 6083004 | ALLODERM SKIN SUB | Supply/Implant | $10,278.40 |
| 6083005 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6083011 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $960.00 |
| 6083016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,502.40 |
| 6083017 | GUIDE WIRE | Supply/Implant | $627.20 |
| 6083021 | SUPPLY IMPLANT | Supply/Implant | $3,673.60 |
| 6083023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,912.00 |
| 6083031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,867.20 |
| 6083036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,990.40 |
| 6083037 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6083038 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6083039 | GRAFT, VASCULAR | Supply/Implant | $16,819.20 |
| 6083040 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6083041 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6083046 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6083047 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6083048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6083049 | SUPPLY IMPLANT | Supply/Implant | $174.08 |
| 6083055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,000.00 |
| 6083080 | SUPPLY IMPLANT | Supply/Implant | $10,515.07 |
| 6083082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6083083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6083089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6083109 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083110 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083111 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083112 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083113 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083114 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083115 | SUPPLY IMPLANT | Supply/Implant | $18,419.20 |
| 6083117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,035.20 |
| 6083118 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6083121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6083127 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083128 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083130 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083131 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083132 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083133 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083134 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083136 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083138 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083141 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083142 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083143 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083144 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083145 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083146 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083147 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083149 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083150 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083151 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083152 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083154 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083155 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083156 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083157 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083158 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083161 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083162 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083164 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083165 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083166 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083167 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083169 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083171 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083172 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083173 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083175 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083176 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083177 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6083191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,376.00 |
| 6083193 | AICD, SINGLE CHAMBER | Supply/Implant | $155,400.00 |
| 6083197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6083198 | MESH (IMPLANTABLE) | Supply/Implant | $390.91 |
| 6083202 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6083204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6083206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083208 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $13,760.00 |
| 6083209 | GUIDE WIRE | Supply/Implant | $2,201.60 |
| 6083216 | MISC SUP/ACC IMP VAD | Supply/Implant | $12,736.00 |
| 6083219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6083224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,048.00 |
| 6083226 | GENERAL SUPPLY | Supply/Implant | $6,359.04 |
| 6083228 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6083229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6083230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6083247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6083280 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6083337 | SUPPLY IMPLANT | Supply/Implant | $4,339.58 |
| 6083339 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $4,172.80 |
| 6083358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,817.60 |
| 6083359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,840.00 |
| 6083366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083382 | GENERAL SUPPLY | Supply/Implant | $2,684.93 |
| 6083383 | GENERAL SUPPLY | Supply/Implant | $356.74 |
| 6083390 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083391 | INTERSPINOUS IMPLANT | Supply/Implant | $10,240.00 |
| 6083392 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083393 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083394 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083395 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6083400 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6083403 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $7,040.00 |
| 6083405 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6083410 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6083415 | GENERAL SUPPLY | Supply/Implant | $282.62 |
| 6083424 | SUPPLY IMPLANT | Supply/Implant | $5,644.80 |
| 6083425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6083428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6083430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6083431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6083432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6083433 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6083439 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,600.00 |
| 6083447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6083449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,980.03 |
| 6083450 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6083451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6083452 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6083454 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6083455 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6083456 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6083457 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6083458 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6083459 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6083460 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6083461 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6083463 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,491.20 |
| 6083464 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6083467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6083468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,924.80 |
| 6083470 | SUPPLY IMPLANT | Supply/Implant | $761.60 |
| 6083471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6083472 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6083473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6083475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,808.00 |
| 6083476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,011.20 |
| 6083477 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6083480 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6083482 | STERILE SUPPLY | Supply/Implant | $12,544.00 |
| 6083491 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6083493 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6083504 | SUPPLY IMPLANT | Supply/Implant | $1,932.80 |
| 6083505 | STERILE SUPPLY | Supply/Implant | $1,984.00 |
| 6083506 | STERILE SUPPLY | Supply/Implant | $4,556.80 |
| 6083514 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6083516 | SUPPLY IMPLANT | Supply/Implant | $1,140.86 |
| 6083517 | SUPPLY IMPLANT | Supply/Implant | $3,225.60 |
| 6083518 | SUPPLY IMPLANT | Supply/Implant | $3,288.60 |
| 6083525 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6083532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6083533 | SUPPLY IMPLANT | Supply/Implant | $996.74 |
| 6083542 | STERILE SUPPLY | Supply/Implant | $621.39 |
| 6083543 | STERILE SUPPLY | Supply/Implant | $621.44 |
| 6083545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,020.80 |
| 6083546 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6083547 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6083548 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6083550 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6083552 | SUPPLY IMPLANT | Supply/Implant | $370.69 |
| 6083553 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6083554 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,518.08 |
| 6083557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6083560 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6083561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6083564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6083565 | SUPPLY IMPLANT | Supply/Implant | $4,106.24 |
| 6083566 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6083569 | SUPPLY IMPLANT | Supply/Implant | $22,101.50 |
| 6083581 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $77,616.00 |
| 6083583 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,376.00 |
| 6083591 | SUPPLY IMPLANT | Supply/Implant | $250.88 |
| 6083603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6083605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,491.20 |
| 6083606 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6083618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6083619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6083620 | SUPPLY IMPLANT | Supply/Implant | $2,325.89 |
| 6083629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6083636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6083646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $92,761.60 |
| 6083647 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6083649 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6083650 | GENERAL SUPPLY | Supply/Implant | $1,498.50 |
| 6083653 | GENERAL SUPPLY | Supply/Implant | $3,545.60 |
| 6083654 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6083656 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6083657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6083658 | SUPPLY IMPLANT | Supply/Implant | $28,648.83 |
| 6083661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6083662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,520.00 |
| 6083665 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6083666 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6083667 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6083668 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6083673 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6083678 | CATHETER, GUIDING | Supply/Implant | $26,304.00 |
| 6083679 | CATHETER, GUIDING | Supply/Implant | $26,304.00 |
| 6083683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,097.60 |
| 6083684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6083685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6083698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6083699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6083704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6083711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,705.60 |
| 6083712 | SUPPLY IMPLANT | Supply/Implant | $2,380.80 |
| 6083720 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6083733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083736 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083738 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083740 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $384.00 |
| 6083746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6083747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6083749 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083750 | SUPPLY IMPLANT | Supply/Implant | $15,646.34 |
| 6083761 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6083764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6083765 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6083766 | CATHETER, GUIDING | Supply/Implant | $486.40 |
| 6083767 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6083771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6083772 | GUIDE WIRE | Supply/Implant | $1,011.20 |
| 6083773 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6083774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6083776 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6083777 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6083781 | CATHETER, GUIDING | Supply/Implant | $278.40 |
| 6083792 | STERILE SUPPLY | Supply/Implant | $318.98 |
| 6083793 | SUPPLY IMPLANT | Supply/Implant | $4,019.20 |
| 6083794 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6083798 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $807.94 |
| 6083801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6083802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6083803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6083804 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6083831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6083832 | INTRO/SHEATH, NON-LASER | Supply/Implant | $755.20 |
| 6083834 | SUPPLY IMPLANT | Supply/Implant | $4,684.80 |
| 6083840 | SUPPLY IMPLANT | Supply/Implant | $2,763.26 |
| 6083846 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6083858 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $716.80 |
| 6083868 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6083872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6083874 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6083875 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6083877 | STERILE SUPPLY | Supply/Implant | $758.27 |
| 6083881 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6083882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,124.80 |
| 6083887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6083890 | SUPPLY IMPLANT | Supply/Implant | $1,067.19 |
| 6083906 | CATHETER, GUIDING | Supply/Implant | $443.52 |
| 6083908 | GUIDE WIRE | Supply/Implant | $526.72 |
| 6083914 | GENERAL SUPPLY | Supply/Implant | $224.38 |
| 6083915 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6083916 | SUPPLY IMPLANT | Supply/Implant | $2,534.40 |
| 6083919 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6083922 | GENERAL SUPPLY | Supply/Implant | $497.92 |
| 6083932 | SUPPLY IMPLANT | Supply/Implant | $6,512.13 |
| 6083933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $105,356.80 |
| 6083935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,705.60 |
| 6083942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6083945 | GENERAL SUPPLY | Supply/Implant | $204.61 |
| 6083949 | MESH (IMPLANTABLE) | Supply/Implant | $32,531.33 |
| 6083952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,135.87 |
| 6083955 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6083961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6083962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6083964 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6083965 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6083966 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6083967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6083969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6083971 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6083972 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6083973 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $804.99 |
| 6083983 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6083984 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6083986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6083988 | SUPPLY IMPLANT | Supply/Implant | $3,468.80 |
| 6083989 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6084002 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6084004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084025 | SUPPLY IMPLANT | Supply/Implant | $405.50 |
| 6084028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6084029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6084030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6084032 | STERILE SUPPLY | Supply/Implant | $506.88 |
| 6084034 | SUPPLY IMPLANT | Supply/Implant | $6,163.20 |
| 6084038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,328.26 |
| 6084039 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6084041 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $47,462.40 |
| 6084047 | SUPPLY IMPLANT | Supply/Implant | $3,238.40 |
| 6084048 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6084049 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6084050 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6084055 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084056 | CATH, DRAINAGE | Supply/Implant | $4,816.64 |
| 6084062 | GENERAL SUPPLY | Supply/Implant | $229.25 |
| 6084063 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6084065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,240.00 |
| 6084070 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6084072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,868.16 |
| 6084073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6084075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,720.00 |
| 6084079 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6084081 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6084083 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6084089 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6084090 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6084091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6084096 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6084097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6084101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6084103 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6084104 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6084106 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,841.60 |
| 6084117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,561.60 |
| 6084118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,561.60 |
| 6084119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6084120 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6084121 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6084125 | SUPPLY IMPLANT | Supply/Implant | $2,028.80 |
| 6084126 | SUPPLY IMPLANT | Supply/Implant | $2,170.88 |
| 6084127 | GENERAL SUPPLY | Supply/Implant | $405.76 |
| 6084132 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6084133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,862.40 |
| 6084134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6084135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6084136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6084140 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6084142 | SUPPLY IMPLANT | Supply/Implant | $33,662.72 |
| 6084143 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6084145 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6084153 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6084163 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6084164 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6084167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,211.39 |
| 6084172 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6084189 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6084195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6084200 | SUPPLY IMPLANT | Supply/Implant | $2,472.96 |
| 6084201 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6084207 | SUPPLY IMPLANT | Supply/Implant | $2,488.32 |
| 6084208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084212 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084213 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084215 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084216 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084217 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084218 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084220 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084221 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084222 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084223 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084225 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084226 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084227 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084228 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084229 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084231 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084232 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084233 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084234 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084235 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084236 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084237 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084240 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084241 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084243 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084244 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084245 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084246 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084248 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084249 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084250 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084251 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084252 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084254 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084256 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084257 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084262 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084264 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084265 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084266 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084267 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084268 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084270 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084271 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084272 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084273 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084275 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084276 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084277 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084278 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084279 | GENERAL SUPPLY | Supply/Implant | $305.02 |
| 6084280 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,705.60 |
| 6084282 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084288 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6084289 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6084296 | SUPPLY IMPLANT | Supply/Implant | $3,983.36 |
| 6084301 | SUPPLY IMPLANT | Supply/Implant | $17,075.20 |
| 6084302 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084303 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6084307 | SUPPLY IMPLANT | Supply/Implant | $7,420.80 |
| 6084310 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,094.40 |
| 6084321 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,040.00 |
| 6084330 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6084332 | SUPPLY IMPLANT | Supply/Implant | $5,419.81 |
| 6084333 | GENERAL SUPPLY | Supply/Implant | $2,048.00 |
| 6084346 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6084347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6084349 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6084350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6084359 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6084360 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,801.60 |
| 6084364 | SUPPLY IMPLANT | Supply/Implant | $2,508.80 |
| 6084365 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6084369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6084370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084377 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084382 | SUPPLY IMPLANT | Supply/Implant | $2,763.26 |
| 6084397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6084403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,657.60 |
| 6084413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6084414 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $107,161.60 |
| 6084417 | SUPPLY IMPLANT | Supply/Implant | $403.20 |
| 6084421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,768.00 |
| 6084431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6084432 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6084436 | SUPPLY IMPLANT | Supply/Implant | $1,197.70 |
| 6084442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6084443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6084444 | SUPPLY IMPLANT | Supply/Implant | $9,344.00 |
| 6084445 | SUPPLY IMPLANT | Supply/Implant | $19,916.80 |
| 6084447 | GENERAL SUPPLY | Supply/Implant | $488.45 |
| 6084448 | SUPPLY IMPLANT | Supply/Implant | $8,422.40 |
| 6084449 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6084451 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6084455 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6084461 | INTRO/SHEATH, NON-LASER | Supply/Implant | $311.17 |
| 6084464 | MESH (IMPLANTABLE) | Supply/Implant | $64,424.96 |
| 6084465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,294.40 |
| 6084471 | GENERAL SUPPLY | Supply/Implant | $194.05 |
| 6084472 | GENERAL SUPPLY | Supply/Implant | $290.56 |
| 6084473 | GENERAL SUPPLY | Supply/Implant | $351.36 |
| 6084474 | GENERAL SUPPLY | Supply/Implant | $351.36 |
| 6084475 | GENERAL SUPPLY | Supply/Implant | $441.34 |
| 6084479 | INTERSPINOUS IMPLANT | Supply/Implant | $77,824.00 |
| 6084484 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6084500 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6084504 | SUPPLY IMPLANT | Supply/Implant | $9,853.44 |
| 6084518 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6084519 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $1,152.00 |
| 6084540 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6084543 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6084552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6084553 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,542.91 |
| 6084555 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,907.20 |
| 6084556 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6084557 | PT PRGRM FOR IMPLT NEUROSTIM | Supply/Implant | $5,120.00 |
| 6084558 | SUPPLY IMPLANT | Supply/Implant | $405.50 |
| 6084560 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6084563 | GRAFT, VASCULAR | Supply/Implant | $25,216.00 |
| 6084565 | GRAFT, VASCULAR | Supply/Implant | $48,230.40 |
| 6084569 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6084570 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6084571 | STERILE SUPPLY | Supply/Implant | $1,024.00 |
| 6084573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6084576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6084584 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6084595 | SUPPLY IMPLANT | Supply/Implant | $3,404.80 |
| 6084596 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6084599 | SUPPLY IMPLANT | Supply/Implant | $21,440.00 |
| 6084600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,112.00 |
| 6084604 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,928.70 |
| 6084605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6084606 | SUPPLY IMPLANT | Supply/Implant | $2,828.80 |
| 6084608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084613 | MESH (IMPLANTABLE) | Supply/Implant | $5,938.94 |
| 6084616 | STERILE SUPPLY | Supply/Implant | $373.25 |
| 6084618 | INTRO/SHEATH, NON-LASER | Supply/Implant | $139.14 |
| 6084622 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6084623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,862.40 |
| 6084626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6084628 | SUPPLY IMPLANT | Supply/Implant | $177.60 |
| 6084629 | SUPPLY IMPLANT | Supply/Implant | $267.65 |
| 6084632 | CLOSURE DEV, VASC | Supply/Implant | $489.74 |
| 6084633 | STERILE SUPPLY | Supply/Implant | $162.87 |
| 6084639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,424.58 |
| 6084640 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6084644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,912.64 |
| 6084645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6084648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,508.80 |
| 6084657 | SUPPLY IMPLANT | Supply/Implant | $4,710.40 |
| 6084664 | SUPPLY IMPLANT | Supply/Implant | $1,598.21 |
| 6084666 | MESH (IMPLANTABLE) | Supply/Implant | $11,457.92 |
| 6084668 | SUPPLY IMPLANT | Supply/Implant | $18,560.00 |
| 6084670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.04 |
| 6084672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6084673 | GRAFT, VASCULAR | Supply/Implant | $36,633.60 |
| 6084674 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6084676 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084681 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $89,600.00 |
| 6084687 | SUPPLY IMPLANT | Supply/Implant | $1,627.52 |
| 6084689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6084691 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $26,342.40 |
| 6084693 | INTEGRA BMWD SKIN SUB | Supply/Implant | $120,846.34 |
| 6084701 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6084704 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6084706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6084708 | SUPPLY IMPLANT | Supply/Implant | $6,028.80 |
| 6084711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,171.20 |
| 6084712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6084713 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6084715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,639.68 |
| 6084716 | SUPPLY IMPLANT | Supply/Implant | $3,806.46 |
| 6084717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6084719 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6084721 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6084747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,545.92 |
| 6084769 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $48,000.00 |
| 6084790 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $768.00 |
| 6084793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6084807 | SUPPLY IMPLANT | Supply/Implant | $47,257.60 |
| 6084811 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $33,500.67 |
| 6084824 | SUPPLY IMPLANT | Supply/Implant | $13,081.60 |
| 6084825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,617.34 |
| 6084827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6084828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6084836 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6084843 | SUPPLY IMPLANT | Supply/Implant | $2,478.72 |
| 6084845 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6084846 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,072.00 |
| 6084847 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,072.00 |
| 6084848 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $20,992.00 |
| 6084849 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084850 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084851 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084852 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,992.00 |
| 6084853 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084854 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084855 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084856 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,992.00 |
| 6084857 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084858 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084859 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084860 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,072.00 |
| 6084863 | GRAFT, VASCULAR | Supply/Implant | $170,898.00 |
| 6084915 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,238.40 |
| 6084917 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6084918 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6084920 | STERILE SUPPLY | Supply/Implant | $4,544.00 |
| 6084921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6084923 | SUPPLY IMPLANT | Supply/Implant | $2,508.80 |
| 6084927 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6084930 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6084932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,657.60 |
| 6084934 | VENA CAVA FILTER | Supply/Implant | $15,347.20 |
| 6084966 | SUPPLY IMPLANT | Supply/Implant | $387.84 |
| 6084970 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6085033 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6085070 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $9,963.52 |
| 6085073 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $9,963.52 |
| 6085074 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6085076 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6085086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6085088 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085089 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085090 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085091 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085093 | CATHETER, GUIDING | Supply/Implant | $9,984.00 |
| 6085094 | SUPPLY IMPLANT | Supply/Implant | $92,800.00 |
| 6085097 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6085127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $41,190.40 |
| 6085139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $41,190.40 |
| 6085147 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6085148 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6085149 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6085150 | SUPPLY IMPLANT | Supply/Implant | $907.67 |
| 6085160 | SUPPLY IMPLANT | Supply/Implant | $2,898.05 |
| 6085165 | GUIDE WIRE | Supply/Implant | $139.52 |
| 6085171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,862.40 |
| 6085173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6085174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6085177 | SUPPLY IMPLANT | Supply/Implant | $1,315.46 |
| 6085179 | GENERAL SUPPLY | Supply/Implant | $215.04 |
| 6085181 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6085182 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6085184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6085186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6085188 | GENERAL SUPPLY | Supply/Implant | $3,361.75 |
| 6085216 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6085229 | SUPPLY IMPLANT | Supply/Implant | $15,385.60 |
| 6085307 | SUPPLY IMPLANT | Supply/Implant | $4,369.92 |
| 6085325 | VENA CAVA FILTER | Supply/Implant | $15,347.20 |
| 6085341 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6085343 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6085360 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6085367 | SUPPLY IMPLANT | Supply/Implant | $8,053.25 |
| 6085376 | SUPPLY IMPLANT | Supply/Implant | $6,752.26 |
| 6085418 | SUPPLY IMPLANT | Supply/Implant | $3,526.66 |
| 6085441 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6085460 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6085461 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6085465 | SUPPLY IMPLANT | Supply/Implant | $2,037.76 |
| 6085467 | GUIDE WIRE | Supply/Implant | $2,870.78 |
| 6085469 | SUPPLY IMPLANT | Supply/Implant | $2,140.16 |
| 6085470 | SUPPLY IMPLANT | Supply/Implant | $2,795.39 |
| 6085472 | SUPPLY IMPLANT | Supply/Implant | $2,795.39 |
| 6085473 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6085474 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6085496 | SUPPLY IMPLANT | Supply/Implant | $2,537.47 |
| 6085497 | SUPPLY IMPLANT | Supply/Implant | $2,537.47 |
| 6085500 | GUIDE WIRE | Supply/Implant | $2,526.72 |
| 6085519 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6085523 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6085531 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6085777 | STERILE SUPPLY | Supply/Implant | $510.34 |
| 6086015 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6086307 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,299.20 |
| 6086311 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6086315 | GENERAL SUPPLY | Supply/Implant | $156.67 |
| 6086321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6086452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086464 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6086473 | STERILE SUPPLY | Supply/Implant | $486.27 |
| 6086502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6086507 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6086510 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6086511 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,840.70 |
| 6086512 | SUPPLY IMPLANT | Supply/Implant | $120,750.00 |
| 6086517 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6086518 | GENERAL SUPPLY | Supply/Implant | $811.78 |
| 6086522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086527 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6086528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6086531 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6086532 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6086533 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6086534 | SUPPLY IMPLANT | Supply/Implant | $1,935.36 |
| 6086536 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,680.00 |
| 6086537 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6086540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,594.05 |
| 6086541 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6086542 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6086545 | CATHETER, GUIDING | Supply/Implant | $443.52 |
| 6086547 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,071.49 |
| 6086550 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6086559 | SUPPLY IMPLANT | Supply/Implant | $6,364.93 |
| 6086563 | SUPPLY IMPLANT | Supply/Implant | $484.10 |
| 6086564 | SUPPLY IMPLANT | Supply/Implant | $484.48 |
| 6086568 | SUPPLY IMPLANT | Supply/Implant | $1,257.34 |
| 6086571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6086572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $95,859.20 |
| 6086574 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6086577 | SUPPLY IMPLANT | Supply/Implant | $58,649.60 |
| 6086578 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6086580 | STERILE SUPPLY | Supply/Implant | $284.24 |
| 6086581 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6086586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6086587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6086588 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6086589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6086590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6086593 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6086604 | SUPPLY IMPLANT | Supply/Implant | $17,395.20 |
| 6086608 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6086609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6086610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6086616 | SUPPLY IMPLANT | Supply/Implant | $47,257.60 |
| 6086617 | STERILE SUPPLY | Supply/Implant | $134.14 |
| 6086619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,693.12 |
| 6086620 | SUPPLY IMPLANT | Supply/Implant | $3,133.44 |
| 6086621 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6086622 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6086624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.29 |
| 6086625 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $91,468.80 |
| 6086643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6086644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,235.20 |
| 6086654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6086655 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $27,840.00 |
| 6086658 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6086660 | CATHETER, GUIDING | Supply/Implant | $11,904.00 |
| 6086666 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6086667 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6086670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,905.60 |
| 6086671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6086677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6086678 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6086680 | STERILE SUPPLY | Supply/Implant | $5,184.00 |
| 6086681 | STERILE SUPPLY | Supply/Implant | $5,248.00 |
| 6086682 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6086683 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6086685 | INTRO/SHEATH, NON-LASER | Supply/Implant | $304.00 |
| 6086689 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6086698 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $14,289.66 |
| 6086699 | SUPPLY IMPLANT | Supply/Implant | $1,757.18 |
| 6086704 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6086705 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6086706 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6086858 | SUPPLY IMPLANT | Supply/Implant | $1,924.61 |
| 6086864 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6086865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6086866 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6086879 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6086895 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6086896 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6086928 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $40,960.00 |
| 6086929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,146.88 |
| 6086936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,512.00 |
| 6086937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6086992 | GUIDE WIRE | Supply/Implant | $1,720.32 |
| 6087037 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6087210 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,483.78 |
| 6087211 | SUPPLY IMPLANT | Supply/Implant | $1,483.78 |
| 6087212 | SUPPLY IMPLANT | Supply/Implant | $1,483.78 |
| 6087213 | SUPPLY IMPLANT | Supply/Implant | $1,483.78 |
| 6087266 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6087267 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6087268 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6087270 | SUPPLY IMPLANT | Supply/Implant | $1,744.77 |
| 6087271 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,702.40 |
| 6087278 | SUPPLY IMPLANT | Supply/Implant | $6,818.30 |
| 6087285 | SUPPLY IMPLANT | Supply/Implant | $2,470.40 |
| 6087287 | SUPPLY IMPLANT | Supply/Implant | $2,251.14 |
| 6087288 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,462.34 |
| 6087292 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,436.48 |
| 6087294 | SUPPLY IMPLANT | Supply/Implant | $2,200.45 |
| 6087296 | SUPPLY IMPLANT | Supply/Implant | $2,381.82 |
| 6087297 | SUPPLY IMPLANT | Supply/Implant | $2,259.33 |
| 6087298 | STERILE SUPPLY | Supply/Implant | $2,489.73 |
| 6087299 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,111.87 |
| 6087300 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,419.58 |
| 6087305 | SUPPLY IMPLANT | Supply/Implant | $2,011.14 |
| 6087316 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6087320 | CONN TISS, NON-HUMAN | Supply/Implant | $15,818.24 |
| 6087321 | SUPPLY IMPLANT | Supply/Implant | $7,488.00 |
| 6087328 | SUPPLY IMPLANT | Supply/Implant | $1,594.24 |
| 6087363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6087366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6087368 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6087369 | SUPPLY IMPLANT | Supply/Implant | $47,142.40 |
| 6087374 | SUPPLY IMPLANT | Supply/Implant | $7,104.38 |
| 6087395 | SUPPLY IMPLANT | Supply/Implant | $2,664.70 |
| 6087408 | CATHETER, GUIDING | Supply/Implant | $13,478.40 |
| 6087409 | CATHETER, GUIDING | Supply/Implant | $13,478.40 |
| 6087430 | SUPPLY IMPLANT | Supply/Implant | $12,038.40 |
| 6087476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6087518 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6087558 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,754.24 |
| 6087602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6087675 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6087688 | SUPPLY IMPLANT | Supply/Implant | $1,894.92 |
| 6087697 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6087699 | SUPPLY IMPLANT | Supply/Implant | $17,728.00 |
| 6087705 | SUPPLY IMPLANT | Supply/Implant | $3,136.38 |
| 6087730 | INTERSPINOUS IMPLANT | Supply/Implant | $16,889.60 |
| 6087747 | GUIDE WIRE | Supply/Implant | $216.83 |
| 6087748 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6087786 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6087788 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6087789 | RET DEV, INSERTABLE | Supply/Implant | $3,584.00 |
| 6087820 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6087827 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6087955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,734.40 |
| 6087985 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6088067 | GENERAL SUPPLY | Supply/Implant | $7,741.44 |
| 6088078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6088080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6088081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6088092 | SUPPLY IMPLANT | Supply/Implant | $1,617.92 |
| 6088099 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6088104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6088112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,732.80 |
| 6088153 | SUPPLY IMPLANT | Supply/Implant | $3,936.00 |
| 6088161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6088163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6088175 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6088176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6088179 | SUPPLY IMPLANT | Supply/Implant | $2,165.76 |
| 6088209 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6088211 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6088225 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088255 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $23,667.20 |
| 6088268 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6088270 | CATHETER, URETERAL | Supply/Implant | $286.77 |
| 6088273 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6088275 | SUPPLY IMPLANT | Supply/Implant | $405.89 |
| 6088282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6088283 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6088301 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6088318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6088319 | SUPPLY IMPLANT | Supply/Implant | $547.58 |
| 6088320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6088401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6088403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6088405 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6088406 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6088408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6088409 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6088411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6088412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6088422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6088427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $56,000.00 |
| 6088450 | SUPPLY IMPLANT | Supply/Implant | $1,039.36 |
| 6088451 | SUPPLY IMPLANT | Supply/Implant | $1,039.36 |
| 6088458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6088459 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6088464 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6088465 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6088475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6088477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,715.20 |
| 6088494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,721.60 |
| 6088496 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6088498 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6088504 | STERILE SUPPLY | Supply/Implant | $1,506.30 |
| 6088506 | SUPPLY IMPLANT | Supply/Implant | $3,454.21 |
| 6088510 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,280.00 |
| 6088512 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,280.00 |
| 6088515 | CATHETER, URETERAL | Supply/Implant | $234.62 |
| 6088516 | CATHETER, URETERAL | Supply/Implant | $138.24 |
| 6088518 | CATHETER, URETERAL | Supply/Implant | $232.96 |
| 6088532 | CATHETER, URETERAL | Supply/Implant | $207.17 |
| 6088535 | SUPPLY IMPLANT | Supply/Implant | $3,644.16 |
| 6088545 | SUPPLY IMPLANT | Supply/Implant | $1,450.24 |
| 6088546 | SUPPLY IMPLANT | Supply/Implant | $1,450.24 |
| 6088549 | SUPPLY IMPLANT | Supply/Implant | $3,444.48 |
| 6088552 | SUPPLY IMPLANT | Supply/Implant | $3,942.40 |
| 6088556 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6088557 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6088559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,265.60 |
| 6088563 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6088568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6088570 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088571 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6088572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6088575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6088576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6088577 | STERILE SUPPLY | Supply/Implant | $319.83 |
| 6088579 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6088585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6088586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6088588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6088590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6088591 | MESH (IMPLANTABLE) | Supply/Implant | $12,975.36 |
| 6088596 | SUPPLY IMPLANT | Supply/Implant | $696.32 |
| 6088597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,476.35 |
| 6088598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,828.35 |
| 6088599 | SUPPLY IMPLANT | Supply/Implant | $2,772.61 |
| 6088600 | SUPPLY IMPLANT | Supply/Implant | $2,772.61 |
| 6088601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,261.82 |
| 6088602 | SUPPLY IMPLANT | Supply/Implant | $1,478.40 |
| 6088604 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6088605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6088606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6088607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6088608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6088623 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6088629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6088632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6088633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6088634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6088635 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6088636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6088637 | SUPPLY IMPLANT | Supply/Implant | $21,440.00 |
| 6088651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6088652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6088653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6088654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6088655 | STERILE SUPPLY | Supply/Implant | $1,164.80 |
| 6088659 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6088661 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,841.60 |
| 6088664 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,312.13 |
| 6088666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6088669 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $6,690.82 |
| 6088670 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $6,690.82 |
| 6088676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.13 |
| 6088683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,567.87 |
| 6088685 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6088686 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6088687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6088690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6088691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6088702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,206.21 |
| 6088704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,356.42 |
| 6088705 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6088706 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6088709 | SUPPLY IMPLANT | Supply/Implant | $2,060.80 |
| 6088710 | SUPPLY IMPLANT | Supply/Implant | $2,403.20 |
| 6088711 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6088712 | CATHETER, GUIDING | Supply/Implant | $2,206.85 |
| 6088715 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6088717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,878.53 |
| 6088720 | GENERAL SUPPLY | Supply/Implant | $162.82 |
| 6088724 | SUPPLY IMPLANT | Supply/Implant | $169.73 |
| 6088725 | SUPPLY IMPLANT | Supply/Implant | $1,793.28 |
| 6088727 | GENERAL SUPPLY | Supply/Implant | $748.16 |
| 6088730 | GENERAL SUPPLY | Supply/Implant | $276.86 |
| 6088731 | GENERAL SUPPLY | Supply/Implant | $276.86 |
| 6088735 | SUPPLY IMPLANT | Supply/Implant | $1,090.82 |
| 6088742 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,680.00 |
| 6088745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6088754 | GENERAL SUPPLY | Supply/Implant | $1,536.00 |
| 6088755 | SUPPLY IMPLANT | Supply/Implant | $869.89 |
| 6088756 | SUPPLY IMPLANT | Supply/Implant | $869.89 |
| 6088760 | STERILE SUPPLY | Supply/Implant | $152.28 |
| 6088761 | GENERAL SUPPLY | Supply/Implant | $263.04 |
| 6088762 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6088774 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6088786 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088787 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088788 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088789 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088790 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088791 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088792 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6088796 | SUPPLY IMPLANT | Supply/Implant | $3,686.40 |
| 6088798 | SUPPLY IMPLANT | Supply/Implant | $416.97 |
| 6088799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6088800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6088808 | SUPPLY IMPLANT | Supply/Implant | $257.79 |
| 6088818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6088824 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6088826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6088830 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6088831 | SUPPLY IMPLANT | Supply/Implant | $4,147.20 |
| 6088835 | SUPPLY IMPLANT | Supply/Implant | $701.95 |
| 6088837 | GUIDE WIRE | Supply/Implant | $195.20 |
| 6088841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6088849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6088850 | STERILE SUPPLY | Supply/Implant | $985.96 |
| 6088853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,288.00 |
| 6088855 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6088857 | SUPPLY IMPLANT | Supply/Implant | $1,833.28 |
| 6088858 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6088859 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6088866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6088867 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088869 | SUPPLY IMPLANT | Supply/Implant | $3,660.80 |
| 6088877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6088879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088891 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6088892 | GENERAL SUPPLY | Supply/Implant | $222.72 |
| 6088893 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6088894 | GENERAL SUPPLY | Supply/Implant | $222.72 |
| 6088895 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6088896 | GENERAL SUPPLY | Supply/Implant | $1,216.00 |
| 6088897 | CATHETER, GUIDING | Supply/Implant | $11,904.00 |
| 6088898 | SUPPLY IMPLANT | Supply/Implant | $599.04 |
| 6088899 | CATHETER, URETERAL | Supply/Implant | $190.59 |
| 6088900 | CATHETER, URETERAL | Supply/Implant | $301.70 |
| 6088901 | CATHETER, URETERAL | Supply/Implant | $186.75 |
| 6088902 | CATHETER, URETERAL | Supply/Implant | $303.10 |
| 6088905 | SUPPLY IMPLANT | Supply/Implant | $1,718.53 |
| 6088907 | SUPPLY IMPLANT | Supply/Implant | $1,544.96 |
| 6088908 | ARTHROFLEX PER 1 SQ CM | Supply/Implant | $49,280.00 |
| 6088915 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6088916 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6088917 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6088920 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088921 | SUPPLY IMPLANT | Supply/Implant | $10,530.78 |
| 6088922 | SUPPLY IMPLANT | Supply/Implant | $11,991.45 |
| 6088923 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,867.20 |
| 6088930 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6088931 | INTRO/SHEATH, NON-LASER | Supply/Implant | $443.52 |
| 6088936 | GENERAL SUPPLY | Supply/Implant | $174.72 |
| 6088945 | SUPPLY IMPLANT | Supply/Implant | $3,148.80 |
| 6088946 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6088947 | ALLODERM SKIN SUB | Supply/Implant | $52,620.80 |
| 6088965 | SUPPLY IMPLANT | Supply/Implant | $109,410.00 |
| 6088972 | CONN TISS, NON-HUMAN | Supply/Implant | $2,659.20 |
| 6088974 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6088976 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6088977 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6088978 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6088979 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $106,752.00 |
| 6088982 | STERILE SUPPLY | Supply/Implant | $1,611.90 |
| 6088983 | STERILE SUPPLY | Supply/Implant | $1,296.38 |
| 6088986 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6089027 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6089028 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6089033 | SUPPLY IMPLANT | Supply/Implant | $332.16 |
| 6089037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6089044 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $492.16 |
| 6089045 | INTRO/SHEATH, NON-LASER | Supply/Implant | $492.16 |
| 6089048 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6089050 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089051 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089052 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089057 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $17,920.00 |
| 6089060 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6089061 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089070 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6089071 | SUPPLY IMPLANT | Supply/Implant | $160.00 |
| 6089073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6089082 | SUPPLY IMPLANT | Supply/Implant | $7,321.60 |
| 6089087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,725.70 |
| 6089088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,860.80 |
| 6089098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6089099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6089100 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6089102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6089107 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6089108 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6089109 | INTRO/SHEATH, NON-LASER | Supply/Implant | $280.96 |
| 6089110 | INTRO/SHEATH, NON-LASER | Supply/Implant | $280.96 |
| 6089111 | INTRO/SHEATH, NON-LASER | Supply/Implant | $280.96 |
| 6089114 | SUPPLY IMPLANT | Supply/Implant | $3,193.34 |
| 6089117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6089118 | PMKR, DUAL, RATE-RESP | Supply/Implant | $65,088.00 |
| 6089123 | CATHETER, GUIDING | Supply/Implant | $304.00 |
| 6089126 | SUPPLY IMPLANT | Supply/Implant | $15,296.00 |
| 6089129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6089133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6089134 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6089139 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6089141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6089144 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6089146 | SUPPLY IMPLANT | Supply/Implant | $2,173.06 |
| 6089150 | SUPPLY IMPLANT | Supply/Implant | $473.60 |
| 6089151 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6089152 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6089153 | SUPPLY IMPLANT | Supply/Implant | $283.90 |
| 6089154 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6089157 | SUPPLY IMPLANT | Supply/Implant | $17,561.60 |
| 6089162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6089163 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6089164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6089165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6089166 | GENERAL SUPPLY | Supply/Implant | $5,145.60 |
| 6089167 | GRAFT, VASCULAR | Supply/Implant | $44,800.00 |
| 6089177 | GENERAL SUPPLY | Supply/Implant | $364.80 |
| 6089184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6089185 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6089188 | SUPPLY IMPLANT | Supply/Implant | $1,226.75 |
| 6089189 | SUPPLY IMPLANT | Supply/Implant | $1,226.75 |
| 6089193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6089196 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089197 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6089199 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089200 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6089201 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089202 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089203 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6089207 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6089208 | SUPPLY IMPLANT | Supply/Implant | $2,450.94 |
| 6089210 | STERILE SUPPLY | Supply/Implant | $5,145.60 |
| 6089212 | STERILE SUPPLY | Supply/Implant | $1,011.20 |
| 6089215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6089218 | SUPPLY IMPLANT | Supply/Implant | $5,794.65 |
| 6089232 | COCHLEAR DEVICE | Supply/Implant | $221,190.00 |
| 6089238 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6089239 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6089242 | RET DEV, INSERTABLE | Supply/Implant | $2,873.34 |
| 6089258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6089259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6089263 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $25,600.00 |
| 6089264 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,387.20 |
| 6089275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6089276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6089277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $119,962.50 |
| 6089278 | SUPPLY IMPLANT | Supply/Implant | $4,113.92 |
| 6089279 | SUPPLY IMPLANT | Supply/Implant | $4,113.92 |
| 6089280 | SUPPLY IMPLANT | Supply/Implant | $5,939.20 |
| 6089281 | SUPPLY IMPLANT | Supply/Implant | $5,939.20 |
| 6089282 | SUPPLY IMPLANT | Supply/Implant | $9,152.00 |
| 6089283 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089284 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089285 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089286 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089287 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089306 | GENERAL SUPPLY | Supply/Implant | $3,072.00 |
| 6089322 | SUPPLY IMPLANT | Supply/Implant | $7,692.80 |
| 6089334 | STERILE SUPPLY | Supply/Implant | $3,010.56 |
| 6089335 | GENERAL SUPPLY | Supply/Implant | $3,010.56 |
| 6089368 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6089376 | GENERAL SUPPLY | Supply/Implant | $2,931.46 |
| 6089380 | GENERAL SUPPLY | Supply/Implant | $930.69 |
| 6089394 | GENERAL SUPPLY | Supply/Implant | $538.24 |
| 6089399 | GENERAL SUPPLY | Supply/Implant | $481.66 |
| 6089400 | GENERAL SUPPLY | Supply/Implant | $443.65 |
| 6089405 | GENERAL SUPPLY | Supply/Implant | $550.40 |
| 6089406 | GENERAL SUPPLY | Supply/Implant | $597.12 |
| 6089414 | GENERAL SUPPLY | Supply/Implant | $1,145.60 |
| 6089422 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6089426 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $423.42 |
| 6089449 | STERILE SUPPLY | Supply/Implant | $414.72 |
| 6089485 | SUPPLY IMPLANT | Supply/Implant | $403.29 |
| 6089504 | GENERAL SUPPLY | Supply/Implant | $396.80 |
| 6089566 | GENERAL SUPPLY | Supply/Implant | $752.26 |
| 6089573 | GENERAL SUPPLY | Supply/Implant | $390.78 |
| 6089581 | GENERAL SUPPLY | Supply/Implant | $692.99 |
| 6089588 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6089601 | GENERAL SUPPLY | Supply/Implant | $555.39 |
| 6089887 | GENERAL SUPPLY | Supply/Implant | $377.60 |
| 6089903 | STERILE SUPPLY | Supply/Implant | $432.00 |
| 6089914 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6089930 | GENERAL SUPPLY | Supply/Implant | $658.56 |
| 6089931 | GENERAL SUPPLY | Supply/Implant | $447.74 |
| 6089945 | GENERAL SUPPLY | Supply/Implant | $364.42 |
| 6089950 | GENERAL SUPPLY | Supply/Implant | $363.65 |
| 6089966 | GENERAL SUPPLY | Supply/Implant | $358.14 |
| 6090006 | GENERAL SUPPLY | Supply/Implant | $348.80 |
| 6090009 | GENERAL SUPPLY | Supply/Implant | $348.29 |
| 6090017 | GENERAL SUPPLY | Supply/Implant | $345.60 |
| 6090032 | GENERAL SUPPLY | Supply/Implant | $345.60 |
| 6090043 | SUPPLY IMPLANT | Supply/Implant | $335.74 |
| 6090059 | GENERAL SUPPLY | Supply/Implant | $329.73 |
| 6090072 | GENERAL SUPPLY | Supply/Implant | $326.40 |
| 6090088 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6090110 | GENERAL SUPPLY | Supply/Implant | $316.80 |
| 6090120 | SUPPLY IMPLANT | Supply/Implant | $313.60 |
| 6090156 | SUPPLY IMPLANT | Supply/Implant | $302.72 |
| 6090173 | GENERAL SUPPLY | Supply/Implant | $298.62 |
| 6090184 | CATHETER, URETERAL | Supply/Implant | $297.60 |
| 6090185 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090186 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090187 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090188 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090192 | GENERAL SUPPLY | Supply/Implant | $294.91 |
| 6090200 | GENERAL SUPPLY | Supply/Implant | $292.48 |
| 6090216 | GENERAL SUPPLY | Supply/Implant | $290.56 |
| 6090218 | GENERAL SUPPLY | Supply/Implant | $480.51 |
| 6090223 | GENERAL SUPPLY | Supply/Implant | $324.61 |
| 6090241 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6090246 | GENERAL SUPPLY | Supply/Implant | $339.20 |
| 6090255 | GENERAL SUPPLY | Supply/Implant | $393.86 |
| 6090282 | GENERAL SUPPLY | Supply/Implant | $461.44 |
| 6090294 | GENERAL SUPPLY | Supply/Implant | $303.72 |
| 6090305 | GENERAL SUPPLY | Supply/Implant | $270.85 |
| 6090307 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $270.59 |
| 6090308 | GENERAL SUPPLY | Supply/Implant | $352.64 |
| 6090324 | GENERAL SUPPLY | Supply/Implant | $268.16 |
| 6090331 | GENERAL SUPPLY | Supply/Implant | $358.66 |
| 6090343 | GENERAL SUPPLY | Supply/Implant | $262.40 |
| 6090360 | GENERAL SUPPLY | Supply/Implant | $258.56 |
| 6090410 | GENERAL SUPPLY | Supply/Implant | $354.30 |
| 6090427 | GENERAL SUPPLY | Supply/Implant | $243.33 |
| 6090440 | GENERAL SUPPLY | Supply/Implant | $242.30 |
| 6090464 | STERILE SUPPLY | Supply/Implant | $238.00 |
| 6090477 | SUPPLY IMPLANT | Supply/Implant | $234.11 |
| 6090504 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6090550 | GENERAL SUPPLY | Supply/Implant | $221.18 |
| 6090555 | GENERAL SUPPLY | Supply/Implant | $1,385.60 |
| 6090558 | GENERAL SUPPLY | Supply/Implant | $372.48 |
| 6090565 | GUIDE WIRE | Supply/Implant | $217.60 |
| 6090568 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6090579 | GENERAL SUPPLY | Supply/Implant | $215.68 |
| 6090591 | GENERAL SUPPLY | Supply/Implant | $381.57 |
| 6090600 | GENERAL SUPPLY | Supply/Implant | $211.20 |
| 6090608 | SUPPLY IMPLANT | Supply/Implant | $211.20 |
| 6090626 | GENERAL SUPPLY | Supply/Implant | $207.36 |
| 6090629 | GENERAL SUPPLY | Supply/Implant | $206.72 |
| 6090638 | GENERAL SUPPLY | Supply/Implant | $204.80 |
| 6090663 | GENERAL SUPPLY | Supply/Implant | $329.22 |
| 6090672 | GENERAL SUPPLY | Supply/Implant | $202.75 |
| 6090674 | GENERAL SUPPLY | Supply/Implant | $202.62 |
| 6090691 | GENERAL SUPPLY | Supply/Implant | $200.19 |
| 6090762 | GENERAL SUPPLY | Supply/Implant | $390.91 |
| 6090765 | GENERAL SUPPLY | Supply/Implant | $191.68 |
| 6090795 | GENERAL SUPPLY | Supply/Implant | $187.90 |
| 6090806 | GENERAL SUPPLY | Supply/Implant | $497.15 |
| 6090822 | GENERAL SUPPLY | Supply/Implant | $185.60 |
| 6090840 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6090846 | GENERAL SUPPLY | Supply/Implant | $182.66 |
| 6090848 | SUPPLY IMPLANT | Supply/Implant | $182.53 |
| 6090878 | STERILE SUPPLY | Supply/Implant | $213.89 |
| 6090882 | GENERAL SUPPLY | Supply/Implant | $178.56 |
| 6090885 | GENERAL SUPPLY | Supply/Implant | $196.70 |
| 6090886 | GENERAL SUPPLY | Supply/Implant | $239.74 |
| 6090887 | GENERAL SUPPLY | Supply/Implant | $249.22 |
| 6090892 | GENERAL SUPPLY | Supply/Implant | $183.04 |
| 6090897 | GENERAL SUPPLY | Supply/Implant | $176.33 |
| 6090913 | GENERAL SUPPLY | Supply/Implant | $307.37 |
| 6090944 | GENERAL SUPPLY | Supply/Implant | $194.05 |
| 6090953 | GENERAL SUPPLY | Supply/Implant | $167.42 |
| 6090982 | STERILE SUPPLY | Supply/Implant | $164.48 |
| 6090983 | GENERAL SUPPLY | Supply/Implant | $164.26 |
| 6090991 | SUPPLY IMPLANT | Supply/Implant | $265.22 |
| 6090997 | GENERAL SUPPLY | Supply/Implant | $302.98 |
| 6091000 | GENERAL SUPPLY | Supply/Implant | $162.43 |
| 6091004 | SUPPLY IMPLANT | Supply/Implant | $161.92 |
| 6091016 | STERILE SUPPLY | Supply/Implant | $173.70 |
| 6091033 | STERILE SUPPLY | Supply/Implant | $164.99 |
| 6091043 | CATHETER, URETERAL | Supply/Implant | $158.34 |
| 6091046 | GENERAL SUPPLY | Supply/Implant | $247.71 |
| 6091047 | GENERAL SUPPLY | Supply/Implant | $158.21 |
| 6091049 | GENERAL SUPPLY | Supply/Implant | $258.18 |
| 6091054 | GENERAL SUPPLY | Supply/Implant | $176.77 |
| 6091106 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6091114 | GENERAL SUPPLY | Supply/Implant | $152.32 |
| 6091125 | STERILE SUPPLY | Supply/Implant | $220.80 |
| 6091141 | STERILE SUPPLY | Supply/Implant | $149.25 |
| 6091150 | GENERAL SUPPLY | Supply/Implant | $220.67 |
| 6091154 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6091157 | GENERAL SUPPLY | Supply/Implant | $146.69 |
| 6091161 | GENERAL SUPPLY | Supply/Implant | $247.07 |
| 6091192 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6091193 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6091198 | SUPPLY IMPLANT | Supply/Implant | $258.69 |
| 6091199 | SUPPLY IMPLANT | Supply/Implant | $258.69 |
| 6091215 | CATHETER, URETERAL | Supply/Implant | $258.18 |
| 6091216 | CATHETER, URETERAL | Supply/Implant | $149.76 |
| 6091232 | GENERAL SUPPLY | Supply/Implant | $140.54 |
| 6091239 | STERILE SUPPLY | Supply/Implant | $168.45 |
| 6091259 | GENERAL SUPPLY | Supply/Implant | $150.53 |
| 6091265 | GENERAL SUPPLY | Supply/Implant | $137.34 |
| 6091267 | GENERAL SUPPLY | Supply/Implant | $137.22 |
| 6091274 | GENERAL SUPPLY | Supply/Implant | $154.62 |
| 6091283 | GENERAL SUPPLY | Supply/Implant | $135.30 |
| 6091288 | SUPPLY IMPLANT | Supply/Implant | $134.53 |
| 6091289 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6091290 | GENERAL SUPPLY | Supply/Implant | $154.11 |
| 6091294 | SUPPLY IMPLANT | Supply/Implant | $176.38 |
| 6091300 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6091301 | STERILE SUPPLY | Supply/Implant | $134.40 |
| 6091302 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6091303 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6091306 | GENERAL SUPPLY | Supply/Implant | $134.14 |
| 6091318 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6091348 | STERILE SUPPLY | Supply/Implant | $128.77 |
| 6091366 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6091368 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6091441 | GENERAL SUPPLY | Supply/Implant | $467.84 |
| 6091478 | GENERAL SUPPLY | Supply/Implant | $182.66 |
| 6091733 | GENERAL SUPPLY | Supply/Implant | $376.32 |
| 6091747 | GENERAL SUPPLY | Supply/Implant | $133.12 |
| 6091758 | GENERAL SUPPLY | Supply/Implant | $166.25 |
| 6091767 | GENERAL SUPPLY | Supply/Implant | $138.24 |
| 6091778 | STERILE SUPPLY | Supply/Implant | $180.35 |
| 6091843 | SUPPLY IMPLANT | Supply/Implant | $365.36 |
| 6091870 | GENERAL SUPPLY | Supply/Implant | $182.23 |
| 6092462 | STERILE SUPPLY | Supply/Implant | $226.65 |
| 6092464 | STERILE SUPPLY | Supply/Implant | $236.60 |
| 6092482 | GENERAL SUPPLY | Supply/Implant | $185.22 |
| 6092946 | STERILE SUPPLY | Supply/Implant | $241.66 |
| 6093502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6093506 | GENERAL SUPPLY | Supply/Implant | $490.24 |
| 6093519 | SUPPLY IMPLANT | Supply/Implant | $1,518.72 |
| 6093521 | SUPPLY IMPLANT | Supply/Implant | $1,287.91 |
| 6093528 | SUPPLY IMPLANT | Supply/Implant | $1,041.92 |
| 6093535 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6093542 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6093543 | SUPPLY IMPLANT | Supply/Implant | $1,161.60 |
| 6093546 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6093547 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6093550 | SUPPLY IMPLANT | Supply/Implant | $1,203.20 |
| 6093553 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6093554 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6093572 | SUPPLY IMPLANT | Supply/Implant | $860.54 |
| 6093576 | SUPPLY IMPLANT | Supply/Implant | $500.22 |
| 6093577 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6093588 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6093604 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6093684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6093708 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6093727 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6093734 | SUPPLY IMPLANT | Supply/Implant | $531.20 |
| 6093744 | SUPPLY IMPLANT | Supply/Implant | $1,236.48 |
| 6093745 | INTRO/SHEATH, NON-LASER | Supply/Implant | $774.14 |
| 6093752 | SUPPLY IMPLANT | Supply/Implant | $1,182.72 |
| 6093753 | CATHETER, URETERAL | Supply/Implant | $218.24 |
| 6093765 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6093827 | SUPPLY IMPLANT | Supply/Implant | $343.68 |
| 6093829 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6093830 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093831 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093832 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093833 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093834 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6093836 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093837 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093838 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6093840 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093844 | CATH, DRAINAGE | Supply/Implant | $1,344.00 |
| 6093848 | SUPPLY IMPLANT | Supply/Implant | $1,164.80 |
| 6093850 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6093853 | SUPPLY IMPLANT | Supply/Implant | $1,038.59 |
| 6093874 | STERILE SUPPLY | Supply/Implant | $1,152.00 |
| 6093884 | SUPPLY IMPLANT | Supply/Implant | $908.80 |
| 6093889 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6093899 | PORT, INDWELLING, IMP | Supply/Implant | $577.02 |
| 6093902 | SUPPLY IMPLANT | Supply/Implant | $754.30 |
| 6093920 | SUPPLY IMPLANT | Supply/Implant | $1,337.86 |
| 6093921 | SUPPLY IMPLANT | Supply/Implant | $969.84 |
| 6093926 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093928 | SUPPLY IMPLANT | Supply/Implant | $669.36 |
| 6093935 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6093938 | CONN TISS, NON-HUMAN | Supply/Implant | $4,224.64 |
| 6093941 | SUPPLY IMPLANT | Supply/Implant | $527.87 |
| 6093942 | SUPPLY IMPLANT | Supply/Implant | $1,458.87 |
| 6093951 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6093954 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6093961 | SUPPLY IMPLANT | Supply/Implant | $435.71 |
| 6093970 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6093977 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6093978 | SUPPLY IMPLANT | Supply/Implant | $1,559.10 |
| 6093994 | SUPPLY IMPLANT | Supply/Implant | $578.69 |
| 6093997 | SUPPLY IMPLANT | Supply/Implant | $404.99 |
| 6094001 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6094002 | SUPPLY IMPLANT | Supply/Implant | $427.78 |
| 6094009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6094010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6094013 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6094018 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6094045 | GUIDE WIRE | Supply/Implant | $433.92 |
| 6094067 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6094068 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6094071 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6094072 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6094085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6094091 | GUIDE WIRE | Supply/Implant | $373.12 |
| 6094106 | SUPPLY IMPLANT | Supply/Implant | $331.01 |
| 6094112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094128 | SUPPLY IMPLANT | Supply/Implant | $307.33 |
| 6094129 | SUPPLY IMPLANT | Supply/Implant | $284.80 |
| 6094130 | SUPPLY IMPLANT | Supply/Implant | $648.58 |
| 6094132 | SUPPLY IMPLANT | Supply/Implant | $284.80 |
| 6094158 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6094159 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6094164 | INTRO/SHEATH, NON-LASER | Supply/Implant | $261.63 |
| 6094203 | GUIDE WIRE | Supply/Implant | $154.75 |
| 6094235 | SUPPLY IMPLANT | Supply/Implant | $188.16 |
| 6094236 | SUPPLY IMPLANT | Supply/Implant | $138.24 |
| 6094237 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6094239 | SUPPLY IMPLANT | Supply/Implant | $274.71 |
| 6094240 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6094256 | SUPPLY IMPLANT | Supply/Implant | $1,232.64 |
| 6094291 | SUPPLY IMPLANT | Supply/Implant | $131.46 |
| 6094401 | SUPPLY IMPLANT | Supply/Implant | $154.66 |
| 6094781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6094782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6094790 | SUPPLY IMPLANT | Supply/Implant | $588.03 |
| 6094791 | CLOSURE DEV, VASC | Supply/Implant | $2,026.88 |
| 6094792 | INTRO/SHEATH, NON-LASER | Supply/Implant | $900.35 |
| 6094793 | GUIDE WIRE | Supply/Implant | $1,497.60 |
| 6094823 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6094824 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6094825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,988.80 |
| 6094827 | SUPPLY IMPLANT | Supply/Implant | $368.51 |
| 6094828 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6094831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,909.50 |
| 6094834 | SUPPLY IMPLANT | Supply/Implant | $1,617.66 |
| 6094839 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6094840 | STERILE SUPPLY | Supply/Implant | $684.53 |
| 6094844 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6094847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6094853 | SUPPLY IMPLANT | Supply/Implant | $1,665.54 |
| 6094855 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6094858 | SUPPLY IMPLANT | Supply/Implant | $3,442.69 |
| 6094861 | GENERAL SUPPLY | Supply/Implant | $406.02 |
| 6094863 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,287.94 |
| 6094871 | STERILE SUPPLY | Supply/Implant | $3,000.96 |
| 6094872 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6094873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,996.29 |
| 6094881 | GENERAL SUPPLY | Supply/Implant | $11,831.55 |
| 6094888 | SUPPLY IMPLANT | Supply/Implant | $626.33 |
| 6094889 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094891 | STERILE SUPPLY | Supply/Implant | $206.72 |
| 6094892 | STERILE SUPPLY | Supply/Implant | $437.76 |
| 6094893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6094895 | SUPPLY IMPLANT | Supply/Implant | $32,320.00 |
| 6094915 | COCHLEAR DEVICE | Supply/Implant | $338,350.00 |
| 6094919 | STERILE SUPPLY | Supply/Implant | $703.36 |
| 6094920 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094921 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094922 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094923 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094924 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094925 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094926 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094927 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094928 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094929 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094931 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094934 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094935 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094938 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094939 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094940 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,856.00 |
| 6094941 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094942 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094944 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094947 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094948 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094951 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094952 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094953 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094954 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094955 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094957 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094960 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094966 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094967 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094968 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094973 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094979 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094990 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094991 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6094992 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6094993 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094994 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094995 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094997 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095000 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095001 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095002 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095003 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095005 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095007 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095009 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095010 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095016 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095017 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095018 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095019 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095020 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095022 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095023 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095025 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095027 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095028 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095029 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095030 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095031 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095033 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095036 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095037 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095038 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095039 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095040 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095042 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6095043 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6095044 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6095045 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6095050 | GENERAL SUPPLY | Supply/Implant | $441.60 |
| 6095058 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,291.20 |
| 6095066 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095068 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095070 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6095072 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,800.00 |
| 6095074 | SUPPLY IMPLANT | Supply/Implant | $1,157.12 |
| 6095076 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6095081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,804.80 |
| 6095084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,149.76 |
| 6095089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,616.00 |
| 6095090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6095091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6095092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,141.44 |
| 6095095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6095096 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6095097 | SUPPLY IMPLANT | Supply/Implant | $3,417.60 |
| 6095098 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6095099 | SUPPLY IMPLANT | Supply/Implant | $3,686.40 |
| 6095100 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6095102 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6095104 | CATHETER, GUIDING | Supply/Implant | $440.45 |
| 6095116 | GRAFT, VASCULAR | Supply/Implant | $57,830.40 |
| 6095119 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6095120 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6095121 | GENERAL SUPPLY | Supply/Implant | $704.00 |
| 6095126 | SUPPLY IMPLANT | Supply/Implant | $23,367.68 |
| 6095127 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6095134 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6095135 | SUPPLY IMPLANT | Supply/Implant | $2,721.59 |
| 6095140 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6095141 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6095147 | STERILE SUPPLY | Supply/Implant | $316.80 |
| 6095148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6095151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6095160 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6095166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095169 | GENERAL SUPPLY | Supply/Implant | $311.46 |
| 6095172 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,381.57 |
| 6095173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,350.40 |
| 6095174 | SUPPLY IMPLANT | Supply/Implant | $4,057.60 |
| 6095179 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $26,342.40 |
| 6095182 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6095188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095189 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095190 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,056.00 |
| 6095203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095204 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6095208 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6095253 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6095254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6095255 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6095256 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6095257 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,760.00 |
| 6095259 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095260 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095261 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6095262 | GENERAL SUPPLY | Supply/Implant | $437.89 |
| 6095267 | SUPPLY IMPLANT | Supply/Implant | $15,296.00 |
| 6095268 | SUPPLY IMPLANT | Supply/Implant | $458.34 |
| 6095274 | STERILE SUPPLY | Supply/Implant | $569.60 |
| 6095275 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6095292 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095295 | STERILE SUPPLY | Supply/Implant | $692.86 |
| 6095296 | GENERAL SUPPLY | Supply/Implant | $719.49 |
| 6095297 | SUPPLY IMPLANT | Supply/Implant | $2,302.85 |
| 6095303 | SUPPLY IMPLANT | Supply/Implant | $1,436.54 |
| 6095311 | SUPPLY IMPLANT | Supply/Implant | $17,395.20 |
| 6095313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6095316 | INTERSPINOUS IMPLANT | Supply/Implant | $32,320.00 |
| 6095317 | INTERSPINOUS IMPLANT | Supply/Implant | $32,320.00 |
| 6095319 | GENERAL SUPPLY | Supply/Implant | $298.11 |
| 6095324 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6095333 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095337 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6095338 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6095345 | CATHETER, GUIDING | Supply/Implant | $4,441.60 |
| 6095346 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6095347 | SUPPLY IMPLANT | Supply/Implant | $5,007.78 |
| 6095348 | SUPPLY IMPLANT | Supply/Implant | $5,712.64 |
| 6095349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6095351 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6095353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6095355 | SUPPLY IMPLANT | Supply/Implant | $160.26 |
| 6095360 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $10,752.00 |
| 6095374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,480.00 |
| 6095375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,480.00 |
| 6095376 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6095379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,936.00 |
| 6095384 | GENERAL SUPPLY | Supply/Implant | $204.80 |
| 6095385 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6095386 | GENERAL SUPPLY | Supply/Implant | $204.80 |
| 6095387 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6095390 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6095391 | STERILE SUPPLY | Supply/Implant | $849.15 |
| 6095395 | GENERAL SUPPLY | Supply/Implant | $593.28 |
| 6095406 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6095414 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6095432 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095433 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095434 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095435 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095441 | GRAFT, VASCULAR | Supply/Implant | $15,475.20 |
| 6095444 | GRAFT, VASCULAR | Supply/Implant | $24,902.78 |
| 6095467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,440.00 |
| 6095476 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6095489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6095492 | GENERAL SUPPLY | Supply/Implant | $692.86 |
| 6095496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $93,747.20 |
| 6095500 | GENERAL SUPPLY | Supply/Implant | $500.48 |
| 6095501 | GENERAL SUPPLY | Supply/Implant | $500.48 |
| 6095502 | STERILE SUPPLY | Supply/Implant | $1,452.01 |
| 6095506 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6095516 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095517 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6095518 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6095522 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6095527 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6095529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,639.68 |
| 6095540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6095541 | STERILE SUPPLY | Supply/Implant | $843.89 |
| 6095544 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6095547 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $127,692.80 |
| 6095548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6095549 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6095550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6095560 | SUPPLY IMPLANT | Supply/Implant | $88,320.00 |
| 6095561 | SUPPLY IMPLANT | Supply/Implant | $9,081.60 |
| 6095564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6095567 | SUPPLY IMPLANT | Supply/Implant | $8,896.00 |
| 6095571 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6095572 | SUPPLY IMPLANT | Supply/Implant | $2,790.40 |
| 6095574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,684.80 |
| 6095575 | CATHETER, GUIDING | Supply/Implant | $192.00 |
| 6095579 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095580 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6095582 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6095585 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,174.40 |
| 6095589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6095591 | SUPPLY IMPLANT | Supply/Implant | $15,552.00 |
| 6095595 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $16,128.00 |
| 6095600 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6095604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6095605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6095607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6095608 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095611 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095615 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095616 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095619 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095620 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095625 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095629 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095633 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095639 | SUPPLY IMPLANT | Supply/Implant | $92,800.00 |
| 6095643 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6095644 | SUPPLY IMPLANT | Supply/Implant | $1,064.26 |
| 6095654 | SUPPLY IMPLANT | Supply/Implant | $311.17 |
| 6095666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095669 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6095670 | GENERAL SUPPLY | Supply/Implant | $1,185.92 |
| 6095672 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $110,272.00 |
| 6095677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,079.23 |
| 6095679 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $55,040.00 |
| 6095680 | SUPPLY IMPLANT | Supply/Implant | $4,178.05 |
| 6095681 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $29,427.20 |
| 6095683 | INTERSPINOUS IMPLANT | Supply/Implant | $75,008.00 |
| 6095684 | SUPPLY IMPLANT | Supply/Implant | $2,524.16 |
| 6095687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,320.00 |
| 6095696 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6095708 | CATHETER, URETERAL | Supply/Implant | $327.04 |
| 6095715 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6095718 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6095738 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6095739 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6095741 | SUPPLY IMPLANT | Supply/Implant | $10,331.37 |
| 6095748 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6095753 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6095755 | SUPPLY IMPLANT | Supply/Implant | $7,936.00 |
| 6095757 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6095759 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6095770 | BRACHYTHERAPY NEEDLE | Supply/Implant | $2,496.00 |
| 6095775 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,542.91 |
| 6095781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6095788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6095794 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6095795 | GUIDE WIRE | Supply/Implant | $332.80 |
| 6095796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6095797 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6095798 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6095799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,754.75 |
| 6095800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,893.25 |
| 6095801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,383.81 |
| 6095811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6095815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6095817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6095825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6095826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6095827 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6095829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6095830 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6095831 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6095840 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6095853 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6095855 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $16,611.84 |
| 6095857 | STERILE SUPPLY | Supply/Implant | $5,568.00 |
| 6095858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6095859 | SUPPLY IMPLANT | Supply/Implant | $1,485.18 |
| 6095861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6095865 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6095866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6095867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095869 | SUPPLY IMPLANT | Supply/Implant | $3,199.36 |
| 6095871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,872.00 |
| 6095872 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,020.80 |
| 6095875 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6095876 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,977.60 |
| 6095877 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6095878 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,417.60 |
| 6095880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,457.60 |
| 6095882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,457.60 |
| 6095885 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6095888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6095889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,818.56 |
| 6095890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,021.44 |
| 6095892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,490.88 |
| 6095896 | SUPPLY IMPLANT | Supply/Implant | $3,494.40 |
| 6095897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,476.80 |
| 6095899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6095907 | STERILE SUPPLY | Supply/Implant | $250.11 |
| 6095908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6095918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6095920 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $13,555.20 |
| 6095921 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6095922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6095923 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,459.39 |
| 6095926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6095927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6095930 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6095931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6095932 | GENERAL SUPPLY | Supply/Implant | $185.20 |
| 6095933 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6095934 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6095936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,287.94 |
| 6095943 | SUPPLY IMPLANT | Supply/Implant | $195,108.06 |
| 6095950 | SUPPLY IMPLANT | Supply/Implant | $8,803.20 |
| 6095953 | GENERAL SUPPLY | Supply/Implant | $553.22 |
| 6095955 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $15,360.00 |
| 6095956 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $15,360.00 |
| 6095958 | LEAD, NEUROSTIMULATOR | Supply/Implant | $32,000.00 |
| 6095959 | LEAD, NEUROSTIMULATOR | Supply/Implant | $32,000.00 |
| 6095962 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $15,360.00 |
| 6095964 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $23,040.00 |
| 6095969 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095970 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095971 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095973 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6095974 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095975 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,560.00 |
| 6095981 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $10,240.00 |
| 6095983 | GENERAL DRUG | Supply/Implant | $208.83 |
| 6095984 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6095992 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6095997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096001 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6096003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096008 | STERILE SUPPLY | Supply/Implant | $454.14 |
| 6096034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6096036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6096041 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6096042 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,760.00 |
| 6096046 | GENERAL SUPPLY | Supply/Implant | $362.62 |
| 6096047 | GENERAL SUPPLY | Supply/Implant | $369.15 |
| 6096050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6096051 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6096052 | CATHETER, GUIDING | Supply/Implant | $25,536.00 |
| 6096064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6096069 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6096071 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6096073 | STERILE SUPPLY | Supply/Implant | $159.21 |
| 6096074 | STERILE SUPPLY | Supply/Implant | $236.54 |
| 6096079 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6096095 | CATHETER, GUIDING | Supply/Implant | $31,616.00 |
| 6096097 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6096098 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6096099 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6096102 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6096104 | STERILE SUPPLY | Supply/Implant | $5,568.00 |
| 6096105 | SUPPLY IMPLANT | Supply/Implant | $92,800.00 |
| 6096107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6096112 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,840.00 |
| 6096114 | SUPPLY IMPLANT | Supply/Implant | $28,206.08 |
| 6096115 | AICD, DUAL CHAMBER | Supply/Implant | $193,315.50 |
| 6096122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6096123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6096129 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6096130 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6096131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6096135 | GENERAL SUPPLY | Supply/Implant | $315.52 |
| 6096137 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6096138 | GENERAL SUPPLY | Supply/Implant | $156.03 |
| 6096139 | GENERAL SUPPLY | Supply/Implant | $155.26 |
| 6096147 | SUPPLY IMPLANT | Supply/Implant | $178.82 |
| 6096150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,754.75 |
| 6096151 | SUPPLY IMPLANT | Supply/Implant | $3,408.00 |
| 6096153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096155 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096156 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6096175 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6096176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096180 | MESH (IMPLANTABLE) | Supply/Implant | $28,552.70 |
| 6096186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6096187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6096188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6096191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6096205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6096210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6096213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.83 |
| 6096215 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096236 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096237 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096241 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6096245 | MISC SUP/ACC IMP VAD | Supply/Implant | $135.68 |
| 6096275 | SUPPLY IMPLANT | Supply/Implant | $563.20 |
| 6096402 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6096403 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6096404 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6096405 | SUPPLY IMPLANT | Supply/Implant | $20,685.18 |
| 6096406 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $107,200.00 |
| 6096407 | GENERAL SUPPLY | Supply/Implant | $1,406.72 |
| 6096417 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,083.20 |
| 6096419 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6096420 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6096421 | SUPPLY IMPLANT | Supply/Implant | $4,473.60 |
| 6096424 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6096425 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6096428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,881.28 |
| 6096429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6096430 | MESH (IMPLANTABLE) | Supply/Implant | $14,195.46 |
| 6096432 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6096438 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6096441 | INTERSPINOUS IMPLANT | Supply/Implant | $75,008.00 |
| 6096454 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6096460 | MESH (IMPLANTABLE) | Supply/Implant | $13,824.00 |
| 6096475 | SUPPLY IMPLANT | Supply/Implant | $2,155.52 |
| 6096477 | MESH (IMPLANTABLE) | Supply/Implant | $7,110.78 |
| 6096481 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6096482 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6096483 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6096484 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6096491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6096506 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $45,273.60 |
| 6096522 | GENERAL SUPPLY | Supply/Implant | $954.24 |
| 6096524 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6096526 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6096544 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6096545 | SUPPLY IMPLANT | Supply/Implant | $2,598.40 |
| 6096546 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6096556 | STERILE SUPPLY | Supply/Implant | $168.83 |
| 6096557 | STERILE SUPPLY | Supply/Implant | $1,110.78 |
| 6096560 | GENERAL SUPPLY | Supply/Implant | $227.84 |
| 6096561 | GUIDE WIRE | Supply/Implant | $6,374.40 |
| 6096562 | SUPPLY IMPLANT | Supply/Implant | $43,379.20 |
| 6096563 | CATHETER, GUIDING | Supply/Implant | $37,619.20 |
| 6096564 | SUPPLY IMPLANT | Supply/Implant | $5,696.00 |
| 6096565 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $24,819.20 |
| 6096576 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6096580 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $55,040.00 |
| 6096583 | LEAD, NEUROSTIMULATOR | Supply/Implant | $7,040.00 |
| 6096584 | SUPPLY IMPLANT | Supply/Implant | $9,267.20 |
| 6096592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6096593 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6096594 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6096597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6096599 | GENERAL SUPPLY | Supply/Implant | $129.79 |
| 6096600 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6096603 | SUPPLY IMPLANT | Supply/Implant | $7,776.51 |
| 6096610 | GENERAL SUPPLY | Supply/Implant | $5,940.35 |
| 6096635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6096636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6096638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6096640 | SUPPLY IMPLANT | Supply/Implant | $2,512.13 |
| 6096648 | SUPPLY IMPLANT | Supply/Implant | $2,620.80 |
| 6096649 | SUPPLY IMPLANT | Supply/Implant | $2,572.80 |
| 6096650 | SUPPLY IMPLANT | Supply/Implant | $4,368.00 |
| 6096653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6096691 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6096694 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6096696 | SUPPLY IMPLANT | Supply/Implant | $2,078.21 |
| 6096697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6096698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6096699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6096701 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6096703 | SUPPLY IMPLANT | Supply/Implant | $3,315.20 |
| 6096704 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6096717 | STERILE SUPPLY | Supply/Implant | $3,812.99 |
| 6096733 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096734 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096735 | SUPPLY IMPLANT | Supply/Implant | $13,570.88 |
| 6096736 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096737 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096739 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6096741 | STERILE SUPPLY | Supply/Implant | $155.24 |
| 6096742 | STERILE SUPPLY | Supply/Implant | $164.04 |
| 6096743 | SUPPLY IMPLANT | Supply/Implant | $7,099.78 |
| 6096745 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6096746 | AICD, DUAL CHAMBER | Supply/Implant | $586,045.50 |
| 6096749 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6096750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6096754 | CATH, DRAINAGE | Supply/Implant | $10,854.40 |
| 6096755 | CATHETER, URETERAL | Supply/Implant | $488.86 |
| 6096756 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6096760 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6096767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096769 | GRAFT, VASCULAR | Supply/Implant | $14,016.00 |
| 6096771 | STERILE SUPPLY | Supply/Implant | $1,497.60 |
| 6096775 | SEPTAL DEFECT IMP SYS | Supply/Implant | $111,360.00 |
| 6096776 | SEPTAL DEFECT IMP SYS | Supply/Implant | $111,360.00 |
| 6096777 | SEPTAL DEFECT IMP SYS | Supply/Implant | $111,360.00 |
| 6096779 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6096780 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6096789 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096790 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096791 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096792 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096797 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6096803 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6096804 | SUPPLY IMPLANT | Supply/Implant | $1,648.51 |
| 6096809 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6096819 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6096824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6096825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6096826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,737.60 |
| 6096827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6096828 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6096829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6096859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6096860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6096867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,606.40 |
| 6096870 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6096873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6096879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,310.72 |
| 6096881 | GENERAL SUPPLY | Supply/Implant | $3,659.39 |
| 6096887 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6096889 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,417.60 |
| 6096901 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6096903 | CATHETER, GUIDING | Supply/Implant | $473.60 |
| 6096911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,937.54 |
| 6096916 | SUPPLY IMPLANT | Supply/Implant | $4,595.20 |
| 6096922 | SUPPLY IMPLANT | Supply/Implant | $4,178.05 |
| 6096925 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6096926 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6096928 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6096929 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,299.20 |
| 6096930 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,299.20 |
| 6096937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6096939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6096941 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6096942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6096943 | SUPPLY IMPLANT | Supply/Implant | $480.00 |
| 6096945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6096951 | GENERAL SUPPLY | Supply/Implant | $10,809.60 |
| 6096954 | SUPPLY IMPLANT | Supply/Implant | $5,926.78 |
| 6096959 | CONN TISS, NON-HUMAN | Supply/Implant | $26,560.00 |
| 6096960 | GRAFT, VASCULAR | Supply/Implant | $26,560.00 |
| 6096961 | GRAFT, VASCULAR | Supply/Implant | $26,560.00 |
| 6096962 | GRAFT, VASCULAR | Supply/Implant | $27,200.00 |
| 6096963 | GRAFT, VASCULAR | Supply/Implant | $27,200.00 |
| 6096966 | GRAFT, VASCULAR | Supply/Implant | $15,680.00 |
| 6096967 | CONN TISS, NON-HUMAN | Supply/Implant | $21,440.00 |
| 6096970 | CONN TISS, NON-HUMAN | Supply/Implant | $21,440.00 |
| 6096978 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6096980 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6096982 | STERILE SUPPLY | Supply/Implant | $355.71 |
| 6096987 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6096988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6096990 | SUPPLY IMPLANT | Supply/Implant | $547.20 |
| 6096991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6096992 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6096997 | SUPPLY IMPLANT | Supply/Implant | $6,931.20 |
| 6097001 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,600.00 |
| 6097003 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6097004 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6097005 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6097008 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6097010 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6097012 | SUPPLY IMPLANT | Supply/Implant | $28,966.40 |
| 6097015 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6097021 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6097029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6097032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6097041 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6097052 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6097056 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6097064 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $48,064.00 |
| 6097073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,516.80 |
| 6097087 | GRAFT, VASCULAR | Supply/Implant | $15,219.20 |
| 6097094 | SUPPLY IMPLANT | Supply/Implant | $1,197.70 |
| 6097097 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6097104 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6097121 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6097122 | SUPPLY IMPLANT | Supply/Implant | $1,120.64 |
| 6097125 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,547.20 |
| 6097135 | RET DEV, INSERTABLE | Supply/Implant | $94,707.20 |
| 6097136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6097141 | CATHETER, GUIDING | Supply/Implant | $14,131.20 |
| 6097143 | SUPPLY IMPLANT | Supply/Implant | $8,737.15 |
| 6097144 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6097145 | STERILE SUPPLY | Supply/Implant | $1,987.20 |
| 6097146 | STERILE SUPPLY | Supply/Implant | $614.40 |
| 6097147 | GENERAL SUPPLY | Supply/Implant | $715.78 |
| 6097149 | GUIDE WIRE | Supply/Implant | $1,334.91 |
| 6097153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6097163 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,713.60 |
| 6097164 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6097167 | CATHETER, GUIDING | Supply/Implant | $16,115.20 |
| 6097168 | CATHETER, GUIDING | Supply/Implant | $16,115.20 |
| 6097169 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $24,819.20 |
| 6097172 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $9,715.20 |
| 6097174 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $14,579.20 |
| 6097175 | STERILE SUPPLY | Supply/Implant | $4,672.00 |
| 6097176 | GRAFT, VASCULAR | Supply/Implant | $57,830.40 |
| 6097177 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6097178 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6097181 | SUPPLY IMPLANT | Supply/Implant | $3,996.29 |
| 6097186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,752.00 |
| 6097195 | GENERAL SUPPLY | Supply/Implant | $213.12 |
| 6097196 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6097197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6097201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6097203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6097209 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6097210 | VENA CAVA FILTER | Supply/Implant | $13,440.00 |
| 6097211 | VENA CAVA FILTER | Supply/Implant | $15,360.00 |
| 6097213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,408.00 |
| 6097217 | SUPPLY IMPLANT | Supply/Implant | $106,752.00 |
| 6097218 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $4,236.80 |
| 6097222 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6097225 | INTRO/SHEATH, NON-LASER | Supply/Implant | $900.35 |
| 6097229 | GUIDE WIRE | Supply/Implant | $7,027.20 |
| 6097230 | GUIDE WIRE | Supply/Implant | $5,120.00 |
| 6097235 | CATH, DRAINAGE | Supply/Implant | $1,657.86 |
| 6097236 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6097238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,735.04 |
| 6097247 | SUPPLY IMPLANT | Supply/Implant | $168,301.46 |
| 6097251 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6097252 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6097253 | SUPPLY IMPLANT | Supply/Implant | $2,969.60 |
| 6097261 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6097262 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6097263 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6097277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,644.86 |
| 6097279 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6097280 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097283 | SUPPLY IMPLANT | Supply/Implant | $2,911.36 |
| 6097285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6097287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6097289 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6097291 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6097292 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6097293 | GUIDE WIRE | Supply/Implant | $912.38 |
| 6097294 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $10,048.00 |
| 6097295 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6097296 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6097301 | SUPPLY IMPLANT | Supply/Implant | $17,728.00 |
| 6097302 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6097304 | GENERAL SUPPLY | Supply/Implant | $565.25 |
| 6097308 | SUPPLY IMPLANT | Supply/Implant | $2,969.60 |
| 6097309 | LEAD, NEUROSTIMULATOR | Supply/Implant | $35,840.00 |
| 6097311 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6097312 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6097314 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,360.00 |
| 6097315 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,360.00 |
| 6097316 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,512.00 |
| 6097318 | SUPPLY IMPLANT | Supply/Implant | $9,024.00 |
| 6097319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6097330 | STERILE SUPPLY | Supply/Implant | $2,560.00 |
| 6097338 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6097339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6097340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097341 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6097342 | SUPPLY IMPLANT | Supply/Implant | $484.10 |
| 6097345 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6097349 | SUPPLY IMPLANT | Supply/Implant | $37,476.10 |
| 6097352 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6097353 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6097359 | BRACHYTHERAPY NEEDLE | Supply/Implant | $6,336.00 |
| 6097364 | SUPPLY IMPLANT | Supply/Implant | $2,280.45 |
| 6097365 | SUPPLY IMPLANT | Supply/Implant | $796.80 |
| 6097368 | SUPPLY IMPLANT | Supply/Implant | $1,448.19 |
| 6097369 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6097370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,030.40 |
| 6097371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6097372 | SUPPLY IMPLANT | Supply/Implant | $2,280.45 |
| 6097376 | SUPPLY IMPLANT | Supply/Implant | $2,598.40 |
| 6097381 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6097383 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6097393 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6097400 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $95,091.20 |
| 6097401 | SUPPLY IMPLANT | Supply/Implant | $5,427.20 |
| 6097404 | SUPPLY IMPLANT | Supply/Implant | $3,993.60 |
| 6097407 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $32,000.00 |
| 6097408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,631.68 |
| 6097412 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6097415 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $906.88 |
| 6097416 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $906.88 |
| 6097417 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6097425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6097428 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097429 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097430 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097431 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097433 | SUPPLY IMPLANT | Supply/Implant | $1,447.04 |
| 6097435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6097437 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $10,048.00 |
| 6097438 | GENERAL SUPPLY | Supply/Implant | $132.35 |
| 6097448 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6097449 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6097454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6097459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6097460 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097461 | GENERAL SUPPLY | Supply/Implant | $1,033.22 |
| 6097463 | GENERAL SUPPLY | Supply/Implant | $1,467.52 |
| 6097465 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6097466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097467 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6097468 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6097470 | SUPPLY IMPLANT | Supply/Implant | $9,024.00 |
| 6097475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097480 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6097481 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097482 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6097483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6097485 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6097487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6097488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6097490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6097491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6097497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6097499 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6097524 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097525 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097526 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097527 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097528 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097529 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097530 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097531 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097532 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097533 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097534 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097535 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097536 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097537 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097538 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097539 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097540 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097541 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097542 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097543 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097544 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097545 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097546 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097547 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097548 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097549 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097550 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097551 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097552 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097553 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097554 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097555 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097556 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097557 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097558 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097559 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097560 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097561 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097562 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097563 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097564 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097565 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097566 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097567 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097568 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097569 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097570 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097571 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097575 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6097578 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097580 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6097583 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6097584 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6097602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,248.00 |
| 6097603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,880.00 |
| 6097604 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6097605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6097606 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6097617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6097618 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6097619 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6097620 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6097623 | SUPPLY IMPLANT | Supply/Implant | $3,430.91 |
| 6097625 | GENERAL SUPPLY | Supply/Implant | $599.17 |
| 6097629 | PROSTHETIC IMPLANT NOS | Supply/Implant | $40,192.00 |
| 6097631 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6097632 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6097633 | SUPPLY IMPLANT | Supply/Implant | $9,678.34 |
| 6097634 | SUPPLY IMPLANT | Supply/Implant | $4,126.85 |
| 6097638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6097639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6097641 | SUPPLY IMPLANT | Supply/Implant | $656.64 |
| 6097642 | SUPPLY IMPLANT | Supply/Implant | $838.40 |
| 6097643 | SUPPLY IMPLANT | Supply/Implant | $2,225.92 |
| 6097648 | GUIDE WIRE | Supply/Implant | $6,571.78 |
| 6097658 | GUIDE WIRE | Supply/Implant | $2,841.60 |
| 6097659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6097660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6097667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,315.20 |
| 6097669 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6097670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6097671 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6097672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6097673 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,680.00 |
| 6097684 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6097685 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6097686 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6097695 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6097698 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6097700 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097701 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097710 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6097711 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6097730 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6097731 | SUPPLY IMPLANT | Supply/Implant | $2,969.60 |
| 6097732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,840.00 |
| 6097733 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6097734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,299.20 |
| 6097735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6097736 | SUPPLY IMPLANT | Supply/Implant | $13,440.00 |
| 6097737 | SUPPLY IMPLANT | Supply/Implant | $6,041.60 |
| 6097738 | STERILE SUPPLY | Supply/Implant | $678.40 |
| 6097739 | STERILE SUPPLY | Supply/Implant | $6,462.72 |
| 6097740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6097745 | GRAFT, VASCULAR | Supply/Implant | $83,200.00 |
| 6097757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,852.80 |
| 6097758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,092.80 |
| 6097760 | SUPPLY IMPLANT | Supply/Implant | $11,302.40 |
| 6097762 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6097763 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6097765 | GENERAL SUPPLY | Supply/Implant | $558.72 |
| 6097766 | SUPPLY IMPLANT | Supply/Implant | $496.77 |
| 6097777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6097784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6097785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6097787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6097789 | SUPPLY IMPLANT | Supply/Implant | $36,032.00 |
| 6097790 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6097794 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097795 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097796 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097799 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097807 | SUPPLY IMPLANT | Supply/Implant | $1,648.38 |
| 6097808 | SUPPLY IMPLANT | Supply/Implant | $1,648.38 |
| 6097809 | SUPPLY IMPLANT | Supply/Implant | $1,648.38 |
| 6097818 | SUPPLY IMPLANT | Supply/Implant | $4,963.97 |
| 6097821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6097823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,924.80 |
| 6097825 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6097826 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6097827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6097850 | STERILE SUPPLY | Supply/Implant | $257.54 |
| 6097860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6097862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6097868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,644.86 |
| 6097869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,052.80 |
| 6097871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6097872 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,640.00 |
| 6097876 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6097879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,701.44 |
| 6097880 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6097882 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097883 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097884 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097885 | SUPPLY IMPLANT | Supply/Implant | $547.20 |
| 6097886 | SUPPLY IMPLANT | Supply/Implant | $547.20 |
| 6097890 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,321.60 |
| 6097896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6097897 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6097901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,091.20 |
| 6097902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,091.20 |
| 6097903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $842.24 |
| 6097911 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,998.40 |
| 6097914 | SUPPLY IMPLANT | Supply/Implant | $18,790.40 |
| 6097915 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6097926 | SUPPLY IMPLANT | Supply/Implant | $12,441.60 |
| 6097926 | SUPPLY IMPLANT | Supply/Implant | $25,294.85 |
| 6097928 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6097930 | SUPPLY IMPLANT | Supply/Implant | $511.36 |
| 6097937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6097945 | SUPPLY IMPLANT | Supply/Implant | $194.69 |
| 6097946 | BRACHYTHERAPY NEEDLE | Supply/Implant | $5,056.00 |
| 6097947 | SUPPLY IMPLANT | Supply/Implant | $83,968.00 |
| 6097952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,174.27 |
| 6097956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6097957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6097973 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $76,864.00 |
| 6097975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $99,673.60 |
| 6097976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,148.80 |
| 6097977 | SUPPLY IMPLANT | Supply/Implant | $14,040.96 |
| 6097978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6097981 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097982 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097984 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6097991 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6098046 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,072.00 |
| 6098048 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,125.25 |
| 6098049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,790.40 |
| 6098050 | SUPPLY IMPLANT | Supply/Implant | $18,790.40 |
| 6098051 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6098054 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6098055 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6098064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,017.60 |
| 6098065 | GENERAL SUPPLY | Supply/Implant | $327.42 |
| 6098066 | GENERAL SUPPLY | Supply/Implant | $163.71 |
| 6098067 | GENERAL SUPPLY | Supply/Implant | $318.08 |
| 6098068 | GENERAL SUPPLY | Supply/Implant | $318.08 |
| 6098069 | GENERAL SUPPLY | Supply/Implant | $318.08 |
| 6098070 | GENERAL SUPPLY | Supply/Implant | $278.40 |
| 6098074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6098075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6098079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6098083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,153.60 |
| 6098084 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6098085 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6098087 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6098088 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6098089 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6098090 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6098091 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6098093 | GRAFT, VASCULAR | Supply/Implant | $23,667.20 |
| 6098095 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6098100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,588.48 |
| 6098102 | SUPPLY IMPLANT | Supply/Implant | $1,737.09 |
| 6098104 | ALLODERM SKIN SUB | Supply/Implant | $65,369.60 |
| 6098106 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098110 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098111 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098114 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098115 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098116 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,984.00 |
| 6098118 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098119 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098120 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,960.00 |
| 6098124 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,984.00 |
| 6098126 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6098141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6098146 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6098153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6098154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6098155 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6098159 | SUPPLY IMPLANT | Supply/Implant | $23,546.88 |
| 6098161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6098162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6098164 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6098171 | SUPPLY IMPLANT | Supply/Implant | $13,760.00 |
| 6098177 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6098189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6098190 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6098191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6098201 | SUPPLY IMPLANT | Supply/Implant | $5,043.97 |
| 6098202 | SUPPLY IMPLANT | Supply/Implant | $1,421.44 |
| 6098203 | SUPPLY IMPLANT | Supply/Implant | $2,727.90 |
| 6098207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6098208 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6098209 | SUPPLY IMPLANT | Supply/Implant | $5,735.17 |
| 6098211 | SUPPLY IMPLANT | Supply/Implant | $4,663.77 |
| 6098212 | SUPPLY IMPLANT | Supply/Implant | $6,113.32 |
| 6098220 | GUIDE WIRE | Supply/Implant | $5,312.00 |
| 6098229 | GUIDE WIRE | Supply/Implant | $2,163.20 |
| 6098236 | GENERAL SUPPLY | Supply/Implant | $358.40 |
| 6098240 | SUPPLY IMPLANT | Supply/Implant | $5,632.00 |
| 6098246 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $2,560.00 |
| 6098248 | CATH OCCLUSION | Supply/Implant | $8,320.00 |
| 6098256 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6098259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,582.40 |
| 6098260 | STERILE SUPPLY | Supply/Implant | $2,764.80 |
| 6098262 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098263 | GENERAL SUPPLY | Supply/Implant | $298.88 |
| 6098269 | CATH OCCLUSION | Supply/Implant | $5,504.00 |
| 6098272 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6098273 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6098275 | GENERAL SUPPLY | Supply/Implant | $212.10 |
| 6098277 | GENERAL SUPPLY | Supply/Implant | $155.39 |
| 6098284 | GUIDE WIRE | Supply/Implant | $332.80 |
| 6098286 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6098287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6098300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6098307 | SUPPLY IMPLANT | Supply/Implant | $6,364.93 |
| 6098308 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6098309 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $3,497.45 |
| 6098322 | MESH (IMPLANTABLE) | Supply/Implant | $69,760.00 |
| 6098323 | MESH (IMPLANTABLE) | Supply/Implant | $116,480.00 |
| 6098324 | MESH (IMPLANTABLE) | Supply/Implant | $143,587.50 |
| 6098325 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098327 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098335 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6098343 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098345 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098347 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6098352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6098353 | STERILE SUPPLY | Supply/Implant | $3,571.20 |
| 6098355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6098356 | SUPPLY IMPLANT | Supply/Implant | $1,561.60 |
| 6098357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,630.40 |
| 6098359 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,312.00 |
| 6098367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,196.16 |
| 6098369 | SUPPLY IMPLANT | Supply/Implant | $38,326.40 |
| 6098373 | GENERAL SUPPLY | Supply/Implant | $2,904.83 |
| 6098374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6098376 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098378 | AICD, SINGLE CHAMBER | Supply/Implant | $169,312.50 |
| 6098388 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6098398 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6098401 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,600.00 |
| 6098402 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,600.00 |
| 6098405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6098406 | STERILE SUPPLY | Supply/Implant | $1,013.38 |
| 6098408 | SUPPLY IMPLANT | Supply/Implant | $745.34 |
| 6098414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6098416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6098419 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $707.84 |
| 6098427 | SUPPLY IMPLANT | Supply/Implant | $524.80 |
| 6098429 | SUPPLY IMPLANT | Supply/Implant | $530.82 |
| 6098430 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6098438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6098443 | SUPPLY IMPLANT | Supply/Implant | $225.54 |
| 6098444 | SUPPLY IMPLANT | Supply/Implant | $137.42 |
| 6098449 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $793.60 |
| 6098450 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $793.60 |
| 6098455 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6098457 | CATH, DRAINAGE | Supply/Implant | $168.32 |
| 6098461 | SUPPLY IMPLANT | Supply/Implant | $170.79 |
| 6098465 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098466 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098467 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098468 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098469 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098470 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098471 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098472 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098473 | CATH, DRAINAGE | Supply/Implant | $228.52 |
| 6098474 | SUPPLY IMPLANT | Supply/Implant | $3,912.70 |
| 6098475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,413.18 |
| 6098479 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6098481 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6098485 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,421.76 |
| 6098486 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,421.76 |
| 6098497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098498 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098500 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098501 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,421.76 |
| 6098506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,091.20 |
| 6098511 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6098517 | STERILE SUPPLY | Supply/Implant | $1,007.10 |
| 6098518 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6098524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6098525 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6098526 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6098532 | SUPPLY IMPLANT | Supply/Implant | $50,560.00 |
| 6098534 | GRAFT, VASCULAR | Supply/Implant | $108,267.01 |
| 6098535 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6098536 | STERILE SUPPLY | Supply/Implant | $180.22 |
| 6098541 | STERILE SUPPLY | Supply/Implant | $4,300.93 |
| 6098543 | GENERAL SUPPLY | Supply/Implant | $231.55 |
| 6098546 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6098554 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098560 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6098564 | SUPPLY IMPLANT | Supply/Implant | $2,179.20 |
| 6098579 | CATH, DRAINAGE | Supply/Implant | $4,257.79 |
| 6098581 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,553.86 |
| 6098583 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6098585 | GENERAL SUPPLY | Supply/Implant | $162.43 |
| 6098590 | GENERAL SUPPLY | Supply/Implant | $712.45 |
| 6098598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,006.40 |
| 6098603 | GENERAL SUPPLY | Supply/Implant | $739.84 |
| 6098608 | STERILE SUPPLY | Supply/Implant | $701.18 |
| 6098609 | STERILE SUPPLY | Supply/Implant | $1,024.51 |
| 6098611 | GENERAL SUPPLY | Supply/Implant | $534.78 |
| 6098612 | STERILE SUPPLY | Supply/Implant | $1,113.73 |
| 6098613 | STERILE SUPPLY | Supply/Implant | $2,264.45 |
| 6098614 | STERILE SUPPLY | Supply/Implant | $923.07 |
| 6098615 | STERILE SUPPLY | Supply/Implant | $1,062.66 |
| 6098616 | STERILE SUPPLY | Supply/Implant | $1,688.70 |
| 6098618 | STERILE SUPPLY | Supply/Implant | $1,618.05 |
| 6098619 | STERILE SUPPLY | Supply/Implant | $946.94 |
| 6098620 | GENERAL SUPPLY | Supply/Implant | $1,182.85 |
| 6098621 | STERILE SUPPLY | Supply/Implant | $1,059.71 |
| 6098625 | STERILE SUPPLY | Supply/Implant | $650.50 |
| 6098626 | STERILE SUPPLY | Supply/Implant | $554.37 |
| 6098628 | GENERAL SUPPLY | Supply/Implant | $198.78 |
| 6098639 | GENERAL SUPPLY | Supply/Implant | $146.56 |
| 6098644 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6098645 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6098652 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098653 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098655 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098656 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098657 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098659 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098660 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098664 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098665 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098669 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098671 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098672 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098673 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098674 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098678 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098679 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098680 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098681 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098682 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098684 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098685 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098687 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098688 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098689 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098690 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098691 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098692 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098693 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098694 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098695 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098696 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098706 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098710 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098711 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098712 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098716 | GUIDE WIRE | Supply/Implant | $597.76 |
| 6098720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6098724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6098725 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6098726 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,559.04 |
| 6098727 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6098729 | STERILE SUPPLY | Supply/Implant | $264.58 |
| 6098758 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6098762 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6098766 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6098770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6098771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,100.80 |
| 6098780 | SUPPLY IMPLANT | Supply/Implant | $29,387.14 |
| 6098781 | SUPPLY IMPLANT | Supply/Implant | $14,040.96 |
| 6098782 | SUPPLY IMPLANT | Supply/Implant | $16,089.60 |
| 6098783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6098784 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6098787 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6098788 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6098795 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6098800 | GENERAL SUPPLY | Supply/Implant | $1,653.38 |
| 6098801 | CONN TISS, NON-HUMAN | Supply/Implant | $6,144.00 |
| 6098803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6098804 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6098805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6098806 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6098810 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6098824 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6098826 | SUPPLY IMPLANT | Supply/Implant | $37,657.60 |
| 6098831 | GENERAL SUPPLY | Supply/Implant | $162.94 |
| 6098838 | SUPPLY IMPLANT | Supply/Implant | $3,403.52 |
| 6098839 | SUPPLY IMPLANT | Supply/Implant | $2,659.20 |
| 6098841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6098845 | BRACHYTHERAPY NEEDLE | Supply/Implant | $219.90 |
| 6098846 | SUPPLY IMPLANT | Supply/Implant | $140.16 |
| 6098854 | GENERAL SUPPLY | Supply/Implant | $204.67 |
| 6098859 | SUPPLY IMPLANT | Supply/Implant | $2,418.43 |
| 6098860 | EVENT RECORDER CARDIAC | Supply/Implant | $63,936.00 |
| 6098861 | GENERAL SUPPLY | Supply/Implant | $723.30 |
| 6098870 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098871 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098873 | STERILE SUPPLY | Supply/Implant | $259.58 |
| 6098883 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,953.54 |
| 6098887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6098888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098892 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6098893 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6098894 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6098895 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6098907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,786.56 |
| 6098908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,786.56 |
| 6098931 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,945.73 |
| 6098933 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6098943 | SUPPLY IMPLANT | Supply/Implant | $19,909.12 |
| 6098945 | SUPPLY IMPLANT | Supply/Implant | $6,118.40 |
| 6098946 | SUPPLY IMPLANT | Supply/Implant | $6,118.40 |
| 6098948 | SUPPLY IMPLANT | Supply/Implant | $49,523.20 |
| 6098951 | SUPPLY IMPLANT | Supply/Implant | $63,308.80 |
| 6098952 | SUPPLY IMPLANT | Supply/Implant | $63,308.80 |
| 6098953 | SUPPLY IMPLANT | Supply/Implant | $63,308.80 |
| 6098954 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098957 | SUPPLY IMPLANT | Supply/Implant | $672.55 |
| 6098962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6098963 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6098971 | GENERAL SUPPLY | Supply/Implant | $820.22 |
| 6098973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6098974 | GUIDE WIRE | Supply/Implant | $204.29 |
| 6098975 | STERILE SUPPLY | Supply/Implant | $149.45 |
| 6098984 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6098991 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6098992 | SUPPLY IMPLANT | Supply/Implant | $1,720.19 |
| 6098993 | SUPPLY IMPLANT | Supply/Implant | $1,755.26 |
| 6098994 | SUPPLY IMPLANT | Supply/Implant | $1,624.45 |
| 6098995 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6098996 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6098998 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6099000 | SUPPLY IMPLANT | Supply/Implant | $864.00 |
| 6099009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6099011 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6099016 | STERILE SUPPLY | Supply/Implant | $318.34 |
| 6099018 | GENERAL SUPPLY | Supply/Implant | $797.95 |
| 6099030 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6099031 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099032 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099033 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099039 | STERILE SUPPLY | Supply/Implant | $133.89 |
| 6099045 | STERILE SUPPLY | Supply/Implant | $7,616.00 |
| 6099046 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6099056 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6099057 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6099059 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6099060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099061 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6099074 | GENERAL SUPPLY | Supply/Implant | $1,327.10 |
| 6099075 | GENERAL SUPPLY | Supply/Implant | $160.13 |
| 6099101 | GENERAL SUPPLY | Supply/Implant | $585.98 |
| 6099131 | GENERAL SUPPLY | Supply/Implant | $1,445.50 |
| 6099162 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6099170 | SUPPLY IMPLANT | Supply/Implant | $19,033.60 |
| 6099175 | STERILE SUPPLY | Supply/Implant | $6,336.00 |
| 6099177 | SUPPLY IMPLANT | Supply/Implant | $199.68 |
| 6099178 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $284.98 |
| 6099182 | GENERAL SUPPLY | Supply/Implant | $531.58 |
| 6099183 | SUPPLY IMPLANT | Supply/Implant | $4,722.69 |
| 6099184 | SUPPLY IMPLANT | Supply/Implant | $4,200.83 |
| 6099188 | CATHETER, GUIDING | Supply/Implant | $282.11 |
| 6099189 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,977.60 |
| 6099190 | SUPPLY IMPLANT | Supply/Implant | $611.71 |
| 6099191 | CATHETER, GUIDING | Supply/Implant | $2,162.18 |
| 6099192 | CATHETER, GUIDING | Supply/Implant | $2,162.18 |
| 6099193 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099196 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099198 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099199 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099201 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,977.60 |
| 6099202 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6099204 | STERILE SUPPLY | Supply/Implant | $154.11 |
| 6099206 | STERILE SUPPLY | Supply/Implant | $321.79 |
| 6099207 | STERILE SUPPLY | Supply/Implant | $892.16 |
| 6099211 | GENERAL SUPPLY | Supply/Implant | $207.99 |
| 6099215 | STERILE SUPPLY | Supply/Implant | $160.64 |
| 6099227 | SUPPLY IMPLANT | Supply/Implant | $569.09 |
| 6099231 | STERILE SUPPLY | Supply/Implant | $223.74 |
| 6099234 | SUPPLY IMPLANT | Supply/Implant | $182.27 |
| 6099237 | STERILE SUPPLY | Supply/Implant | $245.38 |
| 6099239 | STERILE SUPPLY | Supply/Implant | $146.33 |
| 6099243 | GENERAL SUPPLY | Supply/Implant | $722.18 |
| 6099244 | STERILE SUPPLY | Supply/Implant | $443.72 |
| 6099250 | GENERAL SUPPLY | Supply/Implant | $277.38 |
| 6099251 | GENERAL SUPPLY | Supply/Implant | $224.00 |
| 6099256 | GENERAL SUPPLY | Supply/Implant | $194.56 |
| 6099259 | GENERAL SUPPLY | Supply/Implant | $151.68 |
| 6099264 | STERILE SUPPLY | Supply/Implant | $140.54 |
| 6099266 | STERILE SUPPLY | Supply/Implant | $546.69 |
| 6099270 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099271 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099274 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099275 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099276 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099279 | GUIDE WIRE | Supply/Implant | $478.59 |
| 6099281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,769.60 |
| 6099282 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6099285 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099291 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,090.88 |
| 6099293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6099294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6099295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6099296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6099301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6099305 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6099306 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6099307 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6099321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,863.68 |
| 6099349 | SUPPLY IMPLANT | Supply/Implant | $3,302.66 |
| 6099350 | SUPPLY IMPLANT | Supply/Implant | $2,044.80 |
| 6099352 | SUPPLY IMPLANT | Supply/Implant | $669.18 |
| 6099359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6099363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6099364 | STERILE SUPPLY | Supply/Implant | $254.72 |
| 6099365 | SUPPLY IMPLANT | Supply/Implant | $206.22 |
| 6099368 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,504.00 |
| 6099369 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6099371 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6099372 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6099373 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6099374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,950.40 |
| 6099376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6099377 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6099378 | SUPPLY IMPLANT | Supply/Implant | $6,310.40 |
| 6099384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6099385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6099386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6099387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6099394 | SUPPLY IMPLANT | Supply/Implant | $2,795.52 |
| 6099398 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6099399 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6099400 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6099405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6099406 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6099407 | SUPPLY IMPLANT | Supply/Implant | $2,634.24 |
| 6099408 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6099409 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6099411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6099415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6099417 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6099418 | CATHETER, GUIDING | Supply/Implant | $1,365.76 |
| 6099419 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099421 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6099422 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6099425 | STERILE SUPPLY | Supply/Implant | $206.08 |
| 6099428 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6099429 | INTRO/SHEATH, NON-LASER | Supply/Implant | $614.40 |
| 6099432 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $39,635.20 |
| 6099434 | STERILE SUPPLY | Supply/Implant | $5,824.00 |
| 6099520 | STERILE SUPPLY | Supply/Implant | $165.38 |
| 6099529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $543.62 |
| 6099530 | SUPPLY IMPLANT | Supply/Implant | $559.36 |
| 6099546 | GENERAL SUPPLY | Supply/Implant | $227.84 |
| 6099547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6099552 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099553 | SUPPLY IMPLANT | Supply/Implant | $163.20 |
| 6099554 | PORT, INDWELLING, IMP | Supply/Implant | $15,374.34 |
| 6099555 | SUPPLY IMPLANT | Supply/Implant | $22,476.29 |
| 6099562 | CATHETER, GUIDING | Supply/Implant | $619.52 |
| 6099574 | STERILE SUPPLY | Supply/Implant | $187.26 |
| 6099575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,120.32 |
| 6099590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6099591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6099593 | SUPPLY IMPLANT | Supply/Implant | $3,123.20 |
| 6099595 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6099600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6099603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6099604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6099607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6099608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099611 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6099617 | INTRO/SHEATH, NON-LASER | Supply/Implant | $598.27 |
| 6099618 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,504.00 |
| 6099619 | SUPPLY IMPLANT | Supply/Implant | $25,241.60 |
| 6099621 | SUPPLY IMPLANT | Supply/Implant | $25,241.60 |
| 6099622 | SUPPLY IMPLANT | Supply/Implant | $25,241.60 |
| 6099623 | SUPPLY IMPLANT | Supply/Implant | $15,987.20 |
| 6099625 | RET DEV, INSERTABLE | Supply/Implant | $95,936.00 |
| 6099629 | STERILE SUPPLY | Supply/Implant | $2,112.00 |
| 6099632 | PROSTHETIC IMPLANT NOS | Supply/Implant | $50,560.00 |
| 6099633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6099634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6099637 | SUPPLY IMPLANT | Supply/Implant | $34,560.00 |
| 6099643 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6099644 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6099645 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6099647 | GENERAL SUPPLY | Supply/Implant | $211.33 |
| 6099651 | GENERAL SUPPLY | Supply/Implant | $163.33 |
| 6099653 | GENERAL SUPPLY | Supply/Implant | $961.02 |
| 6099657 | GENERAL SUPPLY | Supply/Implant | $820.22 |
| 6099658 | SUPPLY IMPLANT | Supply/Implant | $672.55 |
| 6099667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099674 | SUPPLY IMPLANT | Supply/Implant | $2,805.76 |
| 6099675 | GENERAL SUPPLY | Supply/Implant | $2,560.00 |
| 6099677 | GENERAL SUPPLY | Supply/Implant | $2,528.00 |
| 6099678 | GENERAL SUPPLY | Supply/Implant | $5,440.00 |
| 6099686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6099688 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6099689 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6099691 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6099693 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6099694 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $54,732.80 |
| 6099695 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $53,580.80 |
| 6099697 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099699 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099702 | MESH (IMPLANTABLE) | Supply/Implant | $66,496.00 |
| 6099719 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099720 | SUPPLY IMPLANT | Supply/Implant | $89,600.00 |
| 6099721 | SUPPLY IMPLANT | Supply/Implant | $87,040.00 |
| 6099722 | SUPPLY IMPLANT | Supply/Implant | $92,160.00 |
| 6099723 | SUPPLY IMPLANT | Supply/Implant | $74,124.80 |
| 6099724 | STERILE SUPPLY | Supply/Implant | $738.43 |
| 6099725 | STERILE SUPPLY | Supply/Implant | $154.21 |
| 6099737 | SUPPLY IMPLANT | Supply/Implant | $569.22 |
| 6099738 | GENERAL SUPPLY | Supply/Implant | $569.22 |
| 6099739 | GENERAL SUPPLY | Supply/Implant | $193.41 |
| 6099743 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6099744 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6099746 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6099748 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6099756 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6099757 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099758 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099759 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6099761 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6099762 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099763 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099764 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6099765 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,040.00 |
| 6099767 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099768 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099769 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6099770 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6099777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6099778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6099788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6099791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6099793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6099794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099799 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6099802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.86 |
| 6099831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099864 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099869 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6099874 | CATHETER, GUIDING | Supply/Implant | $38,272.00 |
| 6099875 | STERILE SUPPLY | Supply/Implant | $3,660.80 |
| 6099879 | SUPPLY IMPLANT | Supply/Implant | $435.67 |
| 6099886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6099887 | SUPPLY IMPLANT | Supply/Implant | $12,840.96 |
| 6099895 | SUPPLY IMPLANT | Supply/Implant | $6,430.59 |
| 6099896 | SUPPLY IMPLANT | Supply/Implant | $6,430.59 |
| 6099897 | MESH (IMPLANTABLE) | Supply/Implant | $58,438.66 |
| 6099905 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $17,920.00 |
| 6099909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,953.54 |
| 6099913 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6099929 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6099938 | SUPPLY IMPLANT | Supply/Implant | $5,081.60 |
| 6099939 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6099942 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6099945 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6099948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,472.00 |
| 6099954 | SUPPLY IMPLANT | Supply/Implant | $8,908.80 |
| 6099956 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6099960 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6099964 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099966 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099967 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099968 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099970 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099971 | CATHETER, GUIDING | Supply/Implant | $19,430.40 |
| 6099972 | CATHETER, GUIDING | Supply/Implant | $26,969.60 |
| 6099973 | CATHETER, GUIDING | Supply/Implant | $26,969.60 |
| 6099979 | SUPPLY IMPLANT | Supply/Implant | $1,318.40 |
| 6099981 | SUPPLY IMPLANT | Supply/Implant | $7,659.52 |
| 6099984 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $665.60 |
| 6099992 | SUPPLY IMPLANT | Supply/Implant | $1,100.80 |
| 6099993 | SUPPLY IMPLANT | Supply/Implant | $2,700.80 |
| 6099998 | SUPPLY IMPLANT | Supply/Implant | $5,411.20 |
| 6100001 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6100002 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6100004 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $21,120.00 |
| 6100005 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,641.60 |
| 6100016 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6100021 | SUPPLY IMPLANT | Supply/Implant | $22,976.00 |
| 6100023 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6100024 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6100027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6100039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6100046 | STERILE SUPPLY | Supply/Implant | $2,688.00 |
| 6100047 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6100048 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6100049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6100052 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6100058 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6100060 | SUPPLY IMPLANT | Supply/Implant | $30,528.00 |
| 6100062 | SUPPLY IMPLANT | Supply/Implant | $30,528.00 |
| 6100064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6100065 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6100066 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6100076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6100077 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6100082 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6100084 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6100085 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6100091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6100099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6100100 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6100101 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6100102 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6100103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,705.60 |
| 6100104 | STERILE SUPPLY | Supply/Implant | $1,728.00 |
| 6100105 | SUPPLY IMPLANT | Supply/Implant | $3,958.95 |
| 6100106 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,521.86 |
| 6100116 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6100119 | GUIDE WIRE | Supply/Implant | $3,087.74 |
| 6100124 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6100130 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100136 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100141 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100142 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100143 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100148 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100157 | SUPPLY IMPLANT | Supply/Implant | $15,027.20 |
| 6100161 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6100176 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6100182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100186 | SUPPLY IMPLANT | Supply/Implant | $11,814.40 |
| 6100191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,120.00 |
| 6100194 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100195 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100198 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100201 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100206 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100212 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6100217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,760.00 |
| 6100229 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6100234 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6100237 | GRAFT, VASCULAR | Supply/Implant | $127,987.20 |
| 6100238 | GRAFT, VASCULAR | Supply/Implant | $51,187.20 |
| 6100244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6100245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6100250 | SUPPLY IMPLANT | Supply/Implant | $478.72 |
| 6100254 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6100255 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6100256 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,580.80 |
| 6100258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100264 | STERILE SUPPLY | Supply/Implant | $173.70 |
| 6100268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6100271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6100277 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6100278 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6100279 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6100287 | GENERAL SUPPLY | Supply/Implant | $1,046.91 |
| 6100289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6100290 | SUPPLY IMPLANT | Supply/Implant | $2,060.80 |
| 6100293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,469.95 |
| 6100294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6100301 | SUPPLY IMPLANT | Supply/Implant | $14,673.79 |
| 6100306 | SUPPLY IMPLANT | Supply/Implant | $1,177.60 |
| 6100310 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6100315 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6100316 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6100317 | SUPPLY IMPLANT | Supply/Implant | $6,284.80 |
| 6100318 | SUPPLY IMPLANT | Supply/Implant | $1,421.44 |
| 6100319 | SUPPLY IMPLANT | Supply/Implant | $2,918.23 |
| 6100322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6100323 | SUPPLY IMPLANT | Supply/Implant | $9,932.80 |
| 6100324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6100325 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6100328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6100330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6100331 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6100333 | LEAD, NEUROSTIMULATOR | Supply/Implant | $92,032.00 |
| 6100334 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6100340 | SUPPLY IMPLANT | Supply/Implant | $1,550.34 |
| 6100342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,141.44 |
| 6100343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6100345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6100346 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6100347 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6100366 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,880.00 |
| 6100371 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,880.00 |
| 6100372 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6100373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6100374 | STERILE SUPPLY | Supply/Implant | $625.79 |
| 6100381 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6100386 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6100388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $259.84 |
| 6100389 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6100394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6100396 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6100400 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6100402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6100403 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6100409 | SUPPLY IMPLANT | Supply/Implant | $282,800.00 |
| 6100412 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6100414 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6100417 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6100418 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6100419 | SUPPLY IMPLANT | Supply/Implant | $2,645.38 |
| 6100420 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6100421 | SUPPLY IMPLANT | Supply/Implant | $362.88 |
| 6100428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,280.00 |
| 6100430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,606.40 |
| 6100433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6100434 | GENERAL SUPPLY | Supply/Implant | $313.60 |
| 6100447 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6100448 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $124,800.00 |
| 6100449 | GUIDE WIRE | Supply/Implant | $129.02 |
| 6100466 | SUPPLY IMPLANT | Supply/Implant | $1,305.60 |
| 6100467 | STERILE SUPPLY | Supply/Implant | $234.88 |
| 6100477 | SUPPLY IMPLANT | Supply/Implant | $248.06 |
| 6100478 | SUPPLY IMPLANT | Supply/Implant | $442.38 |
| 6100479 | SUPPLY IMPLANT | Supply/Implant | $248.06 |
| 6100480 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6100482 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $184.58 |
| 6100483 | SUPPLY IMPLANT | Supply/Implant | $951.04 |
| 6100484 | SUPPLY IMPLANT | Supply/Implant | $951.04 |
| 6100485 | CATHETER, GUIDING | Supply/Implant | $21,120.00 |
| 6100486 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6100487 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6100495 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,193.41 |
| 6100497 | SUPPLY IMPLANT | Supply/Implant | $46,771.20 |
| 6100502 | SUPPLY IMPLANT | Supply/Implant | $1,885.31 |
| 6100504 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6100509 | SUPPLY IMPLANT | Supply/Implant | $1,532.16 |
| 6100510 | GUIDE WIRE | Supply/Implant | $229.89 |
| 6100514 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6100515 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6100516 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $13,760.00 |
| 6100517 | SUPPLY IMPLANT | Supply/Implant | $496.00 |
| 6100518 | SUPPLY IMPLANT | Supply/Implant | $496.00 |
| 6100521 | SUPPLY IMPLANT | Supply/Implant | $294.66 |
| 6100523 | GUIDE WIRE | Supply/Implant | $129.02 |
| 6100525 | GUIDE WIRE | Supply/Implant | $129.02 |
| 6100526 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $1,056.00 |
| 6100531 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6100537 | INTRO/SHEATH, NON-LASER | Supply/Implant | $293.12 |
| 6100546 | GRAFT, VASCULAR | Supply/Implant | $19,827.20 |
| 6100552 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6100553 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6100561 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6100562 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6100563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6100572 | GENERAL SUPPLY | Supply/Implant | $2,312.32 |
| 6100573 | SUPPLY IMPLANT | Supply/Implant | $1,530.11 |
| 6100576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,400.32 |
| 6100577 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6100582 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,164.80 |
| 6100586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6100587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6100588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6100593 | PORT, INDWELLING, IMP | Supply/Implant | $4,800.00 |
| 6100595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6100604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $277.76 |
| 6100608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6100609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6100619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100622 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6100630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6100631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6100633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6100634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6100636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6100637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6100638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6100639 | CATH, DRAINAGE | Supply/Implant | $8,817.41 |
| 6100640 | CATHETER, GUIDING | Supply/Implant | $1,337.60 |
| 6100641 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6100642 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,056.00 |
| 6100643 | CATHETER, GUIDING | Supply/Implant | $385.92 |
| 6100652 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,792.00 |
| 6100658 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6100668 | STERILE SUPPLY | Supply/Implant | $131.07 |
| 6100689 | STERILE SUPPLY | Supply/Implant | $639.10 |
| 6100696 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6100701 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6100710 | SUPPLY IMPLANT | Supply/Implant | $2,087.68 |
| 6100711 | SUPPLY IMPLANT | Supply/Implant | $3,834.88 |
| 6100712 | SUPPLY IMPLANT | Supply/Implant | $2,805.76 |
| 6100777 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100778 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100779 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100800 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100801 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100814 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6100815 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100816 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100819 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,480.00 |
| 6100820 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6100821 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6100824 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6100836 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100839 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100840 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100844 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100845 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100847 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100848 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100849 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100850 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100852 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100853 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100856 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100858 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100859 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100860 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100861 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100862 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100878 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100902 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100916 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100917 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100969 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6100992 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6101028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6101035 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,760.00 |
| 6101036 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,760.00 |
| 6101038 | SUPPLY IMPLANT | Supply/Implant | $3,691.52 |
| 6101065 | GUIDE WIRE | Supply/Implant | $1,276.80 |
| 6101068 | GENERAL SUPPLY | Supply/Implant | $490.62 |
| 6101108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6101110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,118.78 |
| 6101111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101121 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6101131 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6101134 | INTRO/SHEATH, NON-LASER | Supply/Implant | $640.00 |
| 6101204 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,432.00 |
| 6101207 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,916.80 |
| 6101217 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6101296 | STERILE SUPPLY | Supply/Implant | $9,984.00 |
| 6101305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6101306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6101312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6101316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,542.72 |
| 6101330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,478.40 |
| 6101343 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6101344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,778.88 |
| 6101345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,970.56 |
| 6101352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6101356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,811.20 |
| 6101357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,811.20 |
| 6101358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,811.20 |
| 6101364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6101367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6101391 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101401 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101453 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101456 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101464 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101467 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101495 | SUPPLY IMPLANT | Supply/Implant | $6,048.00 |
| 6101521 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6101524 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6101526 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6101555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6101556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6101561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6101623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6101624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6101625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6101642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6101643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6101652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6101660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6101672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6101680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6101682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6101693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6101709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6101710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6101711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6101712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6101713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6101723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6101724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6101727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,470.59 |
| 6101729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6101770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6101776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6101824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6101841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6101872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6101894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6101895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6101896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6102071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,765.12 |
| 6102072 | CATH, DRAINAGE | Supply/Implant | $7,966.08 |
| 6102073 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6102080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6102081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6102082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6102088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6102093 | GENERAL SUPPLY | Supply/Implant | $536.19 |
| 6102095 | CATHETER, GUIDING | Supply/Implant | $443.52 |
| 6102097 | MESH (IMPLANTABLE) | Supply/Implant | $8,307.20 |
| 6102099 | GRAFT, VASCULAR | Supply/Implant | $57,830.40 |
| 6102100 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6102106 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6102110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6102116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102129 | SUPPLY IMPLANT | Supply/Implant | $9,081.60 |
| 6102132 | GENERAL SUPPLY | Supply/Implant | $479.87 |
| 6102133 | GENERAL SUPPLY | Supply/Implant | $466.83 |
| 6102134 | GENERAL SUPPLY | Supply/Implant | $670.85 |
| 6102135 | GENERAL SUPPLY | Supply/Implant | $708.86 |
| 6102138 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6102139 | STERILE SUPPLY | Supply/Implant | $182.66 |
| 6102140 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6102141 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6102145 | CATH, DRAINAGE | Supply/Implant | $1,600.00 |
| 6102152 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6102153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6102154 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,321.60 |
| 6102157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6102158 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6102164 | GRAFT, VASCULAR | Supply/Implant | $3,316.61 |
| 6102165 | GRAFT, VASCULAR | Supply/Implant | $5,725.70 |
| 6102175 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6102200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6102201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6102217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6102218 | GENERAL SUPPLY | Supply/Implant | $7,270.40 |
| 6102221 | GENERAL SUPPLY | Supply/Implant | $11,266.56 |
| 6102230 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6102231 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $54,732.80 |
| 6102232 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,304.00 |
| 6102233 | SUPPLY IMPLANT | Supply/Implant | $4,940.80 |
| 6102235 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,312.00 |
| 6102240 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6102241 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6102242 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6102243 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6102244 | SUPPLY IMPLANT | Supply/Implant | $1,248.00 |
| 6102245 | SUPPLY IMPLANT | Supply/Implant | $2,238.59 |
| 6102247 | SUPPLY IMPLANT | Supply/Implant | $1,410.94 |
| 6102249 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6102250 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6102251 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6102252 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6102253 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6102301 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6102302 | CATHETER, GUIDING | Supply/Implant | $465.92 |
| 6102303 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6102304 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6102306 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6102307 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6102314 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6102315 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6102317 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6102318 | GUIDE WIRE | Supply/Implant | $1,423.36 |
| 6102319 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6102320 | CATHETER, GUIDING | Supply/Implant | $473.60 |
| 6102322 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,728.00 |
| 6102323 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6102325 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6102327 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6102331 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6102334 | SUPPLY IMPLANT | Supply/Implant | $480.81 |
| 6102335 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6102336 | GRAFT, VASCULAR | Supply/Implant | $25,972.22 |
| 6102340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6102341 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6102345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6102350 | GENERAL SUPPLY | Supply/Implant | $167.81 |
| 6102351 | GENERAL SUPPLY | Supply/Implant | $1,146.88 |
| 6102356 | SUPPLY IMPLANT | Supply/Implant | $1,190.40 |
| 6102358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6102367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6102368 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6102370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6102371 | GENERAL SUPPLY | Supply/Implant | $243.20 |
| 6102372 | GENERAL SUPPLY | Supply/Implant | $202.62 |
| 6102379 | SUPPLY IMPLANT | Supply/Implant | $33,095.68 |
| 6102380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6102383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6102385 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6102386 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6102387 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6102388 | SUPPLY IMPLANT | Supply/Implant | $7,155.71 |
| 6102390 | CATHETER, GUIDING | Supply/Implant | $7,811.48 |
| 6102396 | GENERAL SUPPLY | Supply/Implant | $158.59 |
| 6102398 | STERILE SUPPLY | Supply/Implant | $221.44 |
| 6102411 | STERILE SUPPLY | Supply/Implant | $888.19 |
| 6102425 | INTRO/SHEATH, NON-LASER | Supply/Implant | $605.57 |
| 6102429 | GENERAL SUPPLY | Supply/Implant | $142.11 |
| 6102438 | CATHETER, URETERAL | Supply/Implant | $197.38 |
| 6102439 | CATHETER, URETERAL | Supply/Implant | $197.38 |
| 6102440 | STERILE SUPPLY | Supply/Implant | $208.13 |
| 6102455 | STERILE SUPPLY | Supply/Implant | $128.26 |
| 6102459 | STERILE SUPPLY | Supply/Implant | $596.48 |
| 6102477 | STERILE SUPPLY | Supply/Implant | $130.44 |
| 6102479 | STERILE SUPPLY | Supply/Implant | $156.80 |
| 6102488 | STERILE SUPPLY | Supply/Implant | $3,487.74 |
| 6102495 | GENERAL SUPPLY | Supply/Implant | $6,952.70 |
| 6102497 | STERILE SUPPLY | Supply/Implant | $196.99 |
| 6102500 | GENERAL SUPPLY | Supply/Implant | $157.36 |
| 6102505 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6102506 | SUPPLY IMPLANT | Supply/Implant | $668.03 |
| 6102507 | STERILE SUPPLY | Supply/Implant | $273.97 |
| 6102508 | SUPPLY IMPLANT | Supply/Implant | $1,092.61 |
| 6102509 | STERILE SUPPLY | Supply/Implant | $2,307.20 |
| 6102510 | SUPPLY IMPLANT | Supply/Implant | $1,540.61 |
| 6102511 | GENERAL SUPPLY | Supply/Implant | $342.40 |
| 6102512 | SUPPLY IMPLANT | Supply/Implant | $240.38 |
| 6102516 | SUPPLY IMPLANT | Supply/Implant | $34,975.49 |
| 6102523 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6102527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6102528 | SUPPLY IMPLANT | Supply/Implant | $4,523.14 |
| 6102530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102531 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6102533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6102536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102538 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6102540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6102551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6102554 | SUPPLY IMPLANT | Supply/Implant | $396.80 |
| 6102555 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102556 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102558 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102559 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102560 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102561 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102562 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102563 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102564 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102565 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102566 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102567 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102568 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102572 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,760.00 |
| 6102573 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,760.00 |
| 6102575 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6102579 | SUPPLY IMPLANT | Supply/Implant | $5,693.44 |
| 6102580 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6102586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6102589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102602 | STERILE SUPPLY | Supply/Implant | $6,123.52 |
| 6102603 | SUPPLY IMPLANT | Supply/Implant | $1,967.10 |
| 6102604 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6102605 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6102606 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6102608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6102613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6102614 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6102616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6102620 | SUPPLY IMPLANT | Supply/Implant | $18,714.62 |
| 6102624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6102626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6102627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6102628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6102629 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6102630 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6102634 | CATHETER, GUIDING | Supply/Implant | $3,392.00 |
| 6102637 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6102641 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6102642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,424.64 |
| 6102643 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6102649 | SUPPLY IMPLANT | Supply/Implant | $1,594.88 |
| 6102653 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6102656 | SUPPLY IMPLANT | Supply/Implant | $367.36 |
| 6102657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $851.20 |
| 6102662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6102663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6102664 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6102673 | SUPPLY IMPLANT | Supply/Implant | $5,158.91 |
| 6102684 | SUPPLY IMPLANT | Supply/Implant | $1,457.66 |
| 6102685 | SUPPLY IMPLANT | Supply/Implant | $2,634.24 |
| 6102687 | SUPPLY IMPLANT | Supply/Implant | $193.66 |
| 6102688 | SUPPLY IMPLANT | Supply/Implant | $539.14 |
| 6102696 | CATHETER, GUIDING | Supply/Implant | $1,632.00 |
| 6102698 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6102699 | STERILE SUPPLY | Supply/Implant | $332.80 |
| 6102700 | SUPPLY IMPLANT | Supply/Implant | $9,907.71 |
| 6102703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6102706 | SUPPLY IMPLANT | Supply/Implant | $1,658.88 |
| 6102707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6102708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6102709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6102711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,888.00 |
| 6102712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,778.88 |
| 6102713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,370.24 |
| 6102717 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6102719 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6102735 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,680.00 |
| 6102738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6102739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6102753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6102767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6102777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $519.68 |
| 6102778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6102785 | SUPPLY IMPLANT | Supply/Implant | $1,067.19 |
| 6102786 | IMPL EXT ACCESS CATH | Supply/Implant | $2,368.00 |
| 6102787 | IMPL EXT ACCESS CATH | Supply/Implant | $2,368.00 |
| 6102789 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6102792 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6102793 | SUPPLY IMPLANT | Supply/Implant | $3,897.98 |
| 6102796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6102797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6102800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6102812 | SUPPLY IMPLANT | Supply/Implant | $1,788.16 |
| 6102813 | CATHETER, URETERAL | Supply/Implant | $499.20 |
| 6102824 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,048.00 |
| 6102828 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6102840 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6102843 | SUPPLY IMPLANT | Supply/Implant | $3,690.62 |
| 6102846 | GUIDE WIRE | Supply/Implant | $1,227.52 |
| 6102848 | INTERSPINOUS IMPLANT | Supply/Implant | $76,800.00 |
| 6102851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6102855 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6102856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6102857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,617.34 |
| 6102858 | SUPPLY IMPLANT | Supply/Implant | $4,396.80 |
| 6102861 | INTRO/SHEATH, NON-LASER | Supply/Implant | $704.00 |
| 6102863 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6102866 | SUPPLY IMPLANT | Supply/Implant | $2,114.56 |
| 6102871 | SUPPLY IMPLANT | Supply/Implant | $1,273.22 |
| 6102872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6102873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6102875 | GENERAL SUPPLY | Supply/Implant | $223.36 |
| 6102876 | SUPPLY IMPLANT | Supply/Implant | $19,169.28 |
| 6102879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6102882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102886 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $2,546.94 |
| 6102887 | GUIDE WIRE | Supply/Implant | $635.39 |
| 6102895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6102898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,012.35 |
| 6102899 | STERILE SUPPLY | Supply/Implant | $408.58 |
| 6102900 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6102909 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6102910 | STERILE SUPPLY | Supply/Implant | $579.20 |
| 6102915 | STERILE SUPPLY | Supply/Implant | $261.64 |
| 6102928 | STERILE SUPPLY | Supply/Implant | $349.70 |
| 6102929 | STERILE SUPPLY | Supply/Implant | $570.20 |
| 6102950 | STERILE SUPPLY | Supply/Implant | $356.75 |
| 6102959 | STERILE SUPPLY | Supply/Implant | $160.00 |
| 6102971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6102972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $519.68 |
| 6102974 | SUPPLY IMPLANT | Supply/Implant | $4,612.61 |
| 6102979 | GRAFT, VASCULAR | Supply/Implant | $18,509.95 |
| 6102985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6102988 | SUPPLY IMPLANT | Supply/Implant | $3,521.28 |
| 6102989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,057.28 |
| 6102990 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,470.59 |
| 6102991 | SUPPLY IMPLANT | Supply/Implant | $25,527.04 |
| 6102997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,778.88 |
| 6102999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6103001 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6103004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6103005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,132.16 |
| 6103007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6103008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6103009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6103023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6103026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6103028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,559.04 |
| 6103029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6103030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,370.24 |
| 6103033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,559.04 |
| 6103037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,132.16 |
| 6103041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6103044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6103045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6103046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,209.28 |
| 6103048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $779.52 |
| 6103049 | SUPPLY IMPLANT | Supply/Implant | $22,426.88 |
| 6103050 | SUPPLY IMPLANT | Supply/Implant | $6,191.36 |
| 6103051 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,469.95 |
| 6103088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6103096 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6103100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6103102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,904.00 |
| 6103106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,904.00 |
| 6103121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6103124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6103129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6103136 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103151 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6103162 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6103165 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103169 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103170 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103171 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103172 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103174 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103177 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103178 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103179 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103190 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,544.00 |
| 6103213 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6103215 | SUPPLY IMPLANT | Supply/Implant | $483.17 |
| 6103217 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,171.07 |
| 6103225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,476.80 |
| 6103227 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6103228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,668.80 |
| 6103230 | CONN TISS, NON-HUMAN | Supply/Implant | $37,440.00 |
| 6103233 | GUIDE WIRE | Supply/Implant | $2,448.00 |
| 6103237 | GRAFT, VASCULAR | Supply/Implant | $28,736.00 |
| 6103238 | GRAFT, VASCULAR | Supply/Implant | $21,401.60 |
| 6103241 | SUPPLY IMPLANT | Supply/Implant | $1,199.74 |
| 6103242 | SUPPLY IMPLANT | Supply/Implant | $521.47 |
| 6103243 | SUPPLY IMPLANT | Supply/Implant | $1,094.27 |
| 6103244 | SUPPLY IMPLANT | Supply/Implant | $154.24 |
| 6103246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,388.80 |
| 6103248 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6103249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6103257 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6103258 | STERILE SUPPLY | Supply/Implant | $601.60 |
| 6103259 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6103271 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $121,296.00 |
| 6103280 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6103285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6103300 | GENERAL SUPPLY | Supply/Implant | $1,109.25 |
| 6103313 | STERILE SUPPLY | Supply/Implant | $280.45 |
| 6103318 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6103319 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6103330 | STERILE SUPPLY | Supply/Implant | $339.20 |
| 6103334 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,360.00 |
| 6103337 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6103338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6103342 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6103345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6103346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6103351 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $2,188.80 |
| 6103352 | STERILE SUPPLY | Supply/Implant | $4,377.60 |
| 6103363 | STERILE SUPPLY | Supply/Implant | $1,177.60 |
| 6103364 | STERILE SUPPLY | Supply/Implant | $1,177.60 |
| 6103365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6103367 | STERILE SUPPLY | Supply/Implant | $8,952.32 |
| 6103368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6103369 | SUPPLY IMPLANT | Supply/Implant | $22,080.00 |
| 6103370 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6103372 | SUPPLY IMPLANT | Supply/Implant | $925.44 |
| 6103380 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,000.00 |
| 6103384 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103388 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6103392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $421.12 |
| 6103403 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6103409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6103417 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103419 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103427 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103429 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103432 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103433 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103440 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103441 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103442 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103462 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103471 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103472 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103476 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103502 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $97,792.00 |
| 6103503 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103520 | SUPPLY IMPLANT | Supply/Implant | $8,867.84 |
| 6103526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6103528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,224.00 |
| 6103532 | GENERAL SUPPLY | Supply/Implant | $5,183.36 |
| 6103537 | STERILE SUPPLY | Supply/Implant | $4,619.78 |
| 6103538 | STERILE SUPPLY | Supply/Implant | $3,182.98 |
| 6103539 | STERILE SUPPLY | Supply/Implant | $399.74 |
| 6103541 | INTRO/SHEATH, NON-LASER | Supply/Implant | $737.28 |
| 6103545 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,382.40 |
| 6103550 | GRAFT, VASCULAR | Supply/Implant | $31,294.08 |
| 6103553 | GENERAL SUPPLY | Supply/Implant | $340.10 |
| 6103555 | SUPPLY IMPLANT | Supply/Implant | $319.23 |
| 6103557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6103558 | SUPPLY IMPLANT | Supply/Implant | $36,288.00 |
| 6103560 | SUPPLY IMPLANT | Supply/Implant | $54,996.48 |
| 6103561 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,665.92 |
| 6103562 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6103563 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,803.20 |
| 6103564 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6103570 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6103571 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $10,880.00 |
| 6103574 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6103575 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6103576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6103577 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103578 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103579 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103580 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103583 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103584 | SUPPLY IMPLANT | Supply/Implant | $1,632.00 |
| 6103588 | SUPPLY IMPLANT | Supply/Implant | $5,822.72 |
| 6103591 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6103595 | STERILE SUPPLY | Supply/Implant | $2,073.47 |
| 6103596 | STERILE SUPPLY | Supply/Implant | $3,914.50 |
| 6103597 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $487.30 |
| 6103598 | GENERAL SUPPLY | Supply/Implant | $3,712.00 |
| 6103599 | GENERAL SUPPLY | Supply/Implant | $2,096.64 |
| 6103600 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6103604 | GENERAL SUPPLY | Supply/Implant | $1,161.60 |
| 6103607 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6103608 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6103609 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6103613 | STERILE SUPPLY | Supply/Implant | $1,989.63 |
| 6103614 | STERILE SUPPLY | Supply/Implant | $1,807.62 |
| 6103615 | STERILE SUPPLY | Supply/Implant | $3,504.90 |
| 6103616 | GENERAL SUPPLY | Supply/Implant | $2,795.39 |
| 6103618 | STERILE SUPPLY | Supply/Implant | $7,702.91 |
| 6103621 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6103622 | GENERAL SUPPLY | Supply/Implant | $2,032.13 |
| 6103625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,852.80 |
| 6103630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6103631 | SUPPLY IMPLANT | Supply/Implant | $11,827.20 |
| 6103638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6103648 | SUPPLY IMPLANT | Supply/Implant | $421.50 |
| 6103649 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6103652 | MESH (IMPLANTABLE) | Supply/Implant | $5,347.46 |
| 6103653 | MESH (IMPLANTABLE) | Supply/Implant | $8,432.51 |
| 6103655 | CONN TISS, NON-HUMAN | Supply/Implant | $3,296.00 |
| 6103658 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6103659 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6103661 | CONN TISS, NON-HUMAN | Supply/Implant | $3,296.00 |
| 6103662 | MESH (IMPLANTABLE) | Supply/Implant | $11,238.91 |
| 6103663 | MESH (IMPLANTABLE) | Supply/Implant | $5,712.00 |
| 6103667 | GENERAL SUPPLY | Supply/Implant | $318.23 |
| 6103668 | GENERAL SUPPLY | Supply/Implant | $318.23 |
| 6103675 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,544.00 |
| 6103683 | MESH (IMPLANTABLE) | Supply/Implant | $6,389.50 |
| 6103686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,472.96 |
| 6103691 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $10,555.14 |
| 6103731 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6103734 | SUPPLY IMPLANT | Supply/Implant | $317.06 |
| 6103738 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103740 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6103748 | GUIDE WIRE | Supply/Implant | $1,011.20 |
| 6103760 | SUPPLY IMPLANT | Supply/Implant | $92,032.00 |
| 6103762 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,237.12 |
| 6103770 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6103772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6103773 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6103774 | SUPPLY IMPLANT | Supply/Implant | $243.79 |
| 6103776 | GUIDE WIRE | Supply/Implant | $1,172.61 |
| 6103789 | STERILE SUPPLY | Supply/Implant | $146.56 |
| 6103790 | GENERAL SUPPLY | Supply/Implant | $2,410.37 |
| 6103800 | GENERAL SUPPLY | Supply/Implant | $329.47 |
| 6103807 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103808 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103809 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103810 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103811 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103812 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103813 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103814 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103829 | GENERAL SUPPLY | Supply/Implant | $423.55 |
| 6103840 | WHFO,NO JOINT, PREFABRICATED | Supply/Implant | $313.47 |
| 6103851 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6103852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6103853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6103854 | SUPPLY IMPLANT | Supply/Implant | $1,673.98 |
| 6103855 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6103858 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6103865 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6103866 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6103867 | SUPPLY IMPLANT | Supply/Implant | $43,452.54 |
| 6103878 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6103880 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6103881 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,265.60 |
| 6103883 | GENERAL SUPPLY | Supply/Implant | $537.60 |
| 6103884 | GENERAL SUPPLY | Supply/Implant | $537.60 |
| 6103885 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,196.16 |
| 6103889 | GENERAL SUPPLY | Supply/Implant | $433.02 |
| 6103893 | SUPPLY IMPLANT | Supply/Implant | $2,634.24 |
| 6103894 | SUPPLY IMPLANT | Supply/Implant | $367.36 |
| 6103895 | SUPPLY IMPLANT | Supply/Implant | $367.36 |
| 6103902 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103903 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103904 | SUPPLY IMPLANT | Supply/Implant | $6,397.44 |
| 6103910 | GENERAL SUPPLY | Supply/Implant | $193.02 |
| 6103919 | SUPPLY IMPLANT | Supply/Implant | $801.09 |
| 6103920 | MESH (IMPLANTABLE) | Supply/Implant | $22,134.91 |
| 6103921 | MESH (IMPLANTABLE) | Supply/Implant | $28,960.90 |
| 6103923 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $59,008.00 |
| 6103924 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103925 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103926 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103927 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103928 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,776.00 |
| 6103937 | GENERAL SUPPLY | Supply/Implant | $266.75 |
| 6103938 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6103939 | SUPPLY IMPLANT | Supply/Implant | $398.30 |
| 6103941 | MESH (IMPLANTABLE) | Supply/Implant | $35,124.22 |
| 6103946 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103947 | PMKR, DUAL, RATE-RESP | Supply/Implant | $66,944.00 |
| 6103948 | PMKR, DUAL, RATE-RESP | Supply/Implant | $69,504.00 |
| 6103949 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103950 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103951 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103952 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103953 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103954 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103955 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103957 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6103962 | STERILE SUPPLY | Supply/Implant | $5,080.19 |
| 6103966 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103967 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103968 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6103969 | SUPPLY IMPLANT | Supply/Implant | $193.13 |
| 6103971 | MESH (IMPLANTABLE) | Supply/Implant | $23,399.68 |
| 6103974 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6103980 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103982 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103984 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103986 | SUPPLY IMPLANT | Supply/Implant | $226.30 |
| 6103988 | RET DEV, INSERTABLE | Supply/Implant | $9,251.84 |
| 6103989 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6103990 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6103991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6103995 | SUPPLY IMPLANT | Supply/Implant | $47,868.42 |
| 6103998 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6104005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104011 | SUPPLY IMPLANT | Supply/Implant | $3,302.40 |
| 6104014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104016 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,164.16 |
| 6104017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,552.00 |
| 6104019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104021 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6104022 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6104023 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6104025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104026 | RET DEV, INSERTABLE | Supply/Implant | $87,040.00 |
| 6104029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6104030 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6104032 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6104033 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,968.00 |
| 6104035 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6104036 | STERILE SUPPLY | Supply/Implant | $3,072.00 |
| 6104041 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6104044 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6104045 | SUPPLY IMPLANT | Supply/Implant | $2,478.72 |
| 6104046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,193.34 |
| 6104047 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,055.87 |
| 6104048 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $8,960.00 |
| 6104066 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6104076 | SUPPLY IMPLANT | Supply/Implant | $16,886.49 |
| 6104077 | SUPPLY IMPLANT | Supply/Implant | $9,287.56 |
| 6104079 | GENERAL SUPPLY | Supply/Implant | $868.84 |
| 6104080 | GRAFT, VASCULAR | Supply/Implant | $16,431.62 |
| 6104082 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6104090 | CLOSURE DEV, VASC | Supply/Implant | $2,496.00 |
| 6104091 | CLOSURE DEV, VASC | Supply/Implant | $2,496.00 |
| 6104092 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6104093 | CATHETER, GUIDING | Supply/Implant | $1,943.04 |
| 6104094 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $448.00 |
| 6104098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6104099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104101 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $10,240.00 |
| 6104104 | MISC SUP/ACC IMP VAD | Supply/Implant | $12,736.00 |
| 6104105 | CATHETER, GUIDING | Supply/Implant | $9,088.00 |
| 6104106 | CATHETER, GUIDING | Supply/Implant | $9,088.00 |
| 6104107 | CATHETER, GUIDING | Supply/Implant | $8,576.00 |
| 6104112 | OCULAR IMPLANT | Supply/Implant | $174.08 |
| 6104113 | OCULAR IMPLANT | Supply/Implant | $166.40 |
| 6104127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104128 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104130 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6104131 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6104132 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6104134 | GENERAL SUPPLY | Supply/Implant | $32,000.00 |
| 6104137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6104138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6104139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6104143 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6104144 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6104146 | STERILE SUPPLY | Supply/Implant | $170.21 |
| 6104155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6104157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,170.24 |
| 6104160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6104161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6104164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6104167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $122,535.00 |
| 6104170 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6104171 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6104172 | SUPPLY IMPLANT | Supply/Implant | $13,450.75 |
| 6104174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104180 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104181 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104182 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104183 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104189 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $329,108.50 |
| 6104193 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $121,296.00 |
| 6104194 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $60,496.00 |
| 6104195 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $77,824.00 |
| 6104200 | GENERAL SUPPLY | Supply/Implant | $1,088.00 |
| 6104204 | SUPPLY IMPLANT | Supply/Implant | $943.74 |
| 6104205 | MESH (IMPLANTABLE) | Supply/Implant | $20,336.64 |
| 6104208 | GENERAL SUPPLY | Supply/Implant | $142.49 |
| 6104210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104212 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104214 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6104216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6104217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104218 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104226 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104229 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6104230 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6104242 | SUPPLY IMPLANT | Supply/Implant | $122,367.00 |
| 6104243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,638.40 |
| 6104245 | GUIDE WIRE | Supply/Implant | $1,472.00 |
| 6104248 | SUPPLY IMPLANT | Supply/Implant | $426.50 |
| 6104249 | SUPPLY IMPLANT | Supply/Implant | $426.50 |
| 6104250 | SUPPLY IMPLANT | Supply/Implant | $426.50 |
| 6104256 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6104260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,632.00 |
| 6104262 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6104263 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6104267 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6104268 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6104269 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $50,150.40 |
| 6104271 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $640.00 |
| 6104272 | SUPPLY IMPLANT | Supply/Implant | $1,725.82 |
| 6104273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,080.77 |
| 6104275 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104280 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $92,800.00 |
| 6104281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6104282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6104283 | SUPPLY IMPLANT | Supply/Implant | $1,265.41 |
| 6104284 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104285 | STERILE SUPPLY | Supply/Implant | $2,531.84 |
| 6104287 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6104288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,049.60 |
| 6104289 | SUPPLY IMPLANT | Supply/Implant | $6,791.68 |
| 6104292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6104294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6104297 | STERILE SUPPLY | Supply/Implant | $979.20 |
| 6104298 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104300 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104301 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104302 | GENERAL SUPPLY | Supply/Implant | $155.78 |
| 6104309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,738.24 |
| 6104310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6104311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6104314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6104316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6104322 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6104323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104324 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6104328 | GUIDE WIRE | Supply/Implant | $2,624.00 |
| 6104330 | CATH OCCLUSION | Supply/Implant | $9,088.00 |
| 6104333 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,576.45 |
| 6104336 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6104337 | CATHETER, GUIDING | Supply/Implant | $282.11 |
| 6104340 | SUPPLY IMPLANT | Supply/Implant | $712.83 |
| 6104341 | STERILE SUPPLY | Supply/Implant | $1,048.32 |
| 6104342 | CONN TISS, NON-HUMAN | Supply/Implant | $3,245.44 |
| 6104345 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6104346 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6104347 | INTRO/SHEATH, NON-LASER | Supply/Implant | $409.60 |
| 6104349 | SUPPLY IMPLANT | Supply/Implant | $2,005.18 |
| 6104353 | SUPPLY IMPLANT | Supply/Implant | $1,630.72 |
| 6104357 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,750.40 |
| 6104358 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $59,888.00 |
| 6104359 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,454.66 |
| 6104367 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6104369 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,968.00 |
| 6104373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6104375 | SUPPLY IMPLANT | Supply/Implant | $8,073.47 |
| 6104380 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6104381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6104386 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6104389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6104408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6104410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6104412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6104418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,406.08 |
| 6104419 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6104420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6104422 | SUPPLY IMPLANT | Supply/Implant | $1,418.75 |
| 6104423 | SUPPLY IMPLANT | Supply/Implant | $1,550.08 |
| 6104430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104432 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6104434 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6104435 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6104437 | GENERAL SUPPLY | Supply/Implant | $603.01 |
| 6104440 | STERILE SUPPLY | Supply/Implant | $5,569.15 |
| 6104442 | SUPPLY IMPLANT | Supply/Implant | $1,703.94 |
| 6104443 | SUPPLY IMPLANT | Supply/Implant | $1,202.05 |
| 6104444 | SUPPLY IMPLANT | Supply/Implant | $5,775.62 |
| 6104449 | SUPPLY IMPLANT | Supply/Implant | $5,744.90 |
| 6104450 | SUPPLY IMPLANT | Supply/Implant | $1,234.94 |
| 6104451 | SUPPLY IMPLANT | Supply/Implant | $4,306.05 |
| 6104453 | SUPPLY IMPLANT | Supply/Implant | $718.34 |
| 6104455 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6104456 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6104457 | SUPPLY IMPLANT | Supply/Implant | $557.31 |
| 6104462 | SUPPLY IMPLANT | Supply/Implant | $186.50 |
| 6104467 | CATHETER, URETERAL | Supply/Implant | $353.28 |
| 6104468 | SUPPLY IMPLANT | Supply/Implant | $1,967.10 |
| 6104469 | SUPPLY IMPLANT | Supply/Implant | $1,472.64 |
| 6104471 | SUPPLY IMPLANT | Supply/Implant | $6,012.16 |
| 6104473 | SUPPLY IMPLANT | Supply/Implant | $6,361.86 |
| 6104474 | SUPPLY IMPLANT | Supply/Implant | $639.36 |
| 6104475 | STERILE SUPPLY | Supply/Implant | $1,331.20 |
| 6104476 | SUPPLY IMPLANT | Supply/Implant | $6,361.86 |
| 6104477 | STERILE SUPPLY | Supply/Implant | $709.12 |
| 6104481 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6104486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,556.86 |
| 6104498 | STERILE SUPPLY | Supply/Implant | $241.77 |
| 6104501 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $35,840.00 |
| 6104503 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,960.00 |
| 6104508 | SUPPLY IMPLANT | Supply/Implant | $1,416.83 |
| 6104511 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6104513 | GRAFT, VASCULAR | Supply/Implant | $3,801.60 |
| 6104517 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6104518 | GUIDE WIRE | Supply/Implant | $3,456.00 |
| 6104519 | GUIDE WIRE | Supply/Implant | $3,456.00 |
| 6104520 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6104521 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6104523 | STERILE SUPPLY | Supply/Implant | $995.71 |
| 6104526 | BRACHYTHERAPY NEEDLE | Supply/Implant | $2,368.00 |
| 6104527 | LEAD, NEUROSTIMULATOR | Supply/Implant | $58,304.00 |
| 6104528 | SUPPLY IMPLANT | Supply/Implant | $1,376.41 |
| 6104534 | CATHETER, URETERAL | Supply/Implant | $504.19 |
| 6104537 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6104538 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6104539 | STERILE SUPPLY | Supply/Implant | $496.77 |
| 6104540 | CONN TISS, NON-HUMAN | Supply/Implant | $5,903.10 |
| 6104541 | CONN TISS, NON-HUMAN | Supply/Implant | $8,095.74 |
| 6104542 | STERILE SUPPLY | Supply/Implant | $396.67 |
| 6104544 | CONN TISS, NON-HUMAN | Supply/Implant | $7,785.98 |
| 6104546 | SUPPLY IMPLANT | Supply/Implant | $206.08 |
| 6104547 | SUPPLY IMPLANT | Supply/Implant | $1,317.89 |
| 6104548 | SUPPLY IMPLANT | Supply/Implant | $1,225.86 |
| 6104549 | SUPPLY IMPLANT | Supply/Implant | $449.36 |
| 6104552 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,371.39 |
| 6104553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6104554 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6104557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6104562 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104563 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104564 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104566 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $303,000.00 |
| 6104567 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $303,000.00 |
| 6104570 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,000.00 |
| 6104572 | GRAFT, VASCULAR | Supply/Implant | $38,464.00 |
| 6104585 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6104590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6104596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6104598 | SUPPLY IMPLANT | Supply/Implant | $14,040.96 |
| 6104599 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6104601 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104603 | STERILE SUPPLY | Supply/Implant | $671.62 |
| 6104604 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6104605 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6104607 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104608 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6104609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104613 | GENERAL SUPPLY | Supply/Implant | $634.88 |
| 6104614 | SUPPLY IMPLANT | Supply/Implant | $22,976.00 |
| 6104617 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6104629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6104637 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6104640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6104653 | CORNEAL TISSUE PROCESSING | Supply/Implant | $56,320.00 |
| 6104655 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6104656 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6104657 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6104659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,204.80 |
| 6104662 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6104666 | SUPPLY IMPLANT | Supply/Implant | $8,908.80 |
| 6104667 | GENERAL SUPPLY | Supply/Implant | $1,024.00 |
| 6104672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,800.00 |
| 6104674 | SUPPLY IMPLANT | Supply/Implant | $3,615.23 |
| 6104676 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6104677 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6104681 | GENERAL SUPPLY | Supply/Implant | $160.44 |
| 6104690 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6104691 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6104693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6104696 | SUPPLY IMPLANT | Supply/Implant | $395.78 |
| 6104701 | MESH (IMPLANTABLE) | Supply/Implant | $4,810.62 |
| 6104704 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6104707 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $832.38 |
| 6104710 | CATHETER, GUIDING | Supply/Implant | $593.92 |
| 6104711 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $648.32 |
| 6104715 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $276.48 |
| 6104716 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $593.92 |
| 6104717 | CATHETER, GUIDING | Supply/Implant | $276.48 |
| 6104718 | CATHETER, GUIDING | Supply/Implant | $2,821.38 |
| 6104720 | CATHETER, GUIDING | Supply/Implant | $2,099.20 |
| 6104721 | CATHETER, GUIDING | Supply/Implant | $273.92 |
| 6104723 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,852.80 |
| 6104725 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6104732 | STERILE SUPPLY | Supply/Implant | $342.53 |
| 6104739 | SUPPLY IMPLANT | Supply/Implant | $17,167.36 |
| 6104741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6104742 | STERILE SUPPLY | Supply/Implant | $402.56 |
| 6104744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6104745 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6104749 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6104751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,164.80 |
| 6104752 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6104758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,848.00 |
| 6104767 | SUPPLY IMPLANT | Supply/Implant | $23,334.40 |
| 6104768 | SUPPLY IMPLANT | Supply/Implant | $12,850.82 |
| 6104769 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6104770 | SUPPLY IMPLANT | Supply/Implant | $16,960.00 |
| 6104780 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6104789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,552.00 |
| 6104790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6104791 | SUPPLY IMPLANT | Supply/Implant | $480.26 |
| 6104792 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,476.74 |
| 6104794 | SUPPLY IMPLANT | Supply/Implant | $6,310.40 |
| 6104799 | STERILE SUPPLY | Supply/Implant | $2,124.80 |
| 6104800 | GENERAL SUPPLY | Supply/Implant | $1,113.60 |
| 6104801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6104816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6104817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6104818 | CATHETER, URETERAL | Supply/Implant | $197.38 |
| 6104820 | GUIDE WIRE | Supply/Implant | $2,222.08 |
| 6104821 | CONN TISS, NON-HUMAN | Supply/Implant | $19,868.16 |
| 6104823 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $832.38 |
| 6104826 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6104827 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6104828 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104829 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104836 | SUPPLY IMPLANT | Supply/Implant | $471.55 |
| 6104843 | STERILE SUPPLY | Supply/Implant | $26,854.40 |
| 6104844 | GENERAL SUPPLY | Supply/Implant | $42,214.40 |
| 6104845 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6104846 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6104853 | STERILE SUPPLY | Supply/Implant | $1,206.53 |
| 6104855 | STERILE SUPPLY | Supply/Implant | $317.82 |
| 6104856 | SUPPLY IMPLANT | Supply/Implant | $5,956.19 |
| 6104859 | GENERAL SUPPLY | Supply/Implant | $1,939.71 |
| 6104861 | GRAFT, VASCULAR | Supply/Implant | $2,001.79 |
| 6104862 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6104863 | STERILE SUPPLY | Supply/Implant | $247.17 |
| 6104864 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $26,816.00 |
| 6104865 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $26,816.00 |
| 6104866 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $26,816.00 |
| 6104875 | SUPPLY IMPLANT | Supply/Implant | $668.03 |
| 6104877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6104896 | STERILE SUPPLY | Supply/Implant | $397.70 |
| 6104900 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,382.53 |
| 6104903 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6104922 | MESH (IMPLANTABLE) | Supply/Implant | $5,347.46 |
| 6104923 | MESH (IMPLANTABLE) | Supply/Implant | $8,432.49 |
| 6104927 | CATHETER, GUIDING | Supply/Implant | $648.58 |
| 6104928 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6104929 | GUIDE WIRE | Supply/Implant | $6,935.04 |
| 6104931 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $178,500.00 |
| 6104944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6104945 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6104947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6104948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6104959 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6104964 | MESH (IMPLANTABLE) | Supply/Implant | $2,907.90 |
| 6104965 | MESH (IMPLANTABLE) | Supply/Implant | $2,907.90 |
| 6104969 | GENERAL SUPPLY | Supply/Implant | $276.86 |
| 6104989 | GRAFT, VASCULAR | Supply/Implant | $11,618.82 |
| 6105009 | SUPPLY IMPLANT | Supply/Implant | $1,661.44 |
| 6105010 | SUPPLY IMPLANT | Supply/Implant | $480.81 |
| 6105012 | GUIDE WIRE | Supply/Implant | $2,457.60 |
| 6105013 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6105014 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6105019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6105020 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6105021 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6105022 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6105025 | GENERAL SUPPLY | Supply/Implant | $283.20 |
| 6105026 | SUPPLY IMPLANT | Supply/Implant | $2,470.40 |
| 6105027 | CATH OCCLUSION | Supply/Implant | $17,920.00 |
| 6105028 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6105030 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $9,280.00 |
| 6105031 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6105032 | SUPPLY IMPLANT | Supply/Implant | $271.24 |
| 6105034 | CONN TISS, NON-HUMAN | Supply/Implant | $3,871.74 |
| 6105037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105045 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6105054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105062 | SUPPLY IMPLANT | Supply/Implant | $4,855.04 |
| 6105065 | GENERAL SUPPLY | Supply/Implant | $422.40 |
| 6105067 | SUPPLY IMPLANT | Supply/Implant | $200.38 |
| 6105068 | SUPPLY IMPLANT | Supply/Implant | $315.52 |
| 6105069 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6105071 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6105073 | STERILE SUPPLY | Supply/Implant | $257.28 |
| 6105075 | STERILE SUPPLY | Supply/Implant | $3,123.20 |
| 6105077 | STERILE SUPPLY | Supply/Implant | $4,318.59 |
| 6105079 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $8,320.00 |
| 6105092 | PORT, INDWELLING, IMP | Supply/Implant | $3,476.86 |
| 6105093 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6105094 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6105096 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6105102 | CATHETER, GUIDING | Supply/Implant | $678.40 |
| 6105103 | CATHETER, GUIDING | Supply/Implant | $678.40 |
| 6105108 | SUPPLY IMPLANT | Supply/Implant | $2,300.03 |
| 6105110 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6105111 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6105115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,785.47 |
| 6105116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,017.28 |
| 6105118 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6105121 | SUPPLY IMPLANT | Supply/Implant | $682.37 |
| 6105126 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6105127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,520.00 |
| 6105128 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6105129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6105134 | GENERAL SUPPLY | Supply/Implant | $316.54 |
| 6105138 | SUPPLY IMPLANT | Supply/Implant | $745.22 |
| 6105141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6105143 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6105145 | SUPPLY IMPLANT | Supply/Implant | $12,864.00 |
| 6105147 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6105149 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6105151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,312.00 |
| 6105156 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,571.20 |
| 6105157 | GENERAL SUPPLY | Supply/Implant | $308.61 |
| 6105160 | STERILE SUPPLY | Supply/Implant | $361.86 |
| 6105166 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6105168 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6105175 | GENERAL SUPPLY | Supply/Implant | $19,200.00 |
| 6105177 | GENERAL SUPPLY | Supply/Implant | $18,560.00 |
| 6105184 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6105185 | GENERAL SUPPLY | Supply/Implant | $364.80 |
| 6105192 | SUPPLY IMPLANT | Supply/Implant | $11,808.77 |
| 6105193 | SUPPLY IMPLANT | Supply/Implant | $1,446.53 |
| 6105199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6105209 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6105214 | GRAFT, VASCULAR | Supply/Implant | $15,836.16 |
| 6105219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6105223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6105224 | SUPPLY IMPLANT | Supply/Implant | $13,178.88 |
| 6105227 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $33,868.80 |
| 6105229 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6105230 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6105231 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $832.38 |
| 6105232 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6105238 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6105239 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6105247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,000.00 |
| 6105256 | GRAFT, VASCULAR | Supply/Implant | $14,579.20 |
| 6105257 | GRAFT, VASCULAR | Supply/Implant | $15,219.20 |
| 6105258 | CATH, DRAINAGE | Supply/Implant | $174.72 |
| 6105259 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6105260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6105261 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6105262 | SUPPLY IMPLANT | Supply/Implant | $50,560.00 |
| 6105269 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105272 | GENERAL SUPPLY | Supply/Implant | $2,467.84 |
| 6105273 | CATH OCCLUSION | Supply/Implant | $3,392.00 |
| 6105274 | STERILE SUPPLY | Supply/Implant | $1,092.10 |
| 6105281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $71,428.48 |
| 6105286 | SUPPLY IMPLANT | Supply/Implant | $343.42 |
| 6105292 | CATHETER, GUIDING | Supply/Implant | $2,521.60 |
| 6105294 | CATH OCCLUSION | Supply/Implant | $2,521.60 |
| 6105308 | SUPPLY IMPLANT | Supply/Implant | $11,569.79 |
| 6105309 | GENERAL SUPPLY | Supply/Implant | $384.00 |
| 6105313 | SUPPLY IMPLANT | Supply/Implant | $8,944.00 |
| 6105316 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6105335 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6105337 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6105347 | SUPPLY IMPLANT | Supply/Implant | $181.50 |
| 6105348 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6105353 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6105354 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $60,496.00 |
| 6105359 | GRAFT, VASCULAR | Supply/Implant | $90,880.00 |
| 6105360 | GRAFT, VASCULAR | Supply/Implant | $90,880.00 |
| 6105362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6105366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6105368 | AICD, SINGLE CHAMBER | Supply/Implant | $138,127.50 |
| 6105373 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6105374 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6105375 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6105379 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6105382 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6105384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,398.40 |
| 6105385 | GENERAL SUPPLY | Supply/Implant | $648.96 |
| 6105389 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $102,400.00 |
| 6105390 | GENERAL SUPPLY | Supply/Implant | $448.26 |
| 6105391 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6105392 | CONN TISS, NON-HUMAN | Supply/Implant | $8,095.74 |
| 6105394 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6105402 | SUPPLY IMPLANT | Supply/Implant | $2,764.80 |
| 6105403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6105404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,035.20 |
| 6105408 | SUPPLY IMPLANT | Supply/Implant | $5,888.00 |
| 6105409 | SUPPLY IMPLANT | Supply/Implant | $13,378.56 |
| 6105411 | STERILE SUPPLY | Supply/Implant | $1,317.12 |
| 6105413 | STERILE SUPPLY | Supply/Implant | $467.20 |
| 6105415 | SUPPLY IMPLANT | Supply/Implant | $33,095.68 |
| 6105421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,209.28 |
| 6105422 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $75,072.00 |
| 6105424 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6105425 | STERILE SUPPLY | Supply/Implant | $172.54 |
| 6105432 | SUPPLY IMPLANT | Supply/Implant | $2,257.92 |
| 6105435 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6105448 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $35,712.00 |
| 6105455 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6105456 | GENERAL SUPPLY | Supply/Implant | $262.02 |
| 6105457 | GENERAL SUPPLY | Supply/Implant | $870.82 |
| 6105458 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6105459 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6105461 | SUPPLY IMPLANT | Supply/Implant | $2,214.40 |
| 6105463 | RET DEV, INSERTABLE | Supply/Implant | $8,320.00 |
| 6105464 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105465 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105466 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105467 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105470 | STERILE SUPPLY | Supply/Implant | $279.04 |
| 6105471 | SUPPLY IMPLANT | Supply/Implant | $3,655.68 |
| 6105472 | GUIDE WIRE | Supply/Implant | $2,005.18 |
| 6105479 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6105482 | STERILE SUPPLY | Supply/Implant | $865.28 |
| 6105489 | SUPPLY IMPLANT | Supply/Implant | $1,698.56 |
| 6105491 | SUPPLY IMPLANT | Supply/Implant | $7,659.52 |
| 6105492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6105493 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6105495 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,863.23 |
| 6105497 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6105499 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6105500 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6105506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6105529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6105530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,079.68 |
| 6105543 | GRAFT, VASCULAR | Supply/Implant | $29,440.00 |
| 6105549 | SUPPLY IMPLANT | Supply/Implant | $2,477.06 |
| 6105554 | SUPPLY IMPLANT | Supply/Implant | $1,830.40 |
| 6105555 | CATHETER, URETERAL | Supply/Implant | $143.74 |
| 6105556 | CATHETER, URETERAL | Supply/Implant | $143.74 |
| 6105557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,779.20 |
| 6105560 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6105561 | SUPPLY IMPLANT | Supply/Implant | $449.36 |
| 6105563 | GUIDE WIRE | Supply/Implant | $294.40 |
| 6105565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,594.88 |
| 6105578 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6105582 | SUPPLY IMPLANT | Supply/Implant | $4,837.12 |
| 6105587 | GENERAL SUPPLY | Supply/Implant | $160.26 |
| 6105588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6105589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6105590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6105592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6105593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6105594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6105595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $772.99 |
| 6105598 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,504.00 |
| 6105599 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $17,830.40 |
| 6105602 | GUIDE WIRE | Supply/Implant | $2,293.76 |
| 6105603 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6105604 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,888.00 |
| 6105606 | SUPPLY IMPLANT | Supply/Implant | $48,320.00 |
| 6105609 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6105620 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6105621 | GUIDE WIRE | Supply/Implant | $1,228.80 |
| 6105634 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6105647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105660 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6105665 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6105671 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6105672 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6105673 | STERILE SUPPLY | Supply/Implant | $294.94 |
| 6105675 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6105679 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6105688 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,031.36 |
| 6105692 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6105693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6105697 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6105699 | GENERAL SUPPLY | Supply/Implant | $1,472.00 |
| 6105700 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6105701 | GENERAL SUPPLY | Supply/Implant | $332.80 |
| 6105702 | GENERAL SUPPLY | Supply/Implant | $5,760.00 |
| 6105704 | GENERAL SUPPLY | Supply/Implant | $704.00 |
| 6105706 | SUPPLY IMPLANT | Supply/Implant | $1,006.72 |
| 6105707 | GENERAL SUPPLY | Supply/Implant | $24,729.60 |
| 6105708 | GENERAL SUPPLY | Supply/Implant | $21,504.00 |
| 6105712 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6105720 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,369.60 |
| 6105721 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,186.18 |
| 6105723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6105727 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6105728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6105740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105741 | SUPPLY IMPLANT | Supply/Implant | $1,062.40 |
| 6105742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,489.28 |
| 6105744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,596.80 |
| 6105749 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6105750 | SUPPLY IMPLANT | Supply/Implant | $28,019.20 |
| 6105755 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105756 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105757 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105759 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105762 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6105763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6105765 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6105766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6105767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6105768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6105769 | CATH OCCLUSION | Supply/Implant | $14,860.80 |
| 6105770 | CATH OCCLUSION | Supply/Implant | $14,860.80 |
| 6105771 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6105772 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6105778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6105779 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6105780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,740.80 |
| 6105788 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6105807 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6105808 | GENERAL SUPPLY | Supply/Implant | $397.70 |
| 6105812 | BRACHYTHERAPY NEEDLE | Supply/Implant | $1,664.00 |
| 6105813 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6105814 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6105815 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,174.34 |
| 6105824 | SUPPLY IMPLANT | Supply/Implant | $283.26 |
| 6105825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6105832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6105840 | STERILE SUPPLY | Supply/Implant | $1,034.88 |
| 6105845 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6105847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6105855 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6105865 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,040.00 |
| 6105866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $79,897.60 |
| 6105874 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6105875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6105876 | GENERAL SUPPLY | Supply/Implant | $23,040.00 |
| 6105894 | AICD, SINGLE CHAMBER | Supply/Implant | $207,050.00 |
| 6105895 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $39,603.20 |
| 6105896 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $39,603.20 |
| 6105897 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $39,603.20 |
| 6105925 | AICD, SINGLE CHAMBER | Supply/Implant | $153,877.50 |
| 6105937 | STERILE SUPPLY | Supply/Implant | $4,614.40 |
| 6105940 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6105952 | SUPPLY IMPLANT | Supply/Implant | $4,073.47 |
| 6105957 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6105963 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6105964 | GRAFT, VASCULAR | Supply/Implant | $113,064.00 |
| 6105965 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6105966 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6105973 | SUPPLY IMPLANT | Supply/Implant | $339.46 |
| 6105976 | CATHETER, GUIDING | Supply/Implant | $640.00 |
| 6105992 | SUPPLY IMPLANT | Supply/Implant | $2,146.18 |
| 6105993 | SUPPLY IMPLANT | Supply/Implant | $2,146.18 |
| 6105995 | SUPPLY IMPLANT | Supply/Implant | $252.16 |
| 6105997 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6105999 | SUPPLY IMPLANT | Supply/Implant | $174.08 |
| 6106000 | SUPPLY IMPLANT | Supply/Implant | $2,649.22 |
| 6106001 | STERILE SUPPLY | Supply/Implant | $229.25 |
| 6106002 | SUPPLY IMPLANT | Supply/Implant | $5,665.60 |
| 6106005 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6106009 | CATHETER, GUIDING | Supply/Implant | $385.92 |
| 6106010 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6106016 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $94,707.20 |
| 6106025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,038.98 |
| 6106029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $888.32 |
| 6106030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,845.95 |
| 6106034 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $4,352.00 |
| 6106045 | STERILE SUPPLY | Supply/Implant | $352.00 |
| 6106046 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6106049 | SUPPLY IMPLANT | Supply/Implant | $176.55 |
| 6106053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6106059 | SUPPLY IMPLANT | Supply/Implant | $652.93 |
| 6106060 | SUPPLY IMPLANT | Supply/Implant | $1,357.18 |
| 6106061 | SUPPLY IMPLANT | Supply/Implant | $1,357.18 |
| 6106071 | GENERAL SUPPLY | Supply/Implant | $734.72 |
| 6106088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6106097 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6106134 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6106136 | MESH (IMPLANTABLE) | Supply/Implant | $762.24 |
| 6106138 | SUPPLY IMPLANT | Supply/Implant | $2,622.46 |
| 6106139 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $14,289.66 |
| 6106140 | GUIDE WIRE | Supply/Implant | $231.30 |
| 6106147 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6106149 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6106163 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6106166 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6106168 | GENERAL SUPPLY | Supply/Implant | $1,009.41 |
| 6106172 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6106173 | STERILE SUPPLY | Supply/Implant | $130.82 |
| 6106178 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6106179 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,244.61 |
| 6106183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6106184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6106192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,658.56 |
| 6106195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,064.00 |
| 6106197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.46 |
| 6106198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.46 |
| 6106200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,786.56 |
| 6106202 | CATH, DRAINAGE | Supply/Implant | $4,257.79 |
| 6106203 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $20,864.00 |
| 6106207 | SUPPLY IMPLANT | Supply/Implant | $2,329.08 |
| 6106208 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6106212 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6106213 | GENERAL SUPPLY | Supply/Implant | $194.56 |
| 6106215 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6106221 | SUPPLY IMPLANT | Supply/Implant | $7,847.30 |
| 6106223 | SUPPLY IMPLANT | Supply/Implant | $1,417.31 |
| 6106224 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,549.76 |
| 6106241 | CATHETER, GUIDING | Supply/Implant | $14,400.00 |
| 6106242 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6106244 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $576.00 |
| 6106251 | GENERAL SUPPLY | Supply/Implant | $4,616.19 |
| 6106252 | STERILE SUPPLY | Supply/Implant | $759.81 |
| 6106253 | STERILE SUPPLY | Supply/Implant | $8,486.40 |
| 6106254 | STERILE SUPPLY | Supply/Implant | $732.16 |
| 6106256 | STERILE SUPPLY | Supply/Implant | $2,875.39 |
| 6106257 | STERILE SUPPLY | Supply/Implant | $1,304.58 |
| 6106268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6106273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6106274 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $768.00 |
| 6106275 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6106277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6106278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6106279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6106280 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6106281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6106282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6106283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6106284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6106285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6106287 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6106288 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6106289 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6106290 | CATHETER, GUIDING | Supply/Implant | $4,352.00 |
| 6106291 | CATHETER, GUIDING | Supply/Implant | $4,352.00 |
| 6106292 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6106293 | GENERAL SUPPLY | Supply/Implant | $704.00 |
| 6106295 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $10,624.00 |
| 6106302 | CATHETER, URETERAL | Supply/Implant | $470.53 |
| 6106303 | CATHETER, URETERAL | Supply/Implant | $470.53 |
| 6106304 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6106307 | CATHETER, GUIDING | Supply/Implant | $1,943.04 |
| 6106308 | GUIDE WIRE | Supply/Implant | $2,675.20 |
| 6106310 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6106314 | GENERAL SUPPLY | Supply/Implant | $184.96 |
| 6106315 | GUIDE WIRE | Supply/Implant | $4,012.80 |
| 6106317 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6106324 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6106337 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $94,707.20 |
| 6106339 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,511.04 |
| 6106432 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6106433 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6106446 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6106450 | SUPPLY IMPLANT | Supply/Implant | $17,395.20 |
| 6106461 | CATHETER, URETERAL | Supply/Implant | $374.14 |
| 6106462 | CATHETER, URETERAL | Supply/Implant | $374.14 |
| 6106463 | CATHETER, URETERAL | Supply/Implant | $374.14 |
| 6106464 | CATHETER, URETERAL | Supply/Implant | $331.14 |
| 6106467 | SUPPLY IMPLANT | Supply/Implant | $1,667.97 |
| 6106468 | SUPPLY IMPLANT | Supply/Implant | $1,667.97 |
| 6106471 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6106477 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,595.52 |
| 6106482 | SUPPLY IMPLANT | Supply/Implant | $2,185.38 |
| 6106483 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6106485 | GUIDE WIRE | Supply/Implant | $2,124.80 |
| 6106486 | CATH, DRAINAGE | Supply/Implant | $832.00 |
| 6106491 | SUPPLY IMPLANT | Supply/Implant | $2,518.53 |
| 6106517 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6106523 | STERILE SUPPLY | Supply/Implant | $43,456.00 |
| 6106524 | SUPPLY IMPLANT | Supply/Implant | $2,506.24 |
| 6106533 | SUPPLY IMPLANT | Supply/Implant | $909.34 |
| 6106548 | SUPPLY IMPLANT | Supply/Implant | $174.82 |
| 6106549 | SUPPLY IMPLANT | Supply/Implant | $175.55 |
| 6106551 | SUPPLY IMPLANT | Supply/Implant | $156.67 |
| 6106555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,193.34 |
| 6106556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,120.45 |
| 6106558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6106559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,818.88 |
| 6106566 | SUPPLY IMPLANT | Supply/Implant | $1,953.28 |
| 6106567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,318.78 |
| 6106572 | SUPPLY IMPLANT | Supply/Implant | $3,055.87 |
| 6106573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $980.22 |
| 6106577 | SUPPLY IMPLANT | Supply/Implant | $20,303.36 |
| 6106595 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6106606 | SUPPLY IMPLANT | Supply/Implant | $2,717.26 |
| 6106617 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $872.83 |
| 6106620 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6106621 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6106631 | SUPPLY IMPLANT | Supply/Implant | $1,205.12 |
| 6106634 | SUPPLY IMPLANT | Supply/Implant | $2,294.78 |
| 6106635 | SUPPLY IMPLANT | Supply/Implant | $2,876.67 |
| 6106636 | CLOSURE DEV, VASC | Supply/Implant | $3,687.94 |
| 6106637 | SUPPLY IMPLANT | Supply/Implant | $3,818.85 |
| 6106640 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,595.26 |
| 6106641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.04 |
| 6106643 | STERILE SUPPLY | Supply/Implant | $533.50 |
| 6106644 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6106647 | SUPPLY IMPLANT | Supply/Implant | $583.55 |
| 6106650 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6106651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,596.80 |
| 6106655 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6106656 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6106658 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,052.80 |
| 6106668 | GENERAL SUPPLY | Supply/Implant | $188.16 |
| 6106677 | STERILE SUPPLY | Supply/Implant | $2,127.56 |
| 6106678 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6106679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,964.16 |
| 6106680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6106681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6106691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6106693 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6106694 | SUPPLY IMPLANT | Supply/Implant | $457.60 |
| 6106695 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,224.00 |
| 6106696 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $226,543.00 |
| 6106697 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6106698 | SUPPLY IMPLANT | Supply/Implant | $1,038.21 |
| 6106699 | CATHETER, GUIDING | Supply/Implant | $3,878.40 |
| 6106700 | CATHETER, GUIDING | Supply/Implant | $3,878.40 |
| 6106701 | GENERAL SUPPLY | Supply/Implant | $140.80 |
| 6106704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6106706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6106707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6106717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6106721 | SUPPLY IMPLANT | Supply/Implant | $128.00 |
| 6106722 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6106725 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6106726 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6106728 | GENERAL SUPPLY | Supply/Implant | $149.76 |
| 6106729 | GENERAL SUPPLY | Supply/Implant | $161.28 |
| 6106744 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6106751 | CATH, DRAINAGE | Supply/Implant | $1,792.00 |
| 6106757 | CATH, DRAINAGE | Supply/Implant | $1,792.00 |
| 6106758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,798.40 |
| 6106762 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106763 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106764 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106765 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106766 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,312.00 |
| 6106792 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6106801 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6106807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6106808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6106809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6106810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6106811 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,069.76 |
| 6106815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6106832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6106834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,732.80 |
| 6106835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,732.80 |
| 6106850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,352.96 |
| 6106851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,352.96 |
| 6106853 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6106858 | CATHETER, GUIDING | Supply/Implant | $1,632.00 |
| 6106860 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6106861 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6106862 | CONN TISS, NON-HUMAN | Supply/Implant | $1,025.66 |
| 6106873 | GENERAL SUPPLY | Supply/Implant | $5,888.00 |
| 6106876 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6106877 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6106879 | GENERAL SUPPLY | Supply/Implant | $32,768.00 |
| 6106880 | GENERAL SUPPLY | Supply/Implant | $1,023.36 |
| 6106881 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,843.20 |
| 6106883 | SUPPLY IMPLANT | Supply/Implant | $1,228.03 |
| 6106884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6106885 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,336.00 |
| 6106887 | SUPPLY IMPLANT | Supply/Implant | $1,407.10 |
| 6106888 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6106890 | GENERAL SUPPLY | Supply/Implant | $717.06 |
| 6106892 | BRACHYTHERAPY NEEDLE | Supply/Implant | $160.00 |
| 6106893 | BRACHYTHERAPY NEEDLE | Supply/Implant | $176.90 |
| 6106896 | STERILE SUPPLY | Supply/Implant | $312.06 |
| 6106897 | STERILE SUPPLY | Supply/Implant | $491.78 |
| 6106916 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $22,912.00 |
| 6106918 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6106919 | GUIDE WIRE | Supply/Implant | $12,160.00 |
| 6106924 | SUPPLY IMPLANT | Supply/Implant | $1,273.60 |
| 6106929 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $14,464.00 |
| 6106931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6106934 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6106935 | GUIDE WIRE | Supply/Implant | $1,228.80 |
| 6106937 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,689.60 |
| 6106938 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,689.60 |
| 6106944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6106952 | SUPPLY IMPLANT | Supply/Implant | $415.36 |
| 6106953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,289.28 |
| 6106955 | SUPPLY IMPLANT | Supply/Implant | $398.34 |
| 6106957 | GRAFT, VASCULAR | Supply/Implant | $6,130.56 |
| 6106958 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $6,690.82 |
| 6106959 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6106962 | SUPPLY IMPLANT | Supply/Implant | $121,296.00 |
| 6106967 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6106968 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6106975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,611.52 |
| 6106983 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $32,640.00 |
| 6106985 | GRAFT, VASCULAR | Supply/Implant | $121,296.00 |
| 6106994 | CATHETER, GUIDING | Supply/Implant | $19,456.00 |
| 6106995 | CATHETER, GUIDING | Supply/Implant | $19,456.00 |
| 6106998 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6107014 | SUPPLY IMPLANT | Supply/Implant | $3,241.60 |
| 6107015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6107018 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6107019 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6107027 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6107028 | SUPPLY IMPLANT | Supply/Implant | $1,032.19 |
| 6107034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,844.80 |
| 6107040 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6107041 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6107043 | SUPPLY IMPLANT | Supply/Implant | $1,265.66 |
| 6107048 | CATH, DRAINAGE | Supply/Implant | $832.00 |
| 6107049 | CATH, DRAINAGE | Supply/Implant | $832.00 |
| 6107053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6107055 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6107060 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6107066 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6107068 | SUPPLY IMPLANT | Supply/Implant | $13,465.60 |
| 6107071 | GENERAL SUPPLY | Supply/Implant | $671.59 |
| 6107082 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6107083 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6107086 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6107087 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6107091 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,655.04 |
| 6107092 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $4,992.00 |
| 6107096 | PROSTHETIC IMPLANT NOS | Supply/Implant | $178,820.25 |
| 6107104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,228.16 |
| 6107106 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6107112 | GUIDE WIRE | Supply/Implant | $633.60 |
| 6107113 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6107131 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6107133 | GUIDE WIRE | Supply/Implant | $6,952.70 |
| 6107142 | SUPPLY IMPLANT | Supply/Implant | $4,467.20 |
| 6107146 | SUPPLY IMPLANT | Supply/Implant | $5,683.20 |
| 6107151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6107152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6107155 | GUIDE WIRE | Supply/Implant | $2,726.40 |
| 6107158 | SUPPLY IMPLANT | Supply/Implant | $10,892.80 |
| 6107159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6107160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6107161 | SUPPLY IMPLANT | Supply/Implant | $9,256.96 |
| 6107162 | SUPPLY IMPLANT | Supply/Implant | $9,256.96 |
| 6107165 | IMPL EXT ACCESS CATH | Supply/Implant | $12,386.30 |
| 6107166 | IMPL EXT ACCESS CATH | Supply/Implant | $9,256.96 |
| 6107169 | IMPL EXT ACCESS CATH | Supply/Implant | $4,928.00 |
| 6107170 | IMPL EXT ACCESS CATH | Supply/Implant | $4,928.00 |
| 6107171 | SUPPLY IMPLANT | Supply/Implant | $4,320.00 |
| 6107177 | INTRO/SHEATH, NON-LASER | Supply/Implant | $640.00 |
| 6107179 | GENERAL SUPPLY | Supply/Implant | $242.18 |
| 6107180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6107181 | STERILE SUPPLY | Supply/Implant | $244.35 |
| 6107185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6107192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.51 |
| 6107193 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6107194 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $106,752.00 |
| 6107198 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6107209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6107211 | GUIDE WIRE | Supply/Implant | $335.87 |
| 6107213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6107215 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6107218 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6107219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6107221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6107223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6107224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6107226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,267.20 |
| 6107229 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6107230 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6107231 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6107236 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6107237 | GENERAL SUPPLY | Supply/Implant | $1,344.00 |
| 6107241 | STERILE SUPPLY | Supply/Implant | $595.20 |
| 6107242 | STERILE SUPPLY | Supply/Implant | $928.00 |
| 6107243 | GENERAL SUPPLY | Supply/Implant | $947.20 |
| 6107244 | STERILE SUPPLY | Supply/Implant | $560.00 |
| 6107251 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $75,072.00 |
| 6107257 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,871.68 |
| 6107258 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,871.68 |
| 6107259 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,871.68 |
| 6107275 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6107286 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6107289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6107290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6107293 | SUPPLY IMPLANT | Supply/Implant | $931.46 |
| 6107302 | SUPPLY IMPLANT | Supply/Implant | $4,684.80 |
| 6107304 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6107305 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6107307 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,928.70 |
| 6107324 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6107325 | GUIDE WIRE | Supply/Implant | $4,352.00 |
| 6107330 | SUPPLY IMPLANT | Supply/Implant | $27,584.00 |
| 6107354 | STERILE SUPPLY | Supply/Implant | $622.34 |
| 6107355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6107370 | SUPPLY IMPLANT | Supply/Implant | $32,988.03 |
| 6107372 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6107375 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6107381 | SUPPLY IMPLANT | Supply/Implant | $12,608.00 |
| 6107409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $948.48 |
| 6107410 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,923.84 |
| 6107411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6107412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6107416 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6107417 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107418 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107419 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107420 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $896.00 |
| 6107422 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6107424 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6107425 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6107426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $563.20 |
| 6107427 | SUPPLY IMPLANT | Supply/Implant | $588.80 |
| 6107428 | SUPPLY IMPLANT | Supply/Implant | $563.20 |
| 6107429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6107430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6107432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6107434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6107442 | SUPPLY IMPLANT | Supply/Implant | $187.65 |
| 6107453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6107458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6107459 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6107463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6107465 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6107466 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6107467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6107478 | STERILE SUPPLY | Supply/Implant | $128.26 |
| 6107491 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6107492 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,852.80 |
| 6107494 | INTRO/SHEATH, NON-LASER | Supply/Implant | $268.80 |
| 6107496 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6107498 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6107499 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6107500 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6107501 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6107502 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6107507 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6107510 | SUPPLY IMPLANT | Supply/Implant | $2,062.08 |
| 6107514 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6107515 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6107518 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6107520 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $1,983.36 |
| 6107524 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6107527 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6107528 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6107536 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $14,144.00 |
| 6107537 | CATHETER, GUIDING | Supply/Implant | $13,760.00 |
| 6107538 | CATHETER, GUIDING | Supply/Implant | $13,760.00 |
| 6107539 | CATHETER, GUIDING | Supply/Implant | $22,361.60 |
| 6107540 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6107541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,852.80 |
| 6107542 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,240.00 |
| 6107546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6107551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6107553 | OCULAR IMPLANT | Supply/Implant | $7,616.00 |
| 6107557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6107558 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107560 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6107561 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6107562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6107563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,822.40 |
| 6107564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,822.40 |
| 6107565 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,152.00 |
| 6107598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6107632 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107636 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107638 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107774 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6107775 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6107776 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,055.36 |
| 6107777 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6107778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6107779 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6107780 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6107782 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6107790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6107858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6107862 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6107866 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6107870 | GUIDE WIRE | Supply/Implant | $3,398.40 |
| 6107871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6107872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6107880 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6107882 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6107883 | SUPPLY IMPLANT | Supply/Implant | $16,721.92 |
| 6107884 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6107888 | GENERAL SUPPLY | Supply/Implant | $128.64 |
| 6107933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6107934 | SUPPLY IMPLANT | Supply/Implant | $444.80 |
| 6107937 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6107942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6107943 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6107953 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,344.96 |
| 6107997 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6108076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6108093 | SUPPLY IMPLANT | Supply/Implant | $7,270.40 |
| 6108094 | STERILE SUPPLY | Supply/Implant | $206.85 |
| 6108100 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6108101 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,240.00 |
| 6108153 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,624.00 |
| 6108234 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,693.25 |
| 6108238 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,693.25 |
| 6108240 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6108241 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6108244 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6108245 | SUPPLY IMPLANT | Supply/Implant | $207.87 |
| 6108247 | GUIDE WIRE | Supply/Implant | $443.90 |
| 6108259 | STERILE SUPPLY | Supply/Implant | $386.07 |
| 6108260 | STERILE SUPPLY | Supply/Implant | $645.12 |
| 6108261 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $178,500.00 |
| 6108263 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $32,000.00 |
| 6108264 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6108266 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6108281 | STERILE SUPPLY | Supply/Implant | $10,531.46 |
| 6108286 | SUPPLY IMPLANT | Supply/Implant | $632.32 |
| 6108289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6108291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6108292 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6108293 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6108294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6108295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6108300 | GUIDE WIRE | Supply/Implant | $3,324.16 |
| 6108302 | SUPPLY IMPLANT | Supply/Implant | $189,378.00 |
| 6108308 | SUPPLY IMPLANT | Supply/Implant | $345.34 |
| 6108309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6108310 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $1,280.00 |
| 6108311 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,600.00 |
| 6108312 | GENERAL SUPPLY | Supply/Implant | $138.62 |
| 6108315 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6108319 | SUPPLY IMPLANT | Supply/Implant | $268.16 |
| 6108320 | SUPPLY IMPLANT | Supply/Implant | $2,259.20 |
| 6108321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6108325 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $6,336.00 |
| 6108326 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6108330 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6108331 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6108335 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6108336 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6108342 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6108343 | GENERAL SUPPLY | Supply/Implant | $516.61 |
| 6108344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6108361 | SUPPLY IMPLANT | Supply/Implant | $209.29 |
| 6108362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6108363 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6108369 | SUPPLY IMPLANT | Supply/Implant | $1,544.96 |
| 6108379 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6108380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6108381 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,378.56 |
| 6108386 | LEAD, NEUROSTIMULATOR | Supply/Implant | $50,560.00 |
| 6108387 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $322,442.50 |
| 6108388 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,800.00 |
| 6108389 | LEAD, NEUROSTIMULATOR | Supply/Implant | $50,560.00 |
| 6108392 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6108397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,622.40 |
| 6108400 | GRAFT, VASCULAR | Supply/Implant | $65,280.00 |
| 6108402 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6108404 | CATHETER, GUIDING | Supply/Implant | $14,144.00 |
| 6108422 | STERILE SUPPLY | Supply/Implant | $545.28 |
| 6108423 | STERILE SUPPLY | Supply/Implant | $491.52 |
| 6108425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6108429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,867.20 |
| 6108430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6108431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6108432 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6108434 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6108435 | INTRO/SHEATH, NON-LASER | Supply/Implant | $448.00 |
| 6108436 | INTRO/SHEATH, NON-LASER | Supply/Implant | $173.31 |
| 6108437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6108451 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6108455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6108456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6108457 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6108458 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6108460 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6108462 | SUPPLY IMPLANT | Supply/Implant | $243.79 |
| 6108463 | SUPPLY IMPLANT | Supply/Implant | $243.79 |
| 6108467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,536.00 |
| 6108485 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,920.00 |
| 6108493 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,484.93 |
| 6108506 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,678.59 |
| 6108514 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,484.93 |
| 6108539 | SUPPLY IMPLANT | Supply/Implant | $774.78 |
| 6108542 | SUPPLY IMPLANT | Supply/Implant | $1,368.70 |
| 6108545 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6108546 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6108547 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6108548 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6108552 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6108554 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6108565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6108568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6108569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6108570 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6108575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6108576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6108577 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6108581 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $15,129.60 |
| 6108582 | SUPPLY IMPLANT | Supply/Implant | $22,131.20 |
| 6108583 | HFO W/JOINT(S) CF | Supply/Implant | $20,800.00 |
| 6108591 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,664.00 |
| 6108592 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,664.00 |
| 6108593 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,664.00 |
| 6108594 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6108596 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6108600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,144.32 |
| 6108606 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6108608 | SUPPLY IMPLANT | Supply/Implant | $203.26 |
| 6108611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6108612 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6108615 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,000.00 |
| 6108620 | SUPPLY IMPLANT | Supply/Implant | $113,064.00 |
| 6108621 | SUPPLY IMPLANT | Supply/Implant | $38,464.00 |
| 6108622 | SUPPLY IMPLANT | Supply/Implant | $38,464.00 |
| 6108623 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6108624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6108632 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6108636 | STERILE SUPPLY | Supply/Implant | $662.78 |
| 6108639 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,752.00 |
| 6108642 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6108643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6108644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6108645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6108646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6108647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,176.96 |
| 6108648 | CATH, SUPRAPUBIC/CYSTOSCOPIC | Supply/Implant | $518.40 |
| 6108660 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6108661 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6108662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,752.00 |
| 6108674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,206.40 |
| 6108676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6108680 | GENERAL SUPPLY | Supply/Implant | $7,489.79 |
| 6108684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,510.78 |
| 6108685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,991.42 |
| 6108688 | SUPPLY IMPLANT | Supply/Implant | $2,994.69 |
| 6108690 | SUPPLY IMPLANT | Supply/Implant | $5,385.98 |
| 6108691 | SUPPLY IMPLANT | Supply/Implant | $11,956.74 |
| 6108699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6108702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6108704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6108705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6108706 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6108707 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6108708 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6108711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6108712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6108713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6108718 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6108721 | SUPPLY IMPLANT | Supply/Implant | $887.81 |
| 6108736 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,816.00 |
| 6108738 | SUPPLY IMPLANT | Supply/Implant | $1,407.05 |
| 6108739 | SUPPLY IMPLANT | Supply/Implant | $5,940.48 |
| 6108740 | SUPPLY IMPLANT | Supply/Implant | $5,940.48 |
| 6108741 | SUPPLY IMPLANT | Supply/Implant | $236.80 |
| 6108747 | GENERAL SUPPLY | Supply/Implant | $341.63 |
| 6108751 | INTERSPINOUS IMPLANT | Supply/Implant | $33,932.80 |
| 6108752 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $431.10 |
| 6108757 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6108766 | GENERAL SUPPLY | Supply/Implant | $186.88 |
| 6108767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,745.28 |
| 6108785 | SUPPLY IMPLANT | Supply/Implant | $18,048.00 |
| 6108788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6108794 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6108795 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6108799 | SUPPLY IMPLANT | Supply/Implant | $1,516.16 |
| 6108801 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6108803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6108806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6108807 | SUPPLY IMPLANT | Supply/Implant | $2,828.80 |
| 6108815 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6108816 | SUPPLY IMPLANT | Supply/Implant | $15,518.85 |
| 6108818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6108823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,896.00 |
| 6108824 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6108828 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6108835 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6108837 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6108848 | CRYOABLATION PROBE | Supply/Implant | $35,840.00 |
| 6108849 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6108864 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $10,560.00 |
| 6108865 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $7,680.00 |
| 6108866 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $8,140.80 |
| 6108867 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $25,344.00 |
| 6108869 | SUPPLY IMPLANT | Supply/Implant | $12,772.22 |
| 6108871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6108878 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $112,512.00 |
| 6108881 | SUPPLY IMPLANT | Supply/Implant | $53,785.60 |
| 6108884 | SUPPLY IMPLANT | Supply/Implant | $12,608.00 |
| 6108893 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6108894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6108900 | SUPPLY IMPLANT | Supply/Implant | $807.55 |
| 6108902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,676.80 |
| 6108908 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6108946 | SUPPLY IMPLANT | Supply/Implant | $1,447.04 |
| 6108952 | GENERAL SUPPLY | Supply/Implant | $319.62 |
| 6108965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6108966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6108967 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6108968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6108969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6108970 | SUPPLY IMPLANT | Supply/Implant | $2,114.56 |
| 6108971 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6108972 | SUPPLY IMPLANT | Supply/Implant | $2,836.48 |
| 6108973 | INTRO/SHEATH, NON-LASER | Supply/Implant | $934.40 |
| 6108979 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6108989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $764.67 |
| 6108991 | GENERAL SUPPLY | Supply/Implant | $1,516.16 |
| 6108995 | STERILE SUPPLY | Supply/Implant | $23,040.00 |
| 6109000 | SUPPLY IMPLANT | Supply/Implant | $7,028.74 |
| 6109004 | GENERAL SUPPLY | Supply/Implant | $722.94 |
| 6109005 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,395.20 |
| 6109006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,803.20 |
| 6109007 | PROSTHETIC IMPLANT NOS | Supply/Implant | $149,765.60 |
| 6109011 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109012 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109013 | SUPPLY IMPLANT | Supply/Implant | $177.60 |
| 6109016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6109018 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6109022 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6109024 | CATHETER, INTRASPINAL | Supply/Implant | $847.49 |
| 6109025 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6109028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,288.32 |
| 6109041 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6109042 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6109043 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6109046 | SUPPLY IMPLANT | Supply/Implant | $4,903.42 |
| 6109047 | SUPPLY IMPLANT | Supply/Implant | $14,454.40 |
| 6109048 | SUPPLY IMPLANT | Supply/Implant | $24,772.86 |
| 6109049 | SUPPLY IMPLANT | Supply/Implant | $34,560.00 |
| 6109054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6109057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6109060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6109063 | GENERAL SUPPLY | Supply/Implant | $470.40 |
| 6109069 | GENERAL SUPPLY | Supply/Implant | $1,044.48 |
| 6109074 | SUPPLY IMPLANT | Supply/Implant | $12,147.20 |
| 6109077 | SUPPLY IMPLANT | Supply/Implant | $368.51 |
| 6109085 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $183,750.00 |
| 6109088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,060.80 |
| 6109095 | STERILE SUPPLY | Supply/Implant | $339.46 |
| 6109098 | STERILE SUPPLY | Supply/Implant | $670.34 |
| 6109100 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6109104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6109106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,060.80 |
| 6109107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6109108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6109114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6109136 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6109137 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6109149 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $161,437.50 |
| 6109154 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $5,124.74 |
| 6109182 | AUD OSSEO DEV INT/EXT COMP | Supply/Implant | $23,283.20 |
| 6109183 | STERILE SUPPLY | Supply/Implant | $160.13 |
| 6109194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6109195 | STERILE SUPPLY | Supply/Implant | $481.92 |
| 6109197 | STERILE SUPPLY | Supply/Implant | $238.08 |
| 6109199 | SUPPLY IMPLANT | Supply/Implant | $2,231.30 |
| 6109200 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6109208 | STERILE SUPPLY | Supply/Implant | $256.17 |
| 6109220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,912.00 |
| 6109221 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6109222 | SUPPLY IMPLANT | Supply/Implant | $332.90 |
| 6109225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6109228 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6109245 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6109246 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6109247 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6109248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109251 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109255 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109256 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109265 | SUPPLY IMPLANT | Supply/Implant | $2,616.32 |
| 6109279 | GENERAL SUPPLY | Supply/Implant | $1,039.72 |
| 6109280 | SUPPLY IMPLANT | Supply/Implant | $462.23 |
| 6109281 | SUPPLY IMPLANT | Supply/Implant | $502.91 |
| 6109282 | STERILE SUPPLY | Supply/Implant | $13,440.00 |
| 6109284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6109285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,188.80 |
| 6109287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6109291 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,335.36 |
| 6109292 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $7,368.96 |
| 6109295 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6109304 | STERILE SUPPLY | Supply/Implant | $475.90 |
| 6109305 | ORTH/DEVIC/DRUG BN/BN,TIS/BN | Supply/Implant | $42,496.00 |
| 6109314 | SUPPLY IMPLANT | Supply/Implant | $5,401.60 |
| 6109316 | SUPPLY IMPLANT | Supply/Implant | $1,966.46 |
| 6109317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,023.36 |
| 6109321 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6109323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6109325 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6109351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6109352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6109353 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6109354 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6109366 | SUPPLY IMPLANT | Supply/Implant | $957.70 |
| 6109373 | STERILE SUPPLY | Supply/Implant | $819.20 |
| 6109379 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6109380 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6109384 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6109385 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6109390 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6109395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,920.00 |
| 6109396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6109402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6109410 | GENERAL SUPPLY | Supply/Implant | $520.19 |
| 6109412 | GENERAL SUPPLY | Supply/Implant | $239.62 |
| 6109413 | STERILE SUPPLY | Supply/Implant | $432.51 |
| 6109415 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6109416 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6109423 | SUPPLY IMPLANT | Supply/Implant | $4,915.20 |
| 6109429 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6109455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6109456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6109457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6109458 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,600.00 |
| 6109459 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $576.00 |
| 6109461 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6109464 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,580.80 |
| 6109465 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,580.80 |
| 6109490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6109498 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6109499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,872.64 |
| 6109539 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,426.94 |
| 6109541 | GENERAL SUPPLY | Supply/Implant | $1,740.80 |
| 6109558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,328.83 |
| 6109561 | GENERAL SUPPLY | Supply/Implant | $304.00 |
| 6109565 | SUPPLY IMPLANT | Supply/Implant | $14,808.32 |
| 6109570 | GENERAL SUPPLY | Supply/Implant | $159.74 |
| 6109574 | AICD, SINGLE CHAMBER | Supply/Implant | $153,877.50 |
| 6109592 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6109593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6109595 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6109598 | SUPPLY IMPLANT | Supply/Implant | $1,045.89 |
| 6109609 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6109611 | STERILE SUPPLY | Supply/Implant | $1,508.61 |
| 6109612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,944.32 |
| 6109613 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6109619 | SUPPLY IMPLANT | Supply/Implant | $538.88 |
| 6109620 | SUPPLY IMPLANT | Supply/Implant | $538.88 |
| 6109621 | SUPPLY IMPLANT | Supply/Implant | $538.88 |
| 6109623 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $127,936.00 |
| 6109624 | SEPTAL DEFECT IMP SYS | Supply/Implant | $127,936.00 |
| 6109629 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6109634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6109635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6109637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6109638 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6109639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,023.36 |
| 6109647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6109651 | GENERAL SUPPLY | Supply/Implant | $156.60 |
| 6109656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6109657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6109658 | GUIDE WIRE | Supply/Implant | $4,352.00 |
| 6109660 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,970.37 |
| 6109662 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $13,440.00 |
| 6109664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6109666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6109668 | SUPPLY IMPLANT | Supply/Implant | $506.88 |
| 6109674 | CATHETER, GUIDING | Supply/Implant | $1,774.08 |
| 6109675 | CATHETER, GUIDING | Supply/Implant | $2,112.00 |
| 6109677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6109678 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $92,800.00 |
| 6109689 | SKIN SUBSTITUTE, NOS | Supply/Implant | $3,970.05 |
| 6109690 | SKIN SUBSTITUTE, NOS | Supply/Implant | $5,923.84 |
| 6109691 | SUPPLY IMPLANT | Supply/Implant | $6,976.64 |
| 6109692 | SUPPLY IMPLANT | Supply/Implant | $10,812.93 |
| 6109693 | SUPPLY IMPLANT | Supply/Implant | $15,039.62 |
| 6109694 | SKIN SUBSTITUTE, NOS | Supply/Implant | $21,117.31 |
| 6109697 | SUPPLY IMPLANT | Supply/Implant | $6,976.64 |
| 6109699 | SUPPLY IMPLANT | Supply/Implant | $15,862.53 |
| 6109700 | SUPPLY IMPLANT | Supply/Implant | $9,099.39 |
| 6109702 | STERILE SUPPLY | Supply/Implant | $1,428.48 |
| 6109703 | AICD, DUAL CHAMBER | Supply/Implant | $168,735.00 |
| 6109704 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6109716 | SUPPLY IMPLANT | Supply/Implant | $7,859.20 |
| 6109717 | SUPPLY IMPLANT | Supply/Implant | $11,264.00 |
| 6109718 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6109726 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6109738 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109739 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6109740 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109743 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109744 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109745 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109746 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109749 | GRAFT, VASCULAR | Supply/Implant | $118,387.50 |
| 6109764 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6109768 | PMKR, DUAL, RATE-RESP | Supply/Implant | $51,200.00 |
| 6109770 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $44,800.00 |
| 6109771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,817.60 |
| 6109773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6109774 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6109775 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6109776 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6109777 | SUPPLY IMPLANT | Supply/Implant | $4,999.68 |
| 6109779 | GUIDE WIRE | Supply/Implant | $341.25 |
| 6109785 | GRAFT, VASCULAR | Supply/Implant | $4,305.41 |
| 6109789 | INTRO/SHEATH, NON-LASER | Supply/Implant | $956.16 |
| 6109802 | SUPPLY IMPLANT | Supply/Implant | $1,751.04 |
| 6109803 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,907.20 |
| 6109809 | SUPPLY IMPLANT | Supply/Implant | $570.75 |
| 6109813 | SUPPLY IMPLANT | Supply/Implant | $4,288.00 |
| 6109820 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6109826 | SUPPLY IMPLANT | Supply/Implant | $10,270.72 |
| 6109828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,369.60 |
| 6109831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,328.83 |
| 6109832 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $716.80 |
| 6109835 | STERILE SUPPLY | Supply/Implant | $8,292.74 |
| 6109840 | GENERAL SUPPLY | Supply/Implant | $625.79 |
| 6109840 | GENERAL SUPPLY | Supply/Implant | $648.91 |
| 6109841 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6109843 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6109848 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $5,696.00 |
| 6109852 | SUPPLY IMPLANT | Supply/Implant | $1,136.51 |
| 6109861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6109862 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6109863 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6109865 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6109867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6109868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6109870 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6109873 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6109874 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6109875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6109876 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,836.80 |
| 6109878 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,148.80 |
| 6109882 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6109884 | STERILE SUPPLY | Supply/Implant | $8,960.00 |
| 6109891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6109894 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6109896 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6109923 | SUPPLY IMPLANT | Supply/Implant | $1,318.40 |
| 6109927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6109928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6109933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6109935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6109943 | MESH (IMPLANTABLE) | Supply/Implant | $98,944.00 |
| 6109945 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $26,304.00 |
| 6109949 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,539.20 |
| 6109970 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6109973 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6109974 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6109975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6109976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6109978 | OCULAR IMPLANT | Supply/Implant | $7,680.00 |
| 6109981 | STERILE SUPPLY | Supply/Implant | $965.63 |
| 6109985 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6109986 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6109988 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6109989 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,224.00 |
| 6109992 | SUPPLY IMPLANT | Supply/Implant | $6,361.86 |
| 6109997 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109998 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6110000 | STERILE SUPPLY | Supply/Implant | $1,122.69 |
| 6110002 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6110003 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6110005 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6110008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6110009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6110012 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6110013 | GRAFT, VASCULAR | Supply/Implant | $77,824.00 |
| 6110014 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,980.80 |
| 6110019 | GENERAL SUPPLY | Supply/Implant | $133.89 |
| 6110020 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6110027 | CATH, DRAINAGE | Supply/Implant | $17,164.80 |
| 6110028 | CATH, DRAINAGE | Supply/Implant | $17,164.80 |
| 6110031 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6110035 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6110042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6110043 | SUPPLY IMPLANT | Supply/Implant | $3,727.36 |
| 6110046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6110048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6110049 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6110051 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6110052 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $14,016.00 |
| 6110056 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110060 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6110075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,484.48 |
| 6110077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,836.16 |
| 6110079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6110080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6110081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6110083 | SUPPLY IMPLANT | Supply/Implant | $566.91 |
| 6110084 | SUPPLY IMPLANT | Supply/Implant | $566.91 |
| 6110089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6110099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6110101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6110104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6110108 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6110115 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6110119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6110124 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6110126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6110127 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6110129 | GUIDE WIRE | Supply/Implant | $8,064.00 |
| 6110132 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6110133 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6110134 | SUPPLY IMPLANT | Supply/Implant | $3,467.14 |
| 6110135 | STERILE SUPPLY | Supply/Implant | $2,249.60 |
| 6110137 | SUPPLY IMPLANT | Supply/Implant | $38,438.40 |
| 6110138 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6110145 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,681.22 |
| 6110150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6110151 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6110153 | GUIDE WIRE | Supply/Implant | $3,596.80 |
| 6110154 | GUIDE WIRE | Supply/Implant | $3,840.00 |
| 6110155 | GUIDE WIRE | Supply/Implant | $3,532.80 |
| 6110156 | GUIDE WIRE | Supply/Implant | $3,776.00 |
| 6110158 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,152.00 |
| 6110159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6110162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,815.36 |
| 6110163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6110167 | SUPPLY IMPLANT | Supply/Implant | $2,129.54 |
| 6110173 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6110174 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6110175 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6110184 | SUPPLY IMPLANT | Supply/Implant | $114,726.40 |
| 6110185 | SUPPLY IMPLANT | Supply/Implant | $114,726.40 |
| 6110186 | SUPPLY IMPLANT | Supply/Implant | $34,560.00 |
| 6110189 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6110190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6110194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6110206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6110223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6110231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6110232 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6110233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6110241 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6110242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6110243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6110250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6110308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110309 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110310 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110313 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6110315 | STERILE SUPPLY | Supply/Implant | $14,904.83 |
| 6110316 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $1,280.00 |
| 6110317 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $12,736.00 |
| 6110323 | STERILE SUPPLY | Supply/Implant | $774.14 |
| 6110324 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,484.80 |
| 6110344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6110348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6110349 | SUPPLY IMPLANT | Supply/Implant | $401,071.00 |
| 6110350 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6110365 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6110366 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6110367 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6110368 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6110369 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6110370 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6110372 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6110373 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6110374 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6110376 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $180.86 |
| 6110378 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $180.86 |
| 6110380 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $180.86 |
| 6110384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6110388 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6110391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,788.80 |
| 6110393 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6110396 | STERILE SUPPLY | Supply/Implant | $128.00 |
| 6110398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,750.40 |
| 6110405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6110411 | SUPPLY IMPLANT | Supply/Implant | $20,352.00 |
| 6110412 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6110413 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6110414 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6110415 | GENERAL SUPPLY | Supply/Implant | $4,628.74 |
| 6110418 | STERILE SUPPLY | Supply/Implant | $343.01 |
| 6110419 | SUPPLY IMPLANT | Supply/Implant | $1,361.41 |
| 6110420 | PROS, URINARY SPH, IMP | Supply/Implant | $7,616.00 |
| 6110421 | PROS, URINARY SPH, IMP | Supply/Implant | $7,616.00 |
| 6110433 | CATHETER, GUIDING | Supply/Implant | $13,312.00 |
| 6110435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6110440 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,800.00 |
| 6110442 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $10,880.00 |
| 6110457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6110476 | SUPPLY IMPLANT | Supply/Implant | $1,621.76 |
| 6110479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6110480 | STERILE SUPPLY | Supply/Implant | $208.13 |
| 6110484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6110487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110496 | GENERAL SUPPLY | Supply/Implant | $640.00 |
| 6110499 | GUIDE WIRE | Supply/Implant | $5,747.20 |
| 6110500 | CATHETER, GUIDING | Supply/Implant | $8,896.00 |
| 6110501 | CATHETER, GUIDING | Supply/Implant | $9,075.20 |
| 6110506 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6110590 | SUPPLY IMPLANT | Supply/Implant | $14,041.60 |
| 6110591 | GENERAL SUPPLY | Supply/Implant | $208.64 |
| 6110597 | SUPPLY IMPLANT | Supply/Implant | $5,909.50 |
| 6110599 | SUPPLY IMPLANT | Supply/Implant | $5,909.50 |
| 6110656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6110661 | SUPPLY IMPLANT | Supply/Implant | $19,936.00 |
| 6110666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110669 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6110671 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6110679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6110682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,064.00 |
| 6110683 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6110685 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110695 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6110701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6110703 | STERILE SUPPLY | Supply/Implant | $666.93 |
| 6110704 | STERILE SUPPLY | Supply/Implant | $12,800.00 |
| 6110705 | VENA CAVA FILTER | Supply/Implant | $3,200.00 |
| 6110721 | SUPPLY IMPLANT | Supply/Implant | $390.49 |
| 6110722 | SUPPLY IMPLANT | Supply/Implant | $211.29 |
| 6110723 | SUPPLY IMPLANT | Supply/Implant | $202.24 |
| 6110728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,800.00 |
| 6110731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6110735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110752 | SUPPLY IMPLANT | Supply/Implant | $4,100.22 |
| 6110753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6110755 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6110757 | LEAD, NEUROSTIMULATOR | Supply/Implant | $92,710.40 |
| 6110761 | MESH (IMPLANTABLE) | Supply/Implant | $66,594.94 |
| 6110763 | SUPPLY IMPLANT | Supply/Implant | $864.00 |
| 6110765 | SUPPLY IMPLANT | Supply/Implant | $1,057.41 |
| 6110766 | RET DEV, INSERTABLE | Supply/Implant | $4,736.00 |
| 6110768 | RET DEV, INSERTABLE | Supply/Implant | $4,736.00 |
| 6110776 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,080.00 |
| 6110779 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,776.00 |
| 6110784 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,688.00 |
| 6110785 | SUPPLY IMPLANT | Supply/Implant | $55,296.00 |
| 6110788 | GUIDE WIRE | Supply/Implant | $226.30 |
| 6110790 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $30,246.40 |
| 6110791 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6110792 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6110793 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6110794 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6110797 | GUIDE WIRE | Supply/Implant | $985.60 |
| 6110800 | SUPPLY IMPLANT | Supply/Implant | $6,520.96 |
| 6110801 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6110802 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6110803 | SUPPLY IMPLANT | Supply/Implant | $13,450.75 |
| 6110804 | SUPPLY IMPLANT | Supply/Implant | $13,450.75 |
| 6110807 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6110808 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6110809 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6110811 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6110813 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6110814 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6110815 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6110823 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6110826 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6110828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6110835 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,500.29 |
| 6110839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6110840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6110842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6110843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6110846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6110848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6110858 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $178,500.00 |
| 6110863 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6110864 | SUPPLY IMPLANT | Supply/Implant | $59,174.40 |
| 6110865 | SUPPLY IMPLANT | Supply/Implant | $59,174.40 |
| 6110868 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6110873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110885 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6110888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6110889 | SUPPLY IMPLANT | Supply/Implant | $41,651.20 |
| 6110900 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $1,004.29 |
| 6110902 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6110905 | GENERAL SUPPLY | Supply/Implant | $266.62 |
| 6110906 | GENERAL SUPPLY | Supply/Implant | $242.18 |
| 6110908 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6110909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110912 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6110916 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6110920 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,219.20 |
| 6110928 | INTERSPINOUS IMPLANT | Supply/Implant | $37,888.00 |
| 6110929 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6110930 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6110931 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6110949 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6110953 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6110954 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6110961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6110962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6110989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6110990 | SUPPLY IMPLANT | Supply/Implant | $188,227.62 |
| 6110993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,594.11 |
| 6111013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6111019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111020 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111021 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,054.40 |
| 6111030 | SUPPLY IMPLANT | Supply/Implant | $455.17 |
| 6111031 | SUPPLY IMPLANT | Supply/Implant | $1,507.84 |
| 6111032 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6111033 | SUPPLY IMPLANT | Supply/Implant | $4,070.40 |
| 6111042 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6111044 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6111063 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6111065 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6111071 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6111074 | MESH (IMPLANTABLE) | Supply/Implant | $28,552.70 |
| 6111079 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6111080 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6111081 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6111086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6111089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6111090 | SUPPLY IMPLANT | Supply/Implant | $1,965.22 |
| 6111093 | LEAD, CORONARY VENOUS | Supply/Implant | $48,640.00 |
| 6111094 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $55,040.00 |
| 6111105 | MISC SUP/ACC IMP VAD | Supply/Implant | $640.00 |
| 6111107 | SUPPLY IMPLANT | Supply/Implant | $18,509.95 |
| 6111121 | SUPPLY IMPLANT | Supply/Implant | $226.30 |
| 6111126 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6111131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6111135 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6111141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6111142 | OCULAR IMP AQUEOUS DRAIN | Supply/Implant | $26,240.00 |
| 6111144 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6111146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,046.40 |
| 6111148 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6111149 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $86,016.00 |
| 6111156 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6111161 | SUPPLY IMPLANT | Supply/Implant | $115,699.50 |
| 6111162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,492.80 |
| 6111165 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6111192 | GENERAL SUPPLY | Supply/Implant | $48,000.00 |
| 6111194 | GENERAL SUPPLY | Supply/Implant | $998.40 |
| 6111195 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6111196 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6111198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6111236 | SUPPLY IMPLANT | Supply/Implant | $5,162.62 |
| 6111240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6111241 | SUPPLY IMPLANT | Supply/Implant | $1,369.60 |
| 6111242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6111244 | STERILE SUPPLY | Supply/Implant | $290.18 |
| 6111266 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6111267 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $329,108.50 |
| 6111268 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6111271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6111273 | CATHETER, GUIDING | Supply/Implant | $21,120.00 |
| 6111279 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6111284 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6111306 | GENERAL SUPPLY | Supply/Implant | $608.00 |
| 6111307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6111314 | SUPPLY IMPLANT | Supply/Implant | $82,619.65 |
| 6111318 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6111320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6111325 | SUPPLY IMPLANT | Supply/Implant | $26,791.81 |
| 6111327 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6111329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6111330 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6111342 | AMNIOTIC MEMBRANE | Supply/Implant | $5,734.40 |
| 6111343 | AMNIOTIC MEMBRANE | Supply/Implant | $7,040.00 |
| 6111344 | AMNIOTIC MEMBRANE | Supply/Implant | $9,164.80 |
| 6111345 | AMNIOTIC MEMBRANE | Supply/Implant | $13,388.80 |
| 6111347 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6111369 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6111378 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6111380 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6111383 | PORT, INDWELLING, IMP | Supply/Implant | $10,357.76 |
| 6111387 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,278.40 |
| 6111388 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6111391 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $793.60 |
| 6111392 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $121,296.00 |
| 6111401 | CATHETER, GUIDING | Supply/Implant | $9,664.00 |
| 6111403 | CATHETER, GUIDING | Supply/Implant | $10,598.40 |
| 6111404 | CATHETER, GUIDING | Supply/Implant | $10,598.40 |
| 6111405 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6111415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6111419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6111420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,580.48 |
| 6111430 | SUPPLY IMPLANT | Supply/Implant | $23,546.88 |
| 6111431 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111432 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111433 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,484.48 |
| 6111437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111440 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6111453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6111463 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6111464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6111471 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6111472 | LEAD, CORONARY VENOUS | Supply/Implant | $120,640.00 |
| 6111473 | SUPPLY IMPLANT | Supply/Implant | $6,179.58 |
| 6111474 | SUPPLY IMPLANT | Supply/Implant | $6,179.58 |
| 6111476 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6111478 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6111479 | GENERAL DRUG | Supply/Implant | $1,626.37 |
| 6111481 | SUPPLY IMPLANT | Supply/Implant | $6,284.80 |
| 6111488 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6111490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,914.30 |
| 6111491 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6111496 | SUPPLY IMPLANT | Supply/Implant | $581.38 |
| 6111502 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6111505 | STERILE SUPPLY | Supply/Implant | $584.06 |
| 6111519 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6111520 | SUPPLY IMPLANT | Supply/Implant | $70,272.00 |
| 6111521 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6111525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6111529 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6111533 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6111536 | SUPPLY IMPLANT | Supply/Implant | $2,380.80 |
| 6111537 | INTRO/SHEATH, NON-LASER | Supply/Implant | $434.53 |
| 6111538 | SUPPLY IMPLANT | Supply/Implant | $9,907.71 |
| 6111541 | GENERAL SUPPLY | Supply/Implant | $3,407.36 |
| 6111543 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $23,155.20 |
| 6111544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6111550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6111554 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6111555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,228.16 |
| 6111557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6111562 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6111563 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6111591 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111594 | SUPPLY IMPLANT | Supply/Implant | $1,740.80 |
| 6111595 | GENERAL SUPPLY | Supply/Implant | $210.70 |
| 6111600 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6111601 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6111602 | GENERAL SUPPLY | Supply/Implant | $518.78 |
| 6111609 | SUPPLY IMPLANT | Supply/Implant | $559.36 |
| 6111618 | STERILE SUPPLY | Supply/Implant | $212.67 |
| 6111622 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111623 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111624 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111625 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111638 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,539.20 |
| 6111641 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,259.20 |
| 6111642 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,539.20 |
| 6111644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6111645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6111646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6111654 | GUIDE WIRE | Supply/Implant | $1,331.20 |
| 6111655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6111659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6111665 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6111666 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6111667 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6111669 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $332.80 |
| 6111673 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6111675 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6111679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6111684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,689.34 |
| 6111685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,689.34 |
| 6111686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,507.52 |
| 6111687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,265.92 |
| 6111689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6111691 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6111692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6111704 | SUPPLY IMPLANT | Supply/Implant | $25,527.04 |
| 6111707 | SUPPLY IMPLANT | Supply/Implant | $4,019.20 |
| 6111709 | STERILE SUPPLY | Supply/Implant | $428.54 |
| 6111710 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6111711 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6111741 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6111742 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6111745 | GENERAL SUPPLY | Supply/Implant | $7,673.60 |
| 6111748 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6111756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $960.00 |
| 6111757 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111758 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6111760 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6111761 | SUPPLY IMPLANT | Supply/Implant | $7,052.80 |
| 6111762 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6111775 | GENERAL SUPPLY | Supply/Implant | $2,275.00 |
| 6111776 | GENERAL SUPPLY | Supply/Implant | $2,206.85 |
| 6111781 | STERILE SUPPLY | Supply/Implant | $839.42 |
| 6111782 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $354.37 |
| 6111784 | LOCM 200-299MG/ML IODINE,1ML | Supply/Implant | $326.40 |
| 6111786 | STERILE SUPPLY | Supply/Implant | $391.55 |
| 6111787 | STERILE SUPPLY | Supply/Implant | $363.65 |
| 6111788 | STERILE SUPPLY | Supply/Implant | $383.62 |
| 6111789 | SUPPLY IMPLANT | Supply/Implant | $4,096.26 |
| 6111791 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6111792 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6111793 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6111794 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6111795 | GUIDE WIRE | Supply/Implant | $2,618.88 |
| 6111796 | GUIDE WIRE | Supply/Implant | $2,618.88 |
| 6111797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6111799 | GENERAL SUPPLY | Supply/Implant | $435.20 |
| 6111800 | STERILE SUPPLY | Supply/Implant | $247.32 |
| 6111802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6111803 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,836.80 |
| 6111804 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,836.80 |
| 6111805 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $39,040.00 |
| 6111806 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $39,040.00 |
| 6111807 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $39,040.00 |
| 6111815 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $39,040.00 |
| 6111821 | SUPPLY IMPLANT | Supply/Implant | $5,043.20 |
| 6111824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6111826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6111827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6111828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6111840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,184.00 |
| 6111847 | GUIDE WIRE | Supply/Implant | $294.40 |
| 6111851 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6111852 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6111872 | GRAFT, VASCULAR | Supply/Implant | $43,241.98 |
| 6111874 | GRAFT, VASCULAR | Supply/Implant | $31,040.00 |
| 6111875 | GRAFT, VASCULAR | Supply/Implant | $43,241.98 |
| 6111887 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111892 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6111895 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6111896 | SUPPLY IMPLANT | Supply/Implant | $14,090.37 |
| 6111921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,138.56 |
| 6111929 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6111932 | SUPPLY IMPLANT | Supply/Implant | $115,437.00 |
| 6111933 | SUPPLY IMPLANT | Supply/Implant | $521.47 |
| 6111934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,577.60 |
| 6111937 | SUPPLY IMPLANT | Supply/Implant | $165.89 |
| 6111946 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6111952 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,651.20 |
| 6111955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6111960 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6111961 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6111973 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6111980 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6111982 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6111983 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6111984 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6111985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6111990 | CATHETER, GUIDING | Supply/Implant | $448.00 |
| 6111992 | GENERAL SUPPLY | Supply/Implant | $264.58 |
| 6111994 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6112001 | GENERAL SUPPLY | Supply/Implant | $151.04 |
| 6112002 | SUPPLY IMPLANT | Supply/Implant | $572.06 |
| 6112003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6112023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6112028 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6112033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6112034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6112038 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6112042 | INTRO/SHEATH, NON-LASER | Supply/Implant | $286.72 |
| 6112049 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6112057 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6112081 | SUPPLY IMPLANT | Supply/Implant | $1,218.56 |
| 6112085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6112087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,149.76 |
| 6112099 | LEAD, NEUROSTIMULATOR | Supply/Implant | $84,480.00 |
| 6112102 | STERILE SUPPLY | Supply/Implant | $1,459.65 |
| 6112104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6112105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6112107 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6112108 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $9,792.00 |
| 6112109 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $9,792.00 |
| 6112111 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6112115 | SUPPLY IMPLANT | Supply/Implant | $3,110.40 |
| 6112116 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $22,808.32 |
| 6112117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6112120 | GENERAL SUPPLY | Supply/Implant | $1,667.97 |
| 6112121 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6112122 | STERILE SUPPLY | Supply/Implant | $12,544.00 |
| 6112124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6112125 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6112126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6112127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6112132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6112133 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6112140 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $761.73 |
| 6112157 | GENERAL SUPPLY | Supply/Implant | $186.88 |
| 6112158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,742.40 |
| 6112160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6112161 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112162 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112174 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6112180 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6112181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,875.20 |
| 6112186 | SUPPLY IMPLANT | Supply/Implant | $142.85 |
| 6112188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6112189 | INTERSPINOUS IMPLANT | Supply/Implant | $26,944.00 |
| 6112194 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6112196 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6112197 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6112198 | GENERAL SUPPLY | Supply/Implant | $745.98 |
| 6112199 | STERILE SUPPLY | Supply/Implant | $332.03 |
| 6112200 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6112206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6112210 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6112211 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6112213 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6112214 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6112217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6112227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6112228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6112234 | SUPPLY IMPLANT | Supply/Implant | $170.65 |
| 6112238 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112240 | SUPPLY IMPLANT | Supply/Implant | $1,516.16 |
| 6112257 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6112258 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6112259 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,068.80 |
| 6112260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6112261 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112262 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112263 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112264 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112265 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112306 | SUPPLY IMPLANT | Supply/Implant | $19,936.00 |
| 6112307 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,408.13 |
| 6112313 | SUPPLY IMPLANT | Supply/Implant | $36,480.00 |
| 6112318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112322 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6112324 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6112327 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6112328 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6112338 | SUPPLY IMPLANT | Supply/Implant | $162,750.00 |
| 6112339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6112340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6112345 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112348 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112349 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112350 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112351 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112352 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112353 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112354 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112355 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112356 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112357 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112358 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112359 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112360 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112361 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112362 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112363 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112364 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112365 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112366 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112367 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112368 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112369 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112370 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112371 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112374 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112375 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112376 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112377 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112378 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112379 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112380 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112385 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6112387 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112388 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112389 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112390 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112391 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112392 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112393 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112394 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112395 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112396 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112397 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112398 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112399 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112400 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112401 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112403 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6112407 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112408 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112409 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112410 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112411 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112412 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112413 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112414 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112415 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112416 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112417 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112418 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112419 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112420 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112421 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112422 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112423 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112438 | STERILE SUPPLY | Supply/Implant | $1,837.06 |
| 6112439 | GENERAL SUPPLY | Supply/Implant | $522.82 |
| 6112444 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,356.80 |
| 6112445 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $63,500.80 |
| 6112447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6112448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6112449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6112451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6112453 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $14,016.00 |
| 6112455 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112456 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112457 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112458 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112459 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112460 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112461 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112462 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112464 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112465 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112468 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,008.00 |
| 6112469 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,374.40 |
| 6112470 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $17,740.80 |
| 6112472 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,740.80 |
| 6112473 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,374.40 |
| 6112474 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,008.00 |
| 6112475 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,008.00 |
| 6112478 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,812.48 |
| 6112479 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,740.80 |
| 6112481 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,008.00 |
| 6112482 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,008.00 |
| 6112483 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,374.40 |
| 6112484 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $17,740.80 |
| 6112486 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,740.80 |
| 6112490 | SUPPLY IMPLANT | Supply/Implant | $50,937.60 |
| 6112492 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6112495 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6112501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6112504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6112513 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6112519 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6112525 | SUPPLY IMPLANT | Supply/Implant | $291.33 |
| 6112528 | SUPPLY IMPLANT | Supply/Implant | $1,446.40 |
| 6112533 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6112534 | SUPPLY IMPLANT | Supply/Implant | $127,936.00 |
| 6112536 | SUPPLY IMPLANT | Supply/Implant | $419.84 |
| 6112539 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6112540 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6112542 | STERILE SUPPLY | Supply/Implant | $888.58 |
| 6112543 | CATH, DRAINAGE | Supply/Implant | $950.40 |
| 6112544 | CATH, DRAINAGE | Supply/Implant | $950.40 |
| 6112545 | SUPPLY IMPLANT | Supply/Implant | $950.40 |
| 6112546 | SUPPLY IMPLANT | Supply/Implant | $950.40 |
| 6112547 | SUPPLY IMPLANT | Supply/Implant | $887.04 |
| 6112568 | SUPPLY IMPLANT | Supply/Implant | $241.92 |
| 6112570 | SUPPLY IMPLANT | Supply/Implant | $4,288.00 |
| 6112575 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,088.00 |
| 6112578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6112580 | MESH (IMPLANTABLE) | Supply/Implant | $18,240.00 |
| 6112581 | MESH (IMPLANTABLE) | Supply/Implant | $38,016.00 |
| 6112585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,520.00 |
| 6112592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6112602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6112606 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6112607 | SUPPLY IMPLANT | Supply/Implant | $729.60 |
| 6112608 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112609 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112610 | SUPPLY IMPLANT | Supply/Implant | $6,976.00 |
| 6112611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,251.26 |
| 6112613 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112614 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112626 | SUPPLY IMPLANT | Supply/Implant | $2,523.26 |
| 6112627 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6112634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6112638 | SUPPLY IMPLANT | Supply/Implant | $2,161.28 |
| 6112639 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6112640 | SUPPLY IMPLANT | Supply/Implant | $3,543.30 |
| 6112643 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $241.66 |
| 6112647 | GENERAL SUPPLY | Supply/Implant | $1,805.31 |
| 6112650 | SUPPLY IMPLANT | Supply/Implant | $18,624.00 |
| 6112651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6112654 | SUPPLY IMPLANT | Supply/Implant | $130.56 |
| 6112655 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6112656 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6112657 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6112658 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6112668 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6112669 | SUPPLY IMPLANT | Supply/Implant | $282.24 |
| 6112670 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6112672 | GRAFT, VASCULAR | Supply/Implant | $121,296.00 |
| 6112673 | INTRO/SHEATH, NON-LASER | Supply/Implant | $832.00 |
| 6112677 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $178,500.00 |
| 6112678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,643.14 |
| 6112679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6112681 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6112695 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6112697 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6112700 | CATHETER, GUIDING | Supply/Implant | $678.40 |
| 6112707 | STERILE SUPPLY | Supply/Implant | $612.99 |
| 6112713 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112714 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112715 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112716 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112717 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112718 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112725 | GENERAL SUPPLY | Supply/Implant | $311.30 |
| 6112726 | GENERAL SUPPLY | Supply/Implant | $291.20 |
| 6112728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6112742 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,707.20 |
| 6112753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6112759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6112760 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6112761 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6112809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6112814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6112815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6112817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $698.88 |
| 6112818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6112835 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $8,960.00 |
| 6112842 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6112843 | VENA CAVA FILTER | Supply/Implant | $13,440.00 |
| 6112849 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112850 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112852 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112853 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112854 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112855 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112856 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112859 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112860 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112862 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112864 | TRANS ANGIOPLASTY CATH | Supply/Implant | $22,400.00 |
| 6112865 | TRANS ANGIOPLASTY CATH | Supply/Implant | $22,400.00 |
| 6112881 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6112882 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6112884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6112902 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6112903 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6112915 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6112916 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6112917 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6112918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,097.60 |
| 6112922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6112927 | GENERAL SUPPLY | Supply/Implant | $268.99 |
| 6112941 | STERILE SUPPLY | Supply/Implant | $1,081.60 |
| 6112945 | SUPPLY IMPLANT | Supply/Implant | $277.76 |
| 6112972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6112973 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6112978 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6112982 | SUPPLY IMPLANT | Supply/Implant | $2,694.40 |
| 6112984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6112987 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6112994 | PORT, INDWELLING, IMP | Supply/Implant | $5,107.20 |
| 6112995 | PORT, INDWELLING, IMP | Supply/Implant | $5,107.20 |
| 6112999 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $202,000.00 |
| 6113002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6113004 | LEAD, CORONARY VENOUS | Supply/Implant | $38,400.00 |
| 6113005 | LEAD, CORONARY VENOUS | Supply/Implant | $38,400.00 |
| 6113007 | SUPPLY IMPLANT | Supply/Implant | $177.28 |
| 6113019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6113020 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113021 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6113022 | RET DEV, INSERTABLE | Supply/Implant | $313.60 |
| 6113026 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6113028 | CATHETER, URETERAL | Supply/Implant | $142.72 |
| 6113037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6113039 | SUPPLY IMPLANT | Supply/Implant | $9,935.74 |
| 6113044 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6113045 | SUPPLY IMPLANT | Supply/Implant | $28,448.00 |
| 6113050 | SUPPLY IMPLANT | Supply/Implant | $9,379.33 |
| 6113052 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6113056 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6113061 | STERILE SUPPLY | Supply/Implant | $695.71 |
| 6113062 | STERILE SUPPLY | Supply/Implant | $420.86 |
| 6113070 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6113079 | MESH (IMPLANTABLE) | Supply/Implant | $1,842.43 |
| 6113080 | GENERAL SUPPLY | Supply/Implant | $206.08 |
| 6113087 | SUPPLY IMPLANT | Supply/Implant | $16,256.00 |
| 6113089 | SUPPLY IMPLANT | Supply/Implant | $1,605.12 |
| 6113092 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6113099 | SUPPLY IMPLANT | Supply/Implant | $4,096.00 |
| 6113100 | SUPPLY IMPLANT | Supply/Implant | $2,694.40 |
| 6113101 | SUPPLY IMPLANT | Supply/Implant | $9,496.83 |
| 6113102 | SUPPLY IMPLANT | Supply/Implant | $11,139.07 |
| 6113103 | SUPPLY IMPLANT | Supply/Implant | $11,180.22 |
| 6113108 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6113109 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6113110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,544.00 |
| 6113115 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113116 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113118 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113119 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,712.00 |
| 6113125 | SUPPLY IMPLANT | Supply/Implant | $6,649.60 |
| 6113127 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6113139 | SUPPLY IMPLANT | Supply/Implant | $214.53 |
| 6113143 | GENERAL SUPPLY | Supply/Implant | $441.60 |
| 6113144 | CATHETER, GUIDING | Supply/Implant | $6,336.00 |
| 6113157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6113158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6113159 | SUPPLY IMPLANT | Supply/Implant | $17,387.52 |
| 6113167 | DRUG/DETAILED CODING REQUIRED | Supply/Implant | $1,446.40 |
| 6113170 | INTRO/SHEATH, NON-LASER | Supply/Implant | $273.43 |
| 6113176 | STERILE SUPPLY | Supply/Implant | $162.05 |
| 6113179 | STERILE SUPPLY | Supply/Implant | $287.62 |
| 6113180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6113186 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6113200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,321.15 |
| 6113201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,749.70 |
| 6113202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,153.60 |
| 6113203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,484.48 |
| 6113207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $556.80 |
| 6113235 | CATHETER, GUIDING | Supply/Implant | $3,648.00 |
| 6113250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6113253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6113260 | SUPPLY IMPLANT | Supply/Implant | $768.51 |
| 6113262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6113264 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6113269 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6113270 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $100,480.00 |
| 6113279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6113280 | SUPPLY IMPLANT | Supply/Implant | $6,447.36 |
| 6113285 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6113286 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6113287 | CATHETER, GUIDING | Supply/Implant | $6,169.60 |
| 6113290 | CATHETER, URETERAL | Supply/Implant | $146.05 |
| 6113292 | CATHETER, URETERAL | Supply/Implant | $146.05 |
| 6113297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6113301 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6113313 | STERILE SUPPLY | Supply/Implant | $449.79 |
| 6113314 | STERILE SUPPLY | Supply/Implant | $705.66 |
| 6113315 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6113325 | GENERAL SUPPLY | Supply/Implant | $282.88 |
| 6113326 | STERILE SUPPLY | Supply/Implant | $278.78 |
| 6113327 | STERILE SUPPLY | Supply/Implant | $318.21 |
| 6113331 | GENERAL SUPPLY | Supply/Implant | $2,094.72 |
| 6113333 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6113339 | STERILE SUPPLY | Supply/Implant | $566.91 |
| 6113406 | SUPPLY IMPLANT | Supply/Implant | $106,854.40 |
| 6113407 | COCHLEAR DEVICE | Supply/Implant | $221,190.00 |
| 6113412 | CONN TISS, NON-HUMAN | Supply/Implant | $3,264.00 |
| 6113413 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6113416 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113423 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $5,696.00 |
| 6113446 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6113475 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113477 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113478 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6113480 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6113485 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6113486 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6113488 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6113492 | INTRO/SHEATH, NON-LASER | Supply/Implant | $611.97 |
| 6113504 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $8,960.00 |
| 6113507 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113510 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113513 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113515 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113517 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6113523 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6113528 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6113529 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6113530 | SUPPLY IMPLANT | Supply/Implant | $113,920.00 |
| 6113533 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,960.00 |
| 6113537 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113551 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,689.54 |
| 6113552 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,689.54 |
| 6113554 | STERILE SUPPLY | Supply/Implant | $84,480.00 |
| 6113557 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $45,273.60 |
| 6113558 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6113560 | CATHETER, GUIDING | Supply/Implant | $20,467.20 |
| 6113564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6113565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6113566 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113567 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113568 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113569 | GENERAL SUPPLY | Supply/Implant | $793.60 |
| 6113570 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113572 | GENERAL SUPPLY | Supply/Implant | $831.87 |
| 6113573 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113574 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113575 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113577 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113580 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113584 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113596 | GUIDE WIRE | Supply/Implant | $3,187.20 |
| 6113598 | REP DEV, URINARY, W/SLING | Supply/Implant | $8,320.00 |
| 6113603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6113607 | SUPPLY IMPLANT | Supply/Implant | $154.24 |
| 6113612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6113613 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6113623 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $467.97 |
| 6113629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6113630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6113632 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6113638 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113639 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113640 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113641 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,520.00 |
| 6113655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6113662 | PMKR, DUAL, RATE-RESP | Supply/Implant | $77,926.40 |
| 6113667 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $39,040.00 |
| 6113671 | RET DEV, INSERTABLE | Supply/Implant | $88,320.00 |
| 6113672 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $11,776.00 |
| 6113673 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $11,776.00 |
| 6113677 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,289.92 |
| 6113678 | SUPPLY IMPLANT | Supply/Implant | $12,615.42 |
| 6113681 | CATHETER, GUIDING | Supply/Implant | $2,240.00 |
| 6113682 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113683 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113687 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113690 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,840.70 |
| 6113691 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,840.70 |
| 6113692 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6113693 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6113698 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113707 | GENERAL SUPPLY | Supply/Implant | $176.13 |
| 6113708 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6113709 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6113710 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6113711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6113715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6113716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6113717 | GUIDE WIRE | Supply/Implant | $663.04 |
| 6113721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6113724 | SUPPLY IMPLANT | Supply/Implant | $139.78 |
| 6113738 | STERILE SUPPLY | Supply/Implant | $343.94 |
| 6113742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6113743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6113744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,126.40 |
| 6113754 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6113755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6113758 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113759 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6113761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6113762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6113763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6113766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6113769 | GUIDE WIRE | Supply/Implant | $1,727.74 |
| 6113770 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6113772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,766.40 |
| 6113777 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6113779 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6113780 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113781 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113783 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6113784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6113785 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6113786 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6113787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6113793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6113796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6113798 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6113801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6113802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6113803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6113810 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6113811 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6113814 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6113815 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $21,056.00 |
| 6113822 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6113828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,777.60 |
| 6113829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,899.20 |
| 6113830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,777.60 |
| 6113833 | PROSTHETIC IMPLANT NOS | Supply/Implant | $8,960.00 |
| 6113839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,812.80 |
| 6113840 | SUPPLY IMPLANT | Supply/Implant | $96,908.80 |
| 6113849 | SUPPLY IMPLANT | Supply/Implant | $1,516.16 |
| 6113850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6113859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6113862 | INTRO/SHEATH, NON-LASER | Supply/Implant | $713.73 |
| 6113868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6113869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6113872 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6113875 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6113879 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6113889 | SUPPLY IMPLANT | Supply/Implant | $4,575.74 |
| 6113890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,948.67 |
| 6113894 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6113895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6113900 | SUPPLY IMPLANT | Supply/Implant | $5,594.88 |
| 6113901 | SUPPLY IMPLANT | Supply/Implant | $5,594.88 |
| 6113902 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6113916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6113921 | STERILE SUPPLY | Supply/Implant | $251.78 |
| 6113922 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6113925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,595.52 |
| 6113926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6113927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6113931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6113933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6113934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6113935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,952.00 |
| 6113938 | GENERAL SUPPLY | Supply/Implant | $280.96 |
| 6113954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6113957 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,052.80 |
| 6113959 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,292.80 |
| 6113964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113985 | SUPPLY IMPLANT | Supply/Implant | $433.92 |
| 6113986 | GUIDE WIRE | Supply/Implant | $166.07 |
| 6113987 | GUIDE WIRE | Supply/Implant | $262.66 |
| 6113991 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6113993 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,061.50 |
| 6114001 | SUPPLY IMPLANT | Supply/Implant | $18,662.40 |
| 6114004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6114017 | STERILE SUPPLY | Supply/Implant | $501.12 |
| 6114018 | SUPPLY IMPLANT | Supply/Implant | $13,952.00 |
| 6114019 | SUPPLY IMPLANT | Supply/Implant | $19,072.00 |
| 6114020 | SUPPLY IMPLANT | Supply/Implant | $19,072.00 |
| 6114021 | SUPPLY IMPLANT | Supply/Implant | $19,072.00 |
| 6114023 | SUPPLY IMPLANT | Supply/Implant | $6,493.18 |
| 6114024 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6114027 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6114028 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6114036 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6114043 | GENERAL SUPPLY | Supply/Implant | $635.39 |
| 6114044 | SUPPLY IMPLANT | Supply/Implant | $95,936.00 |
| 6114045 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6114046 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6114048 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6114055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,864.00 |
| 6114064 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6114065 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6114067 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6114068 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6114082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6114083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6114085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6114094 | GENERAL SUPPLY | Supply/Implant | $3,120.13 |
| 6114095 | GENERAL SUPPLY | Supply/Implant | $7,590.40 |
| 6114096 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114097 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114099 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114100 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114101 | SUPPLY IMPLANT | Supply/Implant | $2,461.18 |
| 6114103 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114104 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114105 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6114107 | GENERAL SUPPLY | Supply/Implant | $1,236.99 |
| 6114111 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6114112 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6114113 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6114114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6114116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6114117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114122 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6114124 | GENERAL SUPPLY | Supply/Implant | $288.51 |
| 6114127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6114132 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6114140 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6114142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6114144 | STERILE SUPPLY | Supply/Implant | $298.88 |
| 6114146 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6114147 | SUPPLY IMPLANT | Supply/Implant | $8,051.20 |
| 6114148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6114153 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $30,720.00 |
| 6114156 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6114161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6114163 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6114165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6114169 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6114177 | GENERAL SUPPLY | Supply/Implant | $192.00 |
| 6114178 | GENERAL SUPPLY | Supply/Implant | $7,488.00 |
| 6114179 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $108,288.00 |
| 6114181 | SUPPLY IMPLANT | Supply/Implant | $242.69 |
| 6114183 | GENERAL SUPPLY | Supply/Implant | $201.22 |
| 6114187 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6114190 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6114191 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6114192 | SUPPLY IMPLANT | Supply/Implant | $125,580.00 |
| 6114193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114194 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114196 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6114197 | GENERAL SUPPLY | Supply/Implant | $282.75 |
| 6114198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,441.60 |
| 6114199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114216 | GUIDE WIRE | Supply/Implant | $2,291.20 |
| 6114223 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6114224 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6114225 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6114226 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6114229 | SUPPLY IMPLANT | Supply/Implant | $12,275.20 |
| 6114231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6114235 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6114237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6114239 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114254 | CRYOABLATION PROBE | Supply/Implant | $16,000.00 |
| 6114257 | GENERAL SUPPLY | Supply/Implant | $280.96 |
| 6114260 | GENERAL SUPPLY | Supply/Implant | $344.96 |
| 6114263 | GENERAL SUPPLY | Supply/Implant | $974.59 |
| 6114266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,096.00 |
| 6114270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114276 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6114277 | STERILE SUPPLY | Supply/Implant | $318.21 |
| 6114290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114303 | GENERAL SUPPLY | Supply/Implant | $269.95 |
| 6114307 | STERILE SUPPLY | Supply/Implant | $140.60 |
| 6114308 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,047.04 |
| 6114315 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6114320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6114324 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6114328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6114329 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6114333 | GENERAL SUPPLY | Supply/Implant | $146.05 |
| 6114341 | STERILE SUPPLY | Supply/Implant | $294.91 |
| 6114345 | STERILE SUPPLY | Supply/Implant | $1,154.01 |
| 6114347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6114348 | MESH (IMPLANTABLE) | Supply/Implant | $2,111.10 |
| 6114352 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6114360 | GENERAL SUPPLY | Supply/Implant | $267.17 |
| 6114362 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $416,242.50 |
| 6114377 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6114382 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114383 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114384 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6114391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6114394 | SUPPLY IMPLANT | Supply/Implant | $77,824.00 |
| 6114405 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6114406 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6114407 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6114411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6114412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6114413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,665.60 |
| 6114415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114416 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6114418 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6114422 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6114424 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6114425 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6114486 | SUPPLY IMPLANT | Supply/Implant | $214.32 |
| 6114489 | GENERAL SUPPLY | Supply/Implant | $185.75 |
| 6114494 | GENERAL SUPPLY | Supply/Implant | $214.32 |
| 6114496 | GENERAL SUPPLY | Supply/Implant | $172.54 |
| 6114499 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6114501 | SUPPLY IMPLANT | Supply/Implant | $7,692.03 |
| 6114502 | SUPPLY IMPLANT | Supply/Implant | $7,776.51 |
| 6114509 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6114512 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $183,750.00 |
| 6114513 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $131,250.00 |
| 6114515 | SUPPLY IMPLANT | Supply/Implant | $183,750.00 |
| 6114516 | SUPPLY IMPLANT | Supply/Implant | $74,880.00 |
| 6114517 | SUPPLY IMPLANT | Supply/Implant | $121,600.00 |
| 6114520 | SUPPLY IMPLANT | Supply/Implant | $199.68 |
| 6114526 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6114539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,705.60 |
| 6114540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6114542 | RET DEV, INSERTABLE | Supply/Implant | $384.00 |
| 6114546 | SUPPLY IMPLANT | Supply/Implant | $11,532.80 |
| 6114547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6114550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6114552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114558 | SUPPLY IMPLANT | Supply/Implant | $78,979.20 |
| 6114559 | SUPPLY IMPLANT | Supply/Implant | $77,824.00 |
| 6114567 | SUPPLY IMPLANT | Supply/Implant | $282,800.00 |
| 6114569 | SUPPLY IMPLANT | Supply/Implant | $1,530.62 |
| 6114571 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114575 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,840.70 |
| 6114577 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6114578 | RET DEV, INSERTABLE | Supply/Implant | $2,873.34 |
| 6114579 | RET DEV, INSERTABLE | Supply/Implant | $2,873.34 |
| 6114580 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6114581 | GUIDE WIRE | Supply/Implant | $3,628.54 |
| 6114586 | SUPPLY IMPLANT | Supply/Implant | $62,835.20 |
| 6114596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,160.00 |
| 6114601 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $8,896.00 |
| 6114602 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6114603 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6114604 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6114605 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6114606 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6114608 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6114615 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6114616 | SUPPLY IMPLANT | Supply/Implant | $2,980.61 |
| 6114617 | SUPPLY IMPLANT | Supply/Implant | $2,980.61 |
| 6114623 | STERILE SUPPLY | Supply/Implant | $169.60 |
| 6114624 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6114625 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6114631 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6114632 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6114638 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $94,707.20 |
| 6114641 | SUPPLY IMPLANT | Supply/Implant | $200.06 |
| 6114653 | GENERAL SUPPLY | Supply/Implant | $135.31 |
| 6114664 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114665 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114666 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114667 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114668 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114669 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114670 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114671 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114672 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114673 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114674 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114675 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114676 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114677 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114678 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114680 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,886.85 |
| 6114688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6114691 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6114692 | INTEGRA MATRIX SKIN SUB | Supply/Implant | $3,644.93 |
| 6114696 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114707 | GENERAL SUPPLY | Supply/Implant | $8,481.79 |
| 6114709 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6114716 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114718 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114726 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114727 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6114730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6114742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6114746 | GENERAL SUPPLY | Supply/Implant | $21,120.00 |
| 6114747 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6114750 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6114751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6114752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6114758 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6114759 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114762 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6114763 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6114764 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6114765 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6114776 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6114777 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6114786 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6114791 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6114795 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6114800 | SUPPLY IMPLANT | Supply/Implant | $2,757.12 |
| 6114807 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6114808 | SUPPLY IMPLANT | Supply/Implant | $55,552.00 |
| 6114810 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6114811 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6114812 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6114813 | SUPPLY IMPLANT | Supply/Implant | $3,010.94 |
| 6114814 | SUPPLY IMPLANT | Supply/Implant | $5,841.02 |
| 6114815 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6114816 | MESH (IMPLANTABLE) | Supply/Implant | $3,245.44 |
| 6114817 | MESH (IMPLANTABLE) | Supply/Implant | $3,278.46 |
| 6114818 | MESH (IMPLANTABLE) | Supply/Implant | $3,311.36 |
| 6114822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,948.67 |
| 6114823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,395.97 |
| 6114824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,848.32 |
| 6114825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,482.82 |
| 6114826 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6114830 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6114831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114833 | STERILE SUPPLY | Supply/Implant | $1,036.80 |
| 6114838 | GENERAL SUPPLY | Supply/Implant | $692.86 |
| 6114846 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6114847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6114848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6114849 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6114850 | SUPPLY IMPLANT | Supply/Implant | $51,136.00 |
| 6114860 | SUPPLY IMPLANT | Supply/Implant | $39,486.08 |
| 6114865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6114866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6114869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114872 | SUPPLY IMPLANT | Supply/Implant | $27,611.52 |
| 6114873 | GENERAL SUPPLY | Supply/Implant | $1,536.00 |
| 6114880 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6114881 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114882 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6114883 | SUPPLY IMPLANT | Supply/Implant | $46,720.00 |
| 6114884 | GENERAL DRUG | Supply/Implant | $181.25 |
| 6114888 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6114894 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114895 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114896 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114897 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114913 | SUPPLY IMPLANT | Supply/Implant | $5,693.44 |
| 6114920 | GENERAL SUPPLY | Supply/Implant | $187.14 |
| 6114921 | GENERAL SUPPLY | Supply/Implant | $3,484.80 |
| 6114922 | SUPPLY IMPLANT | Supply/Implant | $4,080.00 |
| 6114924 | GENERAL SUPPLY | Supply/Implant | $3,120.00 |
| 6114925 | GENERAL SUPPLY | Supply/Implant | $3,542.40 |
| 6114927 | GENERAL SUPPLY | Supply/Implant | $7,200.00 |
| 6114942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6114944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6114945 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6114946 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6114947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6114954 | SUPPLY IMPLANT | Supply/Implant | $5,772.80 |
| 6114958 | SUPPLY IMPLANT | Supply/Implant | $3,010.62 |
| 6114960 | SUPPLY IMPLANT | Supply/Implant | $2,426.88 |
| 6114961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6114962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,659.33 |
| 6114963 | SUPPLY IMPLANT | Supply/Implant | $78,979.20 |
| 6114964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6114966 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $356,237.10 |
| 6114977 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,544.00 |
| 6114979 | EVENT RECORDER CARDIAC | Supply/Implant | $58,880.00 |
| 6114981 | GENERAL SUPPLY | Supply/Implant | $446.46 |
| 6114982 | GENERAL SUPPLY | Supply/Implant | $446.46 |
| 6114993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,630.72 |
| 6115015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6115016 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6115017 | STERILE SUPPLY | Supply/Implant | $152.83 |
| 6115018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6115022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6115024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6115028 | SUPPLY IMPLANT | Supply/Implant | $63,360.00 |
| 6115029 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6115030 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6115031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6115035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6115054 | SUPPLY IMPLANT | Supply/Implant | $2,038.40 |
| 6115058 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6115060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6115076 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6115077 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6115121 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6115124 | GENERAL SUPPLY | Supply/Implant | $8,179.20 |
| 6115132 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115133 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115134 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115136 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115141 | STERILE SUPPLY | Supply/Implant | $1,920.00 |
| 6115142 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $10,112.00 |
| 6115145 | SUPPLY IMPLANT | Supply/Implant | $1,273.22 |
| 6115148 | SUPPLY IMPLANT | Supply/Implant | $2,498.56 |
| 6115153 | GENERAL SUPPLY | Supply/Implant | $3,104.00 |
| 6115162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,433.92 |
| 6115165 | STERILE SUPPLY | Supply/Implant | $329.34 |
| 6115166 | SUPPLY IMPLANT | Supply/Implant | $1,833.34 |
| 6115167 | STERILE SUPPLY | Supply/Implant | $813.70 |
| 6115170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6115176 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6115196 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6115203 | SUPPLY IMPLANT | Supply/Implant | $1,594.88 |
| 6115224 | CRYOABLATION PROBE | Supply/Implant | $18,240.00 |
| 6115227 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6115230 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6115234 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6115238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,225.60 |
| 6115245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6115246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6115252 | SUPPLY IMPLANT | Supply/Implant | $2,066.69 |
| 6115259 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6115270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,480.00 |
| 6115274 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6115275 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6115277 | SUPPLY IMPLANT | Supply/Implant | $18,035.20 |
| 6115278 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $8,512.00 |
| 6115281 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,040.00 |
| 6115282 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6115284 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6115287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6115289 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6115302 | GUIDE WIRE | Supply/Implant | $8,960.00 |
| 6115304 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6115305 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,840.00 |
| 6115364 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,891.97 |
| 6115365 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,891.97 |
| 6115405 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6115480 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6115494 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6115495 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6115496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6115739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,956.16 |
| 6115740 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,956.16 |
| 6115758 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6115759 | SUPPLY IMPLANT | Supply/Implant | $11,865.60 |
| 6115761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,219.20 |
| 6115762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6115763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6115764 | CATHETER, URETERAL | Supply/Implant | $917.25 |
| 6115779 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6115780 | GUIDE WIRE | Supply/Implant | $2,304.00 |
| 6115784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6115785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6115786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6115788 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6115791 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6115792 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6115796 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6115798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6115800 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6115802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6115803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6115807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6115810 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6115812 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6116283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6116340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,549.76 |
| 6116341 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6116342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6116346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6116399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6116401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6116404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6116407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6116410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6116413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,688.00 |
| 6116417 | SUPPLY IMPLANT | Supply/Implant | $114,261.00 |
| 6116418 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6116423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6116424 | GENERAL SUPPLY | Supply/Implant | $384.00 |
| 6116426 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6116427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6116430 | GENERAL SUPPLY | Supply/Implant | $1,445.63 |
| 6116431 | SUPPLY IMPLANT | Supply/Implant | $20,104.58 |
| 6116432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6116433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6116438 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $221,695.00 |
| 6116439 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $19,200.00 |
| 6116440 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $25,600.00 |
| 6116441 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $4,160.00 |
| 6116442 | SUPPLY IMPLANT | Supply/Implant | $3,095.04 |
| 6116443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6116446 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,201.28 |
| 6116448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,376.00 |
| 6116449 | STERILE SUPPLY | Supply/Implant | $1,300.10 |
| 6116453 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6116454 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6116455 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6116456 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6116457 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6116460 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6116462 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,408.00 |
| 6116463 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $76,326.40 |
| 6116467 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6116468 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6116472 | GUIDE WIRE | Supply/Implant | $2,839.04 |
| 6116473 | GUIDE WIRE | Supply/Implant | $2,839.04 |
| 6116490 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6116495 | GUIDE WIRE | Supply/Implant | $1,018.88 |
| 6116501 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6116506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6116509 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6116514 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6116520 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6116522 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6116531 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6116533 | CATHETER, GUIDING | Supply/Implant | $422.40 |
| 6116535 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116538 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116541 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116544 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6116550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6116554 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,084.80 |
| 6116559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116560 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116562 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,450.24 |
| 6116563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6116567 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116579 | SUPPLY IMPLANT | Supply/Implant | $2,421.95 |
| 6116581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $869.12 |
| 6116582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6116583 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6116585 | SUPPLY IMPLANT | Supply/Implant | $13,350.40 |
| 6116586 | SUPPLY IMPLANT | Supply/Implant | $13,350.40 |
| 6116588 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6116589 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6116590 | SUPPLY IMPLANT | Supply/Implant | $1,268.35 |
| 6116592 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6116594 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6116595 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6116599 | GUIDE WIRE | Supply/Implant | $2,304.00 |
| 6116600 | STERILE SUPPLY | Supply/Implant | $251.65 |
| 6116605 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,331.01 |
| 6116613 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6116614 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6116617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,914.05 |
| 6116618 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6116619 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6116621 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6116630 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6116638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6116639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6116640 | CATHETER, GUIDING | Supply/Implant | $6,438.40 |
| 6116641 | SUPPLY IMPLANT | Supply/Implant | $152,250.00 |
| 6116642 | STERILE SUPPLY | Supply/Implant | $3,411.33 |
| 6116643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6116645 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6116646 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6116648 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6116652 | SUPPLY IMPLANT | Supply/Implant | $27,507.20 |
| 6116656 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6116658 | GUIDE WIRE | Supply/Implant | $3,072.00 |
| 6116662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116664 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116665 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6116677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6116678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6116680 | SUPPLY IMPLANT | Supply/Implant | $17,387.52 |
| 6116682 | GUIDE WIRE | Supply/Implant | $1,204.25 |
| 6116686 | RET DEV, INSERTABLE | Supply/Implant | $5,120.00 |
| 6116690 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6116694 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $20,864.00 |
| 6116696 | STERILE SUPPLY | Supply/Implant | $257.54 |
| 6116698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6116699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6116715 | SUPPLY IMPLANT | Supply/Implant | $27,046.66 |
| 6116716 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6116717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6116718 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6116719 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6116727 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6116731 | CATHETER, GUIDING | Supply/Implant | $1,984.00 |
| 6116737 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6116741 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,728.00 |
| 6116745 | SUPPLY IMPLANT | Supply/Implant | $360.83 |
| 6116746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6116747 | SUPPLY IMPLANT | Supply/Implant | $212,605.00 |
| 6116751 | SUPPLY IMPLANT | Supply/Implant | $239.74 |
| 6116752 | SUPPLY IMPLANT | Supply/Implant | $317.82 |
| 6116754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,472.06 |
| 6116755 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6116756 | SUPPLY IMPLANT | Supply/Implant | $715.14 |
| 6116758 | GENERAL SUPPLY | Supply/Implant | $1,440.00 |
| 6116760 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6116762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6116764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6116776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6116779 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6116780 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6116781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6116782 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6116783 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6116784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116786 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116790 | CATH, DRAINAGE | Supply/Implant | $742.40 |
| 6116793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,692.80 |
| 6116806 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6116807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,950.40 |
| 6116812 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6116813 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6116816 | STERILE SUPPLY | Supply/Implant | $8,486.40 |
| 6116819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6116821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6116824 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116825 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116826 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116827 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116837 | SUPPLY IMPLANT | Supply/Implant | $1,131.01 |
| 6116853 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6116859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116860 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,136.00 |
| 6116861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116862 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116863 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6116864 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6116867 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6116872 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6116873 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6116874 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6116875 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6116876 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6116881 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6116886 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6116890 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6116920 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6116931 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6116940 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116941 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116942 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116943 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116944 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116945 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116946 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116948 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116950 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6116974 | STERILE SUPPLY | Supply/Implant | $389.12 |
| 6116975 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,008.64 |
| 6116978 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,075.20 |
| 6116980 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6116983 | GENERAL SUPPLY | Supply/Implant | $601.60 |
| 6116984 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,008.64 |
| 6116985 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,075.20 |
| 6116988 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,024.00 |
| 6116992 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6116993 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $993.28 |
| 6116994 | SUPPLY IMPLANT | Supply/Implant | $993.28 |
| 6116995 | STERILE SUPPLY | Supply/Implant | $614.40 |
| 6116996 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $993.28 |
| 6116997 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,455.17 |
| 6116998 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6117001 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $12,160.00 |
| 6117002 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $12,160.00 |
| 6117005 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $12,160.00 |
| 6117007 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117008 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6117009 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117010 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117011 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6117013 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117017 | CATHETER, GUIDING | Supply/Implant | $12,384.00 |
| 6117018 | CATHETER, GUIDING | Supply/Implant | $11,648.00 |
| 6117019 | CATHETER, GUIDING | Supply/Implant | $12,672.00 |
| 6117020 | CATHETER, GUIDING | Supply/Implant | $12,352.00 |
| 6117021 | CATHETER, GUIDING | Supply/Implant | $12,352.00 |
| 6117022 | CATHETER, GUIDING | Supply/Implant | $12,672.00 |
| 6117023 | CATHETER, GUIDING | Supply/Implant | $11,283.20 |
| 6117024 | CATHETER, GUIDING | Supply/Implant | $12,352.00 |
| 6117025 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117026 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6117027 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6117047 | GENERAL SUPPLY | Supply/Implant | $258.57 |
| 6117050 | SUPPLY IMPLANT | Supply/Implant | $5,030.40 |
| 6117058 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6117062 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6117086 | SUPPLY IMPLANT | Supply/Implant | $121,296.00 |
| 6117089 | GENERAL SUPPLY | Supply/Implant | $218.11 |
| 6117090 | GENERAL SUPPLY | Supply/Implant | $131.88 |
| 6117096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117097 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6117104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6117107 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6117108 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6117116 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6117117 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6117130 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117133 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117138 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6117153 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6117154 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $17,600.00 |
| 6117176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6117177 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117178 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117179 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117181 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117182 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117183 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6117184 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6117206 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117226 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6117228 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6117299 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6117300 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6117302 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6117316 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6117317 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6117318 | SUPPLY IMPLANT | Supply/Implant | $5,621.76 |
| 6117320 | STERILE SUPPLY | Supply/Implant | $250.88 |
| 6117324 | SUPPLY IMPLANT | Supply/Implant | $21,954.56 |
| 6117329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,676.80 |
| 6117330 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6117331 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6117334 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6117335 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6117338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6117347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6117353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6117354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6117356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6117357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6117362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6117364 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6117365 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117366 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117367 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117368 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117369 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117371 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117373 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117374 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117375 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117376 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117377 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117378 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117379 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117380 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117382 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117383 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117385 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117386 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117387 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117388 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117389 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117391 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117396 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6117397 | SUPPLY IMPLANT | Supply/Implant | $2,784.00 |
| 6117398 | SUPPLY IMPLANT | Supply/Implant | $2,784.00 |
| 6117409 | STERILE SUPPLY | Supply/Implant | $1,700.86 |
| 6117411 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117416 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117419 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117420 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117422 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117424 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117431 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117432 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117433 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117435 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117437 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117440 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117442 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117444 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117446 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117452 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117453 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117454 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117459 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117461 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,280.00 |
| 6117490 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6117496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6117499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6117500 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6117503 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6117504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6117505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6117510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6117517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6117520 | STERILE SUPPLY | Supply/Implant | $2,323.58 |
| 6117521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6117523 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6117557 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6117559 | STERILE SUPPLY | Supply/Implant | $3,851.52 |
| 6117562 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $21,760.00 |
| 6117564 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6117565 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6117566 | SUPPLY IMPLANT | Supply/Implant | $4,172.80 |
| 6117567 | SUPPLY IMPLANT | Supply/Implant | $3,814.40 |
| 6117568 | SUPPLY IMPLANT | Supply/Implant | $4,300.80 |
| 6117571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,292.74 |
| 6117573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6117575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6117576 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6117584 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6117585 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6117586 | CATHETER, GUIDING | Supply/Implant | $5,913.60 |
| 6117589 | STERILE SUPPLY | Supply/Implant | $189.31 |
| 6117590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6117591 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6117593 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6117594 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6117595 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6117596 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6117598 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6117599 | ALLODERM SKIN SUB | Supply/Implant | $36,827.14 |
| 6117600 | FLEXHD OR ALLOPATCH HD PER 1 SQ CM | Supply/Implant | $44,826.62 |
| 6117601 | ALLODERM SKIN SUB | Supply/Implant | $57,526.27 |
| 6117602 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6117608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6117609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,368.00 |
| 6117610 | SUPPLY IMPLANT | Supply/Implant | $11,302.40 |
| 6117611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6117615 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6117617 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6117619 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6117620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6117624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6117625 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6117627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6117631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,701.44 |
| 6117634 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6117635 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6117646 | GENERAL SUPPLY | Supply/Implant | $241.28 |
| 6117647 | SUPPLY IMPLANT | Supply/Implant | $1,703.30 |
| 6117656 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6117658 | GUIDE WIRE | Supply/Implant | $742.02 |
| 6117661 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6117662 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6117663 | GUIDE WIRE | Supply/Implant | $742.02 |
| 6117669 | SUPPLY IMPLANT | Supply/Implant | $1,231.36 |
| 6117670 | SUPPLY IMPLANT | Supply/Implant | $1,527.68 |
| 6117671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6117673 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6117675 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6117677 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6117698 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6117701 | SUPPLY IMPLANT | Supply/Implant | $1,149.18 |
| 6117702 | STERILE SUPPLY | Supply/Implant | $221.70 |
| 6117706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6117707 | GENERAL SUPPLY | Supply/Implant | $1,747.97 |
| 6117708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6117709 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6117710 | SUPPLY IMPLANT | Supply/Implant | $870.14 |
| 6117711 | SUPPLY IMPLANT | Supply/Implant | $870.14 |
| 6117712 | SUPPLY IMPLANT | Supply/Implant | $870.14 |
| 6117714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6117715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6117716 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6117717 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6117718 | GENERAL SUPPLY | Supply/Implant | $736.00 |
| 6117720 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6117766 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117767 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117768 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117770 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117771 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117772 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6117781 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6117782 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,880.00 |
| 6117785 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6117788 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6117789 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6117791 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6117792 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,472.00 |
| 6117795 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6117804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6117806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,368.00 |
| 6117811 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6117812 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6117813 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $21,760.00 |
| 6117815 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6117816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6117819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6117821 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6117822 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6117826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117839 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117842 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117845 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117847 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117849 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117853 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117854 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117855 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117856 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117858 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6117860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6117861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6117862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6117875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6117878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117885 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6117886 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6117887 | SUPPLY IMPLANT | Supply/Implant | $2,265.98 |
| 6117888 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,440.00 |
| 6117892 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6117893 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6117894 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6117895 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6117914 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117926 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6117971 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6117975 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,800.00 |
| 6117989 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6117994 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6118002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118009 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $137.73 |
| 6118012 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118014 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6118038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6118043 | SUPPLY IMPLANT | Supply/Implant | $1,801.09 |
| 6118050 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118054 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118064 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,188.48 |
| 6118081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6118083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6118084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6118098 | GUIDE WIRE | Supply/Implant | $1,648.64 |
| 6118100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $96,908.80 |
| 6118103 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6118104 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6118105 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6118107 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6118123 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118127 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118128 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118130 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6118132 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6118141 | GENERAL SUPPLY | Supply/Implant | $767.36 |
| 6118142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118147 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6118148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118149 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6118156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,848.00 |
| 6118159 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6118160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6118162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6118167 | SUPPLY IMPLANT | Supply/Implant | $41,261.44 |
| 6118174 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6118175 | SUPPLY IMPLANT | Supply/Implant | $152,250.00 |
| 6118184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118201 | STERILE SUPPLY | Supply/Implant | $194.56 |
| 6118203 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6118212 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6118213 | CATHETER, GUIDING | Supply/Implant | $7,616.00 |
| 6118214 | CATHETER, GUIDING | Supply/Implant | $8,896.00 |
| 6118215 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6118219 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6118220 | SUPPLY IMPLANT | Supply/Implant | $644.35 |
| 6118227 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118231 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118232 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118233 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118241 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,736.00 |
| 6118245 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,736.00 |
| 6118248 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118251 | CATHETER, GUIDING | Supply/Implant | $6,148.86 |
| 6118252 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6118253 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6118254 | SUPPLY IMPLANT | Supply/Implant | $4,561.92 |
| 6118255 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6118259 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6118263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6118287 | SUPPLY IMPLANT | Supply/Implant | $13,754.88 |
| 6118289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6118291 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6118300 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6118302 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6118305 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6118309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6118310 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6118311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,121.60 |
| 6118312 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6118313 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6118323 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6118331 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118332 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118333 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118334 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118338 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118339 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118340 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118341 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118343 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118344 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118345 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118347 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6118352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6118354 | GENERAL SUPPLY | Supply/Implant | $319.36 |
| 6118355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,773.95 |
| 6118356 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6118360 | SUPPLY IMPLANT | Supply/Implant | $4,428.80 |
| 6118371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6118372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6118383 | GENERAL SUPPLY | Supply/Implant | $318.46 |
| 6118387 | SUPPLY IMPLANT | Supply/Implant | $40,960.00 |
| 6118388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,968.00 |
| 6118401 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6118403 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6118407 | LEAD, AICD, NON SING/DUAL | Supply/Implant | $51,200.00 |
| 6118418 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6118419 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6118422 | SUPPLY IMPLANT | Supply/Implant | $349.18 |
| 6118426 | GENERAL SUPPLY | Supply/Implant | $444.80 |
| 6118431 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6118433 | SUPPLY IMPLANT | Supply/Implant | $673.66 |
| 6118437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6118442 | GUIDE WIRE | Supply/Implant | $2,803.20 |
| 6118447 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6118448 | SUPPLY IMPLANT | Supply/Implant | $1,627.52 |
| 6118449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6118450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6118451 | PROSTHETIC IMPLANT NOS | Supply/Implant | $28,096.00 |
| 6118452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6118453 | PROSTHETIC IMPLANT NOS | Supply/Implant | $28,096.00 |
| 6118454 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6118460 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118461 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118462 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118463 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118467 | GENERAL SUPPLY | Supply/Implant | $16,000.00 |
| 6118470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,428.48 |
| 6118488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6118492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6118493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6118495 | SUPPLY IMPLANT | Supply/Implant | $44,160.00 |
| 6118504 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6118505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,920.00 |
| 6118509 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118519 | SUPPLY IMPLANT | Supply/Implant | $10,496.00 |
| 6118520 | SUPPLY IMPLANT | Supply/Implant | $16,576.00 |
| 6118521 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6118525 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6118528 | SUPPLY IMPLANT | Supply/Implant | $305.54 |
| 6118534 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6118538 | SUPPLY IMPLANT | Supply/Implant | $131.84 |
| 6118541 | CATHETER, GUIDING | Supply/Implant | $371.20 |
| 6118547 | SUPPLY IMPLANT | Supply/Implant | $6,707.20 |
| 6118560 | GENERAL SUPPLY | Supply/Implant | $246.53 |
| 6118565 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6118570 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6118571 | SUPPLY IMPLANT | Supply/Implant | $1,028.35 |
| 6118572 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6118580 | INTRO/SHEATH, NON-LASER | Supply/Implant | $737.28 |
| 6118581 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6118582 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6118584 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6118586 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6118589 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6118591 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6118595 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6118596 | STERILE SUPPLY | Supply/Implant | $671.87 |
| 6118599 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6118600 | SUPPLY IMPLANT | Supply/Implant | $1,120.00 |
| 6118605 | GUIDE WIRE | Supply/Implant | $997.50 |
| 6118608 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6118609 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6118611 | STERILE SUPPLY | Supply/Implant | $522.50 |
| 6118614 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6118615 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6118616 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6118617 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6118618 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6118637 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,867.20 |
| 6118640 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,867.20 |
| 6118644 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,867.20 |
| 6118650 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,720.00 |
| 6118651 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,720.00 |
| 6118677 | GENERAL SUPPLY | Supply/Implant | $1,503.87 |
| 6118681 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6118694 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6118695 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6118696 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6118698 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6118699 | GENERAL SUPPLY | Supply/Implant | $388.99 |
| 6118728 | STERILE SUPPLY | Supply/Implant | $13,056.00 |
| 6118737 | STERILE SUPPLY | Supply/Implant | $186.24 |
| 6118747 | STERILE SUPPLY | Supply/Implant | $129.34 |
| 6118749 | STERILE SUPPLY | Supply/Implant | $490.24 |
| 6118750 | STERILE SUPPLY | Supply/Implant | $368.13 |
| 6118751 | STERILE SUPPLY | Supply/Implant | $225.15 |
| 6118752 | STERILE SUPPLY | Supply/Implant | $519.94 |
| 6118754 | STERILE SUPPLY | Supply/Implant | $498.05 |
| 6118755 | STERILE SUPPLY | Supply/Implant | $563.84 |
| 6118756 | STERILE SUPPLY | Supply/Implant | $195.84 |
| 6118757 | STERILE SUPPLY | Supply/Implant | $448.77 |
| 6118758 | STERILE SUPPLY | Supply/Implant | $2,176.13 |
| 6118759 | STERILE SUPPLY | Supply/Implant | $205.57 |
| 6118771 | SUPPLY IMPLANT | Supply/Implant | $137.98 |
| 6118779 | GENERAL SUPPLY | Supply/Implant | $367.87 |
| 6118780 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6118784 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6118790 | SUPPLY IMPLANT | Supply/Implant | $25,472.00 |
| 6118791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6118810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6118811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6118812 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6118818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6118819 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118820 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118821 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118822 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118828 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118832 | INTERSPINOUS IMPLANT | Supply/Implant | $14,080.00 |
| 6118835 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6118848 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6118855 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6118861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6118952 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6118957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6118958 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $52,480.00 |
| 6118959 | PMKR, DUAL, RATE-RESP | Supply/Implant | $58,880.00 |
| 6118960 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6118961 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6118963 | GUIDE WIRE | Supply/Implant | $2,944.00 |
| 6118964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6118965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6118968 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6118969 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6118971 | GUIDE WIRE | Supply/Implant | $1,996.80 |
| 6118973 | GUIDE WIRE | Supply/Implant | $537.60 |
| 6118993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6118996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6119001 | GENERAL SUPPLY | Supply/Implant | $203.78 |
| 6119002 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,473.15 |
| 6119014 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6119017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6119018 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6119030 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119034 | GENERAL SUPPLY | Supply/Implant | $182.30 |
| 6119071 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6119072 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6119075 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6119076 | PORT, INDWELLING, IMP | Supply/Implant | $7,040.00 |
| 6119077 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,185.60 |
| 6119080 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6119083 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6119084 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6119086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119091 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6119092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6119094 | STERILE SUPPLY | Supply/Implant | $5,825.08 |
| 6119095 | CATHETER, GUIDING | Supply/Implant | $422.40 |
| 6119107 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $3,520.00 |
| 6119110 | SUPPLY IMPLANT | Supply/Implant | $7,561.60 |
| 6119118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6119119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6119121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119131 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6119134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6119135 | GENERAL SUPPLY | Supply/Implant | $344.83 |
| 6119136 | GENERAL SUPPLY | Supply/Implant | $344.83 |
| 6119137 | GENERAL SUPPLY | Supply/Implant | $344.83 |
| 6119145 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6119146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,433.92 |
| 6119147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6119149 | CATHETER, GUIDING | Supply/Implant | $31,616.00 |
| 6119153 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6119164 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6119172 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6119174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6119176 | SUPPLY IMPLANT | Supply/Implant | $5,053.95 |
| 6119177 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6119179 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6119182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119185 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6119187 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6119193 | SUPPLY IMPLANT | Supply/Implant | $1,062.40 |
| 6119194 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6119195 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6119196 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6119197 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6119198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119201 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6119202 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6119203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119204 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119205 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119208 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119209 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119211 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6119214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6119220 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6119222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $91,110.40 |
| 6119225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6119230 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,728.00 |
| 6119231 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6119233 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6119234 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6119235 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6119237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $205,030.00 |
| 6119238 | SUPPLY IMPLANT | Supply/Implant | $41,261.44 |
| 6119239 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6119240 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6119242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,710.40 |
| 6119244 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6119252 | SUPPLY IMPLANT | Supply/Implant | $4,561.92 |
| 6119253 | SUPPLY IMPLANT | Supply/Implant | $4,561.92 |
| 6119254 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6119257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6119270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6119271 | SUPPLY IMPLANT | Supply/Implant | $307,534.90 |
| 6119302 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6119304 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6119306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,163.20 |
| 6119307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6119312 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6119314 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6119315 | STERILE SUPPLY | Supply/Implant | $16,576.00 |
| 6119317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6119320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,512.00 |
| 6119322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,512.00 |
| 6119324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6119334 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,224.00 |
| 6119335 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6119338 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6119340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6119343 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $10,823.68 |
| 6119347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119355 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6119356 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6119357 | STERILE SUPPLY | Supply/Implant | $244.74 |
| 6119360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6119367 | STERILE SUPPLY | Supply/Implant | $12,544.00 |
| 6119368 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6119372 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6119382 | MESH (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6119384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6119385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119388 | GUIDE WIRE | Supply/Implant | $6,987.39 |
| 6119401 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6119403 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6119408 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6119409 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6119410 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6119411 | STERILE SUPPLY | Supply/Implant | $172.80 |
| 6119416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119417 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119450 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6119451 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6119475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6119478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6119502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6119503 | STERILE SUPPLY | Supply/Implant | $603.01 |
| 6119507 | STERILE SUPPLY | Supply/Implant | $1,920.00 |
| 6119508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6119616 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,268.48 |
| 6119617 | CATHETER, GUIDING | Supply/Implant | $4,800.00 |
| 6119619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6119622 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6119624 | GUIDE WIRE | Supply/Implant | $13,760.00 |
| 6119625 | EMBOLIZATION PROTECT SYST | Supply/Implant | $48,000.00 |
| 6119627 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6119632 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,936.00 |
| 6119639 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6119640 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6119641 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6119642 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6119643 | INTERSPINOUS IMPLANT | Supply/Implant | $75,008.00 |
| 6119646 | SUPPLY IMPLANT | Supply/Implant | $916.99 |
| 6119649 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119657 | STERILE SUPPLY | Supply/Implant | $893.82 |
| 6119683 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,632.00 |
| 6119684 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6119687 | STERILE SUPPLY | Supply/Implant | $847.87 |
| 6119689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6119691 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,560.00 |
| 6119697 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6119698 | STERILE SUPPLY | Supply/Implant | $207.36 |
| 6119699 | STERILE SUPPLY | Supply/Implant | $912.00 |
| 6119700 | GENERAL SUPPLY | Supply/Implant | $691.20 |
| 6119701 | SUPPLY IMPLANT | Supply/Implant | $3,546.50 |
| 6119702 | SUPPLY IMPLANT | Supply/Implant | $3,546.50 |
| 6119703 | SUPPLY IMPLANT | Supply/Implant | $4,100.22 |
| 6119709 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,124.74 |
| 6119718 | INTRO/SHEATH, NON-LASER | Supply/Implant | $140.16 |
| 6119719 | GUIDE WIRE | Supply/Implant | $589.85 |
| 6119725 | SUPPLY IMPLANT | Supply/Implant | $435.97 |
| 6119727 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $26,752.00 |
| 6119728 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6119729 | STERILE SUPPLY | Supply/Implant | $3,417.73 |
| 6119730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6119735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,649.60 |
| 6119737 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119740 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6119741 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6119743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6119745 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6119748 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6119749 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6119750 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6119755 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6119762 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,268.29 |
| 6119767 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6119768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6119769 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6119771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6119786 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6119787 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6119788 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6119791 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6119793 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6119794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119796 | INTERSPINOUS IMPLANT | Supply/Implant | $13,754.88 |
| 6119798 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119799 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119800 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119801 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119802 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119803 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119804 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6119805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6119807 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6119811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119814 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119815 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119816 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119817 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119818 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119820 | CATHETER, GUIDING | Supply/Implant | $951.04 |
| 6119821 | GEN, NEURO, NON-HF RECHG BAT | Supply/Implant | $373,700.00 |
| 6119830 | GUIDE WIRE | Supply/Implant | $19,576.45 |
| 6119833 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6119834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,592.00 |
| 6119842 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119845 | SUPPLY IMPLANT | Supply/Implant | $7,872.00 |
| 6119853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6119854 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6119855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119858 | SUPPLY IMPLANT | Supply/Implant | $6,520.32 |
| 6119859 | SUPPLY IMPLANT | Supply/Implant | $6,520.32 |
| 6119866 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6119868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,081.22 |
| 6119877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,856.96 |
| 6119879 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6119884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6119885 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,169.28 |
| 6119887 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6119888 | SUPPLY IMPLANT | Supply/Implant | $819.20 |
| 6119893 | CATHETER, URETERAL | Supply/Implant | $504.19 |
| 6119899 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $322,695.00 |
| 6119900 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $35,840.00 |
| 6119903 | SUPPLY IMPLANT | Supply/Implant | $2,266.02 |
| 6119907 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119908 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119909 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119910 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119915 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6119917 | CATH EP COOL-TIP | Supply/Implant | $23,680.00 |
| 6119921 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119922 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119923 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119924 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119925 | MESH (IMPLANTABLE) | Supply/Implant | $7,900.03 |
| 6119926 | MESH (IMPLANTABLE) | Supply/Implant | $7,900.03 |
| 6119929 | MESH (IMPLANTABLE) | Supply/Implant | $7,026.56 |
| 6119933 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6119941 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6119944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119949 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6119950 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6119952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6119955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,368.00 |
| 6119957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119969 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6119976 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6119977 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6119978 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119979 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119980 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119981 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119982 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119983 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119984 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119985 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119986 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119987 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119988 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119989 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119990 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119991 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119992 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119993 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119994 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119995 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119996 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119997 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119998 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119999 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120000 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120001 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120002 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120003 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120004 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120005 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120006 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120007 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120008 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120009 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120010 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120011 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120012 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120013 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120014 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120015 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120016 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120017 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120018 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120019 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120020 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120021 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120022 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120023 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120024 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120025 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120026 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120027 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120028 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120029 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120030 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120031 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120032 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120033 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120038 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6120039 | SUPPLY IMPLANT | Supply/Implant | $5,053.95 |
| 6120045 | STERILE SUPPLY | Supply/Implant | $603.01 |
| 6120053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,905.60 |
| 6120055 | INTRO/SHEATH, NON-LASER | Supply/Implant | $286.72 |
| 6120056 | GENERAL SUPPLY | Supply/Implant | $274.50 |
| 6120059 | SUPPLY IMPLANT | Supply/Implant | $155.90 |
| 6120061 | STERILE SUPPLY | Supply/Implant | $1,259.85 |
| 6120071 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120075 | STERILE SUPPLY | Supply/Implant | $184.19 |
| 6120077 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6120140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6120141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6120142 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6120143 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6120144 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6120148 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120150 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120151 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6120188 | STERILE SUPPLY | Supply/Implant | $528.13 |
| 6120190 | STERILE SUPPLY | Supply/Implant | $135.68 |
| 6120253 | STERILE SUPPLY | Supply/Implant | $199.04 |
| 6120259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6120270 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,648.00 |
| 6120271 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,518.40 |
| 6120272 | SUPPLY IMPLANT | Supply/Implant | $149,765.60 |
| 6120276 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6120280 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,553.86 |
| 6120282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6120286 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $82,579.20 |
| 6120289 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6120300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6120303 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6120307 | GENERAL SUPPLY | Supply/Implant | $541.98 |
| 6120309 | STERILE SUPPLY | Supply/Implant | $336.69 |
| 6120310 | STERILE SUPPLY | Supply/Implant | $254.84 |
| 6120311 | CATHETER, GUIDING | Supply/Implant | $10,880.00 |
| 6120312 | GUIDE WIRE | Supply/Implant | $4,672.00 |
| 6120313 | STERILE SUPPLY | Supply/Implant | $207.23 |
| 6120318 | GENERAL SUPPLY | Supply/Implant | $242.18 |
| 6120325 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6120328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,424.00 |
| 6120330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6120334 | GENERAL SUPPLY | Supply/Implant | $536.19 |
| 6120335 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $46,144.00 |
| 6120336 | STERILE SUPPLY | Supply/Implant | $166.40 |
| 6120337 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6120384 | SUPPLY IMPLANT | Supply/Implant | $5,135.36 |
| 6120385 | SUPPLY IMPLANT | Supply/Implant | $7,561.60 |
| 6120386 | SUPPLY IMPLANT | Supply/Implant | $7,561.60 |
| 6120387 | SUPPLY IMPLANT | Supply/Implant | $5,135.36 |
| 6120390 | SUPPLY IMPLANT | Supply/Implant | $5,102.72 |
| 6120396 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6120397 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6120398 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6120399 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6120408 | SUPPLY IMPLANT | Supply/Implant | $7,485.44 |
| 6120410 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6120411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6120414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,840.00 |
| 6120415 | CATH, DRAINAGE | Supply/Implant | $912.90 |
| 6120416 | SUPPLY IMPLANT | Supply/Implant | $379.65 |
| 6120417 | GENERAL SUPPLY | Supply/Implant | $188.70 |
| 6120420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6120421 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6120426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6120427 | GENERAL SUPPLY | Supply/Implant | $21,760.00 |
| 6120428 | GENERAL SUPPLY | Supply/Implant | $24,256.00 |
| 6120429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6120430 | GENERAL SUPPLY | Supply/Implant | $44,800.00 |
| 6120433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,096.00 |
| 6120436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6120438 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6120440 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6120445 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6120446 | GENERAL SUPPLY | Supply/Implant | $349.38 |
| 6120455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6120457 | SUPPLY IMPLANT | Supply/Implant | $62,976.00 |
| 6120458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6120459 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6120468 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,864.96 |
| 6120471 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6120474 | SUPPLY IMPLANT | Supply/Implant | $15,040.00 |
| 6120477 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6120478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6120479 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6120484 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6120485 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6120487 | GENERAL SUPPLY | Supply/Implant | $3,072.00 |
| 6120572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6120573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6120574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6120673 | GENERAL SUPPLY | Supply/Implant | $142.08 |
| 6120706 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6120707 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120708 | SUPPLY IMPLANT | Supply/Implant | $25,510.40 |
| 6120716 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6120721 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6120774 | SUPPLY IMPLANT | Supply/Implant | $807.04 |
| 6120779 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6120780 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6120781 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6120789 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6120790 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6120791 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6120792 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6120793 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6120794 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6120795 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6120800 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,432.00 |
| 6120801 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,432.00 |
| 6120803 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,432.00 |
| 6120809 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120812 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120815 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120816 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120817 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6120818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6120819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6120821 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6120832 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6120833 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6120834 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6120835 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6120836 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6120841 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6120842 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6120843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6120844 | SUPPLY IMPLANT | Supply/Implant | $777.60 |
| 6120848 | SUPPLY IMPLANT | Supply/Implant | $10,432.00 |
| 6120850 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120851 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,060.80 |
| 6120870 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6120876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6120877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6120886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6120888 | STERILE SUPPLY | Supply/Implant | $2,803.20 |
| 6120891 | STERILE SUPPLY | Supply/Implant | $755.20 |
| 6120900 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6120902 | GUIDE WIRE | Supply/Implant | $257.66 |
| 6120907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6120912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,302.40 |
| 6120914 | SUPPLY IMPLANT | Supply/Implant | $211.46 |
| 6120915 | STERILE SUPPLY | Supply/Implant | $319.65 |
| 6120916 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6120920 | SUPPLY IMPLANT | Supply/Implant | $4,518.40 |
| 6120921 | SUPPLY IMPLANT | Supply/Implant | $4,518.40 |
| 6120926 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6120933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6120934 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6120935 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6120936 | SUPPLY IMPLANT | Supply/Implant | $1,582.85 |
| 6120939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,022.40 |
| 6120941 | GUIDE WIRE | Supply/Implant | $507.85 |
| 6120942 | GUIDE WIRE | Supply/Implant | $335.87 |
| 6120943 | CATHETER, GUIDING | Supply/Implant | $35,200.00 |
| 6120944 | GUIDE WIRE | Supply/Implant | $333.18 |
| 6120948 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,760.00 |
| 6120951 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6120952 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6120953 | SUPPLY IMPLANT | Supply/Implant | $7,541.25 |
| 6120959 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6120961 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $22,272.00 |
| 6120962 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6120963 | SUPPLY IMPLANT | Supply/Implant | $156.80 |
| 6120965 | INTRO/SHEATH, NON-LASER | Supply/Implant | $948.99 |
| 6120966 | GUIDE WIRE | Supply/Implant | $562.12 |
| 6120968 | GUIDE WIRE | Supply/Implant | $717.21 |
| 6120969 | GUIDE WIRE | Supply/Implant | $625.56 |
| 6120970 | GUIDE WIRE | Supply/Implant | $661.27 |
| 6120971 | GUIDE WIRE | Supply/Implant | $661.27 |
| 6120975 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6120976 | SUPPLY IMPLANT | Supply/Implant | $1,629.57 |
| 6120977 | SUPPLY IMPLANT | Supply/Implant | $811.78 |
| 6120979 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6120981 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6120985 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6120987 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6120993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6120994 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6120996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6120997 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120998 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120999 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6121001 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6121003 | SUPPLY IMPLANT | Supply/Implant | $331.01 |
| 6121005 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6121006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6121007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6121011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6121012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6121018 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6121019 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6121023 | SUPPLY IMPLANT | Supply/Implant | $21,900.80 |
| 6121024 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6121027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121029 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6121033 | GENERAL SUPPLY | Supply/Implant | $698.75 |
| 6121034 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6121035 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6121050 | SUPPLY IMPLANT | Supply/Implant | $24,819.20 |
| 6121051 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $345.60 |
| 6121053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121054 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121059 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6121061 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6121067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6121070 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6121079 | SUPPLY IMPLANT | Supply/Implant | $2,306.69 |
| 6121084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,473.60 |
| 6121085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $81,868.42 |
| 6121086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6121091 | STERILE SUPPLY | Supply/Implant | $6,673.92 |
| 6121092 | STERILE SUPPLY | Supply/Implant | $7,782.40 |
| 6121093 | SUPPLY IMPLANT | Supply/Implant | $12,014.08 |
| 6121097 | SUPPLY IMPLANT | Supply/Implant | $66,162.56 |
| 6121103 | SUPPLY IMPLANT | Supply/Implant | $496.77 |
| 6121104 | INTRO/SHEATH, NON-LASER | Supply/Implant | $496.77 |
| 6121105 | STERILE SUPPLY | Supply/Implant | $988.80 |
| 6121107 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6121112 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6121115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,216.00 |
| 6121116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,344.00 |
| 6121120 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $186.37 |
| 6121124 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6121127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121135 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6121136 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6121137 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6121138 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6121139 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6121141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6121142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,020.80 |
| 6121143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,020.80 |
| 6121149 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6121151 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,160.00 |
| 6121152 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $4,160.00 |
| 6121157 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6121161 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,832.38 |
| 6121162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6121163 | STERILE SUPPLY | Supply/Implant | $275.07 |
| 6121164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6121167 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6121168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121175 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121187 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6121188 | STERILE SUPPLY | Supply/Implant | $222.21 |
| 6121191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121194 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6121201 | SUPPLY IMPLANT | Supply/Implant | $1,532.16 |
| 6121203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,260.54 |
| 6121206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121210 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6121215 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6121216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6121217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6121222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6121224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6121229 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6121232 | ORTH/DEVIC/DRUG BN/BN,TIS/BN | Supply/Implant | $42,496.00 |
| 6121235 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6121236 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121239 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6121240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6121242 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6121250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6121251 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,619.71 |
| 6121253 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121254 | SUPPLY IMPLANT | Supply/Implant | $199.55 |
| 6121255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6121256 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6121265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6121269 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,508.42 |
| 6121275 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6121277 | STERILE SUPPLY | Supply/Implant | $467.25 |
| 6121301 | INTERSPINOUS IMPLANT | Supply/Implant | $125,952.00 |
| 6121302 | INTERSPINOUS IMPLANT | Supply/Implant | $125,952.00 |
| 6121303 | INTERSPINOUS IMPLANT | Supply/Implant | $111,585.60 |
| 6121336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121604 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6121671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121693 | INTERSPINOUS IMPLANT | Supply/Implant | $24,742.40 |
| 6121715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6121738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121749 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6121835 | INTERSPINOUS IMPLANT | Supply/Implant | $111,132.00 |
| 6121845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6121928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6121943 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121956 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6121982 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6121985 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6121989 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6122012 | INTERSPINOUS IMPLANT | Supply/Implant | $115,589.12 |
| 6122059 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6122082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6122086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6122092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122113 | INTERSPINOUS IMPLANT | Supply/Implant | $111,132.00 |
| 6122370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122494 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6122508 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122513 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122519 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122528 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122530 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122531 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122710 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6122727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,908.80 |
| 6122785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6122838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6122880 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6123044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6123049 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123052 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6123054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6123061 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123109 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6123112 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6123114 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6123117 | INTERSPINOUS IMPLANT | Supply/Implant | $115,589.12 |
| 6123118 | INTERSPINOUS IMPLANT | Supply/Implant | $115,589.12 |
| 6123124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6123155 | SUPPLY IMPLANT | Supply/Implant | $19,271.68 |
| 6123213 | SUPPLY IMPLANT | Supply/Implant | $13,455.36 |
| 6123295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6123325 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6123571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6123701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6123830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6123853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6123937 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6123986 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6124006 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6124010 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6124019 | SUPPLY IMPLANT | Supply/Implant | $3,673.60 |
| 6124050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,181.12 |
| 6124051 | STERILE SUPPLY | Supply/Implant | $251.01 |
| 6124054 | STERILE SUPPLY | Supply/Implant | $28,160.00 |
| 6124055 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $32,000.00 |
| 6124059 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6124062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6124073 | STERILE SUPPLY | Supply/Implant | $219.90 |
| 6124076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6124081 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6124086 | GUIDE WIRE | Supply/Implant | $358.40 |
| 6124088 | GUIDE WIRE | Supply/Implant | $1,779.20 |
| 6124089 | GUIDE WIRE | Supply/Implant | $358.40 |
| 6124110 | GUIDE WIRE | Supply/Implant | $6,144.00 |
| 6124113 | GUIDE WIRE | Supply/Implant | $6,144.00 |
| 6124260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124299 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6124349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6124351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $307.20 |
| 6124355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $307.20 |
| 6124365 | SUPPLY IMPLANT | Supply/Implant | $857.60 |
| 6124367 | SUPPLY IMPLANT | Supply/Implant | $857.60 |
| 6124369 | SUPPLY IMPLANT | Supply/Implant | $857.60 |
| 6124430 | SUPPLY IMPLANT | Supply/Implant | $3,891.20 |
| 6124451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124460 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6124502 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124503 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124504 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124505 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,911.74 |
| 6124514 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6124518 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6124519 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $133,297.50 |
| 6124522 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6124545 | SUPPLY IMPLANT | Supply/Implant | $11,387.65 |
| 6124546 | SUPPLY IMPLANT | Supply/Implant | $11,299.33 |
| 6124547 | SUPPLY IMPLANT | Supply/Implant | $11,299.33 |
| 6124552 | SUPPLY IMPLANT | Supply/Implant | $11,299.33 |
| 6124559 | SUPPLY IMPLANT | Supply/Implant | $8,297.98 |
| 6124560 | SUPPLY IMPLANT | Supply/Implant | $8,297.98 |
| 6124561 | SUPPLY IMPLANT | Supply/Implant | $8,297.98 |
| 6124568 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124569 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124573 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124575 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124602 | SUPPLY IMPLANT | Supply/Implant | $8,908.80 |
| 6124611 | STERILE SUPPLY | Supply/Implant | $417.02 |
| 6124612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124615 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6124616 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6124618 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6124619 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6124623 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6124624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6124627 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6124630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6124636 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,785.47 |
| 6124641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6124643 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6124650 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6124652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6124653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6124656 | STERILE SUPPLY | Supply/Implant | $386.05 |
| 6124666 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6124667 | STERILE SUPPLY | Supply/Implant | $10,457.60 |
| 6124669 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6124675 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6124676 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6124679 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6124680 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6124687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6124688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6124689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6124695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6124698 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,815.36 |
| 6124699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6124702 | SUPPLY IMPLANT | Supply/Implant | $8,585.47 |
| 6124705 | SUPPLY IMPLANT | Supply/Implant | $5,546.62 |
| 6124707 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6124708 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6124709 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6124713 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6124716 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6124717 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6124718 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6124719 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6124722 | GENERAL SUPPLY | Supply/Implant | $494.09 |
| 6124723 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6124724 | SUPPLY IMPLANT | Supply/Implant | $698.88 |
| 6124725 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6124728 | SUPPLY IMPLANT | Supply/Implant | $422.03 |
| 6124730 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6124731 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6124732 | SUPPLY IMPLANT | Supply/Implant | $2,188.80 |
| 6124733 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6124734 | SUPPLY IMPLANT | Supply/Implant | $926.85 |
| 6124736 | GENERAL SUPPLY | Supply/Implant | $1,223.40 |
| 6124738 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6124741 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6124742 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124743 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124745 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124748 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124749 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124750 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124751 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6124752 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,880.00 |
| 6124753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6124754 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6124755 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6124756 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6124757 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6124759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6124764 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6124765 | SUPPLY IMPLANT | Supply/Implant | $3,104.64 |
| 6124768 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6124784 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6124785 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6124786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6124787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124791 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6124792 | SUPPLY IMPLANT | Supply/Implant | $289.31 |
| 6124793 | SUPPLY IMPLANT | Supply/Implant | $760.58 |
| 6124794 | SUPPLY IMPLANT | Supply/Implant | $729.60 |
| 6124795 | GENERAL SUPPLY | Supply/Implant | $4,480.00 |
| 6124796 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6124811 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $231.68 |
| 6124813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6124814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6124815 | GENERAL SUPPLY | Supply/Implant | $1,035.14 |
| 6124816 | STERILE SUPPLY | Supply/Implant | $4,736.00 |
| 6124817 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,760.00 |
| 6124820 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6124824 | PROSTHETIC EYE OTHER TYPE | Supply/Implant | $230.40 |
| 6124825 | PROSTHETIC EYE OTHER TYPE | Supply/Implant | $230.40 |
| 6124834 | GENERAL SUPPLY | Supply/Implant | $5,875.20 |
| 6124854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6124855 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6124885 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $29,376.00 |
| 6124886 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6124892 | SUPPLY IMPLANT | Supply/Implant | $15,040.00 |
| 6124893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6124894 | SUPPLY IMPLANT | Supply/Implant | $947.20 |
| 6124907 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6124914 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6124940 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6124943 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6124957 | STERILE SUPPLY | Supply/Implant | $263.68 |
| 6124959 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6124991 | GENERAL SUPPLY | Supply/Implant | $7,360.00 |
| 6125013 | GENERAL SUPPLY | Supply/Implant | $2,442.24 |
| 6125018 | SUPPLY IMPLANT | Supply/Implant | $3,310.08 |
| 6125044 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6125056 | CATH, DRAINAGE | Supply/Implant | $1,728.00 |
| 6125078 | GUIDE WIRE | Supply/Implant | $147.20 |
| 6125097 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6125108 | STERILE SUPPLY | Supply/Implant | $205.95 |
| 6125118 | SUPPLY IMPLANT | Supply/Implant | $406.91 |
| 6125124 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,163.20 |
| 6125126 | SUPPLY IMPLANT | Supply/Implant | $405.50 |
| 6125127 | CATHETER, URETERAL | Supply/Implant | $204.67 |
| 6125130 | INDWELLING CATHETER FOLEY TYPE | Supply/Implant | $204.67 |
| 6125174 | SUPPLY IMPLANT | Supply/Implant | $1,843.20 |
| 6125234 | SUPPLY IMPLANT | Supply/Implant | $407.24 |
| 6125274 | GENERAL SUPPLY | Supply/Implant | $161.19 |
| 6125278 | CATHETER, GUIDING | Supply/Implant | $14,400.00 |
| 6125280 | SUPPLY IMPLANT | Supply/Implant | $3,839.10 |
| 6125282 | GENERAL SUPPLY | Supply/Implant | $4,662.66 |
| 6125291 | SUPPLY IMPLANT | Supply/Implant | $2,437.63 |
| 6125302 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,394.75 |
| 6125304 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125325 | GRAFT, VASCULAR | Supply/Implant | $7,907.46 |
| 6125332 | STERILE SUPPLY | Supply/Implant | $176.38 |
| 6125343 | SUPPLY IMPLANT | Supply/Implant | $585.98 |
| 6125348 | SUPPLY IMPLANT | Supply/Implant | $748.80 |
| 6125360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6125368 | SUPPLY IMPLANT | Supply/Implant | $792.58 |
| 6125396 | SUPPLY IMPLANT | Supply/Implant | $1,509.76 |
| 6125407 | SUPPLY IMPLANT | Supply/Implant | $194.71 |
| 6125409 | SUPPLY IMPLANT | Supply/Implant | $551.55 |
| 6125424 | SUPPLY IMPLANT | Supply/Implant | $574.46 |
| 6125437 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6125501 | CATH, DRAINAGE | Supply/Implant | $501.12 |
| 6125511 | STERILE SUPPLY | Supply/Implant | $612.22 |
| 6125519 | CATHETER, URETERAL | Supply/Implant | $11,251.20 |
| 6125548 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,052.10 |
| 6125558 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125569 | SUPPLY IMPLANT | Supply/Implant | $1,361.31 |
| 6125592 | GENERAL SUPPLY | Supply/Implant | $1,692.80 |
| 6125593 | STERILE SUPPLY | Supply/Implant | $245.89 |
| 6125614 | STERILE SUPPLY | Supply/Implant | $166.22 |
| 6125622 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6125631 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6125636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,180.80 |
| 6125658 | STERILE SUPPLY | Supply/Implant | $10,931.20 |
| 6125664 | GENERAL SUPPLY | Supply/Implant | $2,928.38 |
| 6125670 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125671 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $1,378.94 |
| 6125680 | SUPPLY IMPLANT | Supply/Implant | $1,265.66 |
| 6125681 | SUPPLY IMPLANT | Supply/Implant | $1,414.53 |
| 6125690 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125705 | GRAFT, VASCULAR | Supply/Implant | $7,907.46 |
| 6125712 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,360.00 |
| 6125716 | SUPPLY IMPLANT | Supply/Implant | $1,548.80 |
| 6125721 | STERILE SUPPLY | Supply/Implant | $349.98 |
| 6125724 | SUPPLY IMPLANT | Supply/Implant | $1,651.20 |
| 6125726 | SUPPLY IMPLANT | Supply/Implant | $1,651.20 |
| 6125732 | STERILE SUPPLY | Supply/Implant | $772.86 |
| 6125748 | SUPPLY IMPLANT | Supply/Implant | $283.78 |
| 6125751 | STERILE SUPPLY | Supply/Implant | $773.12 |
| 6125757 | GENERAL SUPPLY | Supply/Implant | $3,264.00 |
| 6125790 | GUIDE WIRE | Supply/Implant | $1,172.61 |
| 6125796 | SUPPLY IMPLANT | Supply/Implant | $1,996.80 |
| 6125802 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6125819 | SUPPLY IMPLANT | Supply/Implant | $257.28 |
| 6125846 | SUPPLY IMPLANT | Supply/Implant | $403.78 |
| 6125854 | SUPPLY IMPLANT | Supply/Implant | $327.30 |
| 6125868 | CATH, DRAINAGE | Supply/Implant | $918.14 |
| 6125873 | SUPPLY IMPLANT | Supply/Implant | $602.11 |
| 6125877 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6125888 | SUPPLY IMPLANT | Supply/Implant | $144.00 |
| 6125891 | SUPPLY IMPLANT | Supply/Implant | $2,243.20 |
| 6125895 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6125911 | GRAFT, VASCULAR | Supply/Implant | $4,075.26 |
| 6125938 | APLIGRAF SKIN SUB | Supply/Implant | $16,576.00 |
| 6125977 | SUPPLY IMPLANT | Supply/Implant | $551.55 |
| 6125978 | STERILE SUPPLY | Supply/Implant | $342.02 |
| 6125995 | STERILE SUPPLY | Supply/Implant | $286.72 |
| 6126001 | SUPPLY IMPLANT | Supply/Implant | $148.74 |
| 6126006 | GUIDE WIRE | Supply/Implant | $139.52 |
| 6126008 | GENERAL SUPPLY | Supply/Implant | $848.00 |
| 6126064 | INTRO/SHEATH, NON-LASER | Supply/Implant | $824.32 |
| 6126150 | STERILE SUPPLY | Supply/Implant | $168.96 |
| 6126169 | SUPPLY IMPLANT | Supply/Implant | $132.48 |
| 6126180 | SUPPLY IMPLANT | Supply/Implant | $4,285.44 |
| 6126189 | SUPPLY IMPLANT | Supply/Implant | $166.45 |
| 6126202 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6126254 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6126257 | STERILE SUPPLY | Supply/Implant | $727.68 |
| 6126258 | SUPPLY IMPLANT | Supply/Implant | $3,310.08 |
| 6126299 | SUPPLY IMPLANT | Supply/Implant | $131.58 |
| 6126318 | STERILE SUPPLY | Supply/Implant | $740.99 |
| 6126348 | SUPPLY IMPLANT | Supply/Implant | $7,567.62 |
| 6126371 | SUPPLY IMPLANT | Supply/Implant | $1,769.98 |
| 6126379 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,596.48 |
| 6126386 | GRAFT, VASCULAR | Supply/Implant | $16,972.80 |
| 6126388 | GRAFT, VASCULAR | Supply/Implant | $16,294.40 |
| 6126395 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $157.31 |
| 6126397 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $157.31 |
| 6126404 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,080.00 |
| 6126405 | SUPPLY IMPLANT | Supply/Implant | $481.22 |
| 6126409 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6126412 | GUIDE WIRE | Supply/Implant | $132.86 |
| 6126454 | STERILE SUPPLY | Supply/Implant | $370.69 |
| 6126466 | SUPPLY IMPLANT | Supply/Implant | $8,005.38 |
| 6126468 | STERILE SUPPLY | Supply/Implant | $1,766.40 |
| 6126480 | GENERAL SUPPLY | Supply/Implant | $1,427.20 |
| 6126485 | GUIDE WIRE | Supply/Implant | $364.29 |
| 6126509 | GENERAL SUPPLY | Supply/Implant | $772.61 |
| 6126515 | GENERAL SUPPLY | Supply/Implant | $683.52 |
| 6126518 | GENERAL SUPPLY | Supply/Implant | $772.35 |
| 6126536 | STERILE SUPPLY | Supply/Implant | $137.22 |
| 6126538 | GENERAL SUPPLY | Supply/Implant | $2,368.00 |
| 6126550 | STERILE SUPPLY | Supply/Implant | $2,114.82 |
| 6126552 | STERILE SUPPLY | Supply/Implant | $284.80 |
| 6126569 | GENERAL SUPPLY | Supply/Implant | $774.66 |
| 6126575 | SUPPLY IMPLANT | Supply/Implant | $156.42 |
| 6126577 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6126586 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6126587 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,273.22 |
| 6126593 | STERILE SUPPLY | Supply/Implant | $3,293.95 |
| 6126594 | STERILE SUPPLY | Supply/Implant | $5,993.60 |
| 6126595 | STERILE SUPPLY | Supply/Implant | $2,157.31 |
| 6126596 | STERILE SUPPLY | Supply/Implant | $4,528.51 |
| 6126597 | STERILE SUPPLY | Supply/Implant | $1,567.62 |
| 6126598 | STERILE SUPPLY | Supply/Implant | $542.98 |
| 6126599 | STERILE SUPPLY | Supply/Implant | $2,249.73 |
| 6126600 | STERILE SUPPLY | Supply/Implant | $930.56 |
| 6126601 | STERILE SUPPLY | Supply/Implant | $2,197.12 |
| 6126602 | STERILE SUPPLY | Supply/Implant | $2,231.94 |
| 6126603 | STERILE SUPPLY | Supply/Implant | $1,603.84 |
| 6126604 | STERILE SUPPLY | Supply/Implant | $878.34 |
| 6126605 | STERILE SUPPLY | Supply/Implant | $1,280.26 |
| 6126606 | STERILE SUPPLY | Supply/Implant | $841.22 |
| 6126607 | STERILE SUPPLY | Supply/Implant | $6,556.54 |
| 6126608 | STERILE SUPPLY | Supply/Implant | $4,020.86 |
| 6126609 | STERILE SUPPLY | Supply/Implant | $577.02 |
| 6126610 | STERILE SUPPLY | Supply/Implant | $1,245.44 |
| 6126611 | STERILE SUPPLY | Supply/Implant | $4,795.78 |
| 6126613 | STERILE SUPPLY | Supply/Implant | $800.64 |
| 6126614 | STERILE SUPPLY | Supply/Implant | $3,303.42 |
| 6126634 | STERILE SUPPLY | Supply/Implant | $639.10 |
| 6126638 | STERILE SUPPLY | Supply/Implant | $374.40 |
| 6126716 | CATH, DRAINAGE | Supply/Implant | $1,516.80 |
| 6126717 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6126737 | GENERAL SUPPLY | Supply/Implant | $261.12 |
| 6126757 | STERILE SUPPLY | Supply/Implant | $521.10 |
| 6126762 | INTRO/SHEATH, NON-LASER | Supply/Implant | $438.78 |
| 6126763 | STERILE SUPPLY | Supply/Implant | $272.64 |
| 6126789 | STERILE SUPPLY | Supply/Implant | $503.68 |
| 6126790 | STERILE SUPPLY | Supply/Implant | $1,469.06 |
| 6126794 | STERILE SUPPLY | Supply/Implant | $1,928.70 |
| 6126795 | GENERAL SUPPLY | Supply/Implant | $188.54 |
| 6126798 | SUPPLY IMPLANT | Supply/Implant | $1,550.46 |
| 6126800 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6126826 | GENERAL SUPPLY | Supply/Implant | $1,970.82 |
| 6126827 | STERILE SUPPLY | Supply/Implant | $1,263.87 |
| 6126828 | STERILE SUPPLY | Supply/Implant | $2,723.20 |
| 6126829 | STERILE SUPPLY | Supply/Implant | $1,421.82 |
| 6126830 | STERILE SUPPLY | Supply/Implant | $2,538.75 |
| 6126831 | GENERAL SUPPLY | Supply/Implant | $3,854.59 |
| 6126832 | STERILE SUPPLY | Supply/Implant | $601.60 |
| 6126849 | STERILE SUPPLY | Supply/Implant | $525.31 |
| 6126854 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6126863 | GUIDE WIRE | Supply/Implant | $6,054.40 |
| 6126873 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,080.00 |
| 6126895 | CATHETER, GUIDING | Supply/Implant | $5,286.40 |
| 6126925 | GENERAL SUPPLY | Supply/Implant | $1,749.12 |
| 6126938 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6126940 | SUPPLY IMPLANT | Supply/Implant | $1,549.31 |
| 6126955 | STERILE SUPPLY | Supply/Implant | $2,072.45 |
| 6126989 | SUPPLY IMPLANT | Supply/Implant | $523.49 |
| 6126994 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6127065 | SUPPLY IMPLANT | Supply/Implant | $1,193.60 |
| 6127182 | GENERAL SUPPLY | Supply/Implant | $231.00 |
| 6127216 | STERILE SUPPLY | Supply/Implant | $8,937.34 |
| 6127241 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6127248 | SUPPLY IMPLANT | Supply/Implant | $1,357.80 |
| 6127271 | SUPPLY IMPLANT | Supply/Implant | $231.94 |
| 6127311 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6127321 | SUPPLY IMPLANT | Supply/Implant | $321.41 |
| 6127327 | SUPPLY IMPLANT | Supply/Implant | $323.84 |
| 6127337 | GUIDE WIRE | Supply/Implant | $2,180.35 |
| 6127352 | SUPPLY IMPLANT | Supply/Implant | $338.69 |
| 6127573 | CATH, DRAINAGE | Supply/Implant | $319.10 |
| 6127579 | STERILE SUPPLY | Supply/Implant | $158.76 |
| 6127627 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,843.20 |
| 6127628 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $5,760.00 |
| 6127660 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6127716 | GUIDE WIRE | Supply/Implant | $168.70 |
| 6127727 | SUPPLY IMPLANT | Supply/Implant | $165.91 |
| 6127748 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6127766 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6127784 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6127807 | GENERAL SUPPLY | Supply/Implant | $220.95 |
| 6127808 | STERILE SUPPLY | Supply/Implant | $292.10 |
| 6127810 | SUPPLY IMPLANT | Supply/Implant | $339.99 |
| 6127822 | SUPPLY IMPLANT | Supply/Implant | $170.50 |
| 6127843 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6127849 | STERILE SUPPLY | Supply/Implant | $3,172.35 |
| 6127850 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $20,480.00 |
| 6127852 | STERILE SUPPLY | Supply/Implant | $1,670.91 |
| 6127866 | GUIDE WIRE | Supply/Implant | $832.00 |
| 6127904 | CATHETER, GUIDING | Supply/Implant | $792.83 |
| 6127906 | STERILE SUPPLY | Supply/Implant | $468.22 |
| 6127908 | CATHETER, GUIDING | Supply/Implant | $419.84 |
| 6128031 | STERILE SUPPLY | Supply/Implant | $2,137.60 |
| 6128094 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6128114 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.12 |
| 6128117 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6128123 | STERILE SUPPLY | Supply/Implant | $76,800.00 |
| 6128184 | STERILE SUPPLY | Supply/Implant | $139.65 |
| 6128185 | STERILE SUPPLY | Supply/Implant | $164.35 |
| 6128189 | SUPPLY IMPLANT | Supply/Implant | $4,167.68 |
| 6128217 | SUPPLY IMPLANT | Supply/Implant | $227.20 |
| 6128252 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6128265 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6128280 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,426.30 |
| 6128285 | STERILE SUPPLY | Supply/Implant | $229.12 |
| 6128299 | STERILE SUPPLY | Supply/Implant | $1,206.66 |
| 6128308 | GUIDE WIRE | Supply/Implant | $2,180.35 |
| 6128309 | GUIDE WIRE | Supply/Implant | $2,180.35 |
| 6128310 | SUPPLY IMPLANT | Supply/Implant | $893.95 |
| 6128315 | SUPPLY IMPLANT | Supply/Implant | $322.43 |
| 6128317 | SUPPLY IMPLANT | Supply/Implant | $353.41 |
| 6128349 | STERILE SUPPLY | Supply/Implant | $489.02 |
| 6128379 | GUIDE WIRE | Supply/Implant | $857.60 |
| 6128400 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,680.00 |
| 6128401 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6128409 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,710.40 |
| 6128429 | SUPPLY IMPLANT | Supply/Implant | $137.22 |
| 6128433 | GENERAL SUPPLY | Supply/Implant | $297.86 |
| 6128434 | GENERAL SUPPLY | Supply/Implant | $311.42 |
| 6128435 | GENERAL SUPPLY | Supply/Implant | $318.21 |
| 6128436 | GENERAL SUPPLY | Supply/Implant | $311.42 |
| 6128438 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6128439 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6128440 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6128447 | SUPPLY IMPLANT | Supply/Implant | $369.78 |
| 6128460 | STERILE SUPPLY | Supply/Implant | $170.37 |
| 6128461 | STERILE SUPPLY | Supply/Implant | $250.62 |
| 6128463 | STERILE SUPPLY | Supply/Implant | $366.59 |
| 6128465 | STERILE SUPPLY | Supply/Implant | $339.05 |
| 6128486 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $20,800.00 |
| 6128490 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6128504 | GUIDE WIRE | Supply/Implant | $845.82 |
| 6128538 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6128544 | GUIDE WIRE | Supply/Implant | $2,754.43 |
| 6128555 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6128556 | GENERAL SUPPLY | Supply/Implant | $716.54 |
| 6128559 | SUPPLY IMPLANT | Supply/Implant | $2,213.89 |
| 6128675 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128677 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128678 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128692 | ALGINATE DRSG >16 <=48 SQ IN | Supply/Implant | $269.70 |
| 6128695 | SUPPLY IMPLANT | Supply/Implant | $182.55 |
| 6128726 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,049.60 |
| 6128738 | SUPPLY IMPLANT | Supply/Implant | $659.20 |
| 6128745 | GENERAL SUPPLY | Supply/Implant | $1,024.00 |
| 6128758 | SUPPLY IMPLANT | Supply/Implant | $1,669.12 |
| 6128801 | SUPPLY IMPLANT | Supply/Implant | $5,308.67 |
| 6128802 | SUPPLY IMPLANT | Supply/Implant | $546.05 |
| 6128803 | SUPPLY IMPLANT | Supply/Implant | $546.05 |
| 6128813 | STERILE SUPPLY | Supply/Implant | $613.25 |
| 6128843 | STERILE SUPPLY | Supply/Implant | $1,355.52 |
| 6128844 | SUPPLY IMPLANT | Supply/Implant | $1,768.96 |
| 6128849 | STERILE SUPPLY | Supply/Implant | $138.37 |
| 6128908 | INTRO/SHEATH, NON-LASER | Supply/Implant | $359.55 |
| 6128918 | GUIDE WIRE | Supply/Implant | $5,760.00 |
| 6128931 | SUPPLY IMPLANT | Supply/Implant | $301.18 |
| 6128944 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6128953 | GUIDE WIRE | Supply/Implant | $3,600.64 |
| 6128967 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6128971 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6128978 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6128989 | SUPPLY IMPLANT | Supply/Implant | $676.61 |
| 6128992 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.12 |
| 6129004 | CATHETER, GUIDING | Supply/Implant | $11,587.58 |
| 6129005 | CATHETER, GUIDING | Supply/Implant | $11,587.58 |
| 6129009 | GENERAL SUPPLY | Supply/Implant | $418.05 |
| 6129021 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129025 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6129078 | GENERAL SUPPLY | Supply/Implant | $563.20 |
| 6129096 | GENERAL SUPPLY | Supply/Implant | $3,040.00 |
| 6129105 | GENERAL SUPPLY | Supply/Implant | $12,160.00 |
| 6129107 | GENERAL SUPPLY | Supply/Implant | $4,032.00 |
| 6129111 | GENERAL SUPPLY | Supply/Implant | $1,881.60 |
| 6129115 | STERILE SUPPLY | Supply/Implant | $1,272.06 |
| 6129124 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6129126 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6129129 | GUIDE WIRE | Supply/Implant | $5,248.00 |
| 6129130 | CATHETER, GUIDING | Supply/Implant | $5,248.00 |
| 6129131 | CATHETER, GUIDING | Supply/Implant | $11,808.00 |
| 6129141 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129142 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,849.28 |
| 6129154 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $304.77 |
| 6129180 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6129182 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,152.00 |
| 6129198 | CATHETER, GUIDING | Supply/Implant | $5,048.58 |
| 6129199 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6129200 | STERILE SUPPLY | Supply/Implant | $1,154.43 |
| 6129202 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6129204 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6129216 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,873.60 |
| 6129236 | RET DEV, INSERTABLE | Supply/Implant | $25,856.00 |
| 6129239 | MESH (IMPLANTABLE) | Supply/Implant | $6,156.93 |
| 6129257 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6129260 | STERILE SUPPLY | Supply/Implant | $750.08 |
| 6129263 | CATHETER, GUIDING | Supply/Implant | $12,395.78 |
| 6129299 | SUPPLY IMPLANT | Supply/Implant | $679.68 |
| 6129302 | CATHETER, GUIDING | Supply/Implant | $9,632.00 |
| 6129307 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6129308 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6129333 | SUPPLY IMPLANT | Supply/Implant | $268.67 |
| 6129349 | GENERAL SUPPLY | Supply/Implant | $269.18 |
| 6129350 | GENERAL SUPPLY | Supply/Implant | $269.18 |
| 6129357 | STERILE SUPPLY | Supply/Implant | $131.07 |
| 6129362 | SUPPLY IMPLANT | Supply/Implant | $3,842.05 |
| 6129364 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6129385 | SUPPLY IMPLANT | Supply/Implant | $248.70 |
| 6129386 | GENERAL SUPPLY | Supply/Implant | $5,310.46 |
| 6129493 | CATHETER, GUIDING | Supply/Implant | $11,808.00 |
| 6129500 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,270.66 |
| 6129507 | SUPPLY IMPLANT | Supply/Implant | $2,020.10 |
| 6129511 | STERILE SUPPLY | Supply/Implant | $240.01 |
| 6129521 | GENERAL SUPPLY | Supply/Implant | $793.22 |
| 6129550 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129557 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6129561 | SUPPLY IMPLANT | Supply/Implant | $6,483.97 |
| 6129566 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6129570 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6129580 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $526.59 |
| 6129582 | STERILE SUPPLY | Supply/Implant | $391.42 |
| 6129586 | STERILE SUPPLY | Supply/Implant | $555.39 |
| 6129667 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6129718 | GENERAL SUPPLY | Supply/Implant | $482.69 |
| 6129730 | STERILE SUPPLY | Supply/Implant | $1,648.64 |
| 6129732 | STERILE SUPPLY | Supply/Implant | $262.40 |
| 6129794 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,209.09 |
| 6129833 | CATHETER, GUIDING | Supply/Implant | $3,840.00 |
| 6129838 | STERILE SUPPLY | Supply/Implant | $486.78 |
| 6129839 | STERILE SUPPLY | Supply/Implant | $595.46 |
| 6129840 | STERILE SUPPLY | Supply/Implant | $873.09 |
| 6129841 | STERILE SUPPLY | Supply/Implant | $169.60 |
| 6129846 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6129857 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6129862 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129864 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129867 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129869 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129870 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,840.00 |
| 6129871 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $15,360.00 |
| 6129873 | LEAD, CORONARY VENOUS | Supply/Implant | $76,800.00 |
| 6129877 | SUPPLY IMPLANT | Supply/Implant | $1,802.24 |
| 6129878 | SUPPLY IMPLANT | Supply/Implant | $1,043.20 |
| 6129893 | STERILE SUPPLY | Supply/Implant | $680.32 |
| 6129895 | SUPPLY IMPLANT | Supply/Implant | $4,544.77 |
| 6129942 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6129951 | CATH, DRAINAGE | Supply/Implant | $1,030.27 |
| 6129959 | SUPPLY IMPLANT | Supply/Implant | $350.59 |
| 6129961 | SUPPLY IMPLANT | Supply/Implant | $276.99 |
| 6129983 | CATHETER, GUIDING | Supply/Implant | $11,808.00 |
| 6130020 | CATHETER, GUIDING | Supply/Implant | $3,648.00 |
| 6130023 | GUIDE WIRE | Supply/Implant | $1,088.00 |
| 6130025 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6130030 | GENERAL SUPPLY | Supply/Implant | $358.40 |
| 6130031 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6130067 | SUPPLY IMPLANT | Supply/Implant | $2,421.12 |
| 6130070 | STERILE SUPPLY | Supply/Implant | $691.33 |
| 6130075 | CATHETER, GUIDING | Supply/Implant | $792.83 |
| 6130086 | GENERAL SUPPLY | Supply/Implant | $623.55 |
| 6130090 | SUPPLY IMPLANT | Supply/Implant | $305.28 |
| 6130100 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6130115 | STERILE SUPPLY | Supply/Implant | $172.80 |
| 6130138 | SUPPLY IMPLANT | Supply/Implant | $1,653.06 |
| 6130139 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,341.09 |
| 6130144 | SUPPLY IMPLANT | Supply/Implant | $1,012.99 |
| 6130149 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6130182 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $744.96 |
| 6130188 | SUPPLY IMPLANT | Supply/Implant | $145.02 |
| 6130220 | STERILE SUPPLY | Supply/Implant | $581.73 |
| 6130284 | STERILE SUPPLY | Supply/Implant | $2,350.98 |
| 6130292 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6130309 | SUPPLY IMPLANT | Supply/Implant | $270.75 |
| 6130327 | SUPPLY IMPLANT | Supply/Implant | $211.07 |
| 6130341 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,410.94 |
| 6130349 | STERILE SUPPLY | Supply/Implant | $565.38 |
| 6130373 | INTRO/SHEATH, NON-LASER | Supply/Implant | $526.08 |
| 6130378 | SUPPLY IMPLANT | Supply/Implant | $935.30 |
| 6130433 | CATHETER, GUIDING | Supply/Implant | $11,535.10 |
| 6130444 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6130447 | STERILE SUPPLY | Supply/Implant | $1,505.54 |
| 6130448 | GENERAL SUPPLY | Supply/Implant | $4,217.98 |
| 6130455 | STERILE SUPPLY | Supply/Implant | $624.00 |
| 6130459 | CATH, DRAINAGE | Supply/Implant | $232.19 |
| 6130460 | SUPPLY IMPLANT | Supply/Implant | $232.19 |
| 6130487 | GENERAL SUPPLY | Supply/Implant | $237.08 |
| 6130491 | SUPPLY IMPLANT | Supply/Implant | $17,792.00 |
| 6130499 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $37,071.49 |
| 6130502 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6130511 | SUPPLY IMPLANT | Supply/Implant | $1,182.34 |
| 6130571 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6130573 | GUIDE WIRE | Supply/Implant | $3,200.00 |
| 6130576 | GENERAL SUPPLY | Supply/Implant | $2,284.54 |
| 6130600 | SUPPLY IMPLANT | Supply/Implant | $2,016.00 |
| 6130601 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6130608 | CATHETER, GUIDING | Supply/Implant | $7,296.00 |
| 6130617 | GENERAL SUPPLY | Supply/Implant | $2,304.00 |
| 6130666 | SUPPLY IMPLANT | Supply/Implant | $764.67 |
| 6130699 | GENERAL SUPPLY | Supply/Implant | $422.53 |
| 6130760 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6130802 | GENERAL SUPPLY | Supply/Implant | $293.76 |
| 6130825 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6130826 | SUPPLY IMPLANT | Supply/Implant | $194.71 |
| 6130829 | GUIDE WIRE | Supply/Implant | $1,817.60 |
| 6130835 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6130851 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6130856 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $352.00 |
| 6130873 | SUPPLY IMPLANT | Supply/Implant | $43,276.80 |
| 6130882 | GENERAL SUPPLY | Supply/Implant | $13,888.00 |
| 6130886 | STERILE SUPPLY | Supply/Implant | $394.62 |
| 6130894 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130895 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130897 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130898 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130899 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130900 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130901 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130902 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130903 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130904 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6130905 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130907 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130908 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130909 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130910 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130919 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,657.60 |
| 6130920 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6130923 | SUPPLY IMPLANT | Supply/Implant | $1,141.76 |
| 6130924 | BRACHYTX NON-STR YTTRIUM-90 | Supply/Implant | $178,500.00 |
| 6130930 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6130941 | GUIDE WIRE | Supply/Implant | $1,344.00 |
| 6130949 | STERILE SUPPLY | Supply/Implant | $188.86 |
| 6130965 | STERILE SUPPLY | Supply/Implant | $827.90 |
| 6130987 | SUPPLY IMPLANT | Supply/Implant | $140.54 |
| 6130994 | STERILE SUPPLY | Supply/Implant | $1,240.32 |
| 6130997 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $1,802.24 |
| 6130998 | GRAFT, VASCULAR | Supply/Implant | $7,907.46 |
| 6131005 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6131011 | SUPPLY IMPLANT | Supply/Implant | $2,446.08 |
| 6131034 | STERILE SUPPLY | Supply/Implant | $194.56 |
| 6131046 | SUPPLY IMPLANT | Supply/Implant | $3,212.80 |
| 6131050 | STERILE SUPPLY | Supply/Implant | $1,079.42 |
| 6131052 | STERILE SUPPLY | Supply/Implant | $2,227.20 |
| 6131059 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6131060 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6131061 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6131062 | STERILE SUPPLY | Supply/Implant | $729.60 |
| 6131069 | STERILE SUPPLY | Supply/Implant | $1,272.58 |
| 6131070 | STERILE SUPPLY | Supply/Implant | $556.80 |
| 6131092 | SUPPLY IMPLANT | Supply/Implant | $266.28 |
| 6131096 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6131100 | STERILE SUPPLY | Supply/Implant | $242.43 |
| 6131103 | GENERAL SUPPLY | Supply/Implant | $1,849.22 |
| 6131104 | SUPPLY IMPLANT | Supply/Implant | $464.64 |
| 6131109 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6131111 | SUPPLY IMPLANT | Supply/Implant | $160.51 |
| 6131114 | MESH (IMPLANTABLE) | Supply/Implant | $2,913.02 |
| 6131115 | STERILE SUPPLY | Supply/Implant | $237.82 |
| 6131133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6131143 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6131148 | SUPPLY IMPLANT | Supply/Implant | $2,219.52 |
| 6131153 | SUPPLY IMPLANT | Supply/Implant | $323.84 |
| 6131154 | SUPPLY IMPLANT | Supply/Implant | $559.87 |
| 6131176 | SYNTHETIC IMPLNT URINARY 1ML | Supply/Implant | $30,979.46 |
| 6131182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,003.84 |
| 6131193 | CATHETER, URETERAL | Supply/Implant | $156.93 |
| 6131195 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6131214 | GENERAL SUPPLY | Supply/Implant | $9,769.34 |
| 6131219 | GENERAL SUPPLY | Supply/Implant | $14,344.19 |
| 6131226 | STERILE SUPPLY | Supply/Implant | $850.18 |
| 6131238 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6131240 | SUPPLY IMPLANT | Supply/Implant | $394.24 |
| 6131248 | GENERAL SUPPLY | Supply/Implant | $2,547.20 |
| 6131249 | GENERAL SUPPLY | Supply/Implant | $3,161.60 |
| 6131250 | GENERAL SUPPLY | Supply/Implant | $2,537.86 |
| 6131251 | STERILE SUPPLY | Supply/Implant | $1,000.96 |
| 6131262 | STERILE SUPPLY | Supply/Implant | $129.15 |
| 6131273 | GENERAL SUPPLY | Supply/Implant | $2,022.40 |
| 6131283 | SUPPLY IMPLANT | Supply/Implant | $701.18 |
| 6131290 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,900.80 |
| 6131306 | SUPPLY IMPLANT | Supply/Implant | $600.06 |
| 6131311 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $201.47 |
| 6131321 | STERILE SUPPLY | Supply/Implant | $138.62 |
| 6131325 | STERILE SUPPLY | Supply/Implant | $201.60 |
| 6131334 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6131358 | STERILE SUPPLY | Supply/Implant | $1,078.66 |
| 6131362 | STERILE SUPPLY | Supply/Implant | $336.00 |
| 6131373 | GENERAL SUPPLY | Supply/Implant | $18,086.40 |
| 6131375 | SUPPLY IMPLANT | Supply/Implant | $3,545.60 |
| 6131401 | INTERSPINOUS IMPLANT | Supply/Implant | $39,488.00 |
| 6131407 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6131410 | SUPPLY IMPLANT | Supply/Implant | $16,832.00 |
| 6131417 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6131425 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6131430 | SUPPLY IMPLANT | Supply/Implant | $829.57 |
| 6131431 | SUPPLY IMPLANT | Supply/Implant | $8,782.72 |
| 6131491 | SUPPLY IMPLANT | Supply/Implant | $39,488.00 |
| 6131532 | STERILE SUPPLY | Supply/Implant | $192.26 |
| 6131539 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6131543 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6131545 | SUPPLY IMPLANT | Supply/Implant | $169.68 |
| 6131569 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6131617 | SUPPLY IMPLANT | Supply/Implant | $2,549.76 |
| 6131620 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6131621 | SUPPLY IMPLANT | Supply/Implant | $19,955.71 |
| 6131633 | SUPPLY IMPLANT | Supply/Implant | $5,897.60 |
| 6131634 | SUPPLY IMPLANT | Supply/Implant | $3,832.06 |
| 6131668 | SUPPLY IMPLANT | Supply/Implant | $140.54 |
| 6131676 | STERILE SUPPLY | Supply/Implant | $1,370.24 |
| 6131682 | SUPPLY IMPLANT | Supply/Implant | $206.59 |
| 6131694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6131732 | SUPPLY IMPLANT | Supply/Implant | $884.99 |
| 6131756 | SUPPLY IMPLANT | Supply/Implant | $504.70 |
| 6131773 | STERILE SUPPLY | Supply/Implant | $826.88 |
| 6131791 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6131796 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,201.60 |
| 6131807 | GENERAL SUPPLY | Supply/Implant | $491.52 |
| 6131808 | SUPPLY IMPLANT | Supply/Implant | $2,617.22 |
| 6131835 | GUIDE WIRE | Supply/Implant | $2,647.04 |
| 6131841 | SUPPLY IMPLANT | Supply/Implant | $11,305.22 |
| 6131854 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6131856 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $11,596.80 |
| 6131877 | SUPPLY IMPLANT | Supply/Implant | $5,527.68 |
| 6131889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6131896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6131936 | STERILE SUPPLY | Supply/Implant | $220.03 |
| 6131941 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6131952 | SUPPLY IMPLANT | Supply/Implant | $5,067.01 |
| 6131973 | SUPPLY IMPLANT | Supply/Implant | $5,345.28 |
| 6131982 | GENERAL SUPPLY | Supply/Implant | $17,587.20 |
| 6131983 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6131993 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6132001 | GRAFT, VASCULAR | Supply/Implant | $4,889.60 |
| 6132005 | SUPPLY IMPLANT | Supply/Implant | $1,821.31 |
| 6132007 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,163.20 |
| 6132009 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6132013 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6132023 | SUPPLY IMPLANT | Supply/Implant | $128.82 |
| 6132026 | SUPPLY IMPLANT | Supply/Implant | $2,265.60 |
| 6132032 | STERILE SUPPLY | Supply/Implant | $268.70 |
| 6132033 | SUPPLY IMPLANT | Supply/Implant | $1,599.87 |
| 6132034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6132044 | SUPPLY IMPLANT | Supply/Implant | $7,000.70 |
| 6132046 | SUPPLY IMPLANT | Supply/Implant | $247.94 |
| 6132047 | SUPPLY IMPLANT | Supply/Implant | $140.54 |
| 6132058 | SUPPLY IMPLANT | Supply/Implant | $1,459.20 |
| 6132060 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6132061 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6132062 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6132071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,115.20 |
| 6132086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6132099 | STERILE SUPPLY | Supply/Implant | $1,040.00 |
| 6132105 | GENERAL SUPPLY | Supply/Implant | $694.40 |
| 6132153 | SUPPLY IMPLANT | Supply/Implant | $1,599.87 |
| 6132161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,115.20 |
| 6132178 | GENERAL SUPPLY | Supply/Implant | $697.60 |
| 6132191 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6132211 | STERILE SUPPLY | Supply/Implant | $304.00 |
| 6132221 | SUPPLY IMPLANT | Supply/Implant | $1,620.22 |
| 6132238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,086.40 |
| 6132252 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6132255 | GUIDE WIRE | Supply/Implant | $2,597.50 |
| 6132285 | SUPPLY IMPLANT | Supply/Implant | $1,804.80 |
| 6132298 | GENERAL SUPPLY | Supply/Implant | $348.36 |
| 6132306 | LOCM 200-299MG/ML IODINE,1ML | Supply/Implant | $219.26 |
| 6132318 | SUPPLY IMPLANT | Supply/Implant | $745.73 |
| 6132324 | GENERAL SUPPLY | Supply/Implant | $559.36 |
| 6132339 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $20,987.75 |
| 6132343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,398.40 |
| 6132348 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6132349 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6132351 | SUPPLY IMPLANT | Supply/Implant | $1,006.08 |
| 6132358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6132359 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6132365 | MESH (IMPLANTABLE) | Supply/Implant | $2,412.03 |
| 6132384 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132385 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132397 | SUPPLY IMPLANT | Supply/Implant | $7,104.00 |
| 6132412 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6132435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $63,207.04 |
| 6132437 | STERILE SUPPLY | Supply/Implant | $6,041.60 |
| 6132443 | SUPPLY IMPLANT | Supply/Implant | $5,540.86 |
| 6132444 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6132455 | SUPPLY IMPLANT | Supply/Implant | $144.00 |
| 6132462 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6132464 | SUPPLY IMPLANT | Supply/Implant | $154.50 |
| 6132467 | SUPPLY IMPLANT | Supply/Implant | $574.08 |
| 6132471 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6132474 | SUPPLY IMPLANT | Supply/Implant | $1,519.23 |
| 6132476 | SUPPLY IMPLANT | Supply/Implant | $129.75 |
| 6132478 | STERILE SUPPLY | Supply/Implant | $285.57 |
| 6132508 | SUPPLY IMPLANT | Supply/Implant | $3,097.60 |
| 6132518 | SUPPLY IMPLANT | Supply/Implant | $642.30 |
| 6132533 | STERILE SUPPLY | Supply/Implant | $1,225.09 |
| 6132535 | SUPPLY IMPLANT | Supply/Implant | $9,049.60 |
| 6132548 | STERILE SUPPLY | Supply/Implant | $887.04 |
| 6132557 | GENERAL SUPPLY | Supply/Implant | $149.76 |
| 6132559 | SUPPLY IMPLANT | Supply/Implant | $2,060.80 |
| 6132562 | STERILE SUPPLY | Supply/Implant | $709.76 |
| 6132564 | STERILE SUPPLY | Supply/Implant | $737.92 |
| 6132570 | SUPPLY IMPLANT | Supply/Implant | $1,472.77 |
| 6132572 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6132586 | GENERAL SUPPLY | Supply/Implant | $919.04 |
| 6132599 | STERILE SUPPLY | Supply/Implant | $967.68 |
| 6132607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,886.08 |
| 6132609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,886.08 |
| 6132610 | SUPPLY IMPLANT | Supply/Implant | $4,556.80 |
| 6132611 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6132619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,063.68 |
| 6132641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,401.73 |
| 6132648 | CATHETER, GUIDING | Supply/Implant | $1,648.38 |
| 6132693 | CATHETER, URETERAL | Supply/Implant | $167.17 |
| 6132708 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6132725 | SUPPLY IMPLANT | Supply/Implant | $2,007.04 |
| 6132729 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6132748 | CATHETER, GUIDING | Supply/Implant | $14,400.00 |
| 6132749 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,063.68 |
| 6132751 | GENERAL SUPPLY | Supply/Implant | $1,408.00 |
| 6132780 | SUPPLY IMPLANT | Supply/Implant | $354.30 |
| 6132783 | STERILE SUPPLY | Supply/Implant | $186.62 |
| 6132786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,063.68 |
| 6132802 | SUPPLY IMPLANT | Supply/Implant | $1,269.25 |
| 6132808 | SUPPLY IMPLANT | Supply/Implant | $9,351.30 |
| 6132811 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6132855 | STERILE SUPPLY | Supply/Implant | $332.93 |
| 6132859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,808.00 |
| 6132894 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6132895 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132900 | SUPPLY IMPLANT | Supply/Implant | $1,577.34 |
| 6132909 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132911 | STERILE SUPPLY | Supply/Implant | $965.25 |
| 6132913 | SUPPLY IMPLANT | Supply/Implant | $1,560.83 |
| 6132917 | MESH (IMPLANTABLE) | Supply/Implant | $2,653.95 |
| 6132926 | SUPPLY IMPLANT | Supply/Implant | $1,539.84 |
| 6132935 | STERILE SUPPLY | Supply/Implant | $287.49 |
| 6132976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,121.60 |
| 6132988 | SUPPLY IMPLANT | Supply/Implant | $22,820.86 |
| 6132994 | SUPPLY IMPLANT | Supply/Implant | $183.04 |
| 6132999 | GUIDE WIRE | Supply/Implant | $659.20 |
| 6133000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,867.20 |
| 6133001 | SUPPLY IMPLANT | Supply/Implant | $6,899.20 |
| 6133006 | SUPPLY IMPLANT | Supply/Implant | $4,928.00 |
| 6133007 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6133014 | SUPPLY IMPLANT | Supply/Implant | $1,628.16 |
| 6133025 | SUPPLY IMPLANT | Supply/Implant | $802.82 |
| 6133052 | SUPPLY IMPLANT | Supply/Implant | $1,599.87 |
| 6133086 | STERILE SUPPLY | Supply/Implant | $549.25 |
| 6133092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,820.86 |
| 6133094 | SUPPLY IMPLANT | Supply/Implant | $2,119.94 |
| 6133128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,717.12 |
| 6133152 | GUIDE WIRE | Supply/Implant | $168.96 |
| 6133184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,600.00 |
| 6133206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,820.86 |
| 6133225 | SUPPLY IMPLANT | Supply/Implant | $147.96 |
| 6133233 | CATHETER, URETERAL | Supply/Implant | $161.28 |
| 6133235 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6133269 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6133275 | SUPPLY IMPLANT | Supply/Implant | $434.30 |
| 6133277 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6133281 | SUPPLY IMPLANT | Supply/Implant | $354.30 |
| 6133285 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $5,131.52 |
| 6133309 | SUPPLY IMPLANT | Supply/Implant | $931.97 |
| 6133310 | GENERAL SUPPLY | Supply/Implant | $1,399.68 |
| 6133313 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $1,487.87 |
| 6133316 | SUPPLY IMPLANT | Supply/Implant | $169.86 |
| 6133332 | STERILE SUPPLY | Supply/Implant | $358.82 |
| 6133338 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6133359 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6133364 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6133375 | SUPPLY IMPLANT | Supply/Implant | $1,062.78 |
| 6133378 | INTRO/SHEATH, NON-LASER | Supply/Implant | $359.55 |
| 6133382 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6133385 | GENERAL SUPPLY | Supply/Implant | $2,217.60 |
| 6133388 | SUPPLY IMPLANT | Supply/Implant | $696.83 |
| 6133393 | STERILE SUPPLY | Supply/Implant | $2,556.42 |
| 6133394 | STERILE SUPPLY | Supply/Implant | $465.54 |
| 6133395 | STERILE SUPPLY | Supply/Implant | $1,543.17 |
| 6133402 | SUPPLY IMPLANT | Supply/Implant | $202.37 |
| 6133407 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6133430 | SUPPLY IMPLANT | Supply/Implant | $13,836.80 |
| 6133488 | SUPPLY IMPLANT | Supply/Implant | $24,239.49 |
| 6133495 | GENERAL SUPPLY | Supply/Implant | $2,112.00 |
| 6133520 | STERILE SUPPLY | Supply/Implant | $241.02 |
| 6133533 | STERILE SUPPLY | Supply/Implant | $3,008.00 |
| 6133534 | STERILE SUPPLY | Supply/Implant | $130.69 |
| 6133552 | SUPPLY IMPLANT | Supply/Implant | $36,169.22 |
| 6133563 | STERILE SUPPLY | Supply/Implant | $337.02 |
| 6133565 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6133567 | SUPPLY IMPLANT | Supply/Implant | $2,321.15 |
| 6133585 | SUPPLY IMPLANT | Supply/Implant | $8,491.39 |
| 6133586 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6133601 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6133608 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6133635 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6133655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6133685 | STERILE SUPPLY | Supply/Implant | $5,491.20 |
| 6133704 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,928.00 |
| 6133710 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6133715 | INTRO/SHEATH, NON-LASER | Supply/Implant | $619.26 |
| 6133720 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.76 |
| 6133729 | SUPPLY IMPLANT | Supply/Implant | $3,276.93 |
| 6133735 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6133768 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6133793 | SUPPLY IMPLANT | Supply/Implant | $819.20 |
| 6133797 | SUPPLY IMPLANT | Supply/Implant | $220.54 |
| 6133798 | STERILE SUPPLY | Supply/Implant | $2,056.45 |
| 6133802 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $157.31 |
| 6133834 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6133855 | STERILE SUPPLY | Supply/Implant | $262.53 |
| 6133857 | STERILE SUPPLY | Supply/Implant | $257.41 |
| 6133858 | STERILE SUPPLY | Supply/Implant | $241.79 |
| 6133863 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6133865 | IMPL SYNTH VOCAL CORD | Supply/Implant | $8,000.00 |
| 6133881 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,693.44 |
| 6133883 | GENERAL SUPPLY | Supply/Implant | $16,832.00 |
| 6133896 | GENERAL SUPPLY | Supply/Implant | $5,693.44 |
| 6133903 | STERILE SUPPLY | Supply/Implant | $1,600.00 |
| 6133905 | GENERAL SUPPLY | Supply/Implant | $355.20 |
| 6133906 | STERILE SUPPLY | Supply/Implant | $4,672.00 |
| 6133927 | SUPPLY IMPLANT | Supply/Implant | $21,273.60 |
| 6133928 | SUPPLY IMPLANT | Supply/Implant | $21,273.60 |
| 6133929 | SUPPLY IMPLANT | Supply/Implant | $22,553.60 |
| 6133931 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6133940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,473.60 |
| 6133941 | SUPPLY IMPLANT | Supply/Implant | $210.43 |
| 6133942 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6134000 | MESH (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6134002 | GENERAL SUPPLY | Supply/Implant | $9,920.00 |
| 6134003 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6134005 | GRAFT, VASCULAR | Supply/Implant | $5,299.20 |
| 6134009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,276.80 |
| 6134010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,283.20 |
| 6134013 | SUPPLY IMPLANT | Supply/Implant | $64,593.92 |
| 6134022 | INTERSPINOUS IMPLANT | Supply/Implant | $64,593.92 |
| 6134031 | SUPPLY IMPLANT | Supply/Implant | $45,836.80 |
| 6134034 | SUPPLY IMPLANT | Supply/Implant | $45,836.80 |
| 6134035 | SUPPLY IMPLANT | Supply/Implant | $45,836.80 |
| 6134047 | STERILE SUPPLY | Supply/Implant | $990.08 |
| 6134070 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $16,427.52 |
| 6134103 | SUPPLY IMPLANT | Supply/Implant | $2,280.83 |
| 6134106 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6134108 | STERILE SUPPLY | Supply/Implant | $238.34 |
| 6134116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6134148 | PORT, INDWELLING, IMP | Supply/Implant | $9,483.26 |
| 6134152 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6134174 | SUPPLY IMPLANT | Supply/Implant | $468.10 |
| 6134182 | SUPPLY IMPLANT | Supply/Implant | $3,609.60 |
| 6134200 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134201 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134204 | SUPPLY IMPLANT | Supply/Implant | $5,693.44 |
| 6134231 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134249 | SUPPLY IMPLANT | Supply/Implant | $12,070.40 |
| 6134266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,134.40 |
| 6134288 | SUPPLY IMPLANT | Supply/Implant | $435.97 |
| 6134291 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,608.00 |
| 6134312 | SUPPLY IMPLANT | Supply/Implant | $8,103.94 |
| 6134379 | STERILE SUPPLY | Supply/Implant | $202.50 |
| 6134388 | SUPPLY IMPLANT | Supply/Implant | $8,514.05 |
| 6134391 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134402 | GENERAL SUPPLY | Supply/Implant | $819.20 |
| 6134403 | STERILE SUPPLY | Supply/Implant | $537.60 |
| 6134404 | SUPPLY IMPLANT | Supply/Implant | $795.52 |
| 6134423 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6134435 | SUPPLY IMPLANT | Supply/Implant | $5,673.47 |
| 6134461 | STERILE SUPPLY | Supply/Implant | $513.02 |
| 6134462 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6134465 | SUPPLY IMPLANT | Supply/Implant | $1,004.80 |
| 6134473 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6134474 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6134489 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6134496 | INTERSPINOUS IMPLANT | Supply/Implant | $64,593.92 |
| 6134503 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $6,336.00 |
| 6134507 | STERILE SUPPLY | Supply/Implant | $874.62 |
| 6134508 | SUPPLY IMPLANT | Supply/Implant | $250.76 |
| 6134525 | STERILE SUPPLY | Supply/Implant | $771.84 |
| 6134546 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6134585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6134587 | SUPPLY IMPLANT | Supply/Implant | $13,273.60 |
| 6134588 | SUPPLY IMPLANT | Supply/Implant | $17,612.80 |
| 6134590 | SUPPLY IMPLANT | Supply/Implant | $13,529.60 |
| 6134598 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6134608 | SUPPLY IMPLANT | Supply/Implant | $734.98 |
| 6134612 | SUPPLY IMPLANT | Supply/Implant | $28,480.00 |
| 6134626 | GENERAL SUPPLY | Supply/Implant | $908.80 |
| 6134634 | GENERAL SUPPLY | Supply/Implant | $2,880.00 |
| 6134637 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6134640 | SUPPLY IMPLANT | Supply/Implant | $2,627.97 |
| 6134643 | SUPPLY IMPLANT | Supply/Implant | $2,627.97 |
| 6134660 | GRAFT, VASCULAR | Supply/Implant | $6,273.54 |
| 6134661 | GRAFT, VASCULAR | Supply/Implant | $6,273.54 |
| 6134662 | SUPPLY IMPLANT | Supply/Implant | $6,273.54 |
| 6134667 | SUPPLY IMPLANT | Supply/Implant | $1,275.65 |
| 6134668 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6134672 | SUPPLY IMPLANT | Supply/Implant | $734.98 |
| 6134678 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,088.00 |
| 6134689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,160.00 |
| 6134696 | STERILE SUPPLY | Supply/Implant | $897.66 |
| 6134704 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,270.66 |
| 6134708 | STERILE SUPPLY | Supply/Implant | $274.82 |
| 6134710 | SUPPLY IMPLANT | Supply/Implant | $3,055.10 |
| 6134736 | SUPPLY IMPLANT | Supply/Implant | $8,720.64 |
| 6134762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6134802 | SUPPLY IMPLANT | Supply/Implant | $10,017.28 |
| 6134804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6134807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,580.80 |
| 6134809 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6134818 | STERILE SUPPLY | Supply/Implant | $263.30 |
| 6134825 | STERILE SUPPLY | Supply/Implant | $207.36 |
| 6134827 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6134846 | GRAFT, VASCULAR | Supply/Implant | $9,740.80 |
| 6134861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6134875 | RET DEV, INSERTABLE | Supply/Implant | $4,992.00 |
| 6134877 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6134908 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,472.00 |
| 6134926 | SUPPLY IMPLANT | Supply/Implant | $2,020.10 |
| 6134927 | SUPPLY IMPLANT | Supply/Implant | $2,020.10 |
| 6134932 | STERILE SUPPLY | Supply/Implant | $190.72 |
| 6134940 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.12 |
| 6134941 | SUPPLY IMPLANT | Supply/Implant | $1,574.40 |
| 6134942 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6134984 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6134985 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6134992 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $34,454.40 |
| 6135002 | SUPPLY IMPLANT | Supply/Implant | $1,369.47 |
| 6135003 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135005 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135006 | ADHESION BARRIER | Supply/Implant | $4,101.12 |
| 6135008 | STERILE SUPPLY | Supply/Implant | $176.90 |
| 6135011 | SUPPLY IMPLANT | Supply/Implant | $468.61 |
| 6135012 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135013 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135014 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135015 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135032 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135037 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135044 | SUPPLY IMPLANT | Supply/Implant | $231.53 |
| 6135060 | CATHETER, GUIDING | Supply/Implant | $11,535.10 |
| 6135063 | GENERAL SUPPLY | Supply/Implant | $166.16 |
| 6135065 | STERILE SUPPLY | Supply/Implant | $473.60 |
| 6135079 | GENERAL SUPPLY | Supply/Implant | $347.65 |
| 6135084 | GUIDE WIRE | Supply/Implant | $156.29 |
| 6135089 | STERILE SUPPLY | Supply/Implant | $533.22 |
| 6135094 | STERILE SUPPLY | Supply/Implant | $1,349.50 |
| 6135095 | SUPPLY IMPLANT | Supply/Implant | $233.96 |
| 6135107 | GENERAL SUPPLY | Supply/Implant | $193.79 |
| 6135152 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6135157 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6135177 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6135178 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6135187 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6135210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135239 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $11,520.00 |
| 6135271 | GUIDE WIRE | Supply/Implant | $219.65 |
| 6135315 | SUPPLY IMPLANT | Supply/Implant | $1,424.64 |
| 6135324 | GENERAL SUPPLY | Supply/Implant | $2,873.34 |
| 6135327 | SUPPLY IMPLANT | Supply/Implant | $4,116.10 |
| 6135344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135369 | SUPPLY IMPLANT | Supply/Implant | $1,246.72 |
| 6135399 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $2,954.50 |
| 6135401 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $26,816.00 |
| 6135420 | SUPPLY IMPLANT | Supply/Implant | $795.52 |
| 6135431 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135448 | GENERAL SUPPLY | Supply/Implant | $2,086.40 |
| 6135458 | SUPPLY IMPLANT | Supply/Implant | $1,288.70 |
| 6135462 | GENERAL SUPPLY | Supply/Implant | $2,170.11 |
| 6135474 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135475 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135476 | CATHETER, GUIDING | Supply/Implant | $11,187.20 |
| 6135488 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135504 | GENERAL SUPPLY | Supply/Implant | $1,313.02 |
| 6135532 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135536 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135560 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6135564 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6135565 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135569 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135571 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135572 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135573 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135574 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135588 | STERILE SUPPLY | Supply/Implant | $3,046.40 |
| 6135604 | STERILE SUPPLY | Supply/Implant | $5,068.80 |
| 6135650 | GENERAL SUPPLY | Supply/Implant | $241.92 |
| 6135666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135684 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135693 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,344.00 |
| 6135695 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6135701 | INTRO/SHEATH, NON-LASER | Supply/Implant | $608.00 |
| 6135707 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $332.29 |
| 6135711 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6135737 | GENERAL SUPPLY | Supply/Implant | $2,014.46 |
| 6135756 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6135769 | GENERAL SUPPLY | Supply/Implant | $5,809.15 |
| 6135770 | SUPPLY IMPLANT | Supply/Implant | $528.51 |
| 6135819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6135826 | GUIDE WIRE | Supply/Implant | $309.38 |
| 6135836 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6135841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6135842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6135874 | GRAFT, VASCULAR | Supply/Implant | $5,633.79 |
| 6135911 | INTRO/SHEATH, NON-LASER | Supply/Implant | $332.29 |
| 6135924 | SUPPLY IMPLANT | Supply/Implant | $7,733.89 |
| 6135932 | SUPPLY IMPLANT | Supply/Implant | $1,028.35 |
| 6135960 | GENERAL SUPPLY | Supply/Implant | $806.40 |
| 6135979 | GENERAL SUPPLY | Supply/Implant | $146.94 |
| 6135981 | STERILE SUPPLY | Supply/Implant | $1,267.20 |
| 6135987 | GRAFT, VASCULAR | Supply/Implant | $5,913.60 |
| 6135990 | GENERAL SUPPLY | Supply/Implant | $1,076.48 |
| 6136004 | SUPPLY IMPLANT | Supply/Implant | $2,457.60 |
| 6136007 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6136051 | GENERAL SUPPLY | Supply/Implant | $974.59 |
| 6136052 | GENERAL SUPPLY | Supply/Implant | $995.33 |
| 6136054 | STERILE SUPPLY | Supply/Implant | $974.59 |
| 6136055 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6136057 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6136078 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6136091 | INTRO/SHEATH, NON-LASER | Supply/Implant | $192.00 |
| 6136109 | SUPPLY IMPLANT | Supply/Implant | $151.81 |
| 6136113 | SUPPLY IMPLANT | Supply/Implant | $1,361.31 |
| 6136118 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6136130 | GENERAL SUPPLY | Supply/Implant | $348.42 |
| 6136132 | SUPPLY IMPLANT | Supply/Implant | $529.54 |
| 6136160 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136165 | STERILE SUPPLY | Supply/Implant | $484.22 |
| 6136179 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6136180 | GUIDE WIRE | Supply/Implant | $130.56 |
| 6136188 | STERILE SUPPLY | Supply/Implant | $797.06 |
| 6136192 | STERILE SUPPLY | Supply/Implant | $770.43 |
| 6136253 | GENERAL SUPPLY | Supply/Implant | $3,110.78 |
| 6136262 | GENERAL SUPPLY | Supply/Implant | $5,518.98 |
| 6136264 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,480.00 |
| 6136265 | GUIDE WIRE | Supply/Implant | $433.79 |
| 6136269 | SUPPLY IMPLANT | Supply/Implant | $17,792.00 |
| 6136272 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $6,105.60 |
| 6136277 | GENERAL SUPPLY | Supply/Implant | $166.66 |
| 6136285 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $836.35 |
| 6136288 | STERILE SUPPLY | Supply/Implant | $1,681.41 |
| 6136289 | GENERAL SUPPLY | Supply/Implant | $4,608.00 |
| 6136290 | STERILE SUPPLY | Supply/Implant | $985.60 |
| 6136294 | GENERAL SUPPLY | Supply/Implant | $146.94 |
| 6136307 | GENERAL SUPPLY | Supply/Implant | $4,045.18 |
| 6136317 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6136321 | STERILE SUPPLY | Supply/Implant | $284.42 |
| 6136326 | STERILE SUPPLY | Supply/Implant | $2,128.90 |
| 6136340 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $751.62 |
| 6136383 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6136397 | EPIFIX 1 SQ CM | Supply/Implant | $4,012.80 |
| 6136410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,907.20 |
| 6136414 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136418 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136420 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136421 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136424 | STERILE SUPPLY | Supply/Implant | $455.81 |
| 6136459 | CATH, DRAINAGE | Supply/Implant | $3,727.36 |
| 6136465 | STERILE SUPPLY | Supply/Implant | $2,232.06 |
| 6136474 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6136478 | SUPPLY IMPLANT | Supply/Implant | $342.40 |
| 6136490 | STERILE SUPPLY | Supply/Implant | $6,228.35 |
| 6136530 | CATHETER, GUIDING | Supply/Implant | $5,094.40 |
| 6136531 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,576.00 |
| 6136534 | AICD, DUAL CHAMBER | Supply/Implant | $586,045.50 |
| 6136589 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $836.35 |
| 6136590 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,280.00 |
| 6136591 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,280.00 |
| 6136592 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,280.00 |
| 6136594 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $836.35 |
| 6136605 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6136612 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136637 | SUPPLY IMPLANT | Supply/Implant | $31,270.40 |
| 6136642 | GENERAL SUPPLY | Supply/Implant | $511.87 |
| 6136657 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $28,160.00 |
| 6136661 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136662 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136671 | SUPPLY IMPLANT | Supply/Implant | $290.05 |
| 6136672 | SUPPLY IMPLANT | Supply/Implant | $290.05 |
| 6136673 | CATH, DRAINAGE | Supply/Implant | $848.90 |
| 6136689 | STERILE SUPPLY | Supply/Implant | $1,113.22 |
| 6136691 | STERILE SUPPLY | Supply/Implant | $422.40 |
| 6136695 | STERILE SUPPLY | Supply/Implant | $3,338.50 |
| 6136704 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136712 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,600.00 |
| 6136718 | GENERAL SUPPLY | Supply/Implant | $148.48 |
| 6136730 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $3,264.00 |
| 6136734 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $12,300.80 |
| 6136735 | STERILE SUPPLY | Supply/Implant | $3,196.03 |
| 6136766 | SUPPLY IMPLANT | Supply/Implant | $13,081.60 |
| 6136773 | STERILE SUPPLY | Supply/Implant | $288.00 |
| 6136776 | CYTAL, PER SQUARE CENTIMETER | Supply/Implant | $24,480.00 |
| 6136777 | MATRISTEM MICROMATRIX 1 MG | Supply/Implant | $30,501.38 |
| 6136780 | SUPPLY IMPLANT | Supply/Implant | $18,304.00 |
| 6136820 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,664.00 |
| 6136825 | GUIDE WIRE | Supply/Implant | $8,704.00 |
| 6136844 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6136849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6136885 | SUPPLY IMPLANT | Supply/Implant | $3,256.58 |
| 6136891 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6136899 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6136901 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136925 | STERILE SUPPLY | Supply/Implant | $169.22 |
| 6136926 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6136932 | SUPPLY IMPLANT | Supply/Implant | $5,636.74 |
| 6136937 | SUPPLY IMPLANT | Supply/Implant | $1,502.98 |
| 6136957 | GENERAL SUPPLY | Supply/Implant | $22,544.64 |
| 6136960 | GENERAL SUPPLY | Supply/Implant | $22,857.73 |
| 6136962 | GENERAL SUPPLY | Supply/Implant | $5,875.20 |
| 6136972 | SUPPLY IMPLANT | Supply/Implant | $8,049.92 |
| 6137003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6137006 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6137013 | GENERAL SUPPLY | Supply/Implant | $601.60 |
| 6137028 | STERILE SUPPLY | Supply/Implant | $6,123.52 |
| 6137029 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6137031 | CATH OCCLUSION | Supply/Implant | $640.00 |
| 6137034 | GUIDE WIRE | Supply/Implant | $4,160.00 |
| 6137038 | STERILE SUPPLY | Supply/Implant | $434.94 |
| 6137058 | GENERAL SUPPLY | Supply/Implant | $915.07 |
| 6137060 | STERILE SUPPLY | Supply/Implant | $129.28 |
| 6137062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6137072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6137077 | SUPPLY IMPLANT | Supply/Implant | $1,390.59 |
| 6137083 | STERILE SUPPLY | Supply/Implant | $355.20 |
| 6137086 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $281,386.00 |
| 6137089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137125 | SUPPLY IMPLANT | Supply/Implant | $6,992.00 |
| 6137128 | STERILE SUPPLY | Supply/Implant | $532.38 |
| 6137132 | CRYOABLATION PROBE | Supply/Implant | $15,360.00 |
| 6137135 | GENERAL SUPPLY | Supply/Implant | $200.19 |
| 6137156 | SUPPLY IMPLANT | Supply/Implant | $864.00 |
| 6137175 | STERILE SUPPLY | Supply/Implant | $521.10 |
| 6137185 | SUPPLY IMPLANT | Supply/Implant | $1,181.57 |
| 6137186 | SUPPLY IMPLANT | Supply/Implant | $1,238.02 |
| 6137192 | GENERAL SUPPLY | Supply/Implant | $18,240.00 |
| 6137215 | STERILE SUPPLY | Supply/Implant | $6,528.00 |
| 6137241 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137280 | STERILE SUPPLY | Supply/Implant | $3,827.20 |
| 6137301 | STERILE SUPPLY | Supply/Implant | $851.33 |
| 6137317 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137321 | STERILE SUPPLY | Supply/Implant | $3,520.51 |
| 6137342 | SUPPLY IMPLANT | Supply/Implant | $862.85 |
| 6137343 | SUPPLY IMPLANT | Supply/Implant | $203.39 |
| 6137351 | CATHETER, GUIDING | Supply/Implant | $947.20 |
| 6137405 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6137410 | SUPPLY IMPLANT | Supply/Implant | $2,641.92 |
| 6137412 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6137418 | CYTAL, PER SQUARE CENTIMETER | Supply/Implant | $13,120.00 |
| 6137480 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137485 | GENERAL SUPPLY | Supply/Implant | $13,606.91 |
| 6137486 | SUPPLY IMPLANT | Supply/Implant | $8,279.04 |
| 6137494 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6137532 | GUIDE WIRE | Supply/Implant | $529.92 |
| 6137561 | INTRO/SHEATH, NON-LASER | Supply/Implant | $12,096.00 |
| 6137569 | SUPPLY IMPLANT | Supply/Implant | $1,916.80 |
| 6137590 | SUPPLY IMPLANT | Supply/Implant | $2,467.20 |
| 6137592 | GENERAL SUPPLY | Supply/Implant | $173.31 |
| 6137646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,701.44 |
| 6137647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,679.68 |
| 6137653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,878.40 |
| 6137659 | LEAD, NEUROSTIMULATOR | Supply/Implant | $27,200.00 |
| 6137663 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6137697 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6137715 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6137716 | GENERAL SUPPLY | Supply/Implant | $476.80 |
| 6137752 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $6,400.00 |
| 6137809 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $11,520.00 |
| 6137810 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6137817 | GENERAL SUPPLY | Supply/Implant | $30,720.00 |
| 6137856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137868 | SUPPLY IMPLANT | Supply/Implant | $3,184.00 |
| 6137892 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137903 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $30,080.00 |
| 6137904 | INTRO/SHEATH, NON-LASER | Supply/Implant | $761.60 |
| 6137905 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,945.60 |
| 6137906 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,945.60 |
| 6137909 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6137919 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137928 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,152.00 |
| 6137930 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6137932 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $66,585.60 |
| 6137937 | PROSTHESIS, BREAST, IMP | Supply/Implant | $13,248.00 |
| 6137945 | SUPPLY IMPLANT | Supply/Implant | $282.62 |
| 6137955 | GENERAL SUPPLY | Supply/Implant | $22,857.73 |
| 6137960 | STERILE SUPPLY | Supply/Implant | $567.17 |
| 6137986 | GENERAL SUPPLY | Supply/Implant | $1,267.20 |
| 6138004 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6138011 | CLOSURE DEV, VASC | Supply/Implant | $2,852.86 |
| 6138012 | GENERAL SUPPLY | Supply/Implant | $1,113.86 |
| 6138015 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,242.88 |
| 6138019 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $761.60 |
| 6138066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,795.20 |
| 6138082 | STERILE SUPPLY | Supply/Implant | $188.80 |
| 6138085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,683.97 |
| 6138101 | SUPPLY IMPLANT | Supply/Implant | $7,872.51 |
| 6138102 | GENERAL SUPPLY | Supply/Implant | $131.07 |
| 6138119 | GENERAL SUPPLY | Supply/Implant | $2,644.61 |
| 6138134 | SUPPLY IMPLANT | Supply/Implant | $203.01 |
| 6138176 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6138183 | SUPPLY IMPLANT | Supply/Implant | $280.45 |
| 6138241 | SUPPLY IMPLANT | Supply/Implant | $2,457.60 |
| 6138242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6138244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6138281 | SUPPLY IMPLANT | Supply/Implant | $293.76 |
| 6138283 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6138288 | GENERAL SUPPLY | Supply/Implant | $6,720.00 |
| 6138293 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138314 | SUPPLY IMPLANT | Supply/Implant | $530.69 |
| 6138315 | SUPPLY IMPLANT | Supply/Implant | $175.48 |
| 6138320 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6138332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6138338 | GENERAL SUPPLY | Supply/Implant | $4,518.40 |
| 6138353 | GENERAL SUPPLY | Supply/Implant | $387.84 |
| 6138361 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $1,280.00 |
| 6138364 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6138365 | SUPPLY IMPLANT | Supply/Implant | $4,153.73 |
| 6138366 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6138378 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138380 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138381 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6138383 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6138386 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6138440 | SUPPLY IMPLANT | Supply/Implant | $2,628.61 |
| 6138469 | MESH (IMPLANTABLE) | Supply/Implant | $56,851.20 |
| 6138474 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6138489 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,984.00 |
| 6138492 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138495 | GUIDE WIRE | Supply/Implant | $1,920.00 |
| 6138500 | SUPPLY IMPLANT | Supply/Implant | $161.54 |
| 6138503 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,680.00 |
| 6138507 | UNCLASSIFIED BIOLOGICS | Supply/Implant | $12,729.60 |
| 6138514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6138516 | SUPPLY IMPLANT | Supply/Implant | $1,455.62 |
| 6138517 | STERILE SUPPLY | Supply/Implant | $274.05 |
| 6138518 | SUPPLY IMPLANT | Supply/Implant | $30,758.40 |
| 6138519 | MESH (IMPLANTABLE) | Supply/Implant | $14,489.60 |
| 6138520 | MESH (IMPLANTABLE) | Supply/Implant | $26,530.56 |
| 6138524 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $607.23 |
| 6138526 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138527 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138528 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138529 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138539 | GENERAL SUPPLY | Supply/Implant | $2,304.00 |
| 6138542 | STERILE SUPPLY | Supply/Implant | $411.52 |
| 6138543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,083.20 |
| 6138545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,083.20 |
| 6138565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138579 | STERILE SUPPLY | Supply/Implant | $1,253.38 |
| 6138584 | GENERAL SUPPLY | Supply/Implant | $7,888.77 |
| 6138590 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6138595 | GENERAL SUPPLY | Supply/Implant | $25,600.00 |
| 6138601 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6138602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6138617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6138618 | SUPPLY IMPLANT | Supply/Implant | $8,051.20 |
| 6138619 | STERILE SUPPLY | Supply/Implant | $173.48 |
| 6138627 | CATHETER, GUIDING | Supply/Implant | $448.00 |
| 6138629 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6138632 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6138642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6138664 | SUPPLY IMPLANT | Supply/Implant | $1,203.20 |
| 6138679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6138686 | GENERAL SUPPLY | Supply/Implant | $242.56 |
| 6138703 | GUIDE WIRE | Supply/Implant | $2,754.43 |
| 6138709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $652.80 |
| 6138714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6138758 | SUPPLY IMPLANT | Supply/Implant | $16,640.00 |
| 6138760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6138773 | STERILE SUPPLY | Supply/Implant | $4,928.00 |
| 6138818 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138819 | SUPPLY IMPLANT | Supply/Implant | $32,691.20 |
| 6138820 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138845 | WIRELESS PRESSURE SENSOR | Supply/Implant | $194,250.00 |
| 6138848 | CATHETER, GUIDING | Supply/Implant | $4,816.64 |
| 6138859 | SUPPLY IMPLANT | Supply/Implant | $1,945.60 |
| 6138864 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $33,920.00 |
| 6138884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,691.20 |
| 6138885 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138935 | SUPPLY IMPLANT | Supply/Implant | $45,798.40 |
| 6138936 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,982.40 |
| 6138938 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,915.20 |
| 6138939 | SUPPLY IMPLANT | Supply/Implant | $48,998.40 |
| 6138952 | GENERAL SUPPLY | Supply/Implant | $742.40 |
| 6138953 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6138954 | GENERAL SUPPLY | Supply/Implant | $1,792.00 |
| 6138969 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138982 | STERILE SUPPLY | Supply/Implant | $621.70 |
| 6138983 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,784.00 |
| 6138995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,660.80 |
| 6139023 | SUPPLY IMPLANT | Supply/Implant | $2,954.50 |
| 6139024 | SUPPLY IMPLANT | Supply/Implant | $3,292.16 |
| 6139025 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6139026 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6139037 | SUPPLY IMPLANT | Supply/Implant | $4,111.36 |
| 6139046 | STERILE SUPPLY | Supply/Implant | $9,600.00 |
| 6139065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6139067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $889.34 |
| 6139077 | GENERAL SUPPLY | Supply/Implant | $9,145.22 |
| 6139092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,294.72 |
| 6139173 | GENERAL SUPPLY | Supply/Implant | $716.54 |
| 6139174 | GENERAL SUPPLY | Supply/Implant | $716.54 |
| 6139193 | SUPPLY IMPLANT | Supply/Implant | $1,671.17 |
| 6139204 | SUPPLY IMPLANT | Supply/Implant | $1,947.65 |
| 6139205 | GENERAL SUPPLY | Supply/Implant | $2,134.40 |
| 6139207 | GUIDE WIRE | Supply/Implant | $2,134.40 |
| 6139223 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6139240 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6139243 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6139252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6139254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6139270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6139273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6139312 | STERILE SUPPLY | Supply/Implant | $194.30 |
| 6139313 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6139315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,528.32 |
| 6139320 | STERILE SUPPLY | Supply/Implant | $215.01 |
| 6139323 | STERILE SUPPLY | Supply/Implant | $281.60 |
| 6139329 | SUPPLY IMPLANT | Supply/Implant | $1,363.71 |
| 6139332 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6139339 | STERILE SUPPLY | Supply/Implant | $222.46 |
| 6139351 | PORT, INDWELLING, IMP | Supply/Implant | $9,483.26 |
| 6139356 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6139358 | SUPPLY IMPLANT | Supply/Implant | $5,754.11 |
| 6139370 | SUPPLY IMPLANT | Supply/Implant | $1,357.95 |
| 6139417 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6139436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6139447 | GENERAL SUPPLY | Supply/Implant | $14,976.00 |
| 6139454 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6139469 | ALLODERM SKIN SUB | Supply/Implant | $113,599.50 |
| 6139473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,827.20 |
| 6139529 | SUPPLY IMPLANT | Supply/Implant | $193.54 |
| 6139602 | GENERAL SUPPLY | Supply/Implant | $1,326.34 |
| 6139604 | SUPPLY IMPLANT | Supply/Implant | $25,254.40 |
| 6139610 | SUPPLY IMPLANT | Supply/Implant | $666.24 |
| 6139620 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6139630 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139631 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139632 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139633 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6139645 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139689 | SUPPLY IMPLANT | Supply/Implant | $55,296.00 |
| 6139690 | SUPPLY IMPLANT | Supply/Implant | $55,296.00 |
| 6139694 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6139696 | GENERAL SUPPLY | Supply/Implant | $366.72 |
| 6139699 | SUPPLY IMPLANT | Supply/Implant | $4,413.82 |
| 6139715 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139716 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139717 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139718 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139723 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6139744 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139752 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $16,427.52 |
| 6139754 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6139760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139768 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6139770 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6139787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6139791 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139792 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,408.00 |
| 6139796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6139800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139809 | STERILE SUPPLY | Supply/Implant | $3,017.86 |
| 6139818 | GENERAL SUPPLY | Supply/Implant | $8,512.00 |
| 6139819 | GENERAL SUPPLY | Supply/Implant | $3,648.00 |
| 6139823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6139828 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,299.20 |
| 6139831 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139833 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139837 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139838 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139839 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139840 | SUPPLY IMPLANT | Supply/Implant | $649.98 |
| 6139842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139844 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139851 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6139858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6139869 | SUPPLY IMPLANT | Supply/Implant | $739.20 |
| 6139877 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $16,427.52 |
| 6139886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6139887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139889 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139890 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139891 | SUPPLY IMPLANT | Supply/Implant | $23,078.40 |
| 6139893 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139896 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6139899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139908 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139922 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6139924 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139929 | MESH (IMPLANTABLE) | Supply/Implant | $25,920.00 |
| 6139931 | SUPPLY IMPLANT | Supply/Implant | $1,142.02 |
| 6139932 | SUPPLY IMPLANT | Supply/Implant | $841.93 |
| 6139933 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6139934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139941 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139954 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139984 | STERILE SUPPLY | Supply/Implant | $452.86 |
| 6140013 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6140022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6140027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140029 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6140045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140086 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6140095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,280.77 |
| 6140105 | GUIDE WIRE | Supply/Implant | $616.96 |
| 6140107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6140117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6140118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140119 | GUIDE WIRE | Supply/Implant | $1,725.82 |
| 6140120 | SUPPLY IMPLANT | Supply/Implant | $2,520.96 |
| 6140126 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140150 | SUPPLY IMPLANT | Supply/Implant | $177.28 |
| 6140154 | GENERAL SUPPLY | Supply/Implant | $3,363.46 |
| 6140167 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6140170 | SUPPLY IMPLANT | Supply/Implant | $342.14 |
| 6140186 | GENERAL SUPPLY | Supply/Implant | $3,520.00 |
| 6140190 | SUPPLY IMPLANT | Supply/Implant | $46,933.38 |
| 6140206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6140210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140252 | SUPPLY IMPLANT | Supply/Implant | $7,303.30 |
| 6140255 | GENERAL SUPPLY | Supply/Implant | $640.00 |
| 6140259 | SUPPLY IMPLANT | Supply/Implant | $264.06 |
| 6140273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140281 | EPIFIX 1 SQ CM | Supply/Implant | $14,649.60 |
| 6140282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6140306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,456.00 |
| 6140309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6140310 | SUPPLY IMPLANT | Supply/Implant | $2,520.96 |
| 6140312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140313 | SUPPLY IMPLANT | Supply/Implant | $4,460.16 |
| 6140314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6140329 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6140330 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6140336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6140349 | GENERAL SUPPLY | Supply/Implant | $6,336.00 |
| 6140354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,720.00 |
| 6140357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6140377 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6140398 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,982.40 |
| 6140402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,982.40 |
| 6140403 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6140409 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6140422 | REP DEV, URINARY, W/O SLING | Supply/Implant | $6,589.44 |
| 6140427 | INTRO/SHEATH, NON-LASER | Supply/Implant | $276.86 |
| 6140428 | SUPPLY IMPLANT | Supply/Implant | $2,506.24 |
| 6140446 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6140471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,568.00 |
| 6140477 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6140479 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6140481 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6140488 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6140492 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6140495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,617.60 |
| 6140507 | SUPPLY IMPLANT | Supply/Implant | $147,000.00 |
| 6140508 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6140510 | SUPPLY IMPLANT | Supply/Implant | $5,561.60 |
| 6140532 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6140534 | SUPPLY IMPLANT | Supply/Implant | $1,296.00 |
| 6140540 | GENERAL SUPPLY | Supply/Implant | $2,624.00 |
| 6140549 | GENERAL SUPPLY | Supply/Implant | $5,532.80 |
| 6140551 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6140570 | STERILE SUPPLY | Supply/Implant | $444.80 |
| 6140578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,110.40 |
| 6140603 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140627 | EPIFIX 1 SQ CM | Supply/Implant | $39,059.20 |
| 6140635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.10 |
| 6140648 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140678 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6140681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6140687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140706 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,480.00 |
| 6140712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6140715 | MESH (IMPLANTABLE) | Supply/Implant | $14,092.80 |
| 6140717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140741 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6140742 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6140744 | STERILE SUPPLY | Supply/Implant | $453.12 |
| 6140745 | EPIFIX 1 SQ CM | Supply/Implant | $119,609.60 |
| 6140778 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,124.74 |
| 6140782 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140793 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6140797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6140801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6140812 | MESH (IMPLANTABLE) | Supply/Implant | $105,799.68 |
| 6140842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140843 | SUPPLY IMPLANT | Supply/Implant | $23,120.00 |
| 6140844 | SUPPLY IMPLANT | Supply/Implant | $28,124.80 |
| 6140853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140857 | SUPPLY IMPLANT | Supply/Implant | $2,309.12 |
| 6140862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6140865 | STERILE SUPPLY | Supply/Implant | $376.32 |
| 6140870 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6140876 | SUPPLY IMPLANT | Supply/Implant | $110,162.05 |
| 6140882 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6140887 | SUPPLY IMPLANT | Supply/Implant | $1,497.09 |
| 6140890 | STERILE SUPPLY | Supply/Implant | $1,253.38 |
| 6140891 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6140893 | SUPPLY IMPLANT | Supply/Implant | $3,513.60 |
| 6140913 | SUPPLY IMPLANT | Supply/Implant | $761.34 |
| 6140918 | SUPPLY IMPLANT | Supply/Implant | $2,175.36 |
| 6140920 | STERILE SUPPLY | Supply/Implant | $4,044.80 |
| 6140927 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6140943 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,121.60 |
| 6140952 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6140961 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6140964 | GUIDE WIRE | Supply/Implant | $2,265.60 |
| 6140967 | GENERAL SUPPLY | Supply/Implant | $24,960.00 |
| 6140977 | STERILE SUPPLY | Supply/Implant | $153.22 |
| 6141002 | STERILE SUPPLY | Supply/Implant | $313.60 |
| 6141015 | STERILE SUPPLY | Supply/Implant | $568.70 |
| 6141084 | MESH (IMPLANTABLE) | Supply/Implant | $2,833.92 |
| 6141100 | STERILE SUPPLY | Supply/Implant | $142.72 |
| 6141110 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6141115 | STERILE SUPPLY | Supply/Implant | $338.30 |
| 6141124 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6141125 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6141133 | STERILE SUPPLY | Supply/Implant | $1,024.38 |
| 6141138 | STERILE SUPPLY | Supply/Implant | $279.55 |
| 6141178 | SUPPLY IMPLANT | Supply/Implant | $14,515.20 |
| 6141200 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6141208 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6141230 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6141265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,083.20 |
| 6141266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6141269 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6141309 | GENERAL SUPPLY | Supply/Implant | $2,892.80 |
| 6141354 | GENERAL SUPPLY | Supply/Implant | $199.17 |
| 6141355 | GENERAL SUPPLY | Supply/Implant | $199.17 |
| 6141368 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,916.67 |
| 6141369 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,060.61 |
| 6141372 | GENERAL SUPPLY | Supply/Implant | $883.20 |
| 6141396 | STERILE SUPPLY | Supply/Implant | $2,300.80 |
| 6141397 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $3,097.60 |
| 6141419 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6141423 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141425 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141426 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6141429 | SUPPLY IMPLANT | Supply/Implant | $2,421.76 |
| 6141469 | SUPPLY IMPLANT | Supply/Implant | $1,824.38 |
| 6141475 | SUPPLY IMPLANT | Supply/Implant | $5,430.40 |
| 6141476 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6141478 | SUPPLY IMPLANT | Supply/Implant | $1,909.89 |
| 6141483 | STERILE SUPPLY | Supply/Implant | $8,326.02 |
| 6141484 | SUPPLY IMPLANT | Supply/Implant | $3,437.06 |
| 6141490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6141493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,144.90 |
| 6141509 | STERILE SUPPLY | Supply/Implant | $389.12 |
| 6141526 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141527 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141528 | SUPPLY IMPLANT | Supply/Implant | $37,580.80 |
| 6141529 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141550 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6141562 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6141563 | SUPPLY IMPLANT | Supply/Implant | $5,561.22 |
| 6141567 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,728.00 |
| 6141572 | SUPPLY IMPLANT | Supply/Implant | $17,498.88 |
| 6141573 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6141576 | SUPPLY IMPLANT | Supply/Implant | $5,135.36 |
| 6141580 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6141583 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6141592 | GENERAL SUPPLY | Supply/Implant | $20,416.00 |
| 6141594 | SUPPLY IMPLANT | Supply/Implant | $3,712.00 |
| 6141595 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6141599 | GENERAL SUPPLY | Supply/Implant | $322.69 |
| 6141617 | STERILE SUPPLY | Supply/Implant | $2,560.00 |
| 6141633 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6141635 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6141650 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6141652 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $20,864.00 |
| 6141669 | SUPPLY IMPLANT | Supply/Implant | $559.36 |
| 6141676 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6141677 | SUPPLY IMPLANT | Supply/Implant | $8,593.92 |
| 6141680 | SUPPLY IMPLANT | Supply/Implant | $4,009.50 |
| 6141690 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6141702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6141733 | VENA CAVA FILTER | Supply/Implant | $15,616.00 |
| 6141735 | SUPPLY IMPLANT | Supply/Implant | $8,512.00 |
| 6141742 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,344.00 |
| 6141743 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,344.00 |
| 6141745 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6141759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,488.32 |
| 6141760 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6141784 | SUPPLY IMPLANT | Supply/Implant | $33,044.61 |
| 6141795 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6141808 | SUPPLY IMPLANT | Supply/Implant | $300.80 |
| 6141818 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6141840 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6141849 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,127.81 |
| 6141885 | SUPPLY IMPLANT | Supply/Implant | $2,949.12 |
| 6141896 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6141910 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6141927 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6141945 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6141950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,684.48 |
| 6141999 | SUPPLY IMPLANT | Supply/Implant | $164.86 |
| 6142025 | SUPPLY IMPLANT | Supply/Implant | $1,971.84 |
| 6142085 | STERILE SUPPLY | Supply/Implant | $2,347.52 |
| 6142099 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $168.45 |
| 6142107 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6142108 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6142109 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6142110 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6142116 | STERILE SUPPLY | Supply/Implant | $591.36 |
| 6142118 | STERILE SUPPLY | Supply/Implant | $663.30 |
| 6142130 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6142137 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142138 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142140 | SUPPLY IMPLANT | Supply/Implant | $2,918.40 |
| 6142144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6142148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6142170 | STERILE SUPPLY | Supply/Implant | $753.28 |
| 6142173 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6142180 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6142181 | STERILE SUPPLY | Supply/Implant | $327.12 |
| 6142196 | SUPPLY IMPLANT | Supply/Implant | $1,573.50 |
| 6142200 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6142201 | PORT, INDWELLING, IMP | Supply/Implant | $3,136.00 |
| 6142254 | SUPPLY IMPLANT | Supply/Implant | $353.02 |
| 6142257 | SUPPLY IMPLANT | Supply/Implant | $353.02 |
| 6142269 | STERILE SUPPLY | Supply/Implant | $577.41 |
| 6142277 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6142279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.10 |
| 6142281 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6142292 | SUPPLY IMPLANT | Supply/Implant | $15,200.64 |
| 6142320 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,648.00 |
| 6142347 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6142357 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6142373 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6142374 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6142376 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,438.40 |
| 6142378 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,898.75 |
| 6142379 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,438.40 |
| 6142380 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,454.66 |
| 6142381 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6142382 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6142388 | STERILE SUPPLY | Supply/Implant | $245.76 |
| 6142395 | GENERAL SUPPLY | Supply/Implant | $2,508.80 |
| 6142396 | INTRO/SHEATH, NON-LASER | Supply/Implant | $564.48 |
| 6142407 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6142449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6142454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6142461 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142462 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142464 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6142504 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142513 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,528.00 |
| 6142518 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,646.40 |
| 6142526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6142538 | SUPPLY IMPLANT | Supply/Implant | $252.80 |
| 6142544 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6142546 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6142557 | STERILE SUPPLY | Supply/Implant | $354.82 |
| 6142558 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6142562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,779.52 |
| 6142565 | GENERAL SUPPLY | Supply/Implant | $5,491.20 |
| 6142567 | GENERAL SUPPLY | Supply/Implant | $1,664.00 |
| 6142588 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,900.80 |
| 6142601 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,880.00 |
| 6142637 | INTERSPINOUS IMPLANT | Supply/Implant | $45,619.20 |
| 6142642 | MESH (IMPLANTABLE) | Supply/Implant | $14,092.80 |
| 6142643 | SUPPLY IMPLANT | Supply/Implant | $2,540.16 |
| 6142646 | SUPPLY IMPLANT | Supply/Implant | $2,257.28 |
| 6142647 | SUPPLY IMPLANT | Supply/Implant | $1,758.21 |
| 6142648 | SUPPLY IMPLANT | Supply/Implant | $1,716.86 |
| 6142649 | SUPPLY IMPLANT | Supply/Implant | $1,593.34 |
| 6142650 | SUPPLY IMPLANT | Supply/Implant | $688.64 |
| 6142657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,001.60 |
| 6142662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6142667 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142700 | GENERAL SUPPLY | Supply/Implant | $2,403.20 |
| 6142701 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6142722 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6142753 | INTERSPINOUS IMPLANT | Supply/Implant | $29,376.00 |
| 6142779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,012.16 |
| 6142786 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,889.60 |
| 6142792 | SUPPLY IMPLANT | Supply/Implant | $10,925.95 |
| 6142795 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,816.00 |
| 6142817 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,880.00 |
| 6142820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6142826 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6142838 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $24,960.00 |
| 6142839 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6142840 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6142842 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6142843 | GENERAL SUPPLY | Supply/Implant | $1,408.00 |
| 6142853 | CATHETER, GUIDING | Supply/Implant | $7,840.00 |
| 6142854 | CATHETER, GUIDING | Supply/Implant | $8,467.20 |
| 6142877 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,622.72 |
| 6142894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6142897 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6142898 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6142900 | STERILE SUPPLY | Supply/Implant | $460.80 |
| 6142903 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142906 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142908 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142909 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142919 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142922 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142924 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6142926 | SUPPLY IMPLANT | Supply/Implant | $2,067.20 |
| 6142929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,888.32 |
| 6142930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,832.64 |
| 6142934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,363.46 |
| 6142982 | SUPPLY IMPLANT | Supply/Implant | $1,363.33 |
| 6142991 | GRAFT, VASCULAR | Supply/Implant | $34,611.20 |
| 6142992 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6142995 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,392.00 |
| 6143024 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6143030 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6143043 | GENERAL SUPPLY | Supply/Implant | $243.20 |
| 6143063 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $10,176.00 |
| 6143072 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,600.00 |
| 6143074 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,800.00 |
| 6143085 | GUIDE WIRE | Supply/Implant | $703.23 |
| 6143086 | SUPPLY IMPLANT | Supply/Implant | $2,213.89 |
| 6143130 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6143152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6143153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6143160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6143173 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6143183 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6143196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,512.70 |
| 6143242 | GENERAL SUPPLY | Supply/Implant | $288.00 |
| 6143390 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6143394 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6143412 | PROSTHETIC IMPLANT NOS | Supply/Implant | $32,000.00 |
| 6143419 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,421.95 |
| 6143421 | SUPPLY IMPLANT | Supply/Implant | $2,577.54 |
| 6143424 | STERILE SUPPLY | Supply/Implant | $1,585.02 |
| 6143440 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,800.00 |
| 6143444 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6143446 | INTRO/SHEATH, NON-LASER | Supply/Implant | $960.00 |
| 6143452 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6143457 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6143458 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6143459 | GUIDE WIRE | Supply/Implant | $1,920.00 |
| 6143466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,296.00 |
| 6143512 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $73,395.20 |
| 6143514 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,499.20 |
| 6143546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $45,798.40 |
| 6143565 | GENERAL SUPPLY | Supply/Implant | $3,187.20 |
| 6143597 | GENERAL SUPPLY | Supply/Implant | $472.32 |
| 6143603 | SUPPLY IMPLANT | Supply/Implant | $4,556.54 |
| 6143610 | SUPPLY IMPLANT | Supply/Implant | $131.16 |
| 6143617 | ALLODERM SKIN SUB | Supply/Implant | $117,001.50 |
| 6143632 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6143663 | SUPPLY IMPLANT | Supply/Implant | $663.68 |
| 6143677 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $20,864.00 |
| 6143694 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6143695 | SUPPLY IMPLANT | Supply/Implant | $1,828.86 |
| 6143714 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $22,976.00 |
| 6143732 | SUPPLY IMPLANT | Supply/Implant | $193.79 |
| 6143733 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6143779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6143812 | GENERAL SUPPLY | Supply/Implant | $10,112.00 |
| 6143816 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $96,640.00 |
| 6143819 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $96,640.00 |
| 6143821 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6143825 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $654.08 |
| 6143826 | SUPPLY IMPLANT | Supply/Implant | $349.82 |
| 6143827 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6143829 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6143841 | STERILE SUPPLY | Supply/Implant | $1,075.20 |
| 6143842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6143849 | SUPPLY IMPLANT | Supply/Implant | $194.71 |
| 6143850 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $563.20 |
| 6143869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6143873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,496.00 |
| 6143875 | SUPPLY IMPLANT | Supply/Implant | $16,597.38 |
| 6143926 | GENERAL SUPPLY | Supply/Implant | $574.85 |
| 6143927 | STERILE SUPPLY | Supply/Implant | $436.48 |
| 6143928 | GENERAL SUPPLY | Supply/Implant | $442.88 |
| 6143966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6143979 | SUPPLY IMPLANT | Supply/Implant | $3,648.00 |
| 6143982 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $7,351.04 |
| 6143983 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $9,079.04 |
| 6143987 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6143989 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6143991 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6143993 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6143995 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6144009 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144010 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144011 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144026 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,520.00 |
| 6144035 | INTERSPINOUS IMPLANT | Supply/Implant | $56,467.20 |
| 6144069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,941.50 |
| 6144088 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6144089 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6144091 | SUPPLY IMPLANT | Supply/Implant | $41,600.00 |
| 6144103 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6144134 | STERILE SUPPLY | Supply/Implant | $428.16 |
| 6144138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,256.00 |
| 6144160 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6144178 | CRYOABLATION PROBE | Supply/Implant | $51,200.00 |
| 6144187 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $22,976.00 |
| 6144189 | SUPPLY IMPLANT | Supply/Implant | $7,251.20 |
| 6144190 | SUPPLY IMPLANT | Supply/Implant | $28,609.28 |
| 6144191 | SUPPLY IMPLANT | Supply/Implant | $51,681.28 |
| 6144192 | SUPPLY IMPLANT | Supply/Implant | $63,678.72 |
| 6144194 | SUPPLY IMPLANT | Supply/Implant | $146.94 |
| 6144214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6144216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,665.60 |
| 6144219 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6144257 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144259 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144279 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,640.00 |
| 6144287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,693.44 |
| 6144291 | GENERAL SUPPLY | Supply/Implant | $546.30 |
| 6144292 | STERILE SUPPLY | Supply/Implant | $470.91 |
| 6144306 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $22,976.00 |
| 6144312 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6144332 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6144343 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6144344 | PURAPLY 1 SQ CM | Supply/Implant | $9,600.00 |
| 6144345 | PURAPLY 1 SQ CM | Supply/Implant | $12,160.00 |
| 6144346 | PURAPLY 1 SQ CM | Supply/Implant | $40,960.00 |
| 6144347 | PURAPLY 1 SQ CM | Supply/Implant | $85,760.00 |
| 6144361 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144411 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144412 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144414 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144419 | SUPPLY IMPLANT | Supply/Implant | $1,625.60 |
| 6144420 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6144422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6144423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6144430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,267.20 |
| 6144442 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6144455 | SUPPLY IMPLANT | Supply/Implant | $5,337.60 |
| 6144482 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6144506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6144514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,475.52 |
| 6144519 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,280.00 |
| 6144532 | GENERAL SUPPLY | Supply/Implant | $66,649.60 |
| 6144536 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6144538 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $19,136.00 |
| 6144557 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144558 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,846.78 |
| 6144592 | GENERAL SUPPLY | Supply/Implant | $376.70 |
| 6144609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $758.40 |
| 6144623 | STERILE SUPPLY | Supply/Implant | $135.17 |
| 6144631 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6144652 | STERILE SUPPLY | Supply/Implant | $473.60 |
| 6144668 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144676 | CRYOABLATION PROBE | Supply/Implant | $15,360.00 |
| 6144689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6144691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,268.80 |
| 6144698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,469.44 |
| 6144705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,709.57 |
| 6144713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6144719 | SUPPLY IMPLANT | Supply/Implant | $169.47 |
| 6144734 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6144771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,140.80 |
| 6144783 | PURAPLY AM 1 SQ CM | Supply/Implant | $167,475.00 |
| 6144817 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144820 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6144832 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6144834 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6144835 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6144836 | STERILE SUPPLY | Supply/Implant | $7,680.00 |
| 6144837 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6144840 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6144847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6144864 | GENERAL SUPPLY | Supply/Implant | $2,368.00 |
| 6144865 | SUPPLY IMPLANT | Supply/Implant | $8,240.00 |
| 6144866 | SUPPLY IMPLANT | Supply/Implant | $34,331.14 |
| 6144867 | SUPPLY IMPLANT | Supply/Implant | $62,017.54 |
| 6144868 | SUPPLY IMPLANT | Supply/Implant | $76,414.46 |
| 6144896 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6144898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,243.90 |
| 6144905 | SUPPLY IMPLANT | Supply/Implant | $9,106.94 |
| 6144916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6144917 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6144918 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6144925 | SUPPLY IMPLANT | Supply/Implant | $9,567.74 |
| 6144948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6144952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,005.95 |
| 6144953 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6144957 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6144986 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144987 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6145020 | INTERSPINOUS IMPLANT | Supply/Implant | $63,769.60 |
| 6145023 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $113,600.00 |
| 6145024 | STERILE SUPPLY | Supply/Implant | $9,344.00 |
| 6145027 | CATHETER, GUIDING | Supply/Implant | $8,899.20 |
| 6145028 | INTRO/SHEATH, NON-LASER | Supply/Implant | $336.00 |
| 6145029 | INTRO/SHEATH, NON-LASER | Supply/Implant | $276.86 |
| 6145030 | INTRO/SHEATH, NON-LASER | Supply/Implant | $335.36 |
| 6145038 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6145058 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6145059 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6145063 | STERILE SUPPLY | Supply/Implant | $486.40 |
| 6145064 | STERILE SUPPLY | Supply/Implant | $486.40 |
| 6145065 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $416,242.50 |
| 6145069 | STERILE SUPPLY | Supply/Implant | $964.99 |
| 6145082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6145083 | GENERAL SUPPLY | Supply/Implant | $225.66 |
| 6145084 | GENERAL SUPPLY | Supply/Implant | $225.66 |
| 6145100 | STERILE SUPPLY | Supply/Implant | $2,070.53 |
| 6145105 | GUIDE WIRE | Supply/Implant | $3,520.00 |
| 6145110 | GENERAL SUPPLY | Supply/Implant | $2,880.00 |
| 6145111 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $11,200.00 |
| 6145125 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $19,136.00 |
| 6145126 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6145127 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $19,136.00 |
| 6145130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,824.00 |
| 6145132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6145154 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145156 | INTERSPINOUS IMPLANT | Supply/Implant | $88,652.80 |
| 6145157 | INTERSPINOUS IMPLANT | Supply/Implant | $88,652.80 |
| 6145163 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6145166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6145168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145192 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6145194 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6145199 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,830.40 |
| 6145200 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,881.60 |
| 6145203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6145224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145225 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145228 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145278 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145285 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145296 | INTRO/SHEATH, NON-LASER | Supply/Implant | $359.55 |
| 6145312 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6145327 | GUIDE WIRE | Supply/Implant | $4,352.00 |
| 6145329 | CATHETER, GUIDING | Supply/Implant | $5,632.00 |
| 6145330 | SUPPLY IMPLANT | Supply/Implant | $76,800.00 |
| 6145340 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6145349 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6145351 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6145365 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6145373 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,126.40 |
| 6145391 | SUPPLY IMPLANT | Supply/Implant | $1,868.80 |
| 6145396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,828.80 |
| 6145410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6145438 | SUPPLY IMPLANT | Supply/Implant | $3,161.60 |
| 6145488 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6145492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145495 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6145498 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6145506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145509 | STERILE SUPPLY | Supply/Implant | $2,137.60 |
| 6145521 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6145523 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6145528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,828.80 |
| 6145539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6145547 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6145585 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6145596 | PURAPLY 1 SQ CM | Supply/Implant | $5,760.00 |
| 6145597 | SUPPLY IMPLANT | Supply/Implant | $8,430.98 |
| 6145598 | SUPPLY IMPLANT | Supply/Implant | $16,362.62 |
| 6145599 | SUPPLY IMPLANT | Supply/Implant | $16,793.60 |
| 6145600 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6145603 | GENERAL SUPPLY | Supply/Implant | $192.00 |
| 6145604 | STERILE SUPPLY | Supply/Implant | $4,710.40 |
| 6145605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145618 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145619 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145639 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6145657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $857.60 |
| 6145663 | SUPPLY IMPLANT | Supply/Implant | $30,400.00 |
| 6145664 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6145667 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6145720 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6145734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6145735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6145737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6145743 | SUPPLY IMPLANT | Supply/Implant | $17,792.00 |
| 6145747 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,684.48 |
| 6145760 | MESH (IMPLANTABLE) | Supply/Implant | $122,880.00 |
| 6145764 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6145784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6145785 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6145794 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6145809 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6145818 | STERILE SUPPLY | Supply/Implant | $4,160.00 |
| 6145824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,051.20 |
| 6145856 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6145865 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6145869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145872 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6145886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145893 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6145894 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6145895 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6145897 | SUPPLY IMPLANT | Supply/Implant | $3,648.00 |
| 6145904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6145907 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145920 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6145921 | SUPPLY IMPLANT | Supply/Implant | $5,639.04 |
| 6145926 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,305.60 |
| 6145937 | STERILE SUPPLY | Supply/Implant | $172.80 |
| 6145965 | GENERAL SUPPLY | Supply/Implant | $6,701.70 |
| 6145974 | GENERAL SUPPLY | Supply/Implant | $30,323.20 |
| 6145989 | SUPPLY IMPLANT | Supply/Implant | $2,915.87 |
| 6145991 | SUPPLY IMPLANT | Supply/Implant | $285.06 |
| 6145995 | GENERAL SUPPLY | Supply/Implant | $228.22 |
| 6146004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6146016 | STERILE SUPPLY | Supply/Implant | $259.97 |
| 6146017 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6146020 | NUSHIELD 1 SQUARE CM | Supply/Implant | $17,920.00 |
| 6146021 | NUSHIELD 1 SQUARE CM | Supply/Implant | $5,056.00 |
| 6146022 | NUSHIELD 1 SQUARE CM | Supply/Implant | $10,176.00 |
| 6146024 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $2,016.90 |
| 6146048 | SUPPLY IMPLANT | Supply/Implant | $16,256.00 |
| 6146054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,465.60 |
| 6146065 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6146071 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $126,796.80 |
| 6146080 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6146081 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6146084 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $127,692.80 |
| 6146146 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6146172 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6146176 | PROSTHESIS, BREAST, IMP | Supply/Implant | $15,360.00 |
| 6146181 | STERILE SUPPLY | Supply/Implant | $190.04 |
| 6146198 | STERILE SUPPLY | Supply/Implant | $2,038.02 |
| 6146204 | CATHETER, GUIDING | Supply/Implant | $3,712.00 |
| 6146212 | SUPPLY IMPLANT | Supply/Implant | $1,198.59 |
| 6146218 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,800.83 |
| 6146220 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,800.83 |
| 6146222 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,230.72 |
| 6146233 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6146236 | ALLODERM SKIN SUB | Supply/Implant | $58,828.80 |
| 6146240 | SUPPLY IMPLANT | Supply/Implant | $5,939.20 |
| 6146256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $328.32 |
| 6146265 | MESH (IMPLANTABLE) | Supply/Implant | $27,648.00 |
| 6146266 | MESH (IMPLANTABLE) | Supply/Implant | $13,824.00 |
| 6146267 | MESH (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6146268 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6146270 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6146271 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6146303 | STERILE SUPPLY | Supply/Implant | $329.86 |
| 6146304 | SUPPLY IMPLANT | Supply/Implant | $3,061.76 |
| 6146306 | SUPPLY IMPLANT | Supply/Implant | $3,061.76 |
| 6146324 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6146339 | GENERAL SUPPLY | Supply/Implant | $1,127.17 |
| 6146350 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6146355 | MESH (IMPLANTABLE) | Supply/Implant | $91,238.40 |
| 6146372 | GENERAL SUPPLY | Supply/Implant | $30,505.86 |
| 6146424 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6146425 | STERILE SUPPLY | Supply/Implant | $1,041.66 |
| 6146435 | SUPPLY IMPLANT | Supply/Implant | $7,459.58 |
| 6146437 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6146445 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6146446 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6146447 | GUIDE WIRE | Supply/Implant | $1,727.74 |
| 6146451 | STERILE SUPPLY | Supply/Implant | $1,580.54 |
| 6146460 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6146523 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6146527 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6146541 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6146559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6146561 | SUPPLY IMPLANT | Supply/Implant | $63,769.60 |
| 6146565 | GENERAL SUPPLY | Supply/Implant | $3,776.00 |
| 6146573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,049.60 |
| 6146574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6146599 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6146600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6146611 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6146651 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,473.02 |
| 6146652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,473.02 |
| 6146658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6146671 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6146682 | SUPPLY IMPLANT | Supply/Implant | $17,344.00 |
| 6146687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,888.32 |
| 6146715 | SUPPLY IMPLANT | Supply/Implant | $1,638.40 |
| 6146718 | STERILE SUPPLY | Supply/Implant | $884.48 |
| 6146719 | STERILE SUPPLY | Supply/Implant | $480.26 |
| 6146721 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $544.00 |
| 6146762 | SUPPLY IMPLANT | Supply/Implant | $4,755.20 |
| 6146777 | GENERAL SUPPLY | Supply/Implant | $368.77 |
| 6146787 | STERILE SUPPLY | Supply/Implant | $1,304.45 |
| 6146790 | STERILE SUPPLY | Supply/Implant | $385.66 |
| 6146800 | STERILE SUPPLY | Supply/Implant | $236.80 |
| 6146803 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6146804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,416.00 |
| 6146805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,416.00 |
| 6146810 | MESH (IMPLANTABLE) | Supply/Implant | $11,895.42 |
| 6146811 | SUPPLY IMPLANT | Supply/Implant | $327.68 |
| 6146840 | SUPPLY IMPLANT | Supply/Implant | $551.55 |
| 6146890 | STERILE SUPPLY | Supply/Implant | $6,284.29 |
| 6146956 | STERILE SUPPLY | Supply/Implant | $1,375.23 |
| 6147042 | SUPPLY IMPLANT | Supply/Implant | $435.97 |
| 6147106 | STERILE SUPPLY | Supply/Implant | $405.50 |
| 6147110 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6147122 | STERILE SUPPLY | Supply/Implant | $405.50 |
| 6147135 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $212.19 |
| 6147144 | SUPPLY IMPLANT | Supply/Implant | $531.71 |
| 6147147 | STERILE SUPPLY | Supply/Implant | $733.57 |
| 6147157 | SUPPLY IMPLANT | Supply/Implant | $3,519.23 |
| 6147168 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6147176 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6147178 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6147179 | REP DEV, URINARY, W/SLING | Supply/Implant | $18,700.80 |
| 6147180 | STERILE SUPPLY | Supply/Implant | $1,701.63 |
| 6147181 | SUPPLY IMPLANT | Supply/Implant | $566.66 |
| 6147182 | SUPPLY IMPLANT | Supply/Implant | $1,146.37 |
| 6147183 | STERILE SUPPLY | Supply/Implant | $528.64 |
| 6147185 | SUPPLY IMPLANT | Supply/Implant | $551.68 |
| 6147190 | SUPPLY IMPLANT | Supply/Implant | $181.76 |
| 6147206 | SUPPLY IMPLANT | Supply/Implant | $1,900.42 |
| 6147224 | STERILE SUPPLY | Supply/Implant | $9,344.00 |
| 6147236 | GENERAL SUPPLY | Supply/Implant | $192.26 |
| 6147254 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6147266 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6147268 | SUPPLY IMPLANT | Supply/Implant | $2,873.60 |
| 6147304 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6147309 | GENERAL SUPPLY | Supply/Implant | $1,945.60 |
| 6147364 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6147378 | STERILE SUPPLY | Supply/Implant | $8,745.22 |
| 6147379 | GENERAL SUPPLY | Supply/Implant | $666.37 |
| 6147384 | GENERAL SUPPLY | Supply/Implant | $415.74 |
| 6147396 | GENERAL SUPPLY | Supply/Implant | $434.43 |
| 6147403 | SUPPLY IMPLANT | Supply/Implant | $406.91 |
| 6147404 | SUPPLY IMPLANT | Supply/Implant | $1,146.37 |
| 6147425 | SUPPLY IMPLANT | Supply/Implant | $3,929.60 |
| 6147459 | STERILE SUPPLY | Supply/Implant | $191.23 |
| 6147463 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6147473 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,235.26 |
| 6147486 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147488 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147490 | GUIDE WIRE | Supply/Implant | $1,856.00 |
| 6147512 | STERILE SUPPLY | Supply/Implant | $280.45 |
| 6147519 | STERILE SUPPLY | Supply/Implant | $317.88 |
| 6147525 | SUPPLY IMPLANT | Supply/Implant | $2,439.17 |
| 6147530 | CATHETER, URETERAL | Supply/Implant | $190.09 |
| 6147531 | GENERAL SUPPLY | Supply/Implant | $533.76 |
| 6147539 | SUPPLY IMPLANT | Supply/Implant | $139.65 |
| 6147547 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147578 | SUPPLY IMPLANT | Supply/Implant | $4,827.26 |
| 6147640 | STERILE SUPPLY | Supply/Implant | $1,089.79 |
| 6147645 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,571.07 |
| 6147646 | GENERAL SUPPLY | Supply/Implant | $362.30 |
| 6147652 | STERILE SUPPLY | Supply/Implant | $257.45 |
| 6147654 | STERILE SUPPLY | Supply/Implant | $196.22 |
| 6147657 | SUPPLY IMPLANT | Supply/Implant | $4,494.44 |
| 6147672 | SUPPLY IMPLANT | Supply/Implant | $2,450.41 |
| 6147678 | STERILE SUPPLY | Supply/Implant | $360.55 |
| 6147690 | STERILE SUPPLY | Supply/Implant | $183.14 |
| 6147691 | STERILE SUPPLY | Supply/Implant | $188.44 |
| 6147694 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6147704 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147739 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147740 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147747 | SUPPLY IMPLANT | Supply/Implant | $570.88 |
| 6147766 | SUPPLY IMPLANT | Supply/Implant | $869.12 |
| 6147768 | GENERAL SUPPLY | Supply/Implant | $165.56 |
| 6147769 | SUPPLY IMPLANT | Supply/Implant | $869.12 |
| 6147770 | SUPPLY IMPLANT | Supply/Implant | $869.12 |
| 6147772 | SUPPLY IMPLANT | Supply/Implant | $237.82 |
| 6147782 | STERILE SUPPLY | Supply/Implant | $323.46 |
| 6147783 | CATHETER, URETERAL | Supply/Implant | $143.49 |
| 6147784 | STERILE SUPPLY | Supply/Implant | $1,979.90 |
| 6147793 | SUPPLY IMPLANT | Supply/Implant | $555.65 |
| 6147820 | GENERAL SUPPLY | Supply/Implant | $1,110.53 |
| 6147843 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147848 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,736.00 |
| 6147850 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6147861 | CATHETER, GUIDING | Supply/Implant | $1,062.40 |
| 6147864 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147866 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147877 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147881 | STERILE SUPPLY | Supply/Implant | $762.88 |
| 6147904 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147917 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147942 | GENERAL SUPPLY | Supply/Implant | $2,752.00 |
| 6147983 | STERILE SUPPLY | Supply/Implant | $1,728.00 |
| 6147991 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6147992 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6147994 | GUIDE WIRE | Supply/Implant | $251.78 |
| 6148004 | GAUZE <=16 IN NO W/SAL W/O B | Supply/Implant | $4,615.68 |
| 6148042 | STERILE SUPPLY | Supply/Implant | $138.71 |
| 6148045 | SUPPLY IMPLANT | Supply/Implant | $2,585.60 |
| 6148054 | CATHETER, GUIDING | Supply/Implant | $204.67 |
| 6148062 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6148109 | GENERAL SUPPLY | Supply/Implant | $252.01 |
| 6148112 | SUPPLY IMPLANT | Supply/Implant | $4,330.88 |
| 6148113 | GENERAL SUPPLY | Supply/Implant | $291.72 |
| 6148130 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6148132 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6148134 | GENERAL SUPPLY | Supply/Implant | $334.46 |
| 6148149 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6148157 | GUIDE WIRE | Supply/Implant | $928.00 |
| 6148158 | CATH, DRAINAGE | Supply/Implant | $2,150.40 |
| 6148166 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,536.00 |
| 6148169 | GENERAL SUPPLY | Supply/Implant | $204.29 |
| 6148170 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6148179 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $343.73 |
| 6148188 | SUPPLY IMPLANT | Supply/Implant | $974.72 |
| 6148191 | GUIDE WIRE | Supply/Implant | $1,216.77 |
| 6148192 | STERILE SUPPLY | Supply/Implant | $327.17 |
| 6148194 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6148204 | SUPPLY IMPLANT | Supply/Implant | $3,461.12 |
| 6148225 | GENERAL SUPPLY | Supply/Implant | $184.58 |
| 6148254 | GENERAL SUPPLY | Supply/Implant | $600.70 |
| 6148276 | SUPPLY IMPLANT | Supply/Implant | $4,352.00 |
| 6148286 | SUPPLY IMPLANT | Supply/Implant | $4,079.74 |
| 6148293 | STERILE SUPPLY | Supply/Implant | $238.31 |
| 6148299 | STERILE SUPPLY | Supply/Implant | $129.02 |
| 6148300 | STERILE SUPPLY | Supply/Implant | $139.39 |
| 6148307 | STERILE SUPPLY | Supply/Implant | $160.77 |
| 6148313 | SUPPLY IMPLANT | Supply/Implant | $259.97 |
| 6148326 | STERILE SUPPLY | Supply/Implant | $270.82 |
| 6148328 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6148342 | STERILE SUPPLY | Supply/Implant | $260.22 |
| 6148344 | STERILE SUPPLY | Supply/Implant | $134.78 |
| 6148350 | SUPPLY IMPLANT | Supply/Implant | $4,537.60 |
| 6148355 | STERILE SUPPLY | Supply/Implant | $1,597.31 |
| 6148363 | STERILE SUPPLY | Supply/Implant | $383.74 |
| 6148369 | GENERAL SUPPLY | Supply/Implant | $440.70 |
| 6148374 | STERILE SUPPLY | Supply/Implant | $440.06 |
| 6148378 | SUPPLY IMPLANT | Supply/Implant | $327.81 |
| 6148379 | STERILE SUPPLY | Supply/Implant | $498.09 |
| 6148380 | STERILE SUPPLY | Supply/Implant | $235.20 |
| 6148382 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,109.50 |
| 6148386 | STERILE SUPPLY | Supply/Implant | $1,346.51 |
| 6148390 | SUPPLY IMPLANT | Supply/Implant | $987.01 |
| 6148398 | STERILE SUPPLY | Supply/Implant | $196.22 |
| 6148421 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,571.07 |
| 6148422 | SUPPLY IMPLANT | Supply/Implant | $1,853.57 |
| 6148424 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6148442 | STERILE SUPPLY | Supply/Implant | $1,092.61 |
| 6148453 | SUPPLY IMPLANT | Supply/Implant | $1,820.29 |
| 6148454 | SUPPLY IMPLANT | Supply/Implant | $2,343.04 |
| 6148455 | SUPPLY IMPLANT | Supply/Implant | $2,094.72 |
| 6148462 | SUPPLY IMPLANT | Supply/Implant | $4,430.46 |
| 6148463 | RET DEV, INSERTABLE | Supply/Implant | $4,405.50 |
| 6148466 | SUPPLY IMPLANT | Supply/Implant | $777.22 |
| 6148467 | SUPPLY IMPLANT | Supply/Implant | $1,761.92 |
| 6148470 | STERILE SUPPLY | Supply/Implant | $749.18 |
| 6148474 | STERILE SUPPLY | Supply/Implant | $159.49 |
| 6148492 | SUPPLY IMPLANT | Supply/Implant | $3,450.75 |
| 6148504 | SUPPLY IMPLANT | Supply/Implant | $2,537.57 |
| 6148506 | GENERAL SUPPLY | Supply/Implant | $368.77 |
| 6148511 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $489.98 |
| 6148515 | SUPPLY IMPLANT | Supply/Implant | $698.75 |
| 6148531 | GENERAL SUPPLY | Supply/Implant | $3,200.64 |
| 6148536 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $489.98 |
| 6148543 | STERILE SUPPLY | Supply/Implant | $218.75 |
| 6148548 | STERILE SUPPLY | Supply/Implant | $157.67 |
| 6148552 | GENERAL SUPPLY | Supply/Implant | $681.47 |
| 6148554 | SUPPLY IMPLANT | Supply/Implant | $1,324.42 |
| 6148579 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,486.40 |
| 6148589 | STERILE SUPPLY | Supply/Implant | $285.06 |
| 6148592 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $534.40 |
| 6148593 | GENERAL SUPPLY | Supply/Implant | $145.51 |
| 6148607 | STERILE SUPPLY | Supply/Implant | $207.36 |
| 6148618 | STERILE SUPPLY | Supply/Implant | $194.62 |
| 6148634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,785.47 |
| 6148658 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,331.52 |
| 6148661 | GENERAL SUPPLY | Supply/Implant | $520.40 |
| 6148693 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6148697 | INTRO/SHEATH, NON-LASER | Supply/Implant | $611.97 |
| 6148709 | STERILE SUPPLY | Supply/Implant | $203.52 |
| 6148718 | STERILE SUPPLY | Supply/Implant | $193.15 |
| 6148723 | SUPPLY IMPLANT | Supply/Implant | $3,525.12 |
| 6148725 | GENERAL SUPPLY | Supply/Implant | $2,380.80 |
| 6148728 | STERILE SUPPLY | Supply/Implant | $303.62 |
| 6148734 | STERILE SUPPLY | Supply/Implant | $303.10 |
| 6148737 | STERILE SUPPLY | Supply/Implant | $711.68 |
| 6148738 | STERILE SUPPLY | Supply/Implant | $985.60 |
| 6148742 | STERILE SUPPLY | Supply/Implant | $699.01 |
| 6148743 | STERILE SUPPLY | Supply/Implant | $698.88 |
| 6148798 | GENERAL SUPPLY | Supply/Implant | $292.86 |
| 6148799 | STERILE SUPPLY | Supply/Implant | $228.01 |
| 6148801 | SUPPLY IMPLANT | Supply/Implant | $264.83 |
| 6148898 | SUPPLY IMPLANT | Supply/Implant | $253.18 |
| 6148899 | SUPPLY IMPLANT | Supply/Implant | $253.18 |
| 6148906 | GENERAL SUPPLY | Supply/Implant | $177.98 |
| 6148907 | SUPPLY IMPLANT | Supply/Implant | $950.40 |
| 6148914 | STERILE SUPPLY | Supply/Implant | $185.98 |
| 6148939 | GENERAL SUPPLY | Supply/Implant | $605.18 |
| 6148972 | GENERAL SUPPLY | Supply/Implant | $6,613.38 |
| 6148992 | SUPPLY IMPLANT | Supply/Implant | $1,066.11 |
| 6148993 | GENERAL SUPPLY | Supply/Implant | $145.87 |
| 6148994 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $489.98 |
| 6148995 | GUIDE WIRE | Supply/Implant | $209.02 |
| 6149007 | SUPPLY IMPLANT | Supply/Implant | $438.91 |
| 6149018 | GENERAL SUPPLY | Supply/Implant | $192.13 |
| 6149033 | SUPPLY IMPLANT | Supply/Implant | $11,212.20 |
| 6149084 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $145.41 |
| 6149085 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $145.41 |
| 6149110 | STERILE SUPPLY | Supply/Implant | $330.75 |
| 6149113 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6149117 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6149120 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6149141 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $178.30 |
| 6149154 | INTRO/SHEATH, NON-LASER | Supply/Implant | $698.37 |
| 6149163 | GENERAL SUPPLY | Supply/Implant | $174.46 |
| 6149209 | MESH (IMPLANTABLE) | Supply/Implant | $1,496.45 |
| 6149215 | STERILE SUPPLY | Supply/Implant | $155.40 |
| 6149226 | SUPPLY IMPLANT | Supply/Implant | $627.84 |
| 6149243 | SUPPLY IMPLANT | Supply/Implant | $2,779.07 |
| 6149260 | STERILE SUPPLY | Supply/Implant | $785.02 |
| 6149263 | STERILE SUPPLY | Supply/Implant | $541.82 |
| 6149267 | STERILE SUPPLY | Supply/Implant | $135.04 |
| 6149272 | STERILE SUPPLY | Supply/Implant | $310.40 |
| 6149300 | STERILE SUPPLY | Supply/Implant | $234.50 |
| 6149356 | GENERAL SUPPLY | Supply/Implant | $140.80 |
| 6149397 | GENERAL SUPPLY | Supply/Implant | $504.83 |
| 6149502 | STERILE SUPPLY | Supply/Implant | $1,816.32 |
| 6149539 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6149577 | STERILE SUPPLY | Supply/Implant | $131.20 |
| 6149655 | SUPPLY IMPLANT | Supply/Implant | $2,301.44 |
| 6149674 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6149774 | SUPPLY IMPLANT | Supply/Implant | $2,581.50 |
| 6149776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6149777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6149792 | GENERAL SUPPLY | Supply/Implant | $128.51 |
| 6149804 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $704.00 |
| 6149818 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,088.00 |
| 6149823 | CATHETER, URETERAL | Supply/Implant | $3,274.75 |
| 6149848 | SUPPLY IMPLANT | Supply/Implant | $649.47 |
| 6149866 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6149877 | STERILE SUPPLY | Supply/Implant | $2,067.20 |
| 6149878 | GENERAL SUPPLY | Supply/Implant | $2,146.18 |
| 6149881 | SUPPLY IMPLANT | Supply/Implant | $5,298.43 |
| 6149884 | GUIDE WIRE | Supply/Implant | $151.68 |
| 6149885 | GENERAL SUPPLY | Supply/Implant | $313.60 |
| 6149889 | GENERAL SUPPLY | Supply/Implant | $313.60 |
| 6149914 | CATHETER, URETERAL | Supply/Implant | $29,239.30 |
| 6149923 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6149930 | SUPPLY IMPLANT | Supply/Implant | $5,995.01 |
| 6149931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $464.00 |
| 6149936 | SUPPLY IMPLANT | Supply/Implant | $7,967.23 |
| 6149939 | STERILE SUPPLY | Supply/Implant | $780.10 |
| 6149945 | SUPPLY IMPLANT | Supply/Implant | $1,082.88 |
| 6149948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6149959 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6149960 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6149961 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6149964 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,028.80 |
| 6149966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6149967 | OCULAR IMPLANT | Supply/Implant | $174.08 |
| 6149969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,536.64 |
| 6149973 | GENERAL SUPPLY | Supply/Implant | $21,177.60 |
| 6149974 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $114,673.13 |
| 6149975 | STERILE SUPPLY | Supply/Implant | $358.17 |
| 6149976 | STERILE SUPPLY | Supply/Implant | $198.66 |
| 6149977 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149978 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149979 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6149981 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149991 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6149992 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6149993 | CATHETER, GUIDING | Supply/Implant | $35,200.00 |
| 6149994 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6149995 | STERILE SUPPLY | Supply/Implant | $8,938.37 |
| 6149996 | STERILE SUPPLY | Supply/Implant | $8,938.37 |
| 6149997 | SUPPLY IMPLANT | Supply/Implant | $9,011.20 |
| 6150000 | STERILE SUPPLY | Supply/Implant | $537.60 |
| 6150011 | SUPPLY IMPLANT | Supply/Implant | $491.65 |
| 6150015 | SUPPLY IMPLANT | Supply/Implant | $93,719.30 |
| 6150016 | SUPPLY IMPLANT | Supply/Implant | $30,789.12 |
| 6150022 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6150023 | SUPPLY IMPLANT | Supply/Implant | $8,435.20 |
| 6150025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6150036 | GUIDE WIRE | Supply/Implant | $2,112.00 |
| 6150041 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $35,840.00 |
| 6150042 | GUIDE WIRE | Supply/Implant | $542.85 |
| 6150047 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6150048 | SUPPLY IMPLANT | Supply/Implant | $544.38 |
| 6150053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6150054 | GENERAL SUPPLY | Supply/Implant | $525.70 |
| 6150057 | SUPPLY IMPLANT | Supply/Implant | $484.99 |
| 6150059 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6150061 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6150067 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6150069 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $896.00 |
| 6150075 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6150076 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6150077 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6150080 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $202,000.00 |
| 6150088 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150092 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6150093 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6150097 | SUPPLY IMPLANT | Supply/Implant | $464.59 |
| 6150099 | GENERAL SUPPLY | Supply/Implant | $157.70 |
| 6150109 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6150114 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6150115 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6150116 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6150117 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6150118 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6150122 | STERILE SUPPLY | Supply/Implant | $276.35 |
| 6150123 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6150124 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6150125 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6150126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6150127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150129 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6150131 | SUPPLY IMPLANT | Supply/Implant | $309.91 |
| 6150139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,648.00 |
| 6150140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,242.88 |
| 6150148 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6150152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6150154 | SUPPLY IMPLANT | Supply/Implant | $188,227.62 |
| 6150155 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6150157 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6150158 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6150159 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6150160 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6150162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6150164 | SUPPLY IMPLANT | Supply/Implant | $1,078.27 |
| 6150165 | STERILE SUPPLY | Supply/Implant | $413.70 |
| 6150167 | SUPPLY IMPLANT | Supply/Implant | $221.95 |
| 6150179 | INTRO/SHEATH, NON-LASER | Supply/Implant | $356.53 |
| 6150180 | INTRO/SHEATH, NON-LASER | Supply/Implant | $356.53 |
| 6150182 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6150191 | INTRO/SHEATH, NON-LASER | Supply/Implant | $600.06 |
| 6150195 | SUPPLY IMPLANT | Supply/Implant | $151.81 |
| 6150196 | CATHETER, GUIDING | Supply/Implant | $836.35 |
| 6150198 | AICD, DUAL CHAMBER | Supply/Implant | $182,070.00 |
| 6150200 | AICD, DUAL CHAMBER | Supply/Implant | $178,342.50 |
| 6150201 | AICD, DUAL CHAMBER | Supply/Implant | $187,267.50 |
| 6150202 | AICD, SINGLE CHAMBER | Supply/Implant | $171,675.00 |
| 6150204 | AICD, SINGLE CHAMBER | Supply/Implant | $166,792.50 |
| 6150205 | AICD, SINGLE CHAMBER | Supply/Implant | $173,827.50 |
| 6150206 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $92,800.00 |
| 6150208 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $92,800.00 |
| 6150209 | GUIDE WIRE | Supply/Implant | $12,736.00 |
| 6150210 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6150212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6150217 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6150218 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6150221 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6150229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6150231 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6150233 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $106,752.00 |
| 6150236 | GENERAL SUPPLY | Supply/Implant | $1,446.40 |
| 6150245 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6150246 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6150248 | SUPPLY IMPLANT | Supply/Implant | $329.34 |
| 6150250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6150253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6150255 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6150256 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6150257 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6150258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6150261 | STERILE SUPPLY | Supply/Implant | $6,293.76 |
| 6150268 | SUPPLY IMPLANT | Supply/Implant | $60,496.00 |
| 6150271 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6150274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,209.60 |
| 6150275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6150281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,560.00 |
| 6150282 | SUPPLY IMPLANT | Supply/Implant | $3,187.07 |
| 6150290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,904.64 |
| 6150293 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6150294 | GENERAL SUPPLY | Supply/Implant | $146.20 |
| 6150294 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $46,912.00 |
| 6150295 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6150296 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $46,912.00 |
| 6150297 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $46,912.00 |
| 6150297 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6150302 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $46,912.00 |
| 6150303 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $46,912.00 |
| 6150305 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6150310 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $50,777.60 |
| 6150314 | SUPPLY IMPLANT | Supply/Implant | $676.61 |
| 6150317 | SUPPLY IMPLANT | Supply/Implant | $8,768.00 |
| 6150329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6150330 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6150334 | SUPPLY IMPLANT | Supply/Implant | $11,068.54 |
| 6150335 | SUPPLY IMPLANT | Supply/Implant | $12,583.68 |
| 6150336 | SUPPLY IMPLANT | Supply/Implant | $11,798.91 |
| 6150337 | SUPPLY IMPLANT | Supply/Implant | $13,697.28 |
| 6150339 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6150342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6150343 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150344 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6150345 | ALLODERM SKIN SUB | Supply/Implant | $52,620.80 |
| 6150349 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $231,593.00 |
| 6150354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6150358 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150359 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150361 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150364 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150365 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150366 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150367 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150368 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150369 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150370 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150371 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150374 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150375 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150376 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150377 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150378 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150379 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150380 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150381 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150382 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150383 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150384 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150385 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150386 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150387 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150388 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150389 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150390 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150391 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150392 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150393 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150394 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150395 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150396 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150397 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150398 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150399 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150400 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150401 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150402 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150403 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150404 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150405 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6150407 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,040.00 |
| 6150419 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6150426 | SUPPLY IMPLANT | Supply/Implant | $1,222.78 |
| 6150430 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6150435 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6150449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,544.00 |
| 6150450 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6150453 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150454 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150455 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150456 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150457 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150458 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150459 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6150461 | SUPPLY IMPLANT | Supply/Implant | $1,077.41 |
| 6150463 | GENERAL SUPPLY | Supply/Implant | $375.17 |
| 6150466 | SUPPLY IMPLANT | Supply/Implant | $4,856.32 |
| 6150468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150470 | STERILE SUPPLY | Supply/Implant | $8,000.00 |
| 6150471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6150475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6150476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6150477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6150478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6150479 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $186.37 |
| 6150487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6150488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6150489 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6150490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6150491 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6150493 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6150496 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6150498 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6150499 | SUPPLY IMPLANT | Supply/Implant | $2,409.98 |
| 6150506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6150509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6150510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6150511 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6150512 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6150513 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6150514 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6150515 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $12,800.00 |
| 6150518 | SUPPLY IMPLANT | Supply/Implant | $222.21 |
| 6150520 | GUIDE WIRE | Supply/Implant | $19,576.45 |
| 6150522 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6150526 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6150530 | SUPPLY IMPLANT | Supply/Implant | $3,383.55 |
| 6150531 | GENERAL SUPPLY | Supply/Implant | $479.00 |
| 6150533 | GENERAL SUPPLY | Supply/Implant | $832.00 |
| 6150534 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6150535 | SUPPLY IMPLANT | Supply/Implant | $1,520.64 |
| 6150536 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6150537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6150538 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6150539 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6150540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6150541 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6150544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6150546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6150547 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6150548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6150549 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6150550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6150553 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6150557 | SUPPLY IMPLANT | Supply/Implant | $52,531.20 |
| 6150558 | STERILE SUPPLY | Supply/Implant | $3,136.00 |
| 6150560 | GENERAL SUPPLY | Supply/Implant | $2,432.00 |
| 6150562 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6150567 | SUPPLY IMPLANT | Supply/Implant | $159.10 |
| 6150568 | CATHETER, GUIDING | Supply/Implant | $3,712.00 |
| 6150570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6150571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6150572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,348.80 |
| 6150573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6150574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6150577 | COCHLEAR DEVICE | Supply/Implant | $169,441.44 |
| 6150578 | COCHLEAR DEVICE | Supply/Implant | $169,441.44 |
| 6150581 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6150582 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6150583 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $35,776.00 |
| 6150584 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6150592 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150593 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150594 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150595 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150597 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6150599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6150600 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6150601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6150602 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $23,040.00 |
| 6150603 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $320.00 |
| 6150605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6150610 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6150611 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6150612 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6150613 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6150616 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6150617 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,376.00 |
| 6150618 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150619 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150620 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,056.00 |
| 6150621 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6150622 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,376.00 |
| 6150623 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150624 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150625 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,056.00 |
| 6150626 | SUPPLY IMPLANT | Supply/Implant | $9,197.06 |
| 6150632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6150636 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6150637 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6150638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6150641 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6150642 | STERILE SUPPLY | Supply/Implant | $5,312.00 |
| 6150644 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6150646 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6150648 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150649 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150650 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150651 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150653 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6150654 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6150656 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6150663 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6150664 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6150667 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6150668 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6150671 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6150672 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150676 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6150677 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6150678 | STERILE SUPPLY | Supply/Implant | $427.14 |
| 6150681 | SUPPLY IMPLANT | Supply/Implant | $4,257.79 |
| 6150682 | SUPPLY IMPLANT | Supply/Implant | $1,680.00 |
| 6150684 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6150685 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6150686 | CATHETER, GUIDING | Supply/Implant | $334.08 |
| 6150690 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $30,208.00 |
| 6150705 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $31,616.00 |
| 6150706 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $28,736.00 |
| 6150707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $31,616.00 |
| 6150708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $28,736.00 |
| 6150709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $31,616.00 |
| 6150710 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,220.80 |
| 6150719 | CATHETER, GUIDING | Supply/Implant | $4,089.60 |
| 6150720 | CATHETER, GUIDING | Supply/Implant | $4,089.60 |
| 6150731 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,672.00 |
| 6150744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6150748 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6150754 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6150763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,584.00 |
| 6150771 | SUPPLY IMPLANT | Supply/Implant | $6,838.53 |
| 6150772 | SUPPLY IMPLANT | Supply/Implant | $2,381.57 |
| 6150773 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6150776 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6150781 | SUPPLY IMPLANT | Supply/Implant | $28,096.00 |
| 6150782 | SKIN SUBSTITUTE, NOS | Supply/Implant | $28,096.00 |
| 6150783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6150784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6150785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,960.00 |
| 6150787 | SUPPLY IMPLANT | Supply/Implant | $7,620.10 |
| 6150788 | STERILE SUPPLY | Supply/Implant | $575.10 |
| 6150796 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6150800 | INTRO/SHEATH, NON-LASER | Supply/Implant | $332.72 |
| 6150823 | GUIDE WIRE | Supply/Implant | $4,646.40 |
| 6150824 | GUIDE WIRE | Supply/Implant | $4,646.40 |
| 6150826 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6150827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6150842 | STERILE SUPPLY | Supply/Implant | $167.04 |
| 6150945 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151035 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151039 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6151073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6151084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151092 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151107 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151108 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151109 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151113 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151115 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151168 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $832.00 |
| 6151169 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $832.00 |
| 6151172 | INTRO/SHEATH, NON-LASER | Supply/Implant | $934.40 |
| 6151174 | CATH OCCLUSION | Supply/Implant | $20,032.00 |
| 6151175 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $20,032.00 |
| 6151176 | CATH OCCLUSION | Supply/Implant | $20,032.00 |
| 6151179 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $282.62 |
| 6151186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151296 | GENERAL SUPPLY | Supply/Implant | $167.30 |
| 6151302 | GENERAL SUPPLY | Supply/Implant | $293.25 |
| 6151337 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6151350 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6151357 | GENERAL SUPPLY | Supply/Implant | $432.38 |
| 6151413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151414 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151415 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $14,627.20 |
| 6151416 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $14,627.20 |
| 6151427 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6151431 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $59,888.00 |
| 6151433 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6151435 | SUPPLY IMPLANT | Supply/Implant | $124,950.00 |
| 6151436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151439 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151442 | SUPPLY IMPLANT | Supply/Implant | $9,894.40 |
| 6151443 | SUPPLY IMPLANT | Supply/Implant | $9,894.40 |
| 6151444 | GENERAL SUPPLY | Supply/Implant | $332.80 |
| 6151481 | SUPPLY IMPLANT | Supply/Implant | $3,808.00 |
| 6151488 | SUPPLY IMPLANT | Supply/Implant | $11,776.00 |
| 6151506 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6151509 | GUIDE WIRE | Supply/Implant | $1,885.31 |
| 6151520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6151521 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6151522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6151523 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6151528 | ALLODERM SKIN SUB | Supply/Implant | $127,603.20 |
| 6151535 | SUPPLY IMPLANT | Supply/Implant | $21,056.00 |
| 6151537 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6151538 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6151540 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6151541 | GENERAL SUPPLY | Supply/Implant | $914.43 |
| 6151542 | GENERAL SUPPLY | Supply/Implant | $220.42 |
| 6151543 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6151544 | GENERAL SUPPLY | Supply/Implant | $1,471.49 |
| 6151546 | GENERAL SUPPLY | Supply/Implant | $185.60 |
| 6151546 | GENERAL SUPPLY | Supply/Implant | $231.74 |
| 6151547 | STERILE SUPPLY | Supply/Implant | $198.39 |
| 6151548 | GENERAL SUPPLY | Supply/Implant | $225.28 |
| 6151551 | SUPPLY IMPLANT | Supply/Implant | $168.96 |
| 6151552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,529.60 |
| 6151565 | SUPPLY IMPLANT | Supply/Implant | $1,322.88 |
| 6151566 | SUPPLY IMPLANT | Supply/Implant | $1,322.88 |
| 6151570 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6151573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6151580 | SUPPLY IMPLANT | Supply/Implant | $1,640.58 |
| 6151582 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6151588 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6151589 | GUIDE WIRE | Supply/Implant | $217.60 |
| 6151590 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6151592 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6151599 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6151600 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6151602 | SUPPLY IMPLANT | Supply/Implant | $1,517.18 |
| 6151606 | SUPPLY IMPLANT | Supply/Implant | $3,808.00 |
| 6151610 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6151611 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6151618 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6151620 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6151623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,765.12 |
| 6151624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6151632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6151633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $204.80 |
| 6151634 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6151638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,238.40 |
| 6151644 | INTRO/SHEATH, NON-LASER | Supply/Implant | $409.60 |
| 6151659 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6151660 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6151661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6151662 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6151679 | GENERAL SUPPLY | Supply/Implant | $912.51 |
| 6151680 | GENERAL SUPPLY | Supply/Implant | $171.26 |
| 6151685 | STERILE SUPPLY | Supply/Implant | $132.71 |
| 6151695 | STERILE SUPPLY | Supply/Implant | $2,688.00 |
| 6151700 | STERILE SUPPLY | Supply/Implant | $719.36 |
| 6151746 | SUPPLY IMPLANT | Supply/Implant | $1,257.22 |
| 6151749 | SUPPLY IMPLANT | Supply/Implant | $2,992.77 |
| 6151754 | SUPPLY IMPLANT | Supply/Implant | $260.99 |
| 6151760 | CATH, DRAINAGE | Supply/Implant | $2,899.97 |
| 6151761 | CATH, DRAINAGE | Supply/Implant | $2,262.27 |
| 6151762 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6151764 | SUPPLY IMPLANT | Supply/Implant | $60,945.92 |
| 6151787 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6151788 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6151789 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6151791 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6151792 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6151797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6151798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6151799 | SUPPLY IMPLANT | Supply/Implant | $48,320.00 |
| 6151800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6151810 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6151811 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6151812 | SUPPLY IMPLANT | Supply/Implant | $493.72 |
| 6151816 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6151817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,633.60 |
| 6151819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6151820 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6151822 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6151823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6151826 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6151833 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6151834 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6151835 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6151836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6151837 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6151841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6151846 | SUPPLY IMPLANT | Supply/Implant | $1,347.71 |
| 6151850 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $208,868.00 |
| 6151851 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $206,898.50 |
| 6151852 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $206,898.50 |
| 6151853 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $221,644.50 |
| 6151854 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $223,664.50 |
| 6151855 | GENERAL SUPPLY | Supply/Implant | $168.70 |
| 6151856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6151863 | STERILE SUPPLY | Supply/Implant | $3,742.72 |
| 6151865 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151866 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151867 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151879 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151901 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151913 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,680.00 |
| 6151935 | GENERAL SUPPLY | Supply/Implant | $3,115.26 |
| 6151937 | GENERAL SUPPLY | Supply/Implant | $2,580.35 |
| 6151940 | STERILE SUPPLY | Supply/Implant | $162.69 |
| 6151941 | STERILE SUPPLY | Supply/Implant | $481.02 |
| 6151942 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6151954 | CATH, DRAINAGE | Supply/Implant | $1,027.20 |
| 6151955 | STERILE SUPPLY | Supply/Implant | $386.30 |
| 6151987 | STERILE SUPPLY | Supply/Implant | $215.17 |
| 6151994 | SUPPLY IMPLANT | Supply/Implant | $158.52 |
| 6151995 | SUPPLY IMPLANT | Supply/Implant | $499.97 |
| 6151998 | SUPPLY IMPLANT | Supply/Implant | $688.00 |
| 6151999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $684.80 |
| 6152012 | GENERAL SUPPLY | Supply/Implant | $608.26 |
| 6152013 | SUPPLY IMPLANT | Supply/Implant | $511.10 |
| 6152028 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6152038 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6152047 | CLOSURE DEV, VASC | Supply/Implant | $2,931.20 |
| 6152080 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,595.52 |
| 6152100 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6152105 | SUPPLY IMPLANT | Supply/Implant | $3,144.32 |
| 6152114 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6152126 | STERILE SUPPLY | Supply/Implant | $721.54 |
| 6152128 | GENERAL SUPPLY | Supply/Implant | $2,284.54 |
| 6152148 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6152150 | STERILE SUPPLY | Supply/Implant | $710.91 |
| 6152158 | INTRO/SHEATH, NON-LASER | Supply/Implant | $352.77 |
| 6152164 | STERILE SUPPLY | Supply/Implant | $30,707.20 |
| 6152169 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6152172 | SUPPLY IMPLANT | Supply/Implant | $567.42 |
| 6152173 | SUPPLY IMPLANT | Supply/Implant | $633.60 |
| 6152174 | CATH, DRAINAGE | Supply/Implant | $507.78 |
| 6152177 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6152188 | SUPPLY IMPLANT | Supply/Implant | $22,592.00 |
| 6152193 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6152200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6152218 | SUPPLY IMPLANT | Supply/Implant | $597.38 |
| 6152219 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6152222 | STERILE SUPPLY | Supply/Implant | $587.52 |
| 6152250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $913.92 |
| 6152254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,993.60 |
| 6152271 | STERILE SUPPLY | Supply/Implant | $976.78 |
| 6152279 | STERILE SUPPLY | Supply/Implant | $144.00 |
| 6152280 | SUPPLY IMPLANT | Supply/Implant | $4,582.40 |
| 6152283 | SUPPLY IMPLANT | Supply/Implant | $371.33 |
| 6152305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6152313 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152324 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6152328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152331 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152333 | GUIDE WIRE | Supply/Implant | $379.14 |
| 6152334 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152335 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.10 |
| 6152344 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6152345 | SUPPLY IMPLANT | Supply/Implant | $282.24 |
| 6152347 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.10 |
| 6152350 | GUIDE WIRE | Supply/Implant | $371.58 |
| 6152385 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6152402 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.10 |
| 6152419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $678.40 |
| 6152421 | STERILE SUPPLY | Supply/Implant | $323.85 |
| 6152433 | SUPPLY IMPLANT | Supply/Implant | $326.40 |
| 6152442 | STERILE SUPPLY | Supply/Implant | $131.20 |
| 6152446 | SUPPLY IMPLANT | Supply/Implant | $2,372.22 |
| 6152458 | STERILE SUPPLY | Supply/Implant | $974.59 |
| 6152460 | SUPPLY IMPLANT | Supply/Implant | $289.66 |
| 6152461 | CATH, DRAINAGE | Supply/Implant | $320.00 |
| 6152468 | SUPPLY IMPLANT | Supply/Implant | $1,633.05 |
| 6152469 | SUPPLY IMPLANT | Supply/Implant | $543.23 |
| 6152474 | GUIDE WIRE | Supply/Implant | $345.60 |
| 6152478 | STERILE SUPPLY | Supply/Implant | $826.62 |
| 6152497 | SUPPLY IMPLANT | Supply/Implant | $9,401.73 |
| 6152500 | SUPPLY IMPLANT | Supply/Implant | $2,414.05 |
| 6152506 | SEPTAL DEFECT IMP SYS | Supply/Implant | $82,419.20 |
| 6152516 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,064.00 |
| 6152521 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6152529 | GENERAL SUPPLY | Supply/Implant | $5,977.98 |
| 6152534 | STERILE SUPPLY | Supply/Implant | $2,100.86 |
| 6152538 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6152545 | SUPPLY IMPLANT | Supply/Implant | $7,667.33 |
| 6152551 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6152560 | STERILE SUPPLY | Supply/Implant | $270.46 |
| 6152612 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6152620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,201.60 |
| 6152627 | SUPPLY IMPLANT | Supply/Implant | $3,179.52 |
| 6152629 | GUIDE WIRE | Supply/Implant | $379.14 |
| 6152657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,380.80 |
| 6152661 | STERILE SUPPLY | Supply/Implant | $1,121.41 |
| 6152672 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6152682 | SUPPLY IMPLANT | Supply/Implant | $2,284.93 |
| 6152685 | STERILE SUPPLY | Supply/Implant | $388.19 |
| 6152694 | SUPPLY IMPLANT | Supply/Implant | $62,112.64 |
| 6152701 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,201.60 |
| 6152709 | SUPPLY IMPLANT | Supply/Implant | $127,680.00 |
| 6152722 | GUIDE WIRE | Supply/Implant | $7,680.00 |
| 6152726 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,208.00 |
| 6152735 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $21,056.00 |
| 6152739 | STERILE SUPPLY | Supply/Implant | $38,400.00 |
| 6152743 | GUIDE WIRE | Supply/Implant | $2,988.16 |
| 6152744 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6152745 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6152746 | SUPPLY IMPLANT | Supply/Implant | $35,110.40 |
| 6152759 | SUPPLY IMPLANT | Supply/Implant | $507.78 |
| 6152774 | GUIDE WIRE | Supply/Implant | $407.68 |
| 6152775 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6152778 | GENERAL SUPPLY | Supply/Implant | $422.40 |
| 6152780 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6152785 | STERILE SUPPLY | Supply/Implant | $300.80 |
| 6152788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,651.20 |
| 6152799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6152800 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6152803 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6152809 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6152811 | SUPPLY IMPLANT | Supply/Implant | $280.96 |
| 6152814 | SUPPLY IMPLANT | Supply/Implant | $252.80 |
| 6152817 | GENERAL SUPPLY | Supply/Implant | $4,330.88 |
| 6152822 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6152827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6152831 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6152836 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6152858 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6152861 | SUPPLY IMPLANT | Supply/Implant | $285.44 |
| 6152862 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6152902 | SUPPLY IMPLANT | Supply/Implant | $1,407.10 |
| 6152904 | GENERAL SUPPLY | Supply/Implant | $2,534.40 |
| 6152934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,993.60 |
| 6152936 | STERILE SUPPLY | Supply/Implant | $1,830.78 |
| 6152946 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6152947 | GENERAL SUPPLY | Supply/Implant | $395.64 |
| 6152948 | GENERAL SUPPLY | Supply/Implant | $251.70 |
| 6152949 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152950 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152953 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152958 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152971 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153009 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153010 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153011 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153012 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153013 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153020 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153022 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153060 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $448.00 |
| 6153071 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6153073 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6153081 | STERILE SUPPLY | Supply/Implant | $7,616.00 |
| 6153082 | STERILE SUPPLY | Supply/Implant | $3,776.00 |
| 6153083 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6153085 | SUPPLY IMPLANT | Supply/Implant | $427,500.00 |
| 6153093 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6153094 | SUPPLY IMPLANT | Supply/Implant | $1,322.88 |
| 6153098 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6153099 | SUPPLY IMPLANT | Supply/Implant | $791.04 |
| 6153100 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6153101 | SUPPLY IMPLANT | Supply/Implant | $791.04 |
| 6153110 | SUPPLY IMPLANT | Supply/Implant | $2,170.88 |
| 6153111 | CATHETER, GUIDING | Supply/Implant | $648.96 |
| 6153113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153118 | SUPPLY IMPLANT | Supply/Implant | $63,360.00 |
| 6153119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6153121 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6153122 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6153124 | INTRO/SHEATH, NON-LASER | Supply/Implant | $979.20 |
| 6153125 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6153136 | SUPPLY IMPLANT | Supply/Implant | $176.64 |
| 6153137 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6153138 | STERILE SUPPLY | Supply/Implant | $139.52 |
| 6153143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,200.00 |
| 6153145 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6153146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6153149 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6153150 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153156 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153157 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153180 | SUPPLY IMPLANT | Supply/Implant | $1,605.76 |
| 6153181 | SUPPLY IMPLANT | Supply/Implant | $268.19 |
| 6153183 | SUPPLY IMPLANT | Supply/Implant | $1,640.58 |
| 6153186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6153187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,916.80 |
| 6153190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6153191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6153192 | STERILE SUPPLY | Supply/Implant | $6,375.81 |
| 6153193 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $17,210.62 |
| 6153194 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $17,210.62 |
| 6153196 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6153203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6153213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6153218 | SUPPLY IMPLANT | Supply/Implant | $20,697.60 |
| 6153223 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6153224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6153225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6153226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6153227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6153228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6153230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6153231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6153238 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6153245 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6153263 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6153264 | SUPPLY IMPLANT | Supply/Implant | $4,812.80 |
| 6153270 | STERILE SUPPLY | Supply/Implant | $137.34 |
| 6153272 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6153274 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6153277 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,817.60 |
| 6153283 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6153288 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,444.80 |
| 6153289 | ALLODERM SKIN SUB | Supply/Implant | $117,001.50 |
| 6153291 | SUPPLY IMPLANT | Supply/Implant | $1,640.58 |
| 6153294 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6153296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153297 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6153302 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $11,456.00 |
| 6153303 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6153304 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6153306 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6153307 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6153308 | GENERAL SUPPLY | Supply/Implant | $15,296.00 |
| 6153310 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6153312 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6153313 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6153314 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6153315 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153322 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153323 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153324 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153325 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153326 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153327 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153328 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153329 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153331 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153332 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153333 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153334 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153336 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153337 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153352 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6153355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6153359 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6153361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153362 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6153363 | SUPPLY IMPLANT | Supply/Implant | $115,919.48 |
| 6153364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6153368 | AMNIOTIC MEMBRANE | Supply/Implant | $37,760.00 |
| 6153369 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6153370 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153371 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153373 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6153375 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6153376 | SUPPLY IMPLANT | Supply/Implant | $174.72 |
| 6153377 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6153379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6153387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153414 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153457 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153460 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153462 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153463 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153472 | SUPPLY IMPLANT | Supply/Implant | $1,107.33 |
| 6153473 | CATHETER, GUIDING | Supply/Implant | $3,890.18 |
| 6153476 | CATHETER, GUIDING | Supply/Implant | $3,890.18 |
| 6153509 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6153510 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6153511 | SUPPLY IMPLANT | Supply/Implant | $13,849.60 |
| 6153512 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6153517 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6153521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,262.40 |
| 6153523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6153526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6153529 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $105,000.00 |
| 6153530 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $70,400.00 |
| 6153531 | INTRO/SHEATH, NON-LASER | Supply/Implant | $19,200.00 |
| 6153532 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6153535 | SUPPLY IMPLANT | Supply/Implant | $4,544.00 |
| 6153538 | PT PRGRM FOR IMPLT NEUROSTIM | Supply/Implant | $15,232.00 |
| 6153539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,446.40 |
| 6153541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6153547 | GENERAL SUPPLY | Supply/Implant | $6,462.72 |
| 6153548 | SUPPLY IMPLANT | Supply/Implant | $5,534.72 |
| 6153549 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6153551 | GENERAL SUPPLY | Supply/Implant | $585.86 |
| 6153552 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6153553 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6153557 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6153585 | STERILE SUPPLY | Supply/Implant | $3,303.42 |
| 6153586 | STERILE SUPPLY | Supply/Implant | $2,696.32 |
| 6153587 | STERILE SUPPLY | Supply/Implant | $3,251.97 |
| 6153588 | STERILE SUPPLY | Supply/Implant | $3,646.72 |
| 6153596 | STERILE SUPPLY | Supply/Implant | $3,667.20 |
| 6153598 | STERILE SUPPLY | Supply/Implant | $321.41 |
| 6153611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153616 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6153617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153621 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153622 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6153623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6153624 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6153626 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6153628 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6153631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6153632 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6153633 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6153634 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6153638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,584.00 |
| 6153643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6153644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6153651 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6153652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6153653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6153655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6153662 | STERILE SUPPLY | Supply/Implant | $362.50 |
| 6153663 | SUPPLY IMPLANT | Supply/Implant | $57,536.00 |
| 6153664 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6153678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,920.00 |
| 6153682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6153688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6153690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,845.76 |
| 6153691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6153693 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153694 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6153695 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6153725 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6153732 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6153733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6153734 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6153738 | GENERAL SUPPLY | Supply/Implant | $2,187.39 |
| 6153739 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153740 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6153746 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $64,278.40 |
| 6153751 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6153757 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6153758 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6153767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6153772 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,738.24 |
| 6153776 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6153777 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6153782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6153787 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6153788 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $48,000.00 |
| 6153799 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6153800 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6153801 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6153802 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6153805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6153806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6153807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6153808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6153809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6153810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6153811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6153813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6153821 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6153824 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6153831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6153839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,952.00 |
| 6153840 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6153843 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6153844 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6153847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6153848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6153851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6153854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,081.22 |
| 6153855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,201.15 |
| 6153856 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6153899 | SUPPLY IMPLANT | Supply/Implant | $291.97 |
| 6153900 | SUPPLY IMPLANT | Supply/Implant | $4,705.41 |
| 6153908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6153909 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6153910 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6153911 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6153912 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6153915 | PORT, INDWELLING, IMP | Supply/Implant | $4,160.00 |
| 6153917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6153920 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6153925 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6153926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153931 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6153933 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $11,072.00 |
| 6153934 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $11,072.00 |
| 6153935 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $11,072.00 |
| 6153937 | SUPPLY IMPLANT | Supply/Implant | $15,040.00 |
| 6153938 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6153940 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6153943 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $512.56 |
| 6153957 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $434.53 |
| 6153959 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6153960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6153961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6153963 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6153968 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153969 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6153970 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6153971 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6153972 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6153977 | STERILE SUPPLY | Supply/Implant | $2,918.40 |
| 6153979 | SUPPLY IMPLANT | Supply/Implant | $4,428.29 |
| 6153981 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6153984 | SUPPLY IMPLANT | Supply/Implant | $8,232.32 |
| 6153985 | AMNIOTIC MEMBRANE | Supply/Implant | $28,096.00 |
| 6153988 | SUPPLY IMPLANT | Supply/Implant | $119,969.33 |
| 6153992 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6153993 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6153995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6153996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6153997 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153999 | STERILE SUPPLY | Supply/Implant | $407.73 |
| 6154000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6154003 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6154005 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6154006 | STERILE SUPPLY | Supply/Implant | $8,640.00 |
| 6154007 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6154008 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6154009 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6154010 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6154011 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6154013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,416.00 |
| 6154019 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,790.40 |
| 6154028 | SUPPLY IMPLANT | Supply/Implant | $1,396.99 |
| 6154031 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6154033 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6154036 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6154038 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154042 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6154043 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6154044 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6154050 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6154056 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154057 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154058 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154059 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154060 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154061 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154062 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154063 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154064 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154065 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154066 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154067 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154068 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154069 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6154070 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154071 | SUPPLY IMPLANT | Supply/Implant | $6,464.00 |
| 6154072 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154073 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154075 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6154076 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154077 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154078 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154079 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154080 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154081 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154082 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154083 | SUPPLY IMPLANT | Supply/Implant | $2,292.48 |
| 6154084 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6154085 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6154089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6154095 | SUPPLY IMPLANT | Supply/Implant | $45,696.00 |
| 6154098 | SUPPLY IMPLANT | Supply/Implant | $206.59 |
| 6154099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6154100 | SUPPLY IMPLANT | Supply/Implant | $300.80 |
| 6154105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,017.22 |
| 6154106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,145.86 |
| 6154109 | STERILE SUPPLY | Supply/Implant | $407.04 |
| 6154110 | CATHETER, GUIDING | Supply/Implant | $3,520.00 |
| 6154129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6154130 | SUPPLY IMPLANT | Supply/Implant | $4,986.88 |
| 6154132 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,124.74 |
| 6154135 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,898.75 |
| 6154141 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6154142 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,371.39 |
| 6154145 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,371.39 |
| 6154146 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6154188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6154189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6154190 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6154191 | SUPPLY IMPLANT | Supply/Implant | $4,986.88 |
| 6154193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6154201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154216 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6154219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6154220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,541.38 |
| 6154221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6154223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6154224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6154237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6154246 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6154247 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6154248 | CATHETER, GUIDING | Supply/Implant | $3,890.18 |
| 6154249 | CATHETER, GUIDING | Supply/Implant | $5,005.18 |
| 6154260 | STERILE SUPPLY | Supply/Implant | $18,700.80 |
| 6154264 | SUPPLY IMPLANT | Supply/Implant | $4,096.00 |
| 6154265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6154266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6154267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6154268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6154271 | CATHETER, GUIDING | Supply/Implant | $5,632.00 |
| 6154272 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6154275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,736.00 |
| 6154287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6154292 | STERILE SUPPLY | Supply/Implant | $363.26 |
| 6154293 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6154298 | GENERAL SUPPLY | Supply/Implant | $975.36 |
| 6154299 | GENERAL SUPPLY | Supply/Implant | $975.36 |
| 6154303 | CATHETER, GUIDING | Supply/Implant | $46,912.00 |
| 6154316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6154317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6154318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6154319 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6154324 | SUPPLY IMPLANT | Supply/Implant | $54,758.40 |
| 6154325 | SUPPLY IMPLANT | Supply/Implant | $5,196.80 |
| 6154326 | SUPPLY IMPLANT | Supply/Implant | $5,196.80 |
| 6154327 | SUPPLY IMPLANT | Supply/Implant | $3,148.80 |
| 6154328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6154329 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6154330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6154331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6154334 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $480.00 |
| 6154338 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6154341 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6154349 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154350 | CATHETER, GUIDING | Supply/Implant | $4,864.00 |
| 6154355 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6154356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6154359 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6154360 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6154367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6154373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6154374 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6154378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6154379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6154380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6154387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6154388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6154389 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6154390 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6154391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6154395 | MESH (IMPLANTABLE) | Supply/Implant | $29,358.98 |
| 6154398 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6154404 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,584.00 |
| 6154405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,017.60 |
| 6154408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6154410 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6154411 | STERILE SUPPLY | Supply/Implant | $3,394.56 |
| 6154412 | GUIDE WIRE | Supply/Implant | $4,659.20 |
| 6154420 | SUPPLY IMPLANT | Supply/Implant | $57,600.00 |
| 6154422 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6154426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6154429 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $183,750.00 |
| 6154430 | SUPPLY IMPLANT | Supply/Implant | $1,215.62 |
| 6154431 | SUPPLY IMPLANT | Supply/Implant | $3,655.81 |
| 6154432 | SUPPLY IMPLANT | Supply/Implant | $3,525.38 |
| 6154433 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,230.72 |
| 6154435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6154436 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6154438 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6154439 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6154450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6154451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6154499 | SUPPLY IMPLANT | Supply/Implant | $1,217.41 |
| 6154504 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6154532 | SUPPLY IMPLANT | Supply/Implant | $1,032.70 |
| 6154539 | SUPPLY IMPLANT | Supply/Implant | $887.81 |
| 6154592 | SUPPLY IMPLANT | Supply/Implant | $3,650.56 |
| 6154631 | SUPPLY IMPLANT | Supply/Implant | $2,593.92 |
| 6154635 | STERILE SUPPLY | Supply/Implant | $1,500.67 |
| 6154736 | SUPPLY IMPLANT | Supply/Implant | $6,547.71 |
| 6154739 | SUPPLY IMPLANT | Supply/Implant | $1,828.48 |
| 6154741 | SUPPLY IMPLANT | Supply/Implant | $34,469.38 |
| 6154758 | SUPPLY IMPLANT | Supply/Implant | $28,546.56 |
| 6154771 | STERILE SUPPLY | Supply/Implant | $10,562.18 |
| 6154789 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6154797 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6154799 | STERILE SUPPLY | Supply/Implant | $351.10 |
| 6154800 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154801 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6154810 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6154813 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154819 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154833 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154852 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6154856 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154867 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154868 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154871 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154883 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154887 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6154890 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154894 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154898 | STERILE SUPPLY | Supply/Implant | $318.21 |
| 6154980 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6154981 | SUPPLY IMPLANT | Supply/Implant | $151.55 |
| 6155016 | SUPPLY IMPLANT | Supply/Implant | $3,851.52 |
| 6155036 | SUPPLY IMPLANT | Supply/Implant | $12,057.60 |
| 6155064 | SUPPLY IMPLANT | Supply/Implant | $125,798.40 |
| 6155086 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6155098 | SUPPLY IMPLANT | Supply/Implant | $8,147.20 |
| 6155102 | SUPPLY IMPLANT | Supply/Implant | $6,353.66 |
| 6155129 | SUPPLY IMPLANT | Supply/Implant | $694.78 |
| 6155145 | SUPPLY IMPLANT | Supply/Implant | $252.54 |
| 6155147 | SUPPLY IMPLANT | Supply/Implant | $403.97 |
| 6155159 | SUPPLY IMPLANT | Supply/Implant | $188.67 |
| 6155177 | SUPPLY IMPLANT | Supply/Implant | $420.74 |
| 6155179 | SUPPLY IMPLANT | Supply/Implant | $348.54 |
| 6155188 | SUPPLY IMPLANT | Supply/Implant | $425.60 |
| 6155191 | SUPPLY IMPLANT | Supply/Implant | $373.12 |
| 6155194 | SUPPLY IMPLANT | Supply/Implant | $1,098.88 |
| 6155198 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6155200 | GENERAL SUPPLY | Supply/Implant | $198.27 |
| 6155203 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6155204 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6155205 | STERILE SUPPLY | Supply/Implant | $319.23 |
| 6155206 | STERILE SUPPLY | Supply/Implant | $414.34 |
| 6155208 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6155211 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6155215 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6155216 | GUIDE WIRE | Supply/Implant | $12,160.00 |
| 6155217 | CATHETER, GUIDING | Supply/Implant | $8,960.00 |
| 6155218 | CATHETER, GUIDING | Supply/Implant | $8,960.00 |
| 6155219 | CATHETER, GUIDING | Supply/Implant | $10,880.00 |
| 6155235 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6155236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6155239 | CATH, DRAINAGE | Supply/Implant | $1,027.20 |
| 6155241 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6155242 | CATHETER, GUIDING | Supply/Implant | $4,352.00 |
| 6155244 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6155245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6155256 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6155259 | STERILE SUPPLY | Supply/Implant | $410.62 |
| 6155260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6155261 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6155262 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6155263 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6155264 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6155267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6155268 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6155272 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6155273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6155280 | STERILE SUPPLY | Supply/Implant | $346.62 |
| 6155287 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $960.00 |
| 6155288 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155289 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155290 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155291 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155292 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155293 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $960.00 |
| 6155294 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6155295 | SUPPLY IMPLANT | Supply/Implant | $9,920.00 |
| 6155300 | CATHETER, URETERAL | Supply/Implant | $334.98 |
| 6155304 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6155305 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,774.40 |
| 6155310 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6155312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6155315 | SUPPLY IMPLANT | Supply/Implant | $1,037.70 |
| 6155316 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6155317 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6155322 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6155325 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,104.96 |
| 6155329 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6155331 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6155333 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6155334 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6155335 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6155344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6155345 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6155352 | OCULAR IMP AQUEOUS DRAIN | Supply/Implant | $29,120.00 |
| 6155355 | PORT, INDWELLING, IMP | Supply/Implant | $1,984.00 |
| 6155356 | PORT, INDWELLING, IMP | Supply/Implant | $1,664.00 |
| 6155362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6155364 | STERILE SUPPLY | Supply/Implant | $407.73 |
| 6155368 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6155369 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6155371 | STERILE SUPPLY | Supply/Implant | $426.27 |
| 6155372 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6155385 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155389 | SUPPLY IMPLANT | Supply/Implant | $465.92 |
| 6155395 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6155403 | INTRO/SHEATH, NON-LASER | Supply/Implant | $931.46 |
| 6155408 | SUPPLY IMPLANT | Supply/Implant | $1,361.41 |
| 6155410 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6155411 | SUPPLY IMPLANT | Supply/Implant | $384.64 |
| 6155412 | SUPPLY IMPLANT | Supply/Implant | $252.54 |
| 6155414 | STERILE SUPPLY | Supply/Implant | $1,925.89 |
| 6155415 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6155416 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6155417 | SUPPLY IMPLANT | Supply/Implant | $5,901.31 |
| 6155418 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6155422 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6155425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,539.20 |
| 6155428 | STERILE SUPPLY | Supply/Implant | $337.41 |
| 6155429 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6155434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6155435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6155436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6155437 | SUPPLY IMPLANT | Supply/Implant | $1,759.94 |
| 6155440 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6155445 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6155447 | STERILE SUPPLY | Supply/Implant | $1,834.11 |
| 6155454 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,428.22 |
| 6155455 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,428.22 |
| 6155456 | STERILE SUPPLY | Supply/Implant | $352.64 |
| 6155457 | CATHETER, GUIDING | Supply/Implant | $15,360.00 |
| 6155458 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155459 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155460 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155461 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155462 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155463 | SUPPLY IMPLANT | Supply/Implant | $4,180.35 |
| 6155468 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6155469 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6155473 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6155475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6155476 | GENERAL SUPPLY | Supply/Implant | $3,372.54 |
| 6155482 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6155485 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6155486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6155490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,579.20 |
| 6155492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6155493 | GUIDE WIRE | Supply/Implant | $1,520.64 |
| 6155494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6155495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6155497 | LEAD, NEUROSTIMULATOR | Supply/Implant | $103,680.00 |
| 6155498 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6155500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,135.87 |
| 6155502 | STERILE SUPPLY | Supply/Implant | $625.66 |
| 6155503 | STERILE SUPPLY | Supply/Implant | $206.08 |
| 6155504 | SUPPLY IMPLANT | Supply/Implant | $5,621.76 |
| 6155505 | SUPPLY IMPLANT | Supply/Implant | $6,046.72 |
| 6155532 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155533 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155534 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155535 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155538 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $100,480.00 |
| 6155544 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,872.00 |
| 6155545 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6155549 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6155550 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6155551 | GENERAL SUPPLY | Supply/Implant | $217.60 |
| 6155552 | SUPPLY IMPLANT | Supply/Implant | $3,257.47 |
| 6155553 | STERILE SUPPLY | Supply/Implant | $320.29 |
| 6155554 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6155557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6155559 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,120.00 |
| 6155560 | SUPPLY IMPLANT | Supply/Implant | $1,473.92 |
| 6155561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6155562 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6155564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6155575 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6155578 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6155579 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $332,562.70 |
| 6155602 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6155603 | SUPPLY IMPLANT | Supply/Implant | $1,947.52 |
| 6155604 | SUPPLY IMPLANT | Supply/Implant | $1,947.52 |
| 6155605 | SUPPLY IMPLANT | Supply/Implant | $1,947.52 |
| 6155606 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6155608 | STERILE SUPPLY | Supply/Implant | $130.42 |
| 6155611 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6155612 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6155616 | SUPPLY IMPLANT | Supply/Implant | $5,990.40 |
| 6155617 | SUPPLY IMPLANT | Supply/Implant | $2,647.81 |
| 6155619 | SUPPLY IMPLANT | Supply/Implant | $133.89 |
| 6155624 | SUPPLY IMPLANT | Supply/Implant | $15,355.78 |
| 6155627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6155628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6155629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.13 |
| 6155636 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6155637 | STERILE SUPPLY | Supply/Implant | $403.20 |
| 6155638 | STERILE SUPPLY | Supply/Implant | $376.58 |
| 6155639 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6155640 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6155641 | SUPPLY IMPLANT | Supply/Implant | $4,544.00 |
| 6155654 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6155672 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6155676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,800.00 |
| 6155677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6155678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $67,200.00 |
| 6155679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,041.60 |
| 6155680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,080.00 |
| 6155681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,760.00 |
| 6155682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,800.00 |
| 6155683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $67,200.00 |
| 6155686 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6155689 | SUPPLY IMPLANT | Supply/Implant | $19,788.80 |
| 6155708 | SUPPLY IMPLANT | Supply/Implant | $20,044.80 |
| 6155719 | SUPPLY IMPLANT | Supply/Implant | $20,044.80 |
| 6155743 | SUPPLY IMPLANT | Supply/Implant | $21,248.00 |
| 6155754 | SUPPLY IMPLANT | Supply/Implant | $20,044.80 |
| 6155771 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6155772 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6155913 | MESH (IMPLANTABLE) | Supply/Implant | $8,848.13 |
| 6155914 | MESH (IMPLANTABLE) | Supply/Implant | $8,848.13 |
| 6155949 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6155958 | STERILE SUPPLY | Supply/Implant | $217.79 |
| 6155961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6155965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,084.48 |
| 6155967 | STERILE SUPPLY | Supply/Implant | $468.48 |
| 6155968 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $312.06 |
| 6155969 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155970 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155971 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155973 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155977 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6155979 | SUPPLY IMPLANT | Supply/Implant | $33,267.20 |
| 6155980 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6155982 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,920.00 |
| 6155983 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,920.00 |
| 6155986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6155987 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6155988 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6155989 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6155990 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6155991 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6155993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6155995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6155996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6156000 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6156001 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6156003 | ALLODERM SKIN SUB | Supply/Implant | $69,132.80 |
| 6156004 | SUPPLY IMPLANT | Supply/Implant | $2,872.32 |
| 6156005 | SUPPLY IMPLANT | Supply/Implant | $3,427.20 |
| 6156007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6156008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6156009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $601.60 |
| 6156012 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6156018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6156019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6156027 | SUPPLY IMPLANT | Supply/Implant | $790.27 |
| 6156034 | SUPPLY IMPLANT | Supply/Implant | $410.88 |
| 6156040 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6156041 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6156042 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6156043 | LEAD, CORONARY VENOUS | Supply/Implant | $47,424.00 |
| 6156044 | SUPPLY IMPLANT | Supply/Implant | $7,072.00 |
| 6156045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6156046 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6156047 | SUPPLY IMPLANT | Supply/Implant | $7,833.60 |
| 6156048 | SUPPLY IMPLANT | Supply/Implant | $2,383.36 |
| 6156049 | OCULAR IMP AQUEOUS DRAIN | Supply/Implant | $24,320.00 |
| 6156050 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6156053 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6156054 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156055 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156056 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156057 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156060 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6156061 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6156062 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6156063 | STERILE SUPPLY | Supply/Implant | $393.73 |
| 6156064 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6156071 | STERILE SUPPLY | Supply/Implant | $313.60 |
| 6156072 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156073 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156074 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156075 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156076 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156077 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156078 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156079 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156080 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156081 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156082 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $6,387.20 |
| 6156087 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156088 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156089 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156090 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156091 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156092 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156093 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156094 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156095 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156096 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156097 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156098 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156100 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156101 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156102 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156106 | SUPPLY IMPLANT | Supply/Implant | $892.42 |
| 6156109 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6156111 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $521.73 |
| 6156118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6156119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6156120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156122 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $222,200.00 |
| 6156123 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $8,256.00 |
| 6156124 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6156126 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6156138 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6156140 | SUPPLY IMPLANT | Supply/Implant | $26,307.07 |
| 6156141 | STERILE SUPPLY | Supply/Implant | $969.60 |
| 6156142 | SUPPLY IMPLANT | Supply/Implant | $5,312.00 |
| 6156145 | SUPPLY IMPLANT | Supply/Implant | $962.69 |
| 6156146 | SUPPLY IMPLANT | Supply/Implant | $962.69 |
| 6156149 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6156152 | GENERAL SUPPLY | Supply/Implant | $2,250.24 |
| 6156158 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6156159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6156164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6156165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6156166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,824.00 |
| 6156168 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6156173 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6156179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6156180 | SUPPLY IMPLANT | Supply/Implant | $30,182.40 |
| 6156182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6156185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,529.41 |
| 6156190 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6156191 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156192 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156193 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156194 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156197 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156198 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156199 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156200 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156201 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156203 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156204 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156205 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156206 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156207 | CATH, DRAINAGE | Supply/Implant | $998.40 |
| 6156208 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156209 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156210 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6156221 | SUPPLY IMPLANT | Supply/Implant | $14,807.32 |
| 6156222 | SUPPLY IMPLANT | Supply/Implant | $16,283.03 |
| 6156223 | CATH, DRAINAGE | Supply/Implant | $6,720.00 |
| 6156224 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156236 | STERILE SUPPLY | Supply/Implant | $488.32 |
| 6156240 | SUPPLY IMPLANT | Supply/Implant | $858.62 |
| 6156245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,920.00 |
| 6156246 | SUPPLY IMPLANT | Supply/Implant | $24,969.60 |
| 6156247 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6156256 | STERILE SUPPLY | Supply/Implant | $12,787.20 |
| 6156258 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6156259 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6156261 | STERILE SUPPLY | Supply/Implant | $329.34 |
| 6156262 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6156268 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6156271 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6156273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6156292 | ALLODERM SKIN SUB | Supply/Implant | $127,603.20 |
| 6156294 | SUPPLY IMPLANT | Supply/Implant | $31,910.40 |
| 6156296 | ARTHROFLEX PER 1 SQ CM | Supply/Implant | $49,280.00 |
| 6156297 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,428.22 |
| 6156301 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,499.20 |
| 6156302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6156305 | GUIDE WIRE | Supply/Implant | $3,246.08 |
| 6156308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,990.40 |
| 6156326 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156327 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156331 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6156332 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6156333 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6156335 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6156339 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156340 | GENERAL SUPPLY | Supply/Implant | $133.12 |
| 6156341 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6156345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156346 | SUPPLY IMPLANT | Supply/Implant | $35,942.40 |
| 6156347 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6156348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6156349 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $12,800.00 |
| 6156350 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6156353 | SUPPLY IMPLANT | Supply/Implant | $15,936.00 |
| 6156355 | SUPPLY IMPLANT | Supply/Implant | $3,525.38 |
| 6156363 | SUPPLY IMPLANT | Supply/Implant | $19,187.20 |
| 6156366 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6156367 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6156368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6156370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6156371 | GENERAL SUPPLY | Supply/Implant | $3,520.00 |
| 6156372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $86,976.00 |
| 6156375 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,640.00 |
| 6156376 | STERILE SUPPLY | Supply/Implant | $4,672.00 |
| 6156379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6156389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6156391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6156392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6156393 | SUPPLY IMPLANT | Supply/Implant | $94,656.00 |
| 6156395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6156398 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6156399 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6156405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156408 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6156413 | SUPPLY IMPLANT | Supply/Implant | $1,364.74 |
| 6156415 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6156416 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6156417 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6156418 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156423 | SUPPLY IMPLANT | Supply/Implant | $4,089.34 |
| 6156424 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $247.05 |
| 6156425 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6156427 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156429 | STERILE SUPPLY | Supply/Implant | $7,186.18 |
| 6156435 | STERILE SUPPLY | Supply/Implant | $8,028.16 |
| 6156438 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6156439 | SUPPLY IMPLANT | Supply/Implant | $4,482.56 |
| 6156440 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6156441 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6156452 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6156453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6156456 | AICD, DUAL CHAMBER | Supply/Implant | $167,128.50 |
| 6156457 | AICD, SINGLE CHAMBER | Supply/Implant | $172,504.50 |
| 6156458 | AICD, SINGLE CHAMBER | Supply/Implant | $167,128.50 |
| 6156459 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $40,153.60 |
| 6156460 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $40,153.60 |
| 6156461 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6156464 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $207,900.00 |
| 6156469 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $928.00 |
| 6156470 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,152.00 |
| 6156478 | GENERAL SUPPLY | Supply/Implant | $192.00 |
| 6156482 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,080.00 |
| 6156483 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $19,840.00 |
| 6156484 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $17,280.00 |
| 6156490 | SUPPLY IMPLANT | Supply/Implant | $8,443.90 |
| 6156491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6156492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6156493 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6156498 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6156511 | SUPPLY IMPLANT | Supply/Implant | $14,714.88 |
| 6156512 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6156513 | SUPPLY IMPLANT | Supply/Implant | $3,832.06 |
| 6156514 | SUPPLY IMPLANT | Supply/Implant | $5,051.29 |
| 6156515 | SUPPLY IMPLANT | Supply/Implant | $8,491.39 |
| 6156516 | SUPPLY IMPLANT | Supply/Implant | $5,573.25 |
| 6156517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6156534 | GUIDE WIRE | Supply/Implant | $6,400.00 |
| 6156535 | SUPPLY IMPLANT | Supply/Implant | $3,891.20 |
| 6156537 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6156539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6156540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6156541 | GUIDE WIRE | Supply/Implant | $3,246.08 |
| 6156546 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $303,000.00 |
| 6156549 | RET DEV, INSERTABLE | Supply/Implant | $1,408.00 |
| 6156551 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6156553 | SUPPLY IMPLANT | Supply/Implant | $858.24 |
| 6156554 | SUPPLY IMPLANT | Supply/Implant | $17,136.00 |
| 6156556 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6156574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6156575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6156578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6156581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6156583 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,753.60 |
| 6156584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6156587 | SUPPLY IMPLANT | Supply/Implant | $6,049.66 |
| 6156589 | GUIDE WIRE | Supply/Implant | $186.11 |
| 6156594 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6156619 | GUIDE WIRE | Supply/Implant | $172.80 |
| 6156623 | AICD, SINGLE CHAMBER | Supply/Implant | $154,531.13 |
| 6156624 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,593.22 |
| 6156627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,676.80 |
| 6156629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6156630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6156631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6156632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6156633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6156634 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6156636 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6156638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6156639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6156641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6156642 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $100,787.20 |
| 6156643 | SUPPLY IMPLANT | Supply/Implant | $13,798.40 |
| 6156647 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6156648 | STERILE SUPPLY | Supply/Implant | $625.79 |
| 6156654 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156657 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156658 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156660 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156661 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156662 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156663 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156664 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156665 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156666 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156667 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156668 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156669 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156670 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156672 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156673 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156674 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156676 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156678 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156679 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156681 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156682 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156683 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156685 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156686 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156687 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156691 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156692 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156693 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156698 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156699 | CATHETER, URETERAL | Supply/Implant | $162.56 |
| 6156700 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6156701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6156702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6156709 | SUPPLY IMPLANT | Supply/Implant | $171.52 |
| 6156713 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6156715 | INTRO/SHEATH, NON-LASER | Supply/Implant | $384.00 |
| 6156717 | SUPPLY IMPLANT | Supply/Implant | $3,949.44 |
| 6156720 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6156730 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6156731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156736 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156738 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6156739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6156741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6156742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6156748 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6156751 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6156753 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6156754 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6156761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6156768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,428.48 |
| 6156800 | SUPPLY IMPLANT | Supply/Implant | $20,849.92 |
| 6156810 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156811 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156825 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156828 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156830 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156833 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156901 | SUPPLY IMPLANT | Supply/Implant | $27,086.08 |
| 6156903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,912.00 |
| 6156904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,912.00 |
| 6156906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6156909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6156912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,125.31 |
| 6156913 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6156914 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6156917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6156967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6156969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156973 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6156974 | SUPPLY IMPLANT | Supply/Implant | $23,296.00 |
| 6156975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6156976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6156977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6156978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6156979 | STERILE SUPPLY | Supply/Implant | $535.30 |
| 6156982 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156983 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156987 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,603.20 |
| 6156989 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6156991 | STERILE SUPPLY | Supply/Implant | $1,611.90 |
| 6156992 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6156994 | MESH (IMPLANTABLE) | Supply/Implant | $13,824.00 |
| 6157001 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6157006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6157008 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157009 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6157015 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6157016 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6157017 | SUPPLY IMPLANT | Supply/Implant | $6,815.10 |
| 6157018 | SUPPLY IMPLANT | Supply/Implant | $7,261.31 |
| 6157019 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6157020 | SUPPLY IMPLANT | Supply/Implant | $5,196.80 |
| 6157023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157029 | SUPPLY IMPLANT | Supply/Implant | $13,440.00 |
| 6157030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6157031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6157039 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6157043 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6157045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6157046 | SUPPLY IMPLANT | Supply/Implant | $2,022.40 |
| 6157052 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $15,360.00 |
| 6157054 | SUPPLY IMPLANT | Supply/Implant | $5,683.20 |
| 6157057 | GUIDE WIRE | Supply/Implant | $7,142.40 |
| 6157058 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,228.80 |
| 6157060 | GUIDE WIRE | Supply/Implant | $9,280.00 |
| 6157061 | GUIDE WIRE | Supply/Implant | $9,280.00 |
| 6157065 | SUPPLY IMPLANT | Supply/Implant | $1,423.36 |
| 6157066 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6157069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6157071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6157080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6157081 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6157083 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $24,960.00 |
| 6157090 | GUIDE WIRE | Supply/Implant | $3,520.00 |
| 6157091 | GUIDE WIRE | Supply/Implant | $3,520.00 |
| 6157094 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157095 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157096 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157097 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157098 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157099 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157100 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157101 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157102 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157105 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157119 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6157140 | GENERAL SUPPLY | Supply/Implant | $244.48 |
| 6157141 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6157143 | SUPPLY IMPLANT | Supply/Implant | $254.08 |
| 6157144 | SUPPLY IMPLANT | Supply/Implant | $4,289.92 |
| 6157148 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6157151 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6157153 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6157158 | SUPPLY IMPLANT | Supply/Implant | $6,280.83 |
| 6157160 | SUPPLY IMPLANT | Supply/Implant | $6,280.83 |
| 6157168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157172 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6157174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6157175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6157176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,177.60 |
| 6157178 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6157181 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6157182 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6157193 | STERILE SUPPLY | Supply/Implant | $318.85 |
| 6157199 | CATHETER, GUIDING | Supply/Implant | $1,774.08 |
| 6157200 | STERILE SUPPLY | Supply/Implant | $411.14 |
| 6157202 | STERILE SUPPLY | Supply/Implant | $238.98 |
| 6157203 | STERILE SUPPLY | Supply/Implant | $4,702.21 |
| 6157204 | STERILE SUPPLY | Supply/Implant | $354.94 |
| 6157218 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $92,096.00 |
| 6157222 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6157224 | GENERAL SUPPLY | Supply/Implant | $1,459.20 |
| 6157225 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6157226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6157227 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $21,324.80 |
| 6157228 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $30,720.00 |
| 6157253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6157258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6157259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6157265 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157266 | SUPPLY IMPLANT | Supply/Implant | $5,043.97 |
| 6157267 | SUPPLY IMPLANT | Supply/Implant | $5,043.97 |
| 6157273 | SUPPLY IMPLANT | Supply/Implant | $252,500.00 |
| 6157275 | SUPPLY IMPLANT | Supply/Implant | $165.38 |
| 6157276 | SUPPLY IMPLANT | Supply/Implant | $20,936.19 |
| 6157278 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $105,000.00 |
| 6157279 | SUPPLY IMPLANT | Supply/Implant | $1,186.56 |
| 6157283 | GENERAL SUPPLY | Supply/Implant | $1,702.40 |
| 6157284 | SUPPLY IMPLANT | Supply/Implant | $2,831.23 |
| 6157285 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6157287 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6157289 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6157292 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6157294 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6157297 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $85,440.00 |
| 6157298 | SUPPLY IMPLANT | Supply/Implant | $33,088.00 |
| 6157299 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,400.00 |
| 6157301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6157302 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6157304 | SUPPLY IMPLANT | Supply/Implant | $3,363.84 |
| 6157305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6157306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6157310 | STERILE SUPPLY | Supply/Implant | $308.99 |
| 6157311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6157315 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6157316 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6157324 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6157325 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6157327 | SUPPLY IMPLANT | Supply/Implant | $32,320.00 |
| 6157328 | SUPPLY IMPLANT | Supply/Implant | $31,616.00 |
| 6157335 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6157347 | SUPPLY IMPLANT | Supply/Implant | $254.34 |
| 6157349 | GENERAL SUPPLY | Supply/Implant | $808.45 |
| 6157350 | GENERAL SUPPLY | Supply/Implant | $808.45 |
| 6157352 | STERILE SUPPLY | Supply/Implant | $459.52 |
| 6157362 | LOCM 200-299MG/ML IODINE,1ML | Supply/Implant | $2,768.90 |
| 6157364 | GAUZE <=16 IN NO W/SAL W/O B | Supply/Implant | $158.98 |
| 6157367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157374 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6157378 | SUPPLY IMPLANT | Supply/Implant | $7,488.00 |
| 6157379 | SUPPLY IMPLANT | Supply/Implant | $7,142.40 |
| 6157380 | SUPPLY IMPLANT | Supply/Implant | $7,488.00 |
| 6157382 | SUPPLY IMPLANT | Supply/Implant | $7,142.40 |
| 6157384 | SUPPLY IMPLANT | Supply/Implant | $7,142.40 |
| 6157386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,680.00 |
| 6157387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,080.00 |
| 6157389 | SUPPLY IMPLANT | Supply/Implant | $2,324.48 |
| 6157397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6157402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157406 | SUPPLY IMPLANT | Supply/Implant | $62,016.00 |
| 6157413 | STERILE SUPPLY | Supply/Implant | $6,387.20 |
| 6157416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6157426 | STERILE SUPPLY | Supply/Implant | $19,136.00 |
| 6157429 | SUPPLY IMPLANT | Supply/Implant | $22,771.20 |
| 6157431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6157432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6157433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6157434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6157437 | SUPPLY IMPLANT | Supply/Implant | $1,755.52 |
| 6157438 | SUPPLY IMPLANT | Supply/Implant | $1,729.66 |
| 6157440 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6157441 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6157443 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6157446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157447 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6157452 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,560.00 |
| 6157453 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6157459 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6157460 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6157462 | SUPPLY IMPLANT | Supply/Implant | $1,729.66 |
| 6157464 | STERILE SUPPLY | Supply/Implant | $394.24 |
| 6157475 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6157477 | GENERAL SUPPLY | Supply/Implant | $21,760.00 |
| 6157478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6157479 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6157482 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6157489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157493 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157494 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157495 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6157502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157503 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157505 | GENERAL SUPPLY | Supply/Implant | $23,360.00 |
| 6157506 | GENERAL SUPPLY | Supply/Implant | $973.44 |
| 6157508 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,492.80 |
| 6157509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6157510 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6157513 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6157517 | SUPPLY IMPLANT | Supply/Implant | $212.74 |
| 6157518 | SUPPLY IMPLANT | Supply/Implant | $1,923.84 |
| 6157520 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6157527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157529 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $11,456.00 |
| 6157533 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $141,750.00 |
| 6157534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6157539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6157540 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6157541 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6157544 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6157546 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6157547 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6157551 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6157552 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6157553 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6157554 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6157556 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6157561 | GENERAL SUPPLY | Supply/Implant | $239.87 |
| 6157567 | SUPPLY IMPLANT | Supply/Implant | $4,106.62 |
| 6157569 | SUPPLY IMPLANT | Supply/Implant | $13,096.96 |
| 6157570 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6157571 | SUPPLY IMPLANT | Supply/Implant | $2,713.60 |
| 6157594 | STERILE SUPPLY | Supply/Implant | $422.39 |
| 6157596 | SUPPLY IMPLANT | Supply/Implant | $354.30 |
| 6157597 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157604 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6157605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6157606 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157615 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6157626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6157634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,742.40 |
| 6157635 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6157639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6157640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,536.00 |
| 6157641 | SUPPLY IMPLANT | Supply/Implant | $4,544.81 |
| 6157642 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6157643 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6157644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6157648 | STERILE SUPPLY | Supply/Implant | $212.12 |
| 6157649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6157653 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6157656 | GENERAL SUPPLY | Supply/Implant | $429.18 |
| 6157659 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6157660 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6157665 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6157666 | FOAM DRSG <=16 SQ IN W/O BDR | Supply/Implant | $2,931.46 |
| 6157667 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6157673 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6157674 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6157679 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6157680 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6157682 | SUPPLY IMPLANT | Supply/Implant | $179.47 |
| 6157683 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6157686 | SUPPLY IMPLANT | Supply/Implant | $1,121.28 |
| 6157688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6157689 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6157700 | SUPPLY IMPLANT | Supply/Implant | $2,066.05 |
| 6157701 | SUPPLY IMPLANT | Supply/Implant | $2,107.74 |
| 6157704 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6157705 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157713 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6157714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6157719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6157723 | SUPPLY IMPLANT | Supply/Implant | $16,793.60 |
| 6157727 | SUPPLY IMPLANT | Supply/Implant | $3,313.66 |
| 6157728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,800.96 |
| 6157730 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6157734 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6157735 | SUPPLY IMPLANT | Supply/Implant | $89,600.00 |
| 6157736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6157738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6157739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6157740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6157742 | GENERAL SUPPLY | Supply/Implant | $19,626.88 |
| 6157743 | STERILE SUPPLY | Supply/Implant | $379.52 |
| 6157744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6157750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6157751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6157753 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6157755 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6157756 | SUPPLY IMPLANT | Supply/Implant | $4,508.42 |
| 6157758 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6157759 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6157760 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6157761 | SUPPLY IMPLANT | Supply/Implant | $6,652.80 |
| 6157762 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6157764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6157774 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6157775 | STERILE SUPPLY | Supply/Implant | $416.63 |
| 6157782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6157792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6157793 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6157796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6157797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6157812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6157824 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157825 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157826 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6157828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6157831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6157834 | SUPPLY IMPLANT | Supply/Implant | $226.94 |
| 6157835 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6157838 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157839 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157840 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157841 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157842 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157845 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6157847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6157850 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,785.60 |
| 6157856 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6157857 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6157860 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6157863 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157864 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157865 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157866 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157876 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157883 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157884 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157886 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157888 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157891 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157892 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157895 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157896 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157897 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157899 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6157900 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6157902 | LEAD, NEUROSTIMULATOR | Supply/Implant | $35,840.00 |
| 6157903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6157904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6157908 | SUPPLY IMPLANT | Supply/Implant | $3,046.40 |
| 6157909 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6157913 | CATHETER, GUIDING | Supply/Implant | $4,796.03 |
| 6157915 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6157917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157933 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6157934 | STERILE SUPPLY | Supply/Implant | $318.72 |
| 6157935 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6157936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6157939 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,733.38 |
| 6157940 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6157944 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6157945 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6157946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6157947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6157949 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6157950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6157952 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6157961 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6157964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,360.00 |
| 6157967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6157968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6157970 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6157972 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6157974 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6157976 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6157977 | GUIDE WIRE | Supply/Implant | $1,209.60 |
| 6157980 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157986 | SUPPLY IMPLANT | Supply/Implant | $1,627.52 |
| 6157995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,928.70 |
| 6158003 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6158004 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6158005 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $179,550.00 |
| 6158006 | LEAD, NEUROSTIMULATOR | Supply/Implant | $24,960.00 |
| 6158007 | LEAD, NEUROSTIMULATOR | Supply/Implant | $43,200.00 |
| 6158008 | GENERAL SUPPLY | Supply/Implant | $17,920.00 |
| 6158010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6158011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158013 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6158014 | SUPPLY IMPLANT | Supply/Implant | $118,387.50 |
| 6158015 | LEAD, NEUROSTIMULATOR | Supply/Implant | $7,040.00 |
| 6158017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6158018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6158019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6158020 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6158023 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6158024 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6158025 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6158029 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6158032 | MESH (IMPLANTABLE) | Supply/Implant | $14,592.00 |
| 6158033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6158038 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6158042 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,640.00 |
| 6158044 | GENERAL SUPPLY | Supply/Implant | $189.06 |
| 6158049 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6158050 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6158052 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6158054 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6158055 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6158062 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6158063 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6158065 | SUPPLY IMPLANT | Supply/Implant | $49,190.40 |
| 6158067 | STERILE SUPPLY | Supply/Implant | $796.80 |
| 6158069 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6158070 | GENERAL SUPPLY | Supply/Implant | $160.00 |
| 6158078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6158079 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6158093 | STERILE SUPPLY | Supply/Implant | $190.87 |
| 6158094 | STERILE SUPPLY | Supply/Implant | $280.01 |
| 6158098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6158100 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158101 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158102 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158103 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158104 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158105 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158106 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158107 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158109 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $11,038.72 |
| 6158110 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $13,760.00 |
| 6158111 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $16,934.40 |
| 6158112 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $36,126.72 |
| 6158115 | GRAFIX CORE | Supply/Implant | $16,934.40 |
| 6158116 | GRAFIX CORE | Supply/Implant | $36,126.72 |
| 6158118 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $6,336.00 |
| 6158119 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $13,760.00 |
| 6158121 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $16,934.40 |
| 6158122 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $36,126.72 |
| 6158123 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $106,624.00 |
| 6158129 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158142 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6158143 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6158147 | SUPPLY IMPLANT | Supply/Implant | $3,763.20 |
| 6158155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6158158 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158160 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158181 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158183 | SUPPLY IMPLANT | Supply/Implant | $209,947.50 |
| 6158186 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158196 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158198 | SUPPLY IMPLANT | Supply/Implant | $209,947.50 |
| 6158201 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158210 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158222 | SUPPLY IMPLANT | Supply/Implant | $217,099.50 |
| 6158224 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158244 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158245 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6158253 | SUPPLY IMPLANT | Supply/Implant | $23,795.20 |
| 6158258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6158260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.00 |
| 6158261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,283.20 |
| 6158262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $460.80 |
| 6158274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158276 | CATHETER, GUIDING | Supply/Implant | $611.71 |
| 6158278 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6158279 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6158282 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6158286 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.00 |
| 6158288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6158290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6158295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,848.32 |
| 6158297 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6158303 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6158315 | SUPPLY IMPLANT | Supply/Implant | $392.58 |
| 6158316 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6158319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6158320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6158321 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6158322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6158323 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6158324 | SUPPLY IMPLANT | Supply/Implant | $1,932.80 |
| 6158325 | SUPPLY IMPLANT | Supply/Implant | $4,812.80 |
| 6158330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6158333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6158336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6158337 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6158343 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6158346 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6158348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6158351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,000.00 |
| 6158357 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6158360 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6158361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6158362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6158364 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6158367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6158368 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6158370 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6158376 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6158380 | SEPTAL DEFECT IMP SYS | Supply/Implant | $131,040.00 |
| 6158383 | SEPTAL DEFECT IMP SYS | Supply/Implant | $131,040.00 |
| 6158386 | GUIDE WIRE | Supply/Implant | $14,105.60 |
| 6158388 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,112.00 |
| 6158390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6158391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,710.40 |
| 6158393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6158395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6158396 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6158397 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6158398 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6158399 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6158402 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158409 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158415 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158420 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158434 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158453 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158468 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158474 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6158494 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6158495 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6158496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6158497 | GRAFTJACKET SKIN SUB | Supply/Implant | $38,643.20 |
| 6158500 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6158503 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6158504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6158505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6158508 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158509 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158514 | STERILE SUPPLY | Supply/Implant | $4,948.22 |
| 6158527 | SUPPLY IMPLANT | Supply/Implant | $1,956.26 |
| 6158531 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6158543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158569 | SUPPLY IMPLANT | Supply/Implant | $14,259.20 |
| 6158575 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,222.72 |
| 6158579 | SUPPLY IMPLANT | Supply/Implant | $731.78 |
| 6158588 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6158589 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6158590 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6158591 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6158595 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6158596 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6158598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6158616 | GENERAL SUPPLY | Supply/Implant | $1,600.00 |
| 6158617 | GENERAL SUPPLY | Supply/Implant | $1,600.00 |
| 6158632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,120.00 |
| 6158633 | SUPPLY IMPLANT | Supply/Implant | $2,099.20 |
| 6158634 | LEAD, PMKR, TRANSVENOUS VDD | Supply/Implant | $6,515.20 |
| 6158636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,528.00 |
| 6158641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6158643 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6158645 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6158647 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6158650 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,200.00 |
| 6158651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6158654 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,432.00 |
| 6158660 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6158672 | STERILE SUPPLY | Supply/Implant | $419.97 |
| 6158686 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158687 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158688 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158690 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158710 | GENERAL SUPPLY | Supply/Implant | $796.80 |
| 6158711 | GENERAL SUPPLY | Supply/Implant | $796.80 |
| 6158712 | GENERAL SUPPLY | Supply/Implant | $796.80 |
| 6158718 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6158719 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158722 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6158727 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6158728 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,547.20 |
| 6158730 | STERILE SUPPLY | Supply/Implant | $41,792.00 |
| 6158731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $101,376.00 |
| 6158732 | SUPPLY IMPLANT | Supply/Implant | $17,136.00 |
| 6158733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6158736 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6158737 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6158739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6158740 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6158760 | SUPPLY IMPLANT | Supply/Implant | $32,780.80 |
| 6158768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6158770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6158771 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,326.40 |
| 6158783 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158784 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158788 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158790 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158793 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158794 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158795 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158796 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6158809 | SUPPLY IMPLANT | Supply/Implant | $3,123.20 |
| 6158810 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6158811 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6158813 | GENERAL SUPPLY | Supply/Implant | $160.00 |
| 6158818 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158819 | CATHETER, GUIDING | Supply/Implant | $7,168.00 |
| 6158820 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6158821 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,136.00 |
| 6158824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,219.20 |
| 6158825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6158836 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6158837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158841 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6158842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,693.12 |
| 6158843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,693.12 |
| 6158844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6158848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158849 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6158865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,541.38 |
| 6158868 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158871 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158872 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158873 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158878 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6158879 | SUPPLY IMPLANT | Supply/Implant | $7,099.78 |
| 6158880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6158882 | PROBE, ROBOTIC, WATER-JET | Supply/Implant | $3,200.00 |
| 6158891 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6158893 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6158901 | COCHLEAR DEVICE | Supply/Implant | $148,785.00 |
| 6158902 | COCHLEAR DEVICE | Supply/Implant | $148,785.00 |
| 6158903 | COCHLEAR DEVICE | Supply/Implant | $148,785.00 |
| 6158907 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158908 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158909 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158911 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158913 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158915 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158916 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158919 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6158923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,833.60 |
| 6158928 | SUPPLY IMPLANT | Supply/Implant | $4,851.20 |
| 6158933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6158937 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158938 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158939 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158940 | REP DEV, URINARY, W/SLING | Supply/Implant | $80,678.40 |
| 6158953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6158960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6158961 | GENERAL SUPPLY | Supply/Implant | $2,547.20 |
| 6158966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,372.80 |
| 6158968 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6158973 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6158975 | STERILE SUPPLY | Supply/Implant | $178.94 |
| 6158978 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6158980 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6158981 | INTERSPINOUS IMPLANT | Supply/Implant | $6,400.00 |
| 6158983 | INTERSPINOUS IMPLANT | Supply/Implant | $57,600.00 |
| 6158986 | SUPPLY IMPLANT | Supply/Implant | $21,593.60 |
| 6158987 | INTERSPINOUS IMPLANT | Supply/Implant | $63,769.60 |
| 6158988 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,706.69 |
| 6158990 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6158992 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6158993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6158994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6158995 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6158996 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6158997 | SUPPLY IMPLANT | Supply/Implant | $1,254.91 |
| 6159004 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6159005 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6159009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6159013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6159014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6159015 | SUPPLY IMPLANT | Supply/Implant | $2,144.00 |
| 6159018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6159019 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6159035 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6159042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6159047 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159048 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6159057 | STERILE SUPPLY | Supply/Implant | $1,254.40 |
| 6159060 | SUPPLY IMPLANT | Supply/Implant | $63,936.00 |
| 6159061 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6159065 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6159069 | SUPPLY IMPLANT | Supply/Implant | $4,851.20 |
| 6159073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,118.40 |
| 6159074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6159076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6159078 | GENERAL SUPPLY | Supply/Implant | $304.00 |
| 6159079 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6159082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6159083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,163.20 |
| 6159084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6159087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6159088 | SUPPLY IMPLANT | Supply/Implant | $1,747.33 |
| 6159093 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6159097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159102 | SUPPLY IMPLANT | Supply/Implant | $14,016.00 |
| 6159105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6159106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6159109 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159110 | SUPPLY IMPLANT | Supply/Implant | $570.24 |
| 6159111 | SUPPLY IMPLANT | Supply/Implant | $570.24 |
| 6159112 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159113 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159115 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159116 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,849.60 |
| 6159132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6159142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6159143 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159144 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159145 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159146 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159147 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159148 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159150 | LEAD, CORONARY VENOUS | Supply/Implant | $42,432.00 |
| 6159151 | CATHETER, GUIDING | Supply/Implant | $5,056.00 |
| 6159153 | SUPPLY IMPLANT | Supply/Implant | $10,892.80 |
| 6159154 | SUPPLY IMPLANT | Supply/Implant | $10,892.80 |
| 6159155 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6159159 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6159163 | GENERAL SUPPLY | Supply/Implant | $598.66 |
| 6159165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6159169 | SUPPLY IMPLANT | Supply/Implant | $3,893.76 |
| 6159171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6159185 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6159189 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6159194 | GUIDE WIRE | Supply/Implant | $1,336.06 |
| 6159196 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159197 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159200 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6159202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6159203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6159206 | GENERAL SUPPLY | Supply/Implant | $178.18 |
| 6159207 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6159210 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6159211 | SUPPLY IMPLANT | Supply/Implant | $35,200.00 |
| 6159214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6159219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6159222 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,438.40 |
| 6159229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6159230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,508.80 |
| 6159237 | SUPPLY IMPLANT | Supply/Implant | $13,096.96 |
| 6159238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6159239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,152.00 |
| 6159242 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159247 | SUPPLY IMPLANT | Supply/Implant | $13,632.00 |
| 6159248 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6159249 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,336.00 |
| 6159250 | SUPPLY IMPLANT | Supply/Implant | $514.56 |
| 6159257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6159258 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6159259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6159261 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6159263 | SUPPLY IMPLANT | Supply/Implant | $76,416.00 |
| 6159264 | SUPPLY IMPLANT | Supply/Implant | $76,416.00 |
| 6159265 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6159268 | GENERAL SUPPLY | Supply/Implant | $808.45 |
| 6159269 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6159270 | SUPPLY IMPLANT | Supply/Implant | $2,452.35 |
| 6159275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,816.00 |
| 6159291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6159292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6159296 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6159297 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6159298 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6159305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,753.60 |
| 6159312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6159313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6159314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6159315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,873.92 |
| 6159316 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6159317 | SUPPLY IMPLANT | Supply/Implant | $5,696.00 |
| 6159318 | GENERAL SUPPLY | Supply/Implant | $2,560.00 |
| 6159320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6159321 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6159322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6159323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6159326 | SUPPLY IMPLANT | Supply/Implant | $6,018.05 |
| 6159327 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6159359 | SUPPLY IMPLANT | Supply/Implant | $18,560.00 |
| 6159362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6159363 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6159365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6159379 | SUPPLY IMPLANT | Supply/Implant | $55,040.00 |
| 6159390 | SUPPLY IMPLANT | Supply/Implant | $806.40 |
| 6159392 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6159394 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6159398 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6159401 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159402 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159404 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159406 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159407 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159411 | SUPPLY IMPLANT | Supply/Implant | $641.56 |
| 6159429 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6159430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6159431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,638.40 |
| 6159432 | SUPPLY IMPLANT | Supply/Implant | $3,823.10 |
| 6159435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6159438 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159439 | SUPPLY IMPLANT | Supply/Implant | $1,690.24 |
| 6159445 | AMNIOTIC MEMBRANE | Supply/Implant | $23,040.00 |
| 6159446 | AMNIOTIC MEMBRANE | Supply/Implant | $40,960.00 |
| 6159447 | AMNIOTIC MEMBRANE | Supply/Implant | $53,120.00 |
| 6159458 | SUPPLY IMPLANT | Supply/Implant | $21,273.60 |
| 6159461 | SUPPLY IMPLANT | Supply/Implant | $698.24 |
| 6159463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6159464 | INTRO/SHEATH, NON-LASER | Supply/Implant | $692.86 |
| 6159469 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6159475 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6159494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6159495 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6159498 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159499 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159500 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159500 | GENERAL SUPPLY | Supply/Implant | $4,648.45 |
| 6159501 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6159502 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159502 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159503 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159503 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159504 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159505 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6159506 | STERILE SUPPLY | Supply/Implant | $338.30 |
| 6159506 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6159509 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159511 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159512 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159513 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159514 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6159515 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6159516 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6159518 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6159520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6159524 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6159525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $131,617.50 |
| 6159531 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6159532 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6159533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6159534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6159537 | STERILE SUPPLY | Supply/Implant | $414.34 |
| 6159539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6159540 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159541 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159542 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159544 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6159547 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6159552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6159557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,248.00 |
| 6159565 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6159572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6159574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6159575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6159580 | GENERAL SUPPLY | Supply/Implant | $24,835.20 |
| 6159582 | SUPPLY IMPLANT | Supply/Implant | $151.83 |
| 6159583 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6159584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6159585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6159586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6159587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6159590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.64 |
| 6159592 | SUPPLY IMPLANT | Supply/Implant | $537.47 |
| 6159599 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159601 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159602 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159603 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159610 | CLOSURE DEV, VASC | Supply/Implant | $3,072.00 |
| 6159611 | GENERAL SUPPLY | Supply/Implant | $2,035.20 |
| 6159612 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6159614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6159617 | STERILE SUPPLY | Supply/Implant | $214.27 |
| 6159623 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,265.60 |
| 6159624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6159626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6159634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6159635 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,009.60 |
| 6159636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,014.40 |
| 6159649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,800.00 |
| 6159665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6159666 | SUPPLY IMPLANT | Supply/Implant | $31,948.80 |
| 6159667 | GENERAL SUPPLY | Supply/Implant | $6,515.20 |
| 6159669 | SUPPLY IMPLANT | Supply/Implant | $25,527.04 |
| 6159670 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6159671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6159672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6159674 | STERILE SUPPLY | Supply/Implant | $9,600.00 |
| 6159675 | GENERAL SUPPLY | Supply/Implant | $301.79 |
| 6159676 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6159677 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6159678 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6159680 | GUIDE WIRE | Supply/Implant | $8,640.00 |
| 6159682 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6159707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6159720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6159721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6159723 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6159726 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6159731 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159732 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159734 | SUPPLY IMPLANT | Supply/Implant | $25,472.00 |
| 6159738 | SUPPLY IMPLANT | Supply/Implant | $5,312.00 |
| 6159747 | SUPPLY IMPLANT | Supply/Implant | $16,640.00 |
| 6159749 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6159750 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6159752 | GENERAL SUPPLY | Supply/Implant | $272.00 |
| 6159753 | GENERAL SUPPLY | Supply/Implant | $272.00 |
| 6159757 | SUPPLY IMPLANT | Supply/Implant | $17,136.00 |
| 6159761 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6159762 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6159763 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6159770 | SUPPLY IMPLANT | Supply/Implant | $21,888.00 |
| 6159784 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6159785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6159786 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6159787 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6159791 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $34,560.00 |
| 6159797 | STERILE SUPPLY | Supply/Implant | $3,863.42 |
| 6159800 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6159801 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6159803 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6159804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6159806 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6159821 | GENERAL SUPPLY | Supply/Implant | $719.49 |
| 6159822 | GENERAL SUPPLY | Supply/Implant | $692.86 |
| 6159824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6159826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6159827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6159829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6159835 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6159836 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6159837 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6159840 | STERILE SUPPLY | Supply/Implant | $3,403.71 |
| 6159843 | SUPPLY IMPLANT | Supply/Implant | $17,971.20 |
| 6159844 | SUPPLY IMPLANT | Supply/Implant | $18,585.60 |
| 6159846 | SUPPLY IMPLANT | Supply/Implant | $21,350.40 |
| 6159847 | SUPPLY IMPLANT | Supply/Implant | $25,856.00 |
| 6159850 | STERILE SUPPLY | Supply/Implant | $10,816.00 |
| 6159852 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6159853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,672.00 |
| 6159857 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6159859 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6159861 | STERILE SUPPLY | Supply/Implant | $1,885.13 |
| 6159862 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6159870 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,521.60 |
| 6159871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,521.60 |
| 6159872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,008.00 |
| 6159878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6159885 | SUPPLY IMPLANT | Supply/Implant | $1,464.32 |
| 6159891 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6159892 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6159895 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6159896 | STERILE SUPPLY | Supply/Implant | $8,320.00 |
| 6159897 | SUPPLY IMPLANT | Supply/Implant | $10,816.00 |
| 6159898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,492.80 |
| 6159900 | GENERAL SUPPLY | Supply/Implant | $1,000.96 |
| 6159901 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159902 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $96,908.80 |
| 6159904 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,265.60 |
| 6159905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6159911 | SUPPLY IMPLANT | Supply/Implant | $3,712.00 |
| 6159913 | PROSTHETIC IMPLANT NOS | Supply/Implant | $37,964.80 |
| 6159918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6159919 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,366.40 |
| 6159920 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6159927 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6159928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,784.64 |
| 6159929 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6159947 | SUPPLY IMPLANT | Supply/Implant | $13,058.18 |
| 6159948 | STERILE SUPPLY | Supply/Implant | $435.20 |
| 6159949 | STERILE SUPPLY | Supply/Implant | $435.20 |
| 6159950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6159951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6159957 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $32,640.00 |
| 6159969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.00 |
| 6159970 | SUPPLY IMPLANT | Supply/Implant | $531,487.00 |
| 6159977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6159978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6159981 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6159982 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6159985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $384.00 |
| 6159988 | SUPPLY IMPLANT | Supply/Implant | $238.08 |
| 6159992 | CATH, DRAINAGE | Supply/Implant | $1,028.35 |
| 6159994 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6159995 | INTRO/SHEATH, NON-LASER | Supply/Implant | $751.62 |
| 6159996 | INTRO/SHEATH, NON-LASER | Supply/Implant | $751.62 |
| 6160000 | INTRO/SHEATH, NON-LASER | Supply/Implant | $751.62 |
| 6160003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6160005 | STERILE SUPPLY | Supply/Implant | $190.89 |
| 6160006 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6160007 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6160009 | SUPPLY IMPLANT | Supply/Implant | $5,145.60 |
| 6160010 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6160012 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6160013 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6160018 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6160020 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6160021 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6160022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6160023 | GUIDE WIRE | Supply/Implant | $583.68 |
| 6160024 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,664.00 |
| 6160025 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,664.00 |
| 6160026 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,088.00 |
| 6160027 | SUPPLY IMPLANT | Supply/Implant | $10,304.00 |
| 6160033 | GRAFT, VASCULAR | Supply/Implant | $6,515.20 |
| 6160040 | REP DEV, URINARY, W/SLING | Supply/Implant | $23,143.68 |
| 6160044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6160045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6160047 | GUIDE WIRE | Supply/Implant | $1,088.00 |
| 6160051 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6160052 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $8,140.80 |
| 6160053 | GENERAL SUPPLY | Supply/Implant | $921.60 |
| 6160055 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6160059 | INTRO/SHEATH, NON-LASER | Supply/Implant | $929.28 |
| 6160061 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6160071 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6160073 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160077 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6160081 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6160082 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6160083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6160084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,516.80 |
| 6160085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,312.00 |
| 6160088 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6160089 | INTRO/SHEATH, NON-LASER | Supply/Implant | $360.06 |
| 6160090 | SUPPLY IMPLANT | Supply/Implant | $42,240.00 |
| 6160091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $112,640.00 |
| 6160092 | SUPPLY IMPLANT | Supply/Implant | $76,847.87 |
| 6160093 | SUPPLY IMPLANT | Supply/Implant | $693.96 |
| 6160099 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $34,560.00 |
| 6160100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6160102 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6160109 | SUPPLY IMPLANT | Supply/Implant | $8,966.40 |
| 6160110 | SUPPLY IMPLANT | Supply/Implant | $8,915.20 |
| 6160111 | SUPPLY IMPLANT | Supply/Implant | $8,915.20 |
| 6160112 | SUPPLY IMPLANT | Supply/Implant | $3,808.00 |
| 6160114 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6160115 | SUPPLY IMPLANT | Supply/Implant | $3,539.20 |
| 6160116 | SUPPLY IMPLANT | Supply/Implant | $2,009.60 |
| 6160117 | SUPPLY IMPLANT | Supply/Implant | $2,009.60 |
| 6160126 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6160128 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6160130 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6160132 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6160152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6160153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6160154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6160156 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6160157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6160158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6160171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6160172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6160180 | SUPPLY IMPLANT | Supply/Implant | $320.51 |
| 6160183 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160184 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6160185 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6160186 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6160188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6160191 | GUIDE WIRE | Supply/Implant | $1,067.78 |
| 6160192 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6160194 | SUPPLY IMPLANT | Supply/Implant | $5,888.00 |
| 6160204 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160205 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160206 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160207 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $752.00 |
| 6160209 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6160210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6160213 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6160219 | MESH (IMPLANTABLE) | Supply/Implant | $2,066.12 |
| 6160233 | AMNIOTIC MEMBRANE | Supply/Implant | $45,440.00 |
| 6160243 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6160252 | SUPPLY IMPLANT | Supply/Implant | $32,588.80 |
| 6160253 | SUPPLY IMPLANT | Supply/Implant | $32,780.80 |
| 6160254 | SUPPLY IMPLANT | Supply/Implant | $32,588.80 |
| 6160265 | SUPPLY IMPLANT | Supply/Implant | $35,302.40 |
| 6160267 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6160269 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6160270 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6160278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160280 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160286 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6160290 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6160292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160294 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6160295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160297 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160312 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6160323 | SUPPLY IMPLANT | Supply/Implant | $27,253.12 |
| 6160325 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6160327 | CATHETER, GUIDING | Supply/Implant | $2,168.96 |
| 6160334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $573.44 |
| 6160335 | STERILE SUPPLY | Supply/Implant | $21,120.00 |
| 6160336 | STERILE SUPPLY | Supply/Implant | $14,080.00 |
| 6160337 | STERILE SUPPLY | Supply/Implant | $24,320.00 |
| 6160338 | STERILE SUPPLY | Supply/Implant | $14,080.00 |
| 6160340 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6160341 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160343 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6160344 | GENERAL SUPPLY | Supply/Implant | $763.39 |
| 6160345 | STERILE SUPPLY | Supply/Implant | $2,958.98 |
| 6160346 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $120,697.50 |
| 6160347 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $120,697.50 |
| 6160348 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $120,697.50 |
| 6160349 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6160350 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6160351 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160354 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6160355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6160356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6160361 | SUPPLY IMPLANT | Supply/Implant | $1,774.72 |
| 6160362 | SUPPLY IMPLANT | Supply/Implant | $2,120.32 |
| 6160367 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160368 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160369 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160370 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160371 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160373 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160374 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160375 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160376 | GRAFTJACKET SKIN SUB | Supply/Implant | $38,643.20 |
| 6160380 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6160384 | SUPPLY IMPLANT | Supply/Implant | $2,518.27 |
| 6160385 | SUPPLY IMPLANT | Supply/Implant | $61,804.16 |
| 6160386 | SUPPLY IMPLANT | Supply/Implant | $21,124.74 |
| 6160387 | SUPPLY IMPLANT | Supply/Implant | $21,307.90 |
| 6160388 | SUPPLY IMPLANT | Supply/Implant | $108,065.79 |
| 6160393 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6160394 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6160397 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160398 | GENERAL SUPPLY | Supply/Implant | $1,144.64 |
| 6160400 | GENERAL SUPPLY | Supply/Implant | $1,254.40 |
| 6160406 | STERILE SUPPLY | Supply/Implant | $1,109.27 |
| 6160407 | SUPPLY IMPLANT | Supply/Implant | $11,084.80 |
| 6160411 | GENERAL SUPPLY | Supply/Implant | $1,103.23 |
| 6160416 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6160423 | SUPPLY IMPLANT | Supply/Implant | $3,973.12 |
| 6160424 | SUPPLY IMPLANT | Supply/Implant | $3,071.23 |
| 6160427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,210.11 |
| 6160429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6160430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160434 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160435 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160436 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160437 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160438 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6160439 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6160440 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6160442 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160443 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160444 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160445 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6160446 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6160447 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6160448 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6160449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $604.16 |
| 6160450 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6160451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $394.24 |
| 6160454 | GUIDE WIRE | Supply/Implant | $1,228.80 |
| 6160456 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6160457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6160458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,004.80 |
| 6160459 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160460 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160462 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,833.60 |
| 6160463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160468 | SUPPLY IMPLANT | Supply/Implant | $31,969.28 |
| 6160470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $779.52 |
| 6160471 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6160472 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6160473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,438.40 |
| 6160474 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6160475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,631.68 |
| 6160476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,631.68 |
| 6160477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6160478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6160479 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6160480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160485 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6160486 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160487 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6160488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6160489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6160490 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,876.48 |
| 6160493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,317.44 |
| 6160494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6160497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6160498 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6160499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,224.00 |
| 6160500 | GRAFT, VASCULAR | Supply/Implant | $70,387.20 |
| 6160501 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6160502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6160503 | GRAFT, VASCULAR | Supply/Implant | $51,187.20 |
| 6160504 | SUPPLY IMPLANT | Supply/Implant | $7,667.20 |
| 6160505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6160506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6160508 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,579.20 |
| 6160509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,579.20 |
| 6160510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6160511 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,200.00 |
| 6160512 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6160513 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,676.48 |
| 6160514 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6160515 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6160516 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,388.35 |
| 6160517 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160526 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6160527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6160530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6160534 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6160535 | GUIDE WIRE | Supply/Implant | $912.38 |
| 6160536 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6160537 | INTRO/SHEATH, NON-LASER | Supply/Implant | $927.36 |
| 6160541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6160542 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6160543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160544 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6160545 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6160546 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6160547 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6160549 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6160550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6160552 | STERILE SUPPLY | Supply/Implant | $243.58 |
| 6160553 | STERILE SUPPLY | Supply/Implant | $132.48 |
| 6160554 | STERILE SUPPLY | Supply/Implant | $145.15 |
| 6160555 | STERILE SUPPLY | Supply/Implant | $132.48 |
| 6160556 | STERILE SUPPLY | Supply/Implant | $356.20 |
| 6160558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160560 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6160561 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6160562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6160563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,352.26 |
| 6160565 | SUPPLY IMPLANT | Supply/Implant | $149.12 |
| 6160567 | SUPPLY IMPLANT | Supply/Implant | $746.62 |
| 6160568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,758.40 |
| 6160570 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6160576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $376.32 |
| 6160577 | SUPPLY IMPLANT | Supply/Implant | $20,416.00 |
| 6160578 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160579 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160580 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6160585 | MESH (IMPLANTABLE) | Supply/Implant | $11,493.12 |
| 6160587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,219.20 |
| 6160588 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6160589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6160590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6160591 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6160592 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,912.00 |
| 6160593 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6160594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6160595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6160596 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6160597 | CATHETER, GUIDING | Supply/Implant | $1,774.08 |
| 6160598 | SUPPLY IMPLANT | Supply/Implant | $5,568.00 |
| 6160599 | SUPPLY IMPLANT | Supply/Implant | $9,049.60 |
| 6160601 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160602 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160604 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160608 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160611 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160612 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160613 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160615 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160617 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160619 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160620 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160621 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160622 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160623 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160624 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160625 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160631 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160634 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6160635 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6160636 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160637 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6160645 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160647 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160648 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160649 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160653 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160659 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6160662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6160663 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6160666 | GENERAL SUPPLY | Supply/Implant | $2,204.16 |
| 6160684 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160685 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6160689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,328.00 |
| 6160690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,810.24 |
| 6160691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6160696 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6160697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6160698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,155.39 |
| 6160700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160702 | SUPPLY IMPLANT | Supply/Implant | $742.40 |
| 6160703 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6160704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6160705 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6160706 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6160708 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6160709 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6160710 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6160715 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6160719 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,156.80 |
| 6160720 | SUPPLY IMPLANT | Supply/Implant | $4,851.20 |
| 6160726 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,259.20 |
| 6160731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6160732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6160733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,847.94 |
| 6160734 | SUPPLY IMPLANT | Supply/Implant | $2,437.12 |
| 6160735 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6160736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6160737 | GENERAL SUPPLY | Supply/Implant | $3,993.60 |
| 6160738 | GENERAL SUPPLY | Supply/Implant | $1,938.05 |
| 6160739 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6160740 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6160741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6160742 | SUPPLY IMPLANT | Supply/Implant | $159.62 |
| 6160745 | SUPPLY IMPLANT | Supply/Implant | $159.62 |
| 6160750 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6160754 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6160755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6160756 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6160757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6160758 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160759 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6160760 | SUPPLY IMPLANT | Supply/Implant | $4,339.20 |
| 6160767 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6160778 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $168,262.50 |
| 6160779 | SUPPLY IMPLANT | Supply/Implant | $2,406.40 |
| 6160780 | SUPPLY IMPLANT | Supply/Implant | $2,406.40 |
| 6160781 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $202,000.00 |
| 6160782 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6160783 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6160784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6160785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6160786 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6160787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6160788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160789 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6160790 | SUPPLY IMPLANT | Supply/Implant | $2,144.00 |
| 6160791 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6160792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6160793 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6160794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160795 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6160796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6160797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,000.00 |
| 6160798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,640.00 |
| 6160799 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6160800 | GENERAL SUPPLY | Supply/Implant | $1,088.00 |
| 6160801 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6160802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6160803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,827.20 |
| 6160805 | SUPPLY IMPLANT | Supply/Implant | $1,498.88 |
| 6160810 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $358.91 |
| 6160811 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6160812 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160817 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160821 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6160822 | STERILE SUPPLY | Supply/Implant | $2,240.00 |
| 6160824 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6160825 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6160826 | SUPPLY IMPLANT | Supply/Implant | $394.60 |
| 6160829 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6160830 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6160831 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6160832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6160833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6160838 | GENERAL SUPPLY | Supply/Implant | $1,127.68 |
| 6160841 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6160843 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6160844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6160845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160846 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6160847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6160848 | SUPPLY IMPLANT | Supply/Implant | $229.89 |
| 6160849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,742.40 |
| 6160851 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6160860 | SUPPLY IMPLANT | Supply/Implant | $29,632.00 |
| 6160863 | SUPPLY IMPLANT | Supply/Implant | $301.06 |
| 6160864 | INTRO/SHEATH, NON-LASER | Supply/Implant | $929.28 |
| 6160866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6160874 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6160875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6160879 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $13,440.00 |
| 6160880 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $13,440.00 |
| 6160881 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $13,440.00 |
| 6160886 | GENERAL SUPPLY | Supply/Implant | $607.82 |
| 6160888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6160891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6160892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6160894 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6160895 | INTERSPINOUS IMPLANT | Supply/Implant | $98,137.60 |
| 6160896 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160897 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6160898 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6160899 | SUPPLY IMPLANT | Supply/Implant | $23,636.86 |
| 6160909 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160912 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160916 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160918 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160930 | SUPPLY IMPLANT | Supply/Implant | $17,856.00 |
| 6160931 | GRAFT, VASCULAR | Supply/Implant | $73,920.00 |
| 6160986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6160987 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6160988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,600.00 |
| 6160997 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6160998 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6160999 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6161000 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6161002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,166.34 |
| 6161012 | SUPPLY IMPLANT | Supply/Implant | $226.66 |
| 6161014 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6161018 | SUPPLY IMPLANT | Supply/Implant | $92,096.00 |
| 6161019 | GENERAL SUPPLY | Supply/Implant | $233.73 |
| 6161023 | SUPPLY IMPLANT | Supply/Implant | $54,445.82 |
| 6161028 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6161029 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6161030 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6161031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,201.28 |
| 6161032 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6161033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,230.21 |
| 6161034 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6161035 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161038 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6161039 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6161040 | SUPPLY IMPLANT | Supply/Implant | $6,485.12 |
| 6161041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,251.26 |
| 6161042 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6161043 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161044 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161045 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161046 | SUPPLY IMPLANT | Supply/Implant | $41,600.00 |
| 6161047 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6161048 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161049 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6161050 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6161051 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $98,176.00 |
| 6161052 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6161053 | SUPPLY IMPLANT | Supply/Implant | $5,632.00 |
| 6161060 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6161061 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6161062 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6161063 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6161064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,231.81 |
| 6161066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,297.09 |
| 6161067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,297.09 |
| 6161068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,430.02 |
| 6161069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,459.20 |
| 6161071 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161072 | PROSTHETIC IMPLANT NOS | Supply/Implant | $4,310.78 |
| 6161073 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161074 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161075 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6161079 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,128.00 |
| 6161080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $63,219.20 |
| 6161081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,198.08 |
| 6161082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,506.24 |
| 6161083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6161084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6161085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,734.40 |
| 6161086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6161087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6161088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6161089 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6161091 | SUPPLY IMPLANT | Supply/Implant | $22,720.00 |
| 6161092 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6161093 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6161094 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6161095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161100 | SUPPLY IMPLANT | Supply/Implant | $20,428.80 |
| 6161102 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6161103 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6161104 | SUPPLY IMPLANT | Supply/Implant | $183,750.00 |
| 6161105 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6161106 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6161107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6161111 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6161113 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6161114 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6161115 | STERILE SUPPLY | Supply/Implant | $736.00 |
| 6161116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $118,080.00 |
| 6161117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161119 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,736.00 |
| 6161121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,736.00 |
| 6161122 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6161123 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6161125 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6161126 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6161127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $135,240.00 |
| 6161128 | GRAFT, VASCULAR | Supply/Implant | $43,888.00 |
| 6161129 | SUPPLY IMPLANT | Supply/Implant | $1,251.84 |
| 6161130 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6161131 | SUPPLY IMPLANT | Supply/Implant | $11,699.20 |
| 6161132 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6161134 | SUPPLY IMPLANT | Supply/Implant | $4,518.40 |
| 6161136 | GENERAL SUPPLY | Supply/Implant | $459.26 |
| 6161137 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6161141 | STERILE SUPPLY | Supply/Implant | $244.74 |
| 6161153 | STERILE SUPPLY | Supply/Implant | $146.94 |
| 6161154 | STERILE SUPPLY | Supply/Implant | $237.31 |
| 6161156 | GENERAL SUPPLY | Supply/Implant | $395.52 |
| 6161157 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6161158 | SUPPLY IMPLANT | Supply/Implant | $31,910.40 |
| 6161159 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6161162 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6161163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6161168 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6161169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6161170 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6161171 | SUPPLY IMPLANT | Supply/Implant | $9,216.00 |
| 6161172 | SUPPLY IMPLANT | Supply/Implant | $16,640.00 |
| 6161173 | SUPPLY IMPLANT | Supply/Implant | $21,954.56 |
| 6161178 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6161179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6161180 | SUPPLY IMPLANT | Supply/Implant | $644.35 |
| 6161182 | INTERSPINOUS IMPLANT | Supply/Implant | $60,480.00 |
| 6161183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,643.20 |
| 6161184 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6161185 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $672.00 |
| 6161186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,536.00 |
| 6161187 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6161188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6161189 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6161190 | STERILE SUPPLY | Supply/Implant | $238.08 |
| 6161202 | SUPPLY IMPLANT | Supply/Implant | $28,544.00 |
| 6161210 | SUPPLY IMPLANT | Supply/Implant | $1,360.00 |
| 6161211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6161213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6161217 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6161223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161224 | SUPPLY IMPLANT | Supply/Implant | $4,488.58 |
| 6161225 | SUPPLY IMPLANT | Supply/Implant | $1,670.40 |
| 6161226 | SUPPLY IMPLANT | Supply/Implant | $1,414.27 |
| 6161227 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6161228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,536.64 |
| 6161229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161232 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6161236 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6161237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161238 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6161239 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $103,833.60 |
| 6161240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6161241 | SUPPLY IMPLANT | Supply/Implant | $15,705.60 |
| 6161242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6161243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,170.56 |
| 6161244 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,280.00 |
| 6161245 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161246 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6161248 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6161249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,439.74 |
| 6161250 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6161251 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6161255 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6161259 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6161260 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6161261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6161262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6161263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $985.60 |
| 6161265 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6161266 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6161275 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6161276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6161279 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6161292 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,880.00 |
| 6161293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6161296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161297 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161298 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6161299 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6161302 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6161304 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161305 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161306 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161307 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6161309 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6161310 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6161311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,412.80 |
| 6161313 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,840.00 |
| 6161314 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6161317 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161318 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161319 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6161320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6161321 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6161325 | SUPPLY IMPLANT | Supply/Implant | $76,847.87 |
| 6161326 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6161327 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6161328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6161331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161332 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161334 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161336 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161340 | STERILE SUPPLY | Supply/Implant | $31,290.88 |
| 6161341 | STERILE SUPPLY | Supply/Implant | $5,371.10 |
| 6161344 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161346 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161347 | SUPPLY IMPLANT | Supply/Implant | $5,599.58 |
| 6161348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6161349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6161351 | SUPPLY IMPLANT | Supply/Implant | $250.32 |
| 6161352 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6161353 | SUPPLY IMPLANT | Supply/Implant | $8,512.00 |
| 6161354 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6161356 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6161357 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6161358 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6161359 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6161361 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161362 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161366 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161373 | SUPPLY IMPLANT | Supply/Implant | $57,600.00 |
| 6161374 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6161375 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6161376 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161377 | SUPPLY IMPLANT | Supply/Implant | $57,600.00 |
| 6161378 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6161379 | CORNEAL TISSUE PROCESSING | Supply/Implant | $53,760.00 |
| 6161380 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161382 | SUPPLY IMPLANT | Supply/Implant | $692.22 |
| 6161383 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6161384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6161392 | MESH (IMPLANTABLE) | Supply/Implant | $27,860.35 |
| 6161403 | SUPPLY IMPLANT | Supply/Implant | $5,030.40 |
| 6161404 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6161405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,507.20 |
| 6161406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,507.20 |
| 6161407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6161409 | STERILE SUPPLY | Supply/Implant | $793.60 |
| 6161410 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6161411 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161412 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161413 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161414 | SUPPLY IMPLANT | Supply/Implant | $2,564.22 |
| 6161415 | SUPPLY IMPLANT | Supply/Implant | $43,626.88 |
| 6161417 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161418 | INTRO/SHEATH, NON-LASER | Supply/Implant | $664.45 |
| 6161420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6161421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6161423 | GUIDE WIRE | Supply/Implant | $1,856.00 |
| 6161424 | SUPPLY IMPLANT | Supply/Implant | $4,399.10 |
| 6161425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161430 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161431 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161432 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6161433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6161434 | SUPPLY IMPLANT | Supply/Implant | $10,777.60 |
| 6161435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6161436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,416.00 |
| 6161438 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,992.00 |
| 6161440 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161442 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,198.40 |
| 6161453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6161454 | STERILE SUPPLY | Supply/Implant | $6,543.36 |
| 6161456 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6161457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,411.52 |
| 6161459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $110,668.80 |
| 6161460 | SUPPLY IMPLANT | Supply/Implant | $3,745.28 |
| 6161461 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6161462 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6161463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6161464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6161465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6161466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6161469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161480 | SUPPLY IMPLANT | Supply/Implant | $24,499.20 |
| 6161481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6161482 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6161483 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161485 | GUIDE WIRE | Supply/Implant | $136.58 |
| 6161486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6161487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,100.80 |
| 6161488 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6161489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,400.00 |
| 6161490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161494 | GENERAL SUPPLY | Supply/Implant | $240.64 |
| 6161495 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6161497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,292.80 |
| 6161499 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6161500 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6161501 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,108.80 |
| 6161502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6161503 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6161513 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161514 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161515 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161516 | SUPPLY IMPLANT | Supply/Implant | $2,828.80 |
| 6161528 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $36,307.20 |
| 6161531 | SUPPLY IMPLANT | Supply/Implant | $128.00 |
| 6161533 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6161534 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6161535 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6161536 | SUPPLY IMPLANT | Supply/Implant | $12,864.00 |
| 6161537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161538 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6161539 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6161540 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,800.00 |
| 6161541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,752.00 |
| 6161543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6161545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161546 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6161547 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6161548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6161549 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6161550 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6161555 | SUPPLY IMPLANT | Supply/Implant | $353,500.00 |
| 6161556 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6161557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6161558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,017.86 |
| 6161559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6161560 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6161561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,737.60 |
| 6161565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,630.40 |
| 6161566 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6161567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6161568 | GENERAL SUPPLY | Supply/Implant | $642.43 |
| 6161569 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161570 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6161571 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $40,960.00 |
| 6161572 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $40,960.00 |
| 6161575 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6161586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6161587 | SUPPLY IMPLANT | Supply/Implant | $60,160.00 |
| 6161588 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6161589 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6161591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6161592 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6161593 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6161594 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6161601 | SUPPLY IMPLANT | Supply/Implant | $1,939.20 |
| 6161602 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $76,992.00 |
| 6161603 | STERILE SUPPLY | Supply/Implant | $1,676.83 |
| 6161604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6161605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6161606 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161607 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6161608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161612 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161613 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161614 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161615 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161616 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161617 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161618 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161619 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161620 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161621 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161623 | SUPPLY IMPLANT | Supply/Implant | $14,528.00 |
| 6161624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161626 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,120.00 |
| 6161627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,120.00 |
| 6161632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6161636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,017.86 |
| 6161638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,017.86 |
| 6161653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6161654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6161655 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6161656 | SUPPLY IMPLANT | Supply/Implant | $186.24 |
| 6161657 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6161658 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6161659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161660 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,321.15 |
| 6161663 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6161664 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6161665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6161666 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6161667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6161668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6161670 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6161671 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161672 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161673 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6161676 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161677 | SUPPLY IMPLANT | Supply/Implant | $3,220.74 |
| 6161692 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6161694 | SUPPLY IMPLANT | Supply/Implant | $22,515.20 |
| 6161695 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161696 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6161697 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6161698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6161699 | SUPPLY IMPLANT | Supply/Implant | $69,504.00 |
| 6161700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6161701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6161702 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6161706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161710 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6161711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161714 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161715 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6161716 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6161718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,521.60 |
| 6161719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,190.40 |
| 6161720 | SUPPLY IMPLANT | Supply/Implant | $118,976.00 |
| 6161721 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6161723 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6161724 | STERILE SUPPLY | Supply/Implant | $2,150.40 |
| 6161727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6161728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,411.52 |
| 6161729 | SUPPLY IMPLANT | Supply/Implant | $197,925.00 |
| 6161731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,589.44 |
| 6161732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,420.80 |
| 6161733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $985.60 |
| 6161734 | GENERAL SUPPLY | Supply/Implant | $832.00 |
| 6161735 | SUPPLY IMPLANT | Supply/Implant | $10,585.60 |
| 6161736 | GEN, NEURO, NON-HF RECHG BAT | Supply/Implant | $267,650.00 |
| 6161737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161738 | SUPPLY IMPLANT | Supply/Implant | $6,937.60 |
| 6161739 | SUPPLY IMPLANT | Supply/Implant | $6,937.60 |
| 6161742 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6161743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6161746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6161747 | SUPPLY IMPLANT | Supply/Implant | $41,600.00 |
| 6161748 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6161749 | SUPPLY IMPLANT | Supply/Implant | $3,968.00 |
| 6161750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6161751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6161752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6161753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,096.00 |
| 6161754 | SUPPLY IMPLANT | Supply/Implant | $1,098.88 |
| 6161755 | STERILE SUPPLY | Supply/Implant | $59,456.00 |
| 6161756 | GEN, NEURO, NON-HF RECHG BAT | Supply/Implant | $12,800.00 |
| 6161757 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $12,800.00 |
| 6161760 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6161761 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6161762 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6161764 | SUPPLY IMPLANT | Supply/Implant | $3,010.56 |
| 6161766 | SUPPLY IMPLANT | Supply/Implant | $19,578.88 |
| 6161767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,317.76 |
| 6161771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6161772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6161774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6161775 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6161781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6161782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6161785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,400.00 |
| 6161786 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,400.00 |
| 6161787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6161790 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6161796 | GRAFT, VASCULAR | Supply/Implant | $24,808.96 |
| 6161801 | INTERSPINOUS IMPLANT | Supply/Implant | $49,920.00 |
| 6161802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6161803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6161805 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6161806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6161807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6161809 | CATHETER, GUIDING | Supply/Implant | $14,310.40 |
| 6161810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6161813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,267.20 |
| 6161814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,611.52 |
| 6161815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6161816 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,611.52 |
| 6161817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6161818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6161819 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161820 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161822 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $564.22 |
| 6161826 | SUPPLY IMPLANT | Supply/Implant | $2,149.89 |
| 6161828 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,259.20 |
| 6161831 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6161832 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6161835 | SUPPLY IMPLANT | Supply/Implant | $13,096.96 |
| 6161847 | SUPPLY IMPLANT | Supply/Implant | $1,781.76 |
| 6161850 | SUPPLY IMPLANT | Supply/Implant | $4,216.32 |
| 6161853 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161854 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161855 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161856 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161859 | SUPPLY IMPLANT | Supply/Implant | $25,344.00 |
| 6161861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6161862 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6161865 | SUPPLY IMPLANT | Supply/Implant | $753.59 |
| 6161866 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $88,464.64 |
| 6161867 | GENERAL SUPPLY | Supply/Implant | $176.58 |
| 6161870 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161871 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161876 | SUPPLY IMPLANT | Supply/Implant | $6,379.52 |
| 6161878 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6161879 | SUPPLY IMPLANT | Supply/Implant | $9,740.80 |
| 6161882 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $15,360.00 |
| 6161884 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6161886 | GUIDE WIRE | Supply/Implant | $1,365.76 |
| 6161887 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161888 | GRAFT, VASCULAR | Supply/Implant | $77,824.00 |
| 6161890 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6161891 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6161892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6161900 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6161901 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6161902 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6161903 | GUIDE WIRE | Supply/Implant | $2,291.20 |
| 6161904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,139.20 |
| 6161905 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,132.80 |
| 6161906 | SUPPLY IMPLANT | Supply/Implant | $82,214.40 |
| 6161907 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161908 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161909 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161910 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161911 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161913 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161914 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161915 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161917 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161918 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161920 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161921 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6161922 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6161923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6161924 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161930 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6161931 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6161932 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6161933 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6161934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,603.20 |
| 6161935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,520.00 |
| 6161936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6161937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,072.00 |
| 6161939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161940 | SUPPLY IMPLANT | Supply/Implant | $2,383.36 |
| 6161941 | GUIDE WIRE | Supply/Implant | $1,925.12 |
| 6161942 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161943 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161944 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6161945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161946 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6161947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6161948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6161949 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6161950 | AUD OSSEO DEV INT/EXT COMP | Supply/Implant | $40,668.29 |
| 6161953 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6161954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6161955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6161956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6161957 | GENERAL SUPPLY | Supply/Implant | $4,672.00 |
| 6161960 | CATHETER, GUIDING | Supply/Implant | $320.00 |
| 6161963 | SUPPLY IMPLANT | Supply/Implant | $3,939.42 |
| 6161968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,831.36 |
| 6161969 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,456.64 |
| 6161970 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161971 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161974 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161975 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161980 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6161981 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161982 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161983 | SUPPLY IMPLANT | Supply/Implant | $11,870.08 |
| 6161984 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6161985 | SUPPLY IMPLANT | Supply/Implant | $6,310.40 |
| 6161986 | SUPPLY IMPLANT | Supply/Implant | $11,200.00 |
| 6161987 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6161988 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $23,680.00 |
| 6161990 | GENERAL SUPPLY | Supply/Implant | $972.80 |
| 6161991 | GENERAL SUPPLY | Supply/Implant | $972.80 |
| 6161992 | SUPPLY IMPLANT | Supply/Implant | $2,472.70 |
| 6161995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,056.00 |
| 6161996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,964.80 |
| 6161997 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6161998 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6161999 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6162000 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $50,150.40 |
| 6162001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6162003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6162005 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6162006 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6162007 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6162008 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6162009 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6162010 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6162011 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6162012 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6162013 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6162014 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6162015 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6162017 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162020 | GENERAL SUPPLY | Supply/Implant | $793.60 |
| 6162022 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6162023 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6162024 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6162025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6162026 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6162027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6162029 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,937.60 |
| 6162034 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,709.44 |
| 6162041 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6162042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162043 | MESH (IMPLANTABLE) | Supply/Implant | $66,496.00 |
| 6162044 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6162045 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6162046 | SUPPLY IMPLANT | Supply/Implant | $55,949.44 |
| 6162047 | SUPPLY IMPLANT | Supply/Implant | $73,728.00 |
| 6162048 | SUPPLY IMPLANT | Supply/Implant | $7,052.80 |
| 6162049 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6162051 | GUIDE WIRE | Supply/Implant | $1,937.86 |
| 6162055 | SUPPLY IMPLANT | Supply/Implant | $450.56 |
| 6162058 | SUPPLY IMPLANT | Supply/Implant | $31,215.49 |
| 6162060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6162061 | SUPPLY IMPLANT | Supply/Implant | $1,923.84 |
| 6162062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,643.20 |
| 6162063 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6162064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6162067 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6162068 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162069 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6162072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6162073 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6162074 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6162075 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6162076 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6162077 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6162078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162084 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6162085 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6162086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6162087 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6162088 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162092 | SUPPLY IMPLANT | Supply/Implant | $25,872.00 |
| 6162094 | SUPPLY IMPLANT | Supply/Implant | $1,657.60 |
| 6162095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6162096 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6162097 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6162098 | GRAFT, VASCULAR | Supply/Implant | $188,475.00 |
| 6162102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6162103 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162104 | INTERSPINOUS IMPLANT | Supply/Implant | $134,400.00 |
| 6162105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6162107 | SUPPLY IMPLANT | Supply/Implant | $2,585.60 |
| 6162109 | SUPPLY IMPLANT | Supply/Implant | $2,363.14 |
| 6162111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6162112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6162113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6162114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6162115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6162116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,059.20 |
| 6162117 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6162119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6162121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,928.64 |
| 6162122 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,400.00 |
| 6162125 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6162126 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6162129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,784.00 |
| 6162130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,784.00 |
| 6162131 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6162132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6162133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6162134 | SUPPLY IMPLANT | Supply/Implant | $25,049.60 |
| 6162135 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6162136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6162137 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6162139 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6162140 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6162144 | STERILE SUPPLY | Supply/Implant | $3,609.60 |
| 6162145 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6162146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6162147 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6162148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6162149 | INTERSPINOUS IMPLANT | Supply/Implant | $60,480.00 |
| 6162150 | INTERSPINOUS IMPLANT | Supply/Implant | $60,480.00 |
| 6162151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6162152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162154 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6162155 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6162156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6162157 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162158 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162159 | SUPPLY IMPLANT | Supply/Implant | $9,920.00 |
| 6162160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6162161 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6162163 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162164 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162165 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,371.20 |
| 6162168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,366.40 |
| 6162169 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6162170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6162172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6162173 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6162174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6162178 | ALLODERM SKIN SUB | Supply/Implant | $65,369.60 |
| 6162179 | ALLODERM SKIN SUB | Supply/Implant | $37,465.60 |
| 6162180 | ALLODERM SKIN SUB | Supply/Implant | $37,465.60 |
| 6162185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,242.88 |
| 6162186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,858.56 |
| 6162187 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6162188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6162189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6162190 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6162191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,419.20 |
| 6162192 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,248.00 |
| 6162220 | SUPPLY IMPLANT | Supply/Implant | $146,947.50 |
| 6162221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6162222 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6162223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6162224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6162225 | SUPPLY IMPLANT | Supply/Implant | $1,003.52 |
| 6162226 | SUPPLY IMPLANT | Supply/Implant | $1,003.52 |
| 6162227 | STERILE SUPPLY | Supply/Implant | $912.26 |
| 6162228 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6162240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,768.00 |
| 6162241 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6162242 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6162243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,720.00 |
| 6162245 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6162250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162251 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162252 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6162257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6162258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,638.40 |
| 6162259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6162260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6162263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6162265 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6162271 | SUPPLY IMPLANT | Supply/Implant | $19,578.88 |
| 6162272 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6162275 | SUPPLY IMPLANT | Supply/Implant | $2,543.04 |
| 6162276 | SUPPLY IMPLANT | Supply/Implant | $2,543.04 |
| 6162277 | SUPPLY IMPLANT | Supply/Implant | $1,875.52 |
| 6162278 | SUPPLY IMPLANT | Supply/Implant | $1,875.52 |
| 6162280 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,311.81 |
| 6162287 | MESH (IMPLANTABLE) | Supply/Implant | $22,272.51 |
| 6162288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6162289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6162290 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6162291 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162292 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6162293 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6162294 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6162295 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6162298 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162299 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162300 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162301 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162302 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162303 | SUPPLY IMPLANT | Supply/Implant | $2,311.81 |
| 6162305 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6162306 | SUPPLY IMPLANT | Supply/Implant | $3,826.56 |
| 6162307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6162309 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162312 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6162313 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162314 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6162315 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,492.16 |
| 6162316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,163.52 |
| 6162317 | PROSTHESIS, BREAST, IMP | Supply/Implant | $21,056.00 |
| 6162318 | PROSTHESIS, BREAST, IMP | Supply/Implant | $21,056.00 |
| 6162319 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6162320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6162321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6162322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6162323 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162324 | SUPPLY IMPLANT | Supply/Implant | $466.94 |
| 6162327 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162333 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6162334 | GENERAL SUPPLY | Supply/Implant | $1,088.00 |
| 6162335 | SUPPLY IMPLANT | Supply/Implant | $7,667.20 |
| 6162337 | SUPPLY IMPLANT | Supply/Implant | $5,145.60 |
| 6162342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6162344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162348 | GUIDE WIRE | Supply/Implant | $1,365.76 |
| 6162355 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6162356 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6162358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $501.12 |
| 6162359 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $501.12 |
| 6162360 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $501.12 |
| 6162361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,352.00 |
| 6162364 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162366 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162367 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162373 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6162374 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,662.72 |
| 6162379 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,217.09 |
| 6162387 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6162388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,944.00 |
| 6162389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,944.00 |
| 6162390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162416 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6162417 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162418 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6162419 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,980.61 |
| 6162420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6162422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $86,976.00 |
| 6162427 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162428 | SUPPLY IMPLANT | Supply/Implant | $20,646.40 |
| 6162429 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162430 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162431 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162432 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6162433 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $19,200.00 |
| 6162434 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $5,760.00 |
| 6162435 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6162438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,305.34 |
| 6162440 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162441 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,670.40 |
| 6162442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6162443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6162444 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162445 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6162450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6162451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6162455 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6162460 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6162461 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6162462 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6162463 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6162464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6162465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6162466 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6162467 | SUPPLY IMPLANT | Supply/Implant | $1,745.28 |
| 6162468 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6162469 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6162470 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6162471 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6162472 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6162473 | SUPPLY IMPLANT | Supply/Implant | $2,995.20 |
| 6162474 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6162475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,805.44 |
| 6162476 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6162477 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,235.20 |
| 6162478 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162479 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162480 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6162481 | SUPPLY IMPLANT | Supply/Implant | $8,384.00 |
| 6162482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6162484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6162485 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,380.80 |
| 6162486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6162487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6162488 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6162489 | NEURAWRAP NERVE PROTECTOR,CM | Supply/Implant | $25,123.20 |
| 6162490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,760.00 |
| 6162491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6162492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6162493 | SUPPLY IMPLANT | Supply/Implant | $131,160.75 |
| 6162494 | SUPPLY IMPLANT | Supply/Implant | $10,137.60 |
| 6162495 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6162496 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6162497 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6162500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,331.20 |
| 6162501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,331.20 |
| 6162502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,227.20 |
| 6162503 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6162504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162508 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162515 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162516 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162518 | RET DEV, INSERTABLE | Supply/Implant | $21,696.00 |
| 6162528 | SUPPLY IMPLANT | Supply/Implant | $4,710.40 |
| 6162529 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6162531 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6162532 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6162533 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6162534 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6162535 | SUPPLY IMPLANT | Supply/Implant | $2,016.00 |
| 6162536 | SUPPLY IMPLANT | Supply/Implant | $30,080.00 |
| 6162537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6162560 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6162580 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6162582 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,508.80 |
| 6162584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6162588 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162589 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162594 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162598 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162599 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162600 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162601 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162602 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162603 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6162604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6162605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6162608 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6162609 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162610 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6162612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6162615 | SUPPLY IMPLANT | Supply/Implant | $70,400.00 |
| 6162616 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,902.40 |
| 6162617 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162618 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162621 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162630 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162632 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162633 | SUPPLY IMPLANT | Supply/Implant | $173.18 |
| 6162641 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6162642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,598.40 |
| 6162643 | SUPPLY IMPLANT | Supply/Implant | $6,464.00 |
| 6162644 | SUPPLY IMPLANT | Supply/Implant | $6,464.00 |
| 6162645 | SUPPLY IMPLANT | Supply/Implant | $3,404.80 |
| 6162646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $205,380.00 |
| 6162647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,339.20 |
| 6162662 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162663 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162669 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162671 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162672 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162675 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162677 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162684 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162706 | SUPPLY IMPLANT | Supply/Implant | $1,128.96 |
| 6162709 | SUPPLY IMPLANT | Supply/Implant | $1,290.24 |
| 6162714 | SUPPLY IMPLANT | Supply/Implant | $36,864.00 |
| 6162717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,546.24 |
| 6162718 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6162719 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6162720 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6162721 | GENERAL SUPPLY | Supply/Implant | $1,254.91 |
| 6162722 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6162723 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6162724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6162726 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6162734 | STERILE SUPPLY | Supply/Implant | $597.80 |
| 6162736 | STERILE SUPPLY | Supply/Implant | $931.71 |
| 6162737 | STERILE SUPPLY | Supply/Implant | $931.71 |
| 6162738 | STERILE SUPPLY | Supply/Implant | $1,026.05 |
| 6162739 | STERILE SUPPLY | Supply/Implant | $575.87 |
| 6162742 | STERILE SUPPLY | Supply/Implant | $653.31 |
| 6162743 | STERILE SUPPLY | Supply/Implant | $312.90 |
| 6162745 | STERILE SUPPLY | Supply/Implant | $1,636.86 |
| 6162747 | STERILE SUPPLY | Supply/Implant | $1,454.08 |
| 6162748 | STERILE SUPPLY | Supply/Implant | $1,164.54 |
| 6162749 | STERILE SUPPLY | Supply/Implant | $1,912.32 |
| 6162750 | STERILE SUPPLY | Supply/Implant | $5,521.41 |
| 6162751 | STERILE SUPPLY | Supply/Implant | $4,252.16 |
| 6162753 | SUPPLY IMPLANT | Supply/Implant | $1,078.14 |
| 6162754 | SUPPLY IMPLANT | Supply/Implant | $985.73 |
| 6162756 | STERILE SUPPLY | Supply/Implant | $1,840.00 |
| 6162757 | STERILE SUPPLY | Supply/Implant | $835.84 |
| 6162758 | STERILE SUPPLY | Supply/Implant | $2,409.34 |
| 6162759 | STERILE SUPPLY | Supply/Implant | $2,771.33 |
| 6162762 | STERILE SUPPLY | Supply/Implant | $1,238.27 |
| 6162763 | STERILE SUPPLY | Supply/Implant | $2,205.31 |
| 6162764 | STERILE SUPPLY | Supply/Implant | $3,672.70 |
| 6162765 | STERILE SUPPLY | Supply/Implant | $1,977.73 |
| 6162766 | STERILE SUPPLY | Supply/Implant | $1,344.51 |
| 6162767 | SUPPLY IMPLANT | Supply/Implant | $1,069.44 |
| 6162768 | SUPPLY IMPLANT | Supply/Implant | $1,562.37 |
| 6162769 | SUPPLY IMPLANT | Supply/Implant | $3,241.47 |
| 6162770 | SUPPLY IMPLANT | Supply/Implant | $4,024.83 |
| 6162771 | SUPPLY IMPLANT | Supply/Implant | $2,359.94 |
| 6162772 | SUPPLY IMPLANT | Supply/Implant | $2,457.60 |
| 6162773 | STERILE SUPPLY | Supply/Implant | $1,274.50 |
| 6162775 | SUPPLY IMPLANT | Supply/Implant | $1,329.54 |
| 6162776 | SUPPLY IMPLANT | Supply/Implant | $874.11 |
| 6162777 | SUPPLY IMPLANT | Supply/Implant | $1,390.34 |
| 6162779 | SUPPLY IMPLANT | Supply/Implant | $1,257.69 |
| 6162780 | STERILE SUPPLY | Supply/Implant | $567.04 |
| 6162781 | STERILE SUPPLY | Supply/Implant | $513.79 |
| 6162782 | STERILE SUPPLY | Supply/Implant | $457.86 |
| 6162784 | STERILE SUPPLY | Supply/Implant | $552.00 |
| 6162789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162796 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6162809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,012.35 |
| 6162810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6162811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,003.84 |
| 6162812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6162813 | SUPPLY IMPLANT | Supply/Implant | $47,766.40 |
| 6162814 | STERILE SUPPLY | Supply/Implant | $396.80 |
| 6162815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6162816 | ALGINATE DRSG >16 <=48 SQ IN | Supply/Implant | $285.70 |
| 6162817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6162818 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6162819 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6162820 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6162821 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6162828 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6162832 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6162838 | GENERAL SUPPLY | Supply/Implant | $1,216.00 |
| 6162839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6162840 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162842 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6162843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6162844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6162845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6162846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6162847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6162848 | SUPPLY IMPLANT | Supply/Implant | $1,726.59 |
| 6162849 | SUPPLY IMPLANT | Supply/Implant | $34,048.00 |
| 6162850 | SUPPLY IMPLANT | Supply/Implant | $15,680.00 |
| 6162851 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6162856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162861 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6162862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6162865 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6162871 | GUIDE WIRE | Supply/Implant | $819.20 |
| 6162872 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6162873 | SUPPLY IMPLANT | Supply/Implant | $6,049.66 |
| 6162874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6162875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6162876 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6162879 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162880 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162881 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162882 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162883 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162887 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,862.08 |
| 6162888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6162889 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6162890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,177.60 |
| 6162891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162895 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6162896 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162901 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,235.26 |
| 6162902 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6162903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,298.88 |
| 6162904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6162905 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6162907 | MESH (IMPLANTABLE) | Supply/Implant | $110,162.05 |
| 6162908 | MESH (IMPLANTABLE) | Supply/Implant | $126,416.90 |
| 6162910 | MESH (IMPLANTABLE) | Supply/Implant | $109,730.78 |
| 6162911 | SUPPLY IMPLANT | Supply/Implant | $17,248.00 |
| 6162912 | SUPPLY IMPLANT | Supply/Implant | $115,080.32 |
| 6162913 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6162914 | SUPPLY IMPLANT | Supply/Implant | $4,147.20 |
| 6162915 | SUPPLY IMPLANT | Supply/Implant | $4,147.20 |
| 6162916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6162920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6162922 | SUPPLY IMPLANT | Supply/Implant | $4,399.10 |
| 6162924 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6162927 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,072.00 |
| 6162930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6162932 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6162933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,251.20 |
| 6162934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,251.20 |
| 6162935 | SUPPLY IMPLANT | Supply/Implant | $6,016.00 |
| 6162939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,638.40 |
| 6162940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162941 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162942 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6162943 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6162944 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6162945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6162948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6162949 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $99,673.60 |
| 6162950 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $76,864.00 |
| 6162951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,944.00 |
| 6162952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162954 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6162955 | SUPPLY IMPLANT | Supply/Implant | $3,225.60 |
| 6162956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,772.16 |
| 6162966 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,481.60 |
| 6162967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,880.00 |
| 6162968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6162970 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6162971 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,392.00 |
| 6162972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,392.00 |
| 6162973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6162974 | SUPPLY IMPLANT | Supply/Implant | $2,612.48 |
| 6162975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6162976 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6162977 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6162980 | SUPPLY IMPLANT | Supply/Implant | $15,557.12 |
| 6162984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6162985 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6162987 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6162989 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162990 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6162995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162997 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163000 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6163002 | STERILE SUPPLY | Supply/Implant | $226.05 |
| 6163003 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,968.00 |
| 6163005 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6163008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,632.00 |
| 6163019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6163032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6163036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6163078 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6163079 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6163080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6163081 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6163082 | SUPPLY IMPLANT | Supply/Implant | $386.43 |
| 6163083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6163087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6163088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6163090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,815.36 |
| 6163091 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163092 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163093 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163094 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163097 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6163098 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,849.60 |
| 6163100 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6163101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,568.32 |
| 6163102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6163103 | GENERAL SUPPLY | Supply/Implant | $314.37 |
| 6163104 | GENERAL SUPPLY | Supply/Implant | $400.04 |
| 6163105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,120.00 |
| 6163106 | GUIDE WIRE | Supply/Implant | $1,925.12 |
| 6163107 | SUPPLY IMPLANT | Supply/Implant | $2,383.36 |
| 6163108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6163109 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6163111 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6163113 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6163114 | STERILE SUPPLY | Supply/Implant | $621.39 |
| 6163116 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6163117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,716.48 |
| 6163126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6163128 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6163130 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,568.00 |
| 6163131 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,568.00 |
| 6163133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,294.40 |
| 6163134 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6163135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,712.00 |
| 6163136 | INTERSPINOUS IMPLANT | Supply/Implant | $46,080.00 |
| 6163137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,276.80 |
| 6163139 | SUPPLY IMPLANT | Supply/Implant | $37,849.60 |
| 6163142 | SUPPLY IMPLANT | Supply/Implant | $2,612.48 |
| 6163143 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6163147 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163148 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163149 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163150 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6163152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6163153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6163155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6163156 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6163157 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $183,750.00 |
| 6163159 | SUPPLY IMPLANT | Supply/Implant | $7,667.20 |
| 6163160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6163161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6163162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,606.08 |
| 6163163 | SUPPLY IMPLANT | Supply/Implant | $2,435.58 |
| 6163164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6163167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,412.99 |
| 6163168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,317.38 |
| 6163172 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6163173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163178 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6163179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,030.40 |
| 6163180 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,395.20 |
| 6163182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6163185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6163186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,768.00 |
| 6163187 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6163192 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $128,625.00 |
| 6163195 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6163196 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6163197 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6163198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6163199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,788.80 |
| 6163200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,788.80 |
| 6163201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6163202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,863.68 |
| 6163205 | SUPPLY IMPLANT | Supply/Implant | $24,576.00 |
| 6163206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163207 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,200.00 |
| 6163209 | SUPPLY IMPLANT | Supply/Implant | $41,894.40 |
| 6163210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,934.40 |
| 6163211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,854.40 |
| 6163215 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163217 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6163218 | INTERSPINOUS IMPLANT | Supply/Implant | $29,376.00 |
| 6163219 | SUPPLY IMPLANT | Supply/Implant | $27,200.00 |
| 6163220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163226 | SUPPLY IMPLANT | Supply/Implant | $39,936.00 |
| 6163227 | SUPPLY IMPLANT | Supply/Implant | $5,171.20 |
| 6163228 | SUPPLY IMPLANT | Supply/Implant | $6,963.20 |
| 6163229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,203.20 |
| 6163230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,392.00 |
| 6163231 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6163232 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6163233 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6163234 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6163235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6163236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6163237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6163238 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6163239 | SUPPLY IMPLANT | Supply/Implant | $15,872.00 |
| 6163240 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6163241 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6163242 | BRACHYTHERAPY NEEDLE | Supply/Implant | $151.30 |
| 6163243 | BRACHYTHERAPY NEEDLE | Supply/Implant | $151.30 |
| 6163244 | BRACHYTHERAPY NEEDLE | Supply/Implant | $169.68 |
| 6163245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6163246 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6163248 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6163250 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6163262 | GUIDE WIRE | Supply/Implant | $1,856.00 |
| 6163263 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6163264 | SUPPLY IMPLANT | Supply/Implant | $1,751.04 |
| 6163265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6163269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6163270 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163271 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163272 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163273 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,408.00 |
| 6163276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6163277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163280 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163283 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6163284 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,896.00 |
| 6163285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6163286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6163287 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163288 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6163289 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163290 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163291 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163292 | OCULAR IMPLANT | Supply/Implant | $8,256.00 |
| 6163293 | INTERSPINOUS IMPLANT | Supply/Implant | $57,600.00 |
| 6163296 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6163300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6163302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,049.28 |
| 6163303 | SUPPLY IMPLANT | Supply/Implant | $1,704.52 |
| 6163304 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6163305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,851.84 |
| 6163306 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6163307 | SUPPLY IMPLANT | Supply/Implant | $5,799.04 |
| 6163308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6163309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6163310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6163312 | SUPPLY IMPLANT | Supply/Implant | $6,466.82 |
| 6163313 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6163314 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6163315 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6163318 | SUPPLY IMPLANT | Supply/Implant | $1,523.20 |
| 6163319 | STERILE SUPPLY | Supply/Implant | $2,368.00 |
| 6163320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6163321 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6163322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,408.00 |
| 6163325 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6163326 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163327 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6163328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163330 | SUPPLY IMPLANT | Supply/Implant | $1,231.36 |
| 6163332 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6163333 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6163334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,480.00 |
| 6163335 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6163336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6163337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,313.60 |
| 6163338 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,280.00 |
| 6163340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,720.00 |
| 6163342 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163344 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6163349 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $10,579.20 |
| 6163350 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6163351 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,503.36 |
| 6163352 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6163353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6163354 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6163355 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6163356 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6163357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6163358 | SUPPLY IMPLANT | Supply/Implant | $20,838.40 |
| 6163359 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6163360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,122.56 |
| 6163361 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,766.40 |
| 6163362 | GENERAL SUPPLY | Supply/Implant | $328.64 |
| 6163364 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6163365 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6163366 | SUPPLY IMPLANT | Supply/Implant | $7,513.60 |
| 6163367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,624.00 |
| 6163368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,624.00 |
| 6163370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,164.80 |
| 6163371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,800.00 |
| 6163372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,752.00 |
| 6163373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,083.20 |
| 6163374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,536.00 |
| 6163375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,649.60 |
| 6163376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163377 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6163380 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6163381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6163382 | SUPPLY IMPLANT | Supply/Implant | $2,262.40 |
| 6163383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,948.80 |
| 6163384 | SUPPLY IMPLANT | Supply/Implant | $15,805.44 |
| 6163385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,800.00 |
| 6163386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,752.00 |
| 6163387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,425.41 |
| 6163388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6163389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6163390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6163391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6163392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6163393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163395 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6163396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6163397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6163398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6163403 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6163404 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,954.56 |
| 6163416 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6163417 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163419 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6163420 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6163425 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6163426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,083.20 |
| 6163427 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,094.72 |
| 6163428 | SUPPLY IMPLANT | Supply/Implant | $60,487.68 |
| 6163429 | SUPPLY IMPLANT | Supply/Implant | $49,497.60 |
| 6163431 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163432 | SUPPLY IMPLANT | Supply/Implant | $36,774.40 |
| 6163433 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6163436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6163439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163441 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,347.20 |
| 6163444 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163445 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163447 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6163448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6163455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6163456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6163457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6163458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6163459 | PROSTHETIC IMPLANT NOS | Supply/Implant | $28,096.00 |
| 6163460 | SUPPLY IMPLANT | Supply/Implant | $7,820.80 |
| 6163464 | STERILE SUPPLY | Supply/Implant | $6,272.00 |
| 6163465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,635.20 |
| 6163466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6163467 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6163468 | SUPPLY IMPLANT | Supply/Implant | $47,040.00 |
| 6163469 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,280.00 |
| 6163470 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,720.00 |
| 6163471 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6163472 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6163473 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163474 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163475 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6163478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,864.00 |
| 6163481 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6163482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,392.00 |
| 6163483 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,520.00 |
| 6163484 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,520.00 |
| 6163486 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6163487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6163488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6163489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6163490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6163491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6163492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6163493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,589.44 |
| 6163495 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6163496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6163497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6163499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6163500 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6163501 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6163502 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6163503 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6163504 | SUPPLY IMPLANT | Supply/Implant | $4,928.00 |
| 6163506 | GENERAL SUPPLY | Supply/Implant | $6,272.00 |
| 6163507 | GENERAL SUPPLY | Supply/Implant | $6,272.00 |
| 6163508 | GENERAL SUPPLY | Supply/Implant | $6,400.00 |
| 6163509 | GENERAL SUPPLY | Supply/Implant | $6,400.00 |
| 6163510 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6163512 | SUPPLY IMPLANT | Supply/Implant | $2,543.04 |
| 6163514 | SUPPLY IMPLANT | Supply/Implant | $2,316.80 |
| 6163515 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6163516 | STERILE SUPPLY | Supply/Implant | $550.40 |
| 6163517 | STERILE SUPPLY | Supply/Implant | $4,006.40 |
| 6163518 | STERILE SUPPLY | Supply/Implant | $27,916.80 |
| 6163519 | STERILE SUPPLY | Supply/Implant | $2,944.00 |
| 6163520 | STERILE SUPPLY | Supply/Implant | $1,408.00 |
| 6163521 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6163522 | STERILE SUPPLY | Supply/Implant | $1,382.40 |
| 6163523 | STERILE SUPPLY | Supply/Implant | $908.80 |
| 6163524 | STERILE SUPPLY | Supply/Implant | $3,648.00 |
| 6163525 | STERILE SUPPLY | Supply/Implant | $93,388.80 |
| 6163526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163527 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6163530 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,288.00 |
| 6163585 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6163586 | GENERAL SUPPLY | Supply/Implant | $285.25 |
| 6163588 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6163589 | SUPPLY IMPLANT | Supply/Implant | $13,145.60 |
| 6163592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6163593 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6163595 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6163596 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6163597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6163599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6163600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $573.44 |
| 6163603 | SUPPLY IMPLANT | Supply/Implant | $1,003.52 |
| 6163604 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6163605 | SUPPLY IMPLANT | Supply/Implant | $2,257.92 |
| 6163607 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,547.20 |
| 6163608 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6163613 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,211.39 |
| 6163614 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,725.70 |
| 6163615 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6163616 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6163618 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163620 | STERILE SUPPLY | Supply/Implant | $134.53 |
| 6163621 | SUPPLY IMPLANT | Supply/Implant | $6,823.68 |
| 6163623 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6163624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6163625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,430.40 |
| 6163626 | STERILE SUPPLY | Supply/Implant | $4,697.60 |
| 6163627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6163628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6163629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6163630 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6163633 | SUPPLY IMPLANT | Supply/Implant | $581.76 |
| 6163634 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6163635 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6163636 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6163637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6163639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6163640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6163641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6163642 | SUPPLY IMPLANT | Supply/Implant | $125,685.00 |
| 6163643 | SUPPLY IMPLANT | Supply/Implant | $10,764.80 |
| 6163644 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6163645 | SUPPLY IMPLANT | Supply/Implant | $5,888.00 |
| 6163646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6163647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6163648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6163649 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6163651 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6163652 | SUPPLY IMPLANT | Supply/Implant | $645.12 |
| 6163653 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6163654 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6163656 | SUPPLY IMPLANT | Supply/Implant | $20,787.20 |
| 6163660 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6163678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,659.33 |
| 6163679 | STERILE SUPPLY | Supply/Implant | $1,152.00 |
| 6163684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163686 | GENERAL SUPPLY | Supply/Implant | $2,432.00 |
| 6163687 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6163690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,055.10 |
| 6163692 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6163693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,978.24 |
| 6163694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,843.20 |
| 6163695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,311.62 |
| 6163696 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163697 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6163698 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6163699 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6163700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6163701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6163702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6163704 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6163707 | CATHETER, GUIDING | Supply/Implant | $21,760.00 |
| 6163709 | BRACHYTHERAPY NEEDLE | Supply/Implant | $211.20 |
| 6163710 | STERILE SUPPLY | Supply/Implant | $134.53 |
| 6163711 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163712 | SUPPLY IMPLANT | Supply/Implant | $10,180.74 |
| 6163714 | STERILE SUPPLY | Supply/Implant | $504.32 |
| 6163716 | STERILE SUPPLY | Supply/Implant | $1,408.00 |
| 6163717 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6163720 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6163721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6163722 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6163723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6163724 | STERILE SUPPLY | Supply/Implant | $422.40 |
| 6163727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6163728 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6163729 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163732 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6163733 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6163734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6163737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6163738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6163742 | SUPPLY IMPLANT | Supply/Implant | $20,070.40 |
| 6163743 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,547.20 |
| 6163744 | STERILE SUPPLY | Supply/Implant | $598.02 |
| 6163746 | SUPPLY IMPLANT | Supply/Implant | $3,010.94 |
| 6163747 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6163750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6163751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6163752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6163753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6163754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6163755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6163756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6163757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,672.00 |
| 6163762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,128.00 |
| 6163763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $63,219.20 |
| 6163764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,198.08 |
| 6163765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,506.24 |
| 6163766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6163767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6163768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,734.40 |
| 6163769 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6163770 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6163771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6163773 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,880.00 |
| 6163774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6163775 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6163776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6163778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163779 | GENERAL SUPPLY | Supply/Implant | $247.19 |
| 6163780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6163781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6163782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6163783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6163784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6163785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6163786 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163787 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6163788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6163789 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6163790 | GENERAL SUPPLY | Supply/Implant | $259.84 |
| 6163793 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6163794 | SUPPLY IMPLANT | Supply/Implant | $396.80 |
| 6163795 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6163796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6163797 | SUPPLY IMPLANT | Supply/Implant | $13,948.54 |
| 6163798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6163799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6163807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6163808 | GUIDE WIRE | Supply/Implant | $311.30 |
| 6163809 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163810 | AMNIOTIC MEMBRANE | Supply/Implant | $13,824.00 |
| 6163817 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,728.00 |
| 6163818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,392.00 |
| 6163819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,392.00 |
| 6163820 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,728.00 |
| 6163821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6163822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $37,760.00 |
| 6163823 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6163825 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163826 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163827 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163828 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6163829 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6163831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $564.22 |
| 6163832 | SUPPLY IMPLANT | Supply/Implant | $66,688.00 |
| 6163833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6163834 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6163835 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6163848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6163850 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6163852 | SUPPLY IMPLANT | Supply/Implant | $30,881.28 |
| 6163853 | SUPPLY IMPLANT | Supply/Implant | $2,363.14 |
| 6163857 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6163859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163862 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6163864 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6163865 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6163868 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6163869 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6163870 | SUPPLY IMPLANT | Supply/Implant | $5,145.60 |
| 6163871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6163872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6163875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $972.80 |
| 6163876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $665.60 |
| 6163878 | SUPPLY IMPLANT | Supply/Implant | $4,019.20 |
| 6163879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6163880 | SUPPLY IMPLANT | Supply/Implant | $15,557.12 |
| 6163881 | GENERAL SUPPLY | Supply/Implant | $640.00 |
| 6163882 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6163883 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6163886 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6163887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6163890 | GRAFT, VASCULAR | Supply/Implant | $162,750.00 |
| 6163891 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6163901 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6163902 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6163903 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6163904 | CATH, DRAINAGE | Supply/Implant | $512.00 |
| 6163905 | SUPPLY IMPLANT | Supply/Implant | $69,184.00 |
| 6163906 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6163908 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6163910 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6163911 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6163912 | GENERAL SUPPLY | Supply/Implant | $1,242.88 |
| 6163913 | GENERAL SUPPLY | Supply/Implant | $1,242.88 |
| 6163914 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6163915 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6163916 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6163917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6163918 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6163919 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6163920 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6163921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,004.80 |
| 6163922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,126.40 |
| 6163923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163924 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6163931 | GENERAL SUPPLY | Supply/Implant | $11,970.56 |
| 6163932 | GENERAL SUPPLY | Supply/Implant | $18,833.92 |
| 6163933 | GENERAL SUPPLY | Supply/Implant | $94,169.60 |
| 6163934 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6163935 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6163936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6163937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6163938 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6163939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6163940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,806.72 |
| 6163941 | GENERAL SUPPLY | Supply/Implant | $4,881.79 |
| 6163942 | GENERAL SUPPLY | Supply/Implant | $6,170.75 |
| 6163943 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6163945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6163946 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163947 | GENERAL SUPPLY | Supply/Implant | $36,111.87 |
| 6163948 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6163949 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6163951 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6163952 | GENERAL SUPPLY | Supply/Implant | $7,680.00 |
| 6163953 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6163954 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6163957 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6163958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6163959 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6163960 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6163962 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6163963 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6163964 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6163965 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6163966 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6163968 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6163969 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6163970 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6163972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6163973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,398.40 |
| 6163975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6163977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,589.44 |
| 6163978 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6163979 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6163980 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $624.00 |
| 6163981 | GENERAL SUPPLY | Supply/Implant | $28,795.52 |
| 6163982 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163983 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,787.20 |
| 6163985 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6163986 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6163987 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6163988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,928.64 |
| 6163989 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6163990 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6163993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6163994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163998 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6163999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6164000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6164001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164005 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $21,056.00 |
| 6164006 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6164008 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6164010 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6164014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6164016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6164017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6164018 | SUPPLY IMPLANT | Supply/Implant | $25,510.40 |
| 6164019 | SUPPLY IMPLANT | Supply/Implant | $22,080.00 |
| 6164020 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6164021 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6164022 | SUPPLY IMPLANT | Supply/Implant | $4,860.67 |
| 6164026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,092.80 |
| 6164027 | SUPPLY IMPLANT | Supply/Implant | $13,414.40 |
| 6164028 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6164029 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6164032 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6164039 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6164040 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6164041 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6164042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6164043 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164049 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6164050 | STERILE SUPPLY | Supply/Implant | $6,927.36 |
| 6164052 | SUPPLY IMPLANT | Supply/Implant | $5,037.44 |
| 6164056 | GENERAL SUPPLY | Supply/Implant | $742.40 |
| 6164066 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $576.00 |
| 6164067 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6164068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164070 | CATH OCCLUSION | Supply/Implant | $2,560.00 |
| 6164079 | SUPPLY IMPLANT | Supply/Implant | $1,449.98 |
| 6164082 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6164084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,851.84 |
| 6164087 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6164089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6164102 | GENERAL SUPPLY | Supply/Implant | $2,016.00 |
| 6164103 | SUPPLY IMPLANT | Supply/Implant | $1,178.11 |
| 6164104 | SUPPLY IMPLANT | Supply/Implant | $1,178.11 |
| 6164105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6164107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,096.00 |
| 6164115 | SUPPLY IMPLANT | Supply/Implant | $44,064.00 |
| 6164121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6164127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6164128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6164129 | SUPPLY IMPLANT | Supply/Implant | $674.05 |
| 6164142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164153 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6164156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6164157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6164158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6164159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,536.00 |
| 6164161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6164162 | GRAFT, VASCULAR | Supply/Implant | $72,947.20 |
| 6164163 | SUPPLY IMPLANT | Supply/Implant | $832.90 |
| 6164165 | CATHETER, GUIDING | Supply/Implant | $7,168.00 |
| 6164168 | SUPPLY IMPLANT | Supply/Implant | $1,454.21 |
| 6164185 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6164186 | SUPPLY IMPLANT | Supply/Implant | $3,269.58 |
| 6164189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6164194 | STERILE SUPPLY | Supply/Implant | $24,487.68 |
| 6164200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164205 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6164208 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6164218 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6164220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6164235 | MESH (IMPLANTABLE) | Supply/Implant | $3,402.24 |
| 6164240 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,662.72 |
| 6164244 | MESH (IMPLANTABLE) | Supply/Implant | $16,410.88 |
| 6164246 | MESH (IMPLANTABLE) | Supply/Implant | $3,095.04 |
| 6164248 | MESH (IMPLANTABLE) | Supply/Implant | $3,095.04 |
| 6164249 | MESH (IMPLANTABLE) | Supply/Implant | $3,402.24 |
| 6164260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,806.72 |
| 6164261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,894.72 |
| 6164262 | GENERAL SUPPLY | Supply/Implant | $573.31 |
| 6164274 | SUPPLY IMPLANT | Supply/Implant | $5,037.57 |
| 6164276 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6164279 | STERILE SUPPLY | Supply/Implant | $141.06 |
| 6164282 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6164283 | GENERAL SUPPLY | Supply/Implant | $215.42 |
| 6164289 | STERILE SUPPLY | Supply/Implant | $647.55 |
| 6164292 | STERILE SUPPLY | Supply/Implant | $229.89 |
| 6164294 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6164295 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6164297 | SUPPLY IMPLANT | Supply/Implant | $64,998.40 |
| 6164300 | GENERAL SUPPLY | Supply/Implant | $1,536.00 |
| 6164307 | SUPPLY IMPLANT | Supply/Implant | $2,311.81 |
| 6164311 | SUPPLY IMPLANT | Supply/Implant | $2,227.20 |
| 6164312 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6164326 | SUPPLY IMPLANT | Supply/Implant | $19,494.40 |
| 6164327 | STERILE SUPPLY | Supply/Implant | $1,523.20 |
| 6164329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,168.00 |
| 6164330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6164331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6164332 | GUIDE WIRE | Supply/Implant | $7,508.86 |
| 6164336 | GENERAL SUPPLY | Supply/Implant | $6,696.32 |
| 6164338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6164339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6164348 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $356,752.20 |
| 6164359 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6164363 | GENERAL SUPPLY | Supply/Implant | $549.76 |
| 6164364 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164366 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164368 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164369 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164372 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164376 | GENERAL SUPPLY | Supply/Implant | $10,944.00 |
| 6164377 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6164380 | STERILE SUPPLY | Supply/Implant | $1,241.60 |
| 6164389 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6164390 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6164393 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,051.20 |
| 6164394 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6164395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6164397 | SUPPLY IMPLANT | Supply/Implant | $7,907.46 |
| 6164433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6164435 | GUIDE WIRE | Supply/Implant | $4,160.00 |
| 6164436 | CORNEAL TISSUE PROCESSING | Supply/Implant | $53,760.00 |
| 6164438 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6164448 | SUPPLY IMPLANT | Supply/Implant | $8,182.14 |
| 6164449 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6164464 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6164465 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6164466 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6164474 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $201,663.00 |
| 6164475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6164479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6164480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,622.40 |
| 6164481 | SUPPLY IMPLANT | Supply/Implant | $3,800.83 |
| 6164482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6164483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,432.64 |
| 6164485 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,779.20 |
| 6164487 | SUPPLY IMPLANT | Supply/Implant | $8,691.20 |
| 6164491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164497 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6164498 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6164510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164511 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6164512 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6164513 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $13,324.80 |
| 6164519 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6164520 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6164522 | SUPPLY IMPLANT | Supply/Implant | $4,352.00 |
| 6164523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,842.88 |
| 6164524 | SUPPLY IMPLANT | Supply/Implant | $2,858.62 |
| 6164525 | STERILE SUPPLY | Supply/Implant | $4,173.82 |
| 6164526 | GENERAL SUPPLY | Supply/Implant | $131.20 |
| 6164527 | STERILE SUPPLY | Supply/Implant | $254.26 |
| 6164534 | STERILE SUPPLY | Supply/Implant | $976.90 |
| 6164535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6164536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164538 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6164541 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6164542 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6164543 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6164548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6164560 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6164561 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6164562 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6164564 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6164565 | SUPPLY IMPLANT | Supply/Implant | $4,217.09 |
| 6164566 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6164567 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6164568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6164569 | SUPPLY IMPLANT | Supply/Implant | $24,384.00 |
| 6164570 | SUPPLY IMPLANT | Supply/Implant | $24,384.00 |
| 6164571 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6164572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6164573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6164574 | SUPPLY IMPLANT | Supply/Implant | $27,611.52 |
| 6164576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6164577 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6164580 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6164582 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6164587 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6164588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,787.20 |
| 6164589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,787.20 |
| 6164590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6164591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6164592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6164593 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6164594 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6164595 | GRAFT, VASCULAR | Supply/Implant | $118,572.83 |
| 6164599 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,168.96 |
| 6164601 | SUPPLY IMPLANT | Supply/Implant | $48,640.00 |
| 6164602 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6164606 | SUPPLY IMPLANT | Supply/Implant | $28,096.00 |
| 6164607 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6164608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6164609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $687.85 |
| 6164616 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6164620 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6164621 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6164623 | STERILE SUPPLY | Supply/Implant | $437.76 |
| 6164627 | INTERSPINOUS IMPLANT | Supply/Implant | $1,536.00 |
| 6164628 | SUPPLY IMPLANT | Supply/Implant | $7,171.20 |
| 6164629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,817.60 |
| 6164631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6164633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6164634 | INTERSPINOUS IMPLANT | Supply/Implant | $43,584.00 |
| 6164635 | INTERSPINOUS IMPLANT | Supply/Implant | $43,584.00 |
| 6164643 | PROSTHETIC IMPLANT NOS | Supply/Implant | $17,510.91 |
| 6164654 | GENERAL SUPPLY | Supply/Implant | $172.54 |
| 6164655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $155,347.50 |
| 6164661 | SUPPLY IMPLANT | Supply/Implant | $1,224.83 |
| 6164662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6164663 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6164664 | SUPPLY IMPLANT | Supply/Implant | $3,686.40 |
| 6164665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,931.07 |
| 6164666 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6164667 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.32 |
| 6164674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,059.58 |
| 6164675 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $78,663.94 |
| 6164677 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,124.74 |
| 6164678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,685.18 |
| 6164679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,307.90 |
| 6164680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $108,065.92 |
| 6164685 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6164686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6164687 | SUPPLY IMPLANT | Supply/Implant | $11,200.00 |
| 6164698 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6164699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.75 |
| 6164700 | INTERSPINOUS IMPLANT | Supply/Implant | $84,128.00 |
| 6164701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,432.64 |
| 6164702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6164703 | CONN TISS, NON-HUMAN | Supply/Implant | $19,200.00 |
| 6164706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6164707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,720.00 |
| 6164709 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6164711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,921.60 |
| 6164712 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6164713 | STERILE SUPPLY | Supply/Implant | $208.81 |
| 6164715 | STERILE SUPPLY | Supply/Implant | $29,248.00 |
| 6164717 | SUPPLY IMPLANT | Supply/Implant | $13,056.00 |
| 6164718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,518.40 |
| 6164719 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6164721 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6164723 | GENERAL SUPPLY | Supply/Implant | $341.34 |
| 6164724 | SUPPLY IMPLANT | Supply/Implant | $418.14 |
| 6164725 | SUPPLY IMPLANT | Supply/Implant | $7,155.20 |
| 6164727 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,492.80 |
| 6164731 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6164733 | SUPPLY IMPLANT | Supply/Implant | $88,391.04 |
| 6164734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6164735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6164736 | SUPPLY IMPLANT | Supply/Implant | $431.10 |
| 6164743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6164744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6164745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6164746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6164751 | SUPPLY IMPLANT | Supply/Implant | $2,133.34 |
| 6164753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6164754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6164755 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6164756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,542.72 |
| 6164757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6164758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6164762 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,779.52 |
| 6164763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,851.84 |
| 6164764 | SUPPLY IMPLANT | Supply/Implant | $310.91 |
| 6164765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6164766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6164767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6164768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164769 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6164770 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6164771 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6164772 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6164773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.13 |
| 6164774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6164779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6164781 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6164784 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6164786 | COCHLEAR DEVICE | Supply/Implant | $239,875.00 |
| 6164787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164793 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164794 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6164795 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6164796 | SUPPLY IMPLANT | Supply/Implant | $9,920.00 |
| 6164804 | SUPPLY IMPLANT | Supply/Implant | $20,480.00 |
| 6164805 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6164806 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6164807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6164808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6164809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,265.92 |
| 6164811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164812 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6164813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,584.00 |
| 6164814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,584.00 |
| 6164815 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6164816 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $720.00 |
| 6164821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164837 | GENERAL SUPPLY | Supply/Implant | $31,744.00 |
| 6164839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6164844 | SUPPLY IMPLANT | Supply/Implant | $32,473.60 |
| 6164845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6164847 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6164848 | SUPPLY IMPLANT | Supply/Implant | $12,710.40 |
| 6164849 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6164850 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6164853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6164854 | SUPPLY IMPLANT | Supply/Implant | $82,174.46 |
| 6164855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164857 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6164861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6164863 | SUPPLY IMPLANT | Supply/Implant | $28,108.80 |
| 6164865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,441.60 |
| 6164866 | GENERAL SUPPLY | Supply/Implant | $7,265.28 |
| 6164867 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164868 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164871 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6164873 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6164874 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6164875 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6164878 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $38,336.00 |
| 6164879 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6164880 | SUPPLY IMPLANT | Supply/Implant | $9,676.80 |
| 6164881 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164882 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6164883 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6164884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $98,176.00 |
| 6164885 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6164886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,499.20 |
| 6164887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6164888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6164889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6164890 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6164891 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,393.60 |
| 6164892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164895 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6164897 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6164898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,284.03 |
| 6164899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,254.78 |
| 6164900 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,233.15 |
| 6164903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164906 | SUPPLY IMPLANT | Supply/Implant | $69,184.00 |
| 6164907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $573.44 |
| 6164911 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6164931 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6164933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6164941 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6164943 | SUPPLY IMPLANT | Supply/Implant | $9,817.60 |
| 6164944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,694.40 |
| 6164945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,694.40 |
| 6164947 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $83,443.20 |
| 6164948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $88,537.60 |
| 6164952 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6164953 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6164954 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6164955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6164956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164959 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,611.20 |
| 6164963 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,473.60 |
| 6164964 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6164966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164967 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6164968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6164973 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164975 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6164976 | INTERSPINOUS IMPLANT | Supply/Implant | $29,376.00 |
| 6164977 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6164978 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6164979 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6164980 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6164985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164988 | STERILE SUPPLY | Supply/Implant | $334.23 |
| 6164989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,868.16 |
| 6164992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6164993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $452.48 |
| 6164994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,886.08 |
| 6164995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6164996 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6164998 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,323.52 |
| 6165000 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6165003 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6165004 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165005 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6165008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165009 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6165010 | GENERAL SUPPLY | Supply/Implant | $163.84 |
| 6165011 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6165012 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6165014 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $147,525.00 |
| 6165015 | GENERAL SUPPLY | Supply/Implant | $783.36 |
| 6165016 | STERILE SUPPLY | Supply/Implant | $204.80 |
| 6165018 | SUPPLY IMPLANT | Supply/Implant | $151,725.00 |
| 6165031 | SUPPLY IMPLANT | Supply/Implant | $138,075.00 |
| 6165032 | SUPPLY IMPLANT | Supply/Implant | $138,075.00 |
| 6165046 | GENERAL SUPPLY | Supply/Implant | $186.33 |
| 6165049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165050 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6165051 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6165056 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165057 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165058 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6165059 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6165060 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6165061 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6165064 | GENERAL SUPPLY | Supply/Implant | $1,068.26 |
| 6165069 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6165079 | GENERAL SUPPLY | Supply/Implant | $196.15 |
| 6165080 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165081 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165082 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165083 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165085 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6165088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $46,604.80 |
| 6165089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165093 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6165098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,888.00 |
| 6165100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,985.60 |
| 6165101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165102 | SUPPLY IMPLANT | Supply/Implant | $9,203.20 |
| 6165104 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6165105 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6165106 | GENERAL SUPPLY | Supply/Implant | $12,800.00 |
| 6165107 | SUPPLY IMPLANT | Supply/Implant | $78,668.80 |
| 6165108 | SUPPLY IMPLANT | Supply/Implant | $22,873.60 |
| 6165109 | SUPPLY IMPLANT | Supply/Implant | $21,120.00 |
| 6165110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6165111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6165112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6165113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6165114 | SUPPLY IMPLANT | Supply/Implant | $307.42 |
| 6165118 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6165119 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165120 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,840.00 |
| 6165122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6165124 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6165125 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $793.60 |
| 6165128 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $793.60 |
| 6165134 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6165135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6165136 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6165137 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6165138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6165140 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6165142 | SUPPLY IMPLANT | Supply/Implant | $95,744.00 |
| 6165148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6165152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6165153 | STERILE SUPPLY | Supply/Implant | $1,121.41 |
| 6165154 | STERILE SUPPLY | Supply/Implant | $1,121.41 |
| 6165155 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,328.00 |
| 6165156 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6165157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6165158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6165159 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $16,640.00 |
| 6165162 | SUPPLY IMPLANT | Supply/Implant | $6,845.18 |
| 6165168 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6165176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,894.72 |
| 6165177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,894.72 |
| 6165178 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6165182 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6165183 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,725.70 |
| 6165184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,542.91 |
| 6165190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,476.80 |
| 6165196 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $33,454.08 |
| 6165209 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,600.00 |
| 6165213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6165214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6165215 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6165216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6165217 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165269 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $475,000.00 |
| 6165276 | SUPPLY IMPLANT | Supply/Implant | $1,740.80 |
| 6165282 | GRAFIX CORE | Supply/Implant | $27,584.00 |
| 6165287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6165288 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6165296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6165309 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,907.20 |
| 6165315 | EVENT RECORDER CARDIAC | Supply/Implant | $53,760.00 |
| 6165316 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6165317 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6165318 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6165319 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6165320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6165321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6165323 | SUPPLY IMPLANT | Supply/Implant | $11,942.40 |
| 6165324 | SUPPLY IMPLANT | Supply/Implant | $5,209.60 |
| 6165325 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6165330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6165334 | SUPPLY IMPLANT | Supply/Implant | $3,540.48 |
| 6165338 | SUPPLY IMPLANT | Supply/Implant | $18,880.00 |
| 6165339 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6165340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6165341 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $16,640.00 |
| 6165342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,383.81 |
| 6165344 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6165348 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,473.60 |
| 6165349 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6165350 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165351 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165352 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165355 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6165356 | SUPPLY IMPLANT | Supply/Implant | $8,051.20 |
| 6165357 | SUPPLY IMPLANT | Supply/Implant | $11,481.60 |
| 6165358 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6165361 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6165362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6165363 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,497.60 |
| 6165364 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,432.00 |
| 6165365 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6165366 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6165367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,366.40 |
| 6165373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6165380 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $5,884.54 |
| 6165381 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6165382 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6165383 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6165384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6165385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,049.60 |
| 6165386 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6165387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6165388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6165389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6165390 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6165391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165393 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165394 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6165398 | GENERAL SUPPLY | Supply/Implant | $179.55 |
| 6165422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6165423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,408.00 |
| 6165424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6165425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6165427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6165428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6165429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $291.84 |
| 6165430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6165431 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $201,663.00 |
| 6165432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6165433 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6165434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6165438 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $18,150.40 |
| 6165439 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $18,150.40 |
| 6165440 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $18,150.40 |
| 6165441 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165442 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6165443 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6165444 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165445 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165446 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6165447 | STERILE SUPPLY | Supply/Implant | $1,698.30 |
| 6165448 | GUIDE WIRE | Supply/Implant | $780.80 |
| 6165449 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6165450 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6165451 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6165452 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $6,720.00 |
| 6165453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6165455 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,854.72 |
| 6165457 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6165458 | STERILE SUPPLY | Supply/Implant | $4,608.00 |
| 6165460 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165463 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6165464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,227.20 |
| 6165465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,227.20 |
| 6165466 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6165467 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6165470 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6165472 | SUPPLY IMPLANT | Supply/Implant | $42,240.00 |
| 6165473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,513.28 |
| 6165474 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,513.28 |
| 6165475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,513.28 |
| 6165476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,667.84 |
| 6165477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,335.10 |
| 6165478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,467.78 |
| 6165479 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6165480 | CATHETER, GUIDING | Supply/Implant | $87,680.00 |
| 6165482 | CATHETER, GUIDING | Supply/Implant | $87,680.00 |
| 6165483 | CATHETER, GUIDING | Supply/Implant | $74,880.00 |
| 6165484 | CATHETER, GUIDING | Supply/Implant | $25,536.00 |
| 6165485 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6165486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6165487 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165488 | STERILE SUPPLY | Supply/Implant | $1,587.84 |
| 6165489 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6165498 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6165499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.32 |
| 6165500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165501 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165502 | GUIDE WIRE | Supply/Implant | $640.00 |
| 6165507 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165518 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6165551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6165552 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6165553 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6165555 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,321.60 |
| 6165557 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6165559 | SKIN SUBSTITUTE, NOS | Supply/Implant | $13,824.00 |
| 6165560 | SKIN SUBSTITUTE, NOS | Supply/Implant | $16,576.00 |
| 6165561 | SKIN SUBSTITUTE, NOS | Supply/Implant | $44,736.00 |
| 6165563 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6165564 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6165568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6165570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6165572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165575 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165576 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165577 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6165581 | SUPPLY IMPLANT | Supply/Implant | $5,427.20 |
| 6165582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,294.08 |
| 6165583 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,520.00 |
| 6165584 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $2,099.20 |
| 6165586 | SUPPLY IMPLANT | Supply/Implant | $73,216.00 |
| 6165587 | SUPPLY IMPLANT | Supply/Implant | $53,107.20 |
| 6165588 | SUPPLY IMPLANT | Supply/Implant | $42,240.00 |
| 6165591 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6165592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,043.52 |
| 6165593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,806.72 |
| 6165594 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6165607 | SUPPLY IMPLANT | Supply/Implant | $107,584.00 |
| 6165608 | SUPPLY IMPLANT | Supply/Implant | $205,380.00 |
| 6165609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6165616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6165617 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6165619 | CATHETER, GUIDING | Supply/Implant | $11,456.00 |
| 6165625 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6165629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6165630 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $2,833.92 |
| 6165632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,283.20 |
| 6165633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,041.60 |
| 6165638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,630.40 |
| 6165639 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6165640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6165641 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6165642 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6165645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165646 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6165647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6165648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,816.00 |
| 6165649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6165654 | STERILE SUPPLY | Supply/Implant | $6,076.16 |
| 6165655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,910.40 |
| 6165656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,910.40 |
| 6165657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,910.40 |
| 6165658 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6165659 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165660 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $105,356.80 |
| 6165661 | SUPPLY IMPLANT | Supply/Implant | $8,121.60 |
| 6165662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6165663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6165664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6165665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $707.20 |
| 6165666 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $11,511.42 |
| 6165667 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6165668 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165669 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165670 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6165672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6165673 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6165674 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6165675 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6165676 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6165680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,912.00 |
| 6165683 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6165684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6165685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6165687 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,141.95 |
| 6165689 | SUPPLY IMPLANT | Supply/Implant | $28,713.60 |
| 6165691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6165692 | SUPPLY IMPLANT | Supply/Implant | $20,480.00 |
| 6165693 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6165698 | GENERAL SUPPLY | Supply/Implant | $169.08 |
| 6165700 | PMKR, DUAL, RATE-RESP | Supply/Implant | $58,880.00 |
| 6165701 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,737.60 |
| 6165702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6165703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6165704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165705 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6165706 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6165708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6165720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,694.40 |
| 6165723 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6165724 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $83,443.20 |
| 6165725 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $88,537.60 |
| 6165726 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6165727 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6165728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6165729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6165730 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6165731 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6165734 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6165742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6165743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6165744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165751 | EVENT RECORDER CARDIAC | Supply/Implant | $63,936.00 |
| 6165754 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $3,200.00 |
| 6165755 | GENERAL SUPPLY | Supply/Implant | $250.79 |
| 6165756 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,630.40 |
| 6165757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165762 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6165763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6165764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6165765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6165766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6165767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,409.28 |
| 6165768 | GENERAL SUPPLY | Supply/Implant | $9,587.20 |
| 6165769 | SUPPLY IMPLANT | Supply/Implant | $1,376.00 |
| 6165770 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,640.00 |
| 6165771 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,640.00 |
| 6165772 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,000.00 |
| 6165773 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,000.00 |
| 6165774 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,000.00 |
| 6165777 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6165778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6165779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6165780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,920.00 |
| 6165781 | SUPPLY IMPLANT | Supply/Implant | $3,161.60 |
| 6165782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,576.00 |
| 6165783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $972.80 |
| 6165784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,576.00 |
| 6165786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6165787 | STERILE SUPPLY | Supply/Implant | $7,296.00 |
| 6165789 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $4,480.00 |
| 6165790 | SUPPLY IMPLANT | Supply/Implant | $797.44 |
| 6165792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,616.00 |
| 6165794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6165795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,630.40 |
| 6165796 | SUPPLY IMPLANT | Supply/Implant | $1,741.57 |
| 6165798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.00 |
| 6165803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6165804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6165805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,976.00 |
| 6165810 | SUPPLY IMPLANT | Supply/Implant | $13,056.00 |
| 6165811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6165812 | STERILE SUPPLY | Supply/Implant | $614.40 |
| 6165817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,662.40 |
| 6165823 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6165825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6165826 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,120.00 |
| 6165828 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,340.80 |
| 6165831 | SUPPLY IMPLANT | Supply/Implant | $3,468.80 |
| 6165833 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6165834 | SUPPLY IMPLANT | Supply/Implant | $13,312.00 |
| 6165835 | OCULAR IMPLANT | Supply/Implant | $192.00 |
| 6165836 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6165837 | GENERAL SUPPLY | Supply/Implant | $19,840.00 |
| 6165842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6165843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6165845 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6165846 | SUPPLY IMPLANT | Supply/Implant | $205,380.00 |
| 6165847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6165848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6165849 | SUPPLY IMPLANT | Supply/Implant | $8,793.60 |
| 6165850 | SUPPLY IMPLANT | Supply/Implant | $3,404.80 |
| 6165851 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,160.00 |
| 6165852 | SUPPLY IMPLANT | Supply/Implant | $1,168.00 |
| 6165853 | SUPPLY IMPLANT | Supply/Implant | $1,952.00 |
| 6165854 | SUPPLY IMPLANT | Supply/Implant | $1,968.00 |
| 6165855 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6165856 | GENERAL SUPPLY | Supply/Implant | $21,056.00 |
| 6165857 | GENERAL SUPPLY | Supply/Implant | $14,016.00 |
| 6165858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $63,193.60 |
| 6165859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6165860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6165861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6165862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,328.00 |
| 6165863 | SUPPLY IMPLANT | Supply/Implant | $2,521.60 |
| 6165864 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6165865 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6165866 | SUPPLY IMPLANT | Supply/Implant | $5,037.57 |
| 6165867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6165868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,143.68 |
| 6165869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6165870 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165872 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6165873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6165874 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165875 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6165876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6165878 | SUPPLY IMPLANT | Supply/Implant | $80,629.76 |
| 6165879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6165884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6165893 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6165894 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6165897 | GENERAL SUPPLY | Supply/Implant | $310.40 |
| 6165899 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6165904 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6165905 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6165927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6165928 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6165929 | INTERSPINOUS IMPLANT | Supply/Implant | $115,200.00 |
| 6165930 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6165937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6165938 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6165939 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6165940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,328.83 |
| 6165941 | GENERAL SUPPLY | Supply/Implant | $15,104.00 |
| 6165944 | SUPPLY IMPLANT | Supply/Implant | $208,868.00 |
| 6165950 | STERILE SUPPLY | Supply/Implant | $5,436.38 |
| 6165953 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165954 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6165955 | INTERSPINOUS IMPLANT | Supply/Implant | $37,760.00 |
| 6165956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6165961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,294.40 |
| 6165962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6165967 | GENERAL SUPPLY | Supply/Implant | $819.88 |
| 6165968 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165969 | SUPPLY IMPLANT | Supply/Implant | $4,642.56 |
| 6165970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6165971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6165972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165973 | SUPPLY IMPLANT | Supply/Implant | $13,798.40 |
| 6165974 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6165975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $39,680.00 |
| 6165977 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6165987 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6165990 | GENERAL SUPPLY | Supply/Implant | $196.26 |
| 6165991 | GENERAL SUPPLY | Supply/Implant | $217.60 |
| 6165994 | GENERAL SUPPLY | Supply/Implant | $10,419.20 |
| 6165995 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6165997 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6166011 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $2,432.00 |
| 6166013 | SUPPLY IMPLANT | Supply/Implant | $30,297.60 |
| 6166014 | EVENT RECORDER CARDIAC | Supply/Implant | $53,760.00 |
| 6166015 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,411.52 |
| 6166026 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $35,225.60 |
| 6166028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166037 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6166046 | SUPPLY IMPLANT | Supply/Implant | $9,792.00 |
| 6166047 | SUPPLY IMPLANT | Supply/Implant | $9,792.00 |
| 6166048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6166049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166050 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166051 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166052 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6166053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6166054 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6166055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6166056 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166060 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6166061 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166064 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6166070 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $7,616.00 |
| 6166089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,643.20 |
| 6166090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $67,200.00 |
| 6166091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6166092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,235.20 |
| 6166093 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6166094 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6166095 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,000.00 |
| 6166096 | STERILE SUPPLY | Supply/Implant | $1,536.00 |
| 6166097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6166098 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6166099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,368.96 |
| 6166101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,048.32 |
| 6166102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,784.00 |
| 6166103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6166104 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166108 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6166109 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6166111 | SUPPLY IMPLANT | Supply/Implant | $412.16 |
| 6166112 | SUPPLY IMPLANT | Supply/Implant | $4,828.16 |
| 6166113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,060.80 |
| 6166114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,475.84 |
| 6166115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,118.72 |
| 6166116 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6166117 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6166120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6166122 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6166123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6166127 | SUPPLY IMPLANT | Supply/Implant | $2,795.52 |
| 6166129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6166130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6166131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $50,849.92 |
| 6166132 | SUPPLY IMPLANT | Supply/Implant | $247,071.25 |
| 6166133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6166134 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6166135 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6166136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166139 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6166140 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,141.95 |
| 6166142 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6166145 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6166146 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6166147 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6166152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166153 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6166154 | INTERSPINOUS IMPLANT | Supply/Implant | $123,900.00 |
| 6166158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,083.20 |
| 6166159 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6166160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,936.00 |
| 6166161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,936.00 |
| 6166165 | SUPPLY IMPLANT | Supply/Implant | $4,120.70 |
| 6166166 | SUPPLY IMPLANT | Supply/Implant | $4,120.70 |
| 6166168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6166169 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6166170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6166171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6166172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6166173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6166190 | SUPPLY IMPLANT | Supply/Implant | $7,076.48 |
| 6166192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6166195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166201 | SUPPLY IMPLANT | Supply/Implant | $4,849.92 |
| 6166203 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6166207 | MESH (IMPLANTABLE) | Supply/Implant | $183,750.00 |
| 6166208 | SUPPLY IMPLANT | Supply/Implant | $6,038.40 |
| 6166210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6166217 | CATHETER, GUIDING | Supply/Implant | $5,440.00 |
| 6166219 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6166220 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6166221 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $10,560.00 |
| 6166222 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6166223 | GENERAL SUPPLY | Supply/Implant | $19,840.00 |
| 6166224 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166225 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $202,000.00 |
| 6166226 | AICD, SINGLE CHAMBER | Supply/Implant | $154,531.13 |
| 6166233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,663.49 |
| 6166234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6166235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,663.49 |
| 6166236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,246.08 |
| 6166237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6166238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6166239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,240.00 |
| 6166240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,503.36 |
| 6166241 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,503.36 |
| 6166242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6166243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6166244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6166246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6166247 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6166248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6166250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6166251 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6166252 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6166269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6166270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6166271 | GENERAL SUPPLY | Supply/Implant | $20,915.20 |
| 6166281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,201.28 |
| 6166287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6166288 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6166289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6166292 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6166293 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6166327 | GENERAL SUPPLY | Supply/Implant | $323.94 |
| 6166328 | SUPPLY IMPLANT | Supply/Implant | $209,241.70 |
| 6166329 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6166330 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6166333 | STERILE SUPPLY | Supply/Implant | $427.14 |
| 6166335 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6166336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166340 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6166341 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6166342 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6166346 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6166347 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,912.00 |
| 6166351 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,772.80 |
| 6166352 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6166353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,484.80 |
| 6166354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,484.80 |
| 6166355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,200.00 |
| 6166356 | GENERAL SUPPLY | Supply/Implant | $3,782.40 |
| 6166357 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6166359 | GENERAL SUPPLY | Supply/Implant | $2,515.20 |
| 6166360 | GENERAL SUPPLY | Supply/Implant | $551.94 |
| 6166361 | GENERAL SUPPLY | Supply/Implant | $1,718.40 |
| 6166362 | GENERAL SUPPLY | Supply/Implant | $1,075.20 |
| 6166363 | GENERAL SUPPLY | Supply/Implant | $1,075.20 |
| 6166364 | GENERAL SUPPLY | Supply/Implant | $3,542.40 |
| 6166365 | GENERAL SUPPLY | Supply/Implant | $3,657.60 |
| 6166366 | GENERAL SUPPLY | Supply/Implant | $9,004.80 |
| 6166367 | GENERAL SUPPLY | Supply/Implant | $22,185.60 |
| 6166368 | GENERAL SUPPLY | Supply/Implant | $26,102.40 |
| 6166369 | GENERAL SUPPLY | Supply/Implant | $21,302.40 |
| 6166370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,153.60 |
| 6166371 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6166372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,153.60 |
| 6166394 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $7,616.00 |
| 6166396 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6166397 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6166398 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6166399 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,353.60 |
| 6166400 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6166401 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,608.00 |
| 6166402 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,353.60 |
| 6166403 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,200.00 |
| 6166410 | SUPPLY IMPLANT | Supply/Implant | $4,304.77 |
| 6166411 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6166412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6166413 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6166414 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6166417 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6166418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6166419 | SUPPLY IMPLANT | Supply/Implant | $195,108.06 |
| 6166420 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6166421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,673.60 |
| 6166424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.20 |
| 6166425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.20 |
| 6166426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.20 |
| 6166427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,928.64 |
| 6166428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,403.20 |
| 6166429 | SUPPLY IMPLANT | Supply/Implant | $62,112.64 |
| 6166430 | SUPPLY IMPLANT | Supply/Implant | $2,597.25 |
| 6166431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6166432 | STERILE SUPPLY | Supply/Implant | $2,969.60 |
| 6166434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,656.00 |
| 6166435 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6166436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6166437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6166438 | SUPPLY IMPLANT | Supply/Implant | $44,876.80 |
| 6166439 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6166440 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6166441 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $12,160.00 |
| 6166442 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6166443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,098.24 |
| 6166452 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,772.80 |
| 6166457 | GENERAL SUPPLY | Supply/Implant | $7,315.20 |
| 6166458 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6166459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6166460 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6166461 | MESH (IMPLANTABLE) | Supply/Implant | $66,594.94 |
| 6166465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6166466 | GENERAL SUPPLY | Supply/Implant | $330.88 |
| 6166467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,098.24 |
| 6166494 | SUPPLY IMPLANT | Supply/Implant | $11,622.40 |
| 6166495 | GENERAL SUPPLY | Supply/Implant | $15,994.88 |
| 6166496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6166497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,055.36 |
| 6166498 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $17,280.00 |
| 6166500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,984.00 |
| 6166501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6166502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6166503 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6166504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6166505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6166508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,416.00 |
| 6166509 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6166510 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6166511 | STERILE SUPPLY | Supply/Implant | $1,894.40 |
| 6166513 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6166518 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6166521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,416.00 |
| 6166522 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6166524 | STERILE SUPPLY | Supply/Implant | $24,960.00 |
| 6166525 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6166526 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166527 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6166529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,984.00 |
| 6166533 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6166534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6166535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6166536 | STERILE SUPPLY | Supply/Implant | $11,489.28 |
| 6166537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,608.00 |
| 6166539 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $22,976.00 |
| 6166542 | GENERAL SUPPLY | Supply/Implant | $54,400.00 |
| 6166543 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6166544 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6166546 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $672.38 |
| 6166550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,532.80 |
| 6166551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6166552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,204.80 |
| 6166553 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $24,153.60 |
| 6166561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6166562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6166563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6166566 | SUPPLY IMPLANT | Supply/Implant | $427,500.00 |
| 6166569 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6166571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,099.20 |
| 6166575 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6166576 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6166577 | INTERSPINOUS IMPLANT | Supply/Implant | $84,128.00 |
| 6166578 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6166580 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6166581 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6166582 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6166583 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6166584 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6166585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6166586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6166587 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6166588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6166593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6166594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6166595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6166597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6166598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,704.00 |
| 6166599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,254.72 |
| 6166600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,254.72 |
| 6166601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,254.72 |
| 6166602 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $10,560.00 |
| 6166603 | CATH, DRAINAGE | Supply/Implant | $1,516.80 |
| 6166604 | GUIDE WIRE | Supply/Implant | $1,600.00 |
| 6166616 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6166617 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6166619 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6166621 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,532.80 |
| 6166622 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6166623 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,662.40 |
| 6166625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6166628 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6166629 | INTERSPINOUS IMPLANT | Supply/Implant | $57,600.00 |
| 6166634 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6166642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,774.40 |
| 6166643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,984.00 |
| 6166647 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6166648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6166649 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6166650 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6166651 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6166652 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $535.04 |
| 6166653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6166655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6166656 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6166658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6166659 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,280.00 |
| 6166663 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6166664 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6166665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,040.00 |
| 6166666 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6166669 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6166674 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6166675 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6166679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166681 | SUPPLY IMPLANT | Supply/Implant | $162,750.00 |
| 6166682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,501.89 |
| 6166705 | GENERAL SUPPLY | Supply/Implant | $4,915.20 |
| 6166706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,298.88 |
| 6166708 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,912.00 |
| 6166709 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6166710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6166727 | SUPPLY IMPLANT | Supply/Implant | $7,206.40 |
| 6166728 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6166730 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6166731 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6166732 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6166736 | AICD, DUAL CHAMBER | Supply/Implant | $158,602.50 |
| 6166738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,910.40 |
| 6166739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6166740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,584.00 |
| 6166745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6166750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6166751 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6166752 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6166753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,928.64 |
| 6166754 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6166755 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6166756 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6166757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6166758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,968.51 |
| 6166759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,914.43 |
| 6166780 | SUPPLY IMPLANT | Supply/Implant | $60,160.00 |
| 6166781 | SUPPLY IMPLANT | Supply/Implant | $60,160.00 |
| 6166786 | AICD, SINGLE CHAMBER | Supply/Implant | $154,531.13 |
| 6166799 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166801 | SUPPLY IMPLANT | Supply/Implant | $24,320.00 |
| 6166807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6166808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6166809 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6166811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6166813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6166814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6166815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6166816 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6166841 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6166842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,798.40 |
| 6166843 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6166846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,163.52 |
| 6166847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6166848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6166849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6166850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6166851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6166852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6166856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $97,351.68 |
| 6166857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,454.40 |
| 6166858 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6166859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6166860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.80 |
| 6166866 | ORTH/DEVIC/DRUG BN/BN,TIS/BN | Supply/Implant | $12,236.80 |
| 6166871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6166876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6166992 | SUPPLY IMPLANT | Supply/Implant | $12,840.96 |
| 6999901 | EXTERNAL COCHLEAR PROCESSOR | Supply/Implant | $132,870.15 |
| 6999902 | EXTERNAL COCHLEAR MAGNET | Supply/Implant | $26,226.30 |
| 6999910 | PROLACTA HMF 10ML 93901-10 | Supply/Implant | $73.24 |
| 6999911 | PROLACTA HMF 20ML 93901-20 | Supply/Implant | $73.24 |
| 6999912 | PROLACTA HMF 30ML 93901-30 | Supply/Implant | $73.24 |
| 6999913 | PROLACTA HMF 40ML 93901-40 | Supply/Implant | $73.24 |
| 6999915 | PROLACTA RTF 26 100ML 95026-100 | Supply/Implant | $20.92 |
| 6999917 | MILK DONOR 50ML NY MILK BANK | Supply/Implant | $2.52 |
| 6999918 | MILK DONOR 100ML NY MILK BANK | Supply/Implant | $1.70 |
| 6999920 | MILK DONOR 60ML NY MILK BANK | Supply/Implant | $2.52 |
| 6999921 | MILK DONOR 120ML NY MILK BANK | Supply/Implant | $1.89 |
| 2025960 | HC TELEHEALTH FACILITY FEE | Telemedicine | $84.58 |
| 2026539 | HC HH TELEHEALTH FACILITY FEE | Telemedicine | $174.90 |
| 2026579 | HC HH TELEMONITORING/HOME SNTI PER MNTH | Telemedicine | $420.00 |
| 2026807 | HC HCPRO PHONE CALL 5-10MIN | Telemedicine | $20.44 |
| 2026808 | HC HCPRO PHONE CALL 11-20MIN | Telemedicine | $40.37 |
| 2026809 | HC HCPRO PHONE CALL 21-30MIN | Telemedicine | $58.30 |
| 2026815 | HC INPT/TELE FOLLOW UP 15 MIN | Telemedicine | $47.35 |
| 2026816 | HC INPT/TELE FOLLOW UP 25 MIN | Telemedicine | $87.16 |
| 2026933 | HC FHC TELE SBH HCPRO PHONE CALL 5-10MIN | Telemedicine | $19.29 |
| 2025437 | HC PRE ARRIV TRAUMA RESPONS W/ CC | Trauma Response - Level I | $7,511.03 |
| 2026977 | HC PRE ARRIV TRAUMA RESPONS W/O CC | Trauma Response - Level I | $7,511.03 |
| MS-DRG | Description | Average Charges |
|---|---|---|
| MS001 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC | $2,257,244 |
| MS002 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC | $1,474,938 |
| MS003 | ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH NECK W MAJ O.R. | $1,557,354 |
| MS004 | TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH NECK W/O MAJ O.R. | $742,629 |
| MS005 | LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT | $1,383,670 |
| MS006 | LIVER TRANSPLANT W/O MCC | $1,021,471 |
| MS007 | LUNG TRANSPLANT | $1,378,765 |
| MS008 | SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT | $1,005,607 |
| MS010 | PANCREAS TRANSPLANT | $740,971 |
| MS011 | TRACHEOSTOMY FOR FACE, MOUTH NECK DIAGNOSES OR LARYNGECTOMY W MCC | $634,928 |
| MS012 | TRACHEOSTOMY FOR FACE, MOUTH NECK DIAGNOSES OR LARYNGECTOMY W CC | $426,523 |
| MS013 | TRACHEOSTOMY FOR FACE, MOUTH NECK DIAGNOSES OR LARYNGECTOMY W/O CC/MCC | $210,193 |
| MS014 | ALLOGENEIC BONE MARROW TRANSPLANT | $744,697 |
| MS016 | AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC OR T-CELL IMMUNOTHERAPY | $482,617 |
| MS020 | INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC | $631,090 |
| MS021 | INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC | $458,886 |
| MS022 | INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC | $262,359 |
| MS023 | CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX W MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY W NEUROSTIMULATOR | $524,985 |
| MS024 | CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC | $330,651 |
| MS025 | CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC | $314,060 |
| MS026 | CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W CC | $273,197 |
| MS027 | CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC | $253,063 |
| MS028 | SPINAL PROCEDURES W MCC | $364,804 |
| MS029 | SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS | $226,233 |
| MS030 | SPINAL PROCEDURES W/O CC/MCC | $154,373 |
| MS031 | VENTRICULAR SHUNT PROCEDURES W MCC | $263,249 |
| MS032 | VENTRICULAR SHUNT PROCEDURES W CC | $160,246 |
| MS033 | VENTRICULAR SHUNT PROCEDURES W/O CC/MCC | $110,179 |
| MS034 | CAROTID ARTERY STENT PROCEDURE W MCC | $284,779 |
| MS035 | CAROTID ARTERY STENT PROCEDURE W CC | $182,446 |
| MS036 | CAROTID ARTERY STENT PROCEDURE W/O CC/MCC | $158,700 |
| MS037 | EXTRACRANIAL PROCEDURES W MCC | $221,542 |
| MS038 | EXTRACRANIAL PROCEDURES W CC | $144,519 |
| MS039 | EXTRACRANIAL PROCEDURES W/O CC/MCC | $88,423 |
| MS040 | PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W MCC | $262,627 |
| MS041 | PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM | $211,599 |
| MS042 | PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W/O CC/MCC | $205,669 |
| MS052 | SPINAL DISORDERS INJURIES W CC/MCC | $340,694 |
| MS053 | SPINAL DISORDERS INJURIES W/O CC/MCC | $165,071 |
| MS054 | NERVOUS SYSTEM NEOPLASMS W MCC | $122,110 |
| MS055 | NERVOUS SYSTEM NEOPLASMS W/O MCC | $77,160 |
| MS056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC | $190,375 |
| MS057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC | $150,804 |
| MS058 | MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W MCC | $147,596 |
| MS059 | MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W CC | $99,753 |
| MS060 | MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W/O CC/MCC | $81,396 |
| MS061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W MCC | $241,540 |
| MS062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC | $171,641 |
| MS063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC | $149,375 |
| MS064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC | $149,124 |
| MS065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS | $95,883 |
| MS066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC | $70,396 |
| MS067 | NONSPECIFIC CVA PRECEREBRAL OCCLUSION W/O INFARCT W MCC | $104,780 |
| MS068 | NONSPECIFIC CVA PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC | $64,336 |
| MS069 | TRANSIENT ISCHEMIA W/O THROMBOLYTIC | $67,012 |
| MS070 | NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC | $175,575 |
| MS071 | NONSPECIFIC CEREBROVASCULAR DISORDERS W CC | $106,181 |
| MS072 | NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC | $75,074 |
| MS073 | CRANIAL PERIPHERAL NERVE DISORDERS W MCC | $166,705 |
| MS074 | CRANIAL PERIPHERAL NERVE DISORDERS W/O MCC | $89,722 |
| MS075 | VIRAL MENINGITIS W CC/MCC | $95,892 |
| MS076 | VIRAL MENINGITIS W/O CC/MCC | $37,858 |
| MS077 | HYPERTENSIVE ENCEPHALOPATHY W MCC | $83,111 |
| MS078 | HYPERTENSIVE ENCEPHALOPATHY W CC | $138,144 |
| MS080 | NONTRAUMATIC STUPOR COMA W MCC | $116,672 |
| MS081 | NONTRAUMATIC STUPOR COMA W/O MCC | $57,490 |
| MS082 | TRAUMATIC STUPOR COMA, COMA >1 HR W MCC | $127,111 |
| MS083 | TRAUMATIC STUPOR COMA, COMA >1 HR W CC | $101,163 |
| MS084 | TRAUMATIC STUPOR COMA, COMA >1 HR W/O CC/MCC | $59,711 |
| MS085 | TRAUMATIC STUPOR COMA, COMA <1 HR W MCC | $136,882 |
| MS086 | TRAUMATIC STUPOR COMA, COMA <1 HR W CC | $84,509 |
| MS087 | TRAUMATIC STUPOR COMA, COMA <1 HR W/O CC/MCC | $45,501 |
| MS089 | CONCUSSION W CC | $96,554 |
| MS090 | CONCUSSION W/O CC/MCC | $52,292 |
| MS091 | OTHER DISORDERS OF NERVOUS SYSTEM W MCC | $162,192 |
| MS092 | OTHER DISORDERS OF NERVOUS SYSTEM W CC | $127,073 |
| MS093 | OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC | $69,509 |
| MS094 | BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC | $188,314 |
| MS095 | BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC | $196,269 |
| MS096 | BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC | $185,819 |
| MS097 | NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC | $339,221 |
| MS098 | NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC | $178,315 |
| MS099 | NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC | $132,724 |
| MS100 | SEIZURES W MCC | $154,490 |
| MS101 | SEIZURES W/O MCC | $95,930 |
| MS102 | HEADACHES W MCC | $99,605 |
| MS103 | HEADACHES W/O MCC | $53,283 |
| MS113 | ORBITAL PROCEDURES W CC/MCC | $99,602 |
| MS114 | ORBITAL PROCEDURES W/O CC/MCC | $126,738 |
| MS115 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT | $148,438 |
| MS116 | INTRAOCULAR PROCEDURES W CC/MCC | $143,510 |
| MS117 | INTRAOCULAR PROCEDURES W/O CC/MCC | $52,810 |
| MS121 | ACUTE MAJOR EYE INFECTIONS W CC/MCC | $52,532 |
| MS122 | ACUTE MAJOR EYE INFECTIONS W/O CC/MCC | $31,211 |
| MS123 | NEUROLOGICAL EYE DISORDERS | $81,418 |
| MS124 | OTHER DISORDERS OF THE EYE W MCC | $107,559 |
| MS125 | OTHER DISORDERS OF THE EYE W/O MCC | $57,174 |
| MS129 | MAJOR HEAD NECK PROCEDURES W CC/MCC OR MAJOR DEVICE | $320,293 |
| MS130 | MAJOR HEAD NECK PROCEDURES W/O CC/MCC | $105,003 |
| MS131 | CRANIAL/FACIAL PROCEDURES W CC/MCC | $217,337 |
| MS132 | CRANIAL/FACIAL PROCEDURES W/O CC/MCC | $120,406 |
| MS133 | OTHER EAR, NOSE, MOUTH THROAT O.R. PROCEDURES W CC/MCC | $142,570 |
| MS134 | OTHER EAR, NOSE, MOUTH THROAT O.R. PROCEDURES W/O CC/MCC | $71,611 |
| MS135 | SINUS MASTOID PROCEDURES W CC/MCC | $163,319 |
| MS136 | SINUS MASTOID PROCEDURES W/O CC/MCC | $117,611 |
| MS137 | MOUTH PROCEDURES W CC/MCC | $52,623 |
| MS138 | MOUTH PROCEDURES W/O CC/MCC | $55,408 |
| MS146 | EAR, NOSE, MOUTH THROAT MALIGNANCY W MCC | $108,781 |
| MS147 | EAR, NOSE, MOUTH THROAT MALIGNANCY W CC | $53,718 |
| MS148 | EAR, NOSE, MOUTH THROAT MALIGNANCY W/O CC/MCC | $94,383 |
| MS149 | DYSEQUILIBRIUM | $58,338 |
| MS150 | EPISTAXIS W MCC | $501,959 |
| MS151 | EPISTAXIS W/O MCC | $54,333 |
| MS152 | OTITIS MEDIA URI W MCC | $60,293 |
| MS153 | OTITIS MEDIA URI W/O MCC | $26,827 |
| MS154 | OTHER EAR, NOSE, MOUTH THROAT DIAGNOSES W MCC | $171,104 |
| MS155 | OTHER EAR, NOSE, MOUTH THROAT DIAGNOSES W CC | $60,625 |
| MS156 | OTHER EAR, NOSE, MOUTH THROAT DIAGNOSES W/O CC/MCC | $34,882 |
| MS157 | DENTAL ORAL DISEASES W MCC | $107,935 |
| MS158 | DENTAL ORAL DISEASES W CC | $53,674 |
| MS159 | DENTAL ORAL DISEASES W/O CC/MCC | $40,935 |
| MS163 | MAJOR CHEST PROCEDURES W MCC | $275,944 |
| MS164 | MAJOR CHEST PROCEDURES W CC | $180,944 |
| MS165 | MAJOR CHEST PROCEDURES W/O CC/MCC | $157,027 |
| MS166 | OTHER RESP SYSTEM O.R. PROCEDURES W MCC | $319,894 |
| MS167 | OTHER RESP SYSTEM O.R. PROCEDURES W CC | $113,506 |
| MS168 | OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC | $112,346 |
| MS175 | PULMONARY EMBOLISM W MCC | $99,811 |
| MS176 | PULMONARY EMBOLISM W/O MCC | $51,415 |
| MS177 | RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | $116,798 |
| MS178 | RESPIRATORY INFECTIONS INFLAMMATIONS W CC | $83,221 |
| MS179 | RESPIRATORY INFECTIONS INFLAMMATIONS W/O CC/MCC | $58,824 |
| MS180 | RESPIRATORY NEOPLASMS W MCC | $100,836 |
| MS181 | RESPIRATORY NEOPLASMS W CC | $56,263 |
| MS182 | RESPIRATORY NEOPLASMS W/O CC/MCC | $32,563 |
| MS183 | MAJOR CHEST TRAUMA W MCC | $137,130 |
| MS184 | MAJOR CHEST TRAUMA W CC | $71,261 |
| MS185 | MAJOR CHEST TRAUMA W/O CC/MCC | $49,842 |
| MS186 | PLEURAL EFFUSION W MCC | $87,999 |
| MS187 | PLEURAL EFFUSION W CC | $62,907 |
| MS188 | PLEURAL EFFUSION W/O CC/MCC | $41,094 |
| MS189 | PULMONARY EDEMA RESPIRATORY FAILURE | $77,236 |
| MS190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC | $73,893 |
| MS191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC | $54,775 |
| MS192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC | $46,092 |
| MS193 | SIMPLE PNEUMONIA PLEURISY W MCC | $80,552 |
| MS194 | SIMPLE PNEUMONIA PLEURISY W CC | $48,734 |
| MS195 | SIMPLE PNEUMONIA PLEURISY W/O CC/MCC | $34,374 |
| MS196 | INTERSTITIAL LUNG DISEASE W MCC | $123,953 |
| MS197 | INTERSTITIAL LUNG DISEASE W CC | $72,985 |
| MS198 | INTERSTITIAL LUNG DISEASE W/O CC/MCC | $45,841 |
| MS199 | PNEUMOTHORAX W MCC | $88,910 |
| MS200 | PNEUMOTHORAX W CC | $49,796 |
| MS201 | PNEUMOTHORAX W/O CC/MCC | $37,385 |
| MS202 | BRONCHITIS ASTHMA W CC/MCC | $54,994 |
| MS203 | BRONCHITIS ASTHMA W/O CC/MCC | $26,105 |
| MS204 | RESPIRATORY SIGNS SYMPTOMS | $43,800 |
| MS205 | OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC | $96,703 |
| MS206 | OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC | $56,260 |
| MS207 | RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $402,573 |
| MS208 | RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | $140,261 |
| MS215 | OTHER HEART ASSIST SYSTEM IMPLANT | $807,160 |
| MS216 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC | $561,819 |
| MS217 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC | $395,029 |
| MS218 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC | $320,035 |
| MS219 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC | $396,326 |
| MS220 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC | $313,226 |
| MS221 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC | $255,564 |
| MS222 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC | $734,184 |
| MS223 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC | $259,111 |
| MS224 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC | $712,800 |
| MS225 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC | $519,149 |
| MS226 | CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC | $491,938 |
| MS227 | CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC | $432,552 |
| MS228 | OTHER CARDIOTHORACIC PROCEDURES W MCC | $378,002 |
| MS229 | OTHER CARDIOTHORACIC PROCEDURES W/O MCC | $255,111 |
| MS231 | CORONARY BYPASS W PTCA W MCC | $915,465 |
| MS232 | CORONARY BYPASS W PTCA W/O MCC | $331,909 |
| MS233 | CORONARY BYPASS W CARDIAC CATH W MCC | $413,468 |
| MS234 | CORONARY BYPASS W CARDIAC CATH W/O MCC | $302,174 |
| MS235 | CORONARY BYPASS W/O CARDIAC CATH W MCC | $297,994 |
| MS236 | CORONARY BYPASS W/O CARDIAC CATH W/O MCC | $236,143 |
| MS239 | AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W MCC | $379,160 |
| MS240 | AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W CC | $243,858 |
| MS241 | AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W/O CC/MCC | $214,437 |
| MS242 | PERMANENT CARDIAC PACEMAKER IMPLANT W MCC | $267,551 |
| MS243 | PERMANENT CARDIAC PACEMAKER IMPLANT W CC | $222,942 |
| MS244 | PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC | $163,847 |
| MS245 | AICD GENERATOR PROCEDURES | $362,316 |
| MS246 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS | $230,609 |
| MS247 | PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC | $164,611 |
| MS248 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS | $192,793 |
| MS249 | PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC | $150,631 |
| MS250 | PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC | $170,145 |
| MS251 | PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC | $139,305 |
| MS252 | OTHER VASCULAR PROCEDURES W MCC | $269,885 |
| MS253 | OTHER VASCULAR PROCEDURES W CC | $198,435 |
| MS254 | OTHER VASCULAR PROCEDURES W/O CC/MCC | $145,160 |
| MS255 | UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC | $191,994 |
| MS256 | UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC | $98,160 |
| MS257 | UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC | $26,871 |
| MS258 | CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC | $301,929 |
| MS259 | CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC | $153,040 |
| MS260 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC | $211,963 |
| MS261 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC | $179,521 |
| MS262 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC | $168,821 |
| MS263 | VEIN LIGATION STRIPPING | $197,128 |
| MS264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $215,539 |
| MS265 | AICD LEAD PROCEDURES | $346,850 |
| MS266 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC | $425,685 |
| MS267 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC | $388,182 |
| MS268 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC | $556,921 |
| MS269 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC | $340,848 |
| MS270 | OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC | $347,929 |
| MS271 | OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC | $250,015 |
| MS272 | OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC | $223,392 |
| MS273 | PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC | $320,158 |
| MS274 | PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC | $292,476 |
| MS280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC | $99,363 |
| MS281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC | $68,891 |
| MS282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC | $52,110 |
| MS283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC | $123,695 |
| MS284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC | $16,818 |
| MS286 | CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC | $153,763 |
| MS287 | CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC | $88,950 |
| MS288 | ACUTE SUBACUTE ENDOCARDITIS W MCC | $98,901 |
| MS289 | ACUTE SUBACUTE ENDOCARDITIS W CC | $157,125 |
| MS290 | ACUTE SUBACUTE ENDOCARDITIS W/O CC/MCC | $119,148 |
| MS291 | HEART FAILURE SHOCK W MCC OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $87,219 |
| MS292 | HEART FAILURE SHOCK W CC | $61,652 |
| MS293 | HEART FAILURE SHOCK W/O CC/MCC | $41,822 |
| MS294 | DEEP VEIN THROMBOPHLEBITIS W CC/MCC | $23,191 |
| MS296 | CARDIAC ARREST, UNEXPLAINED W MCC OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $210,001 |
| MS297 | CARDIAC ARREST, UNEXPLAINED W CC | $5,657 |
| MS299 | PERIPHERAL VASCULAR DISORDERS W MCC | $85,460 |
| MS300 | PERIPHERAL VASCULAR DISORDERS W CC | $63,200 |
| MS301 | PERIPHERAL VASCULAR DISORDERS W/O CC/MCC | $52,246 |
| MS302 | ATHEROSCLEROSIS W MCC | $87,406 |
| MS303 | ATHEROSCLEROSIS W/O MCC | $45,989 |
| MS304 | HYPERTENSION W MCC | $86,491 |
| MS305 | HYPERTENSION W/O MCC | $52,232 |
| MS306 | CARDIAC CONGENITAL VALVULAR DISORDERS W MCC | $107,681 |
| MS307 | CARDIAC CONGENITAL VALVULAR DISORDERS W/O MCC | $48,737 |
| MS308 | CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W MCC | $80,492 |
| MS309 | CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC | $47,141 |
| MS310 | CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W/O CC/MCC | $34,421 |
| MS311 | ANGINA PECTORIS | $48,054 |
| MS312 | SYNCOPE COLLAPSE | $54,989 |
| MS313 | CHEST PAIN | $40,337 |
| MS314 | OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC | $116,694 |
| MS315 | OTHER CIRCULATORY SYSTEM DIAGNOSES W CC | $63,414 |
| MS316 | OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC | $52,210 |
| MS319 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES W MCC | $247,970 |
| MS320 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES W/O MCC | $68,732 |
| MS326 | STOMACH, ESOPHAGEAL DUODENAL PROC W MCC | $344,336 |
| MS327 | STOMACH, ESOPHAGEAL DUODENAL PROC W CC | $168,756 |
| MS328 | STOMACH, ESOPHAGEAL DUODENAL PROC W/O CC/MCC | $127,044 |
| MS329 | MAJOR SMALL LARGE BOWEL PROCEDURES W MCC | $308,797 |
| MS330 | MAJOR SMALL LARGE BOWEL PROCEDURES W CC | $165,777 |
| MS331 | MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC | $135,125 |
| MS332 | RECTAL RESECTION W MCC | $209,696 |
| MS333 | RECTAL RESECTION W CC | $181,909 |
| MS334 | RECTAL RESECTION W/O CC/MCC | $176,248 |
| MS335 | PERITONEAL ADHESIOLYSIS W MCC | $236,149 |
| MS336 | PERITONEAL ADHESIOLYSIS W CC | $151,788 |
| MS337 | PERITONEAL ADHESIOLYSIS W/O CC/MCC | $126,440 |
| MS338 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC | $210,547 |
| MS339 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC | $115,268 |
| MS340 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC | $89,489 |
| MS341 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC | $98,507 |
| MS342 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC | $90,215 |
| MS343 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC | $75,996 |
| MS344 | MINOR SMALL LARGE BOWEL PROCEDURES W MCC | $128,650 |
| MS345 | MINOR SMALL LARGE BOWEL PROCEDURES W CC | $100,513 |
| MS346 | MINOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC | $113,034 |
| MS347 | ANAL STOMAL PROCEDURES W MCC | $174,760 |
| MS348 | ANAL STOMAL PROCEDURES W CC | $75,767 |
| MS349 | ANAL STOMAL PROCEDURES W/O CC/MCC | $51,375 |
| MS350 | INGUINAL FEMORAL HERNIA PROCEDURES W MCC | $164,418 |
| MS351 | INGUINAL FEMORAL HERNIA PROCEDURES W CC | $107,554 |
| MS352 | INGUINAL FEMORAL HERNIA PROCEDURES W/O CC/MCC | $83,228 |
| MS353 | HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W MCC | $235,584 |
| MS354 | HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W CC | $119,391 |
| MS355 | HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W/O CC/MCC | $107,664 |
| MS356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC | $282,837 |
| MS357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC | $128,532 |
| MS358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC | $136,394 |
| MS368 | MAJOR ESOPHAGEAL DISORDERS W MCC | $154,817 |
| MS369 | MAJOR ESOPHAGEAL DISORDERS W CC | $59,972 |
| MS370 | MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC | $55,859 |
| MS371 | MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W MCC | $124,025 |
| MS372 | MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W CC | $58,888 |
| MS373 | MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W/O CC/MCC | $36,614 |
| MS374 | DIGESTIVE MALIGNANCY W MCC | $120,629 |
| MS375 | DIGESTIVE MALIGNANCY W CC | $80,408 |
| MS376 | DIGESTIVE MALIGNANCY W/O CC/MCC | $122,465 |
| MS377 | G.I. HEMORRHAGE W MCC | $117,418 |
| MS378 | G.I. HEMORRHAGE W CC | $73,619 |
| MS379 | G.I. HEMORRHAGE W/O CC/MCC | $43,360 |
| MS380 | COMPLICATED PEPTIC ULCER W MCC | $131,103 |
| MS381 | COMPLICATED PEPTIC ULCER W CC | $94,651 |
| MS382 | COMPLICATED PEPTIC ULCER W/O CC/MCC | $68,762 |
| MS383 | UNCOMPLICATED PEPTIC ULCER W MCC | $426,557 |
| MS384 | UNCOMPLICATED PEPTIC ULCER W/O MCC | $54,308 |
| MS385 | INFLAMMATORY BOWEL DISEASE W MCC | $127,836 |
| MS386 | INFLAMMATORY BOWEL DISEASE W CC | $79,751 |
| MS387 | INFLAMMATORY BOWEL DISEASE W/O CC/MCC | $71,219 |
| MS388 | G.I. OBSTRUCTION W MCC | $124,282 |
| MS389 | G.I. OBSTRUCTION W CC | $58,457 |
| MS390 | G.I. OBSTRUCTION W/O CC/MCC | $47,254 |
| MS391 | ESOPHAGITIS, GASTROENT MISC DIGEST DISORDERS W MCC | $98,848 |
| MS392 | ESOPHAGITIS, GASTROENT MISC DIGEST DISORDERS W/O MCC | $48,549 |
| MS393 | OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC | $129,850 |
| MS394 | OTHER DIGESTIVE SYSTEM DIAGNOSES W CC | $67,006 |
| MS395 | OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC | $44,554 |
| MS405 | PANCREAS, LIVER SHUNT PROCEDURES W MCC | $494,240 |
| MS406 | PANCREAS, LIVER SHUNT PROCEDURES W CC | $231,766 |
| MS407 | PANCREAS, LIVER SHUNT PROCEDURES W/O CC/MCC | $172,209 |
| MS408 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC | $248,240 |
| MS409 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC | $155,065 |
| MS410 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC | $142,573 |
| MS412 | CHOLECYSTECTOMY W C.D.E. W CC | $384,815 |
| MS414 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC | $198,133 |
| MS415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC | $132,236 |
| MS416 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC | $131,946 |
| MS417 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC | $155,351 |
| MS418 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC | $114,931 |
| MS419 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC | $93,288 |
| MS420 | HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC | $345,510 |
| MS421 | HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC | $110,482 |
| MS422 | HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC | $157,546 |
| MS423 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC | $598,507 |
| MS424 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC | $111,724 |
| MS432 | CIRRHOSIS ALCOHOLIC HEPATITIS W MCC | $132,455 |
| MS433 | CIRRHOSIS ALCOHOLIC HEPATITIS W CC | $61,377 |
| MS434 | CIRRHOSIS ALCOHOLIC HEPATITIS W/O CC/MCC | $52,120 |
| MS435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC | $116,363 |
| MS436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC | $77,118 |
| MS437 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC | $84,316 |
| MS438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC | $121,329 |
| MS439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC | $60,292 |
| MS440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC | $42,162 |
| MS441 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC | $159,238 |
| MS442 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC | $80,035 |
| MS443 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC | $55,744 |
| MS444 | DISORDERS OF THE BILIARY TRACT W MCC | $123,943 |
| MS445 | DISORDERS OF THE BILIARY TRACT W CC | $88,942 |
| MS446 | DISORDERS OF THE BILIARY TRACT W/O CC/MCC | $59,155 |
| MS453 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC | $606,058 |
| MS454 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC | $480,219 |
| MS455 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC | $361,193 |
| MS456 | SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC | $426,067 |
| MS457 | SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC | $421,954 |
| MS458 | SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC | $393,963 |
| MS459 | SPINAL FUSION EXCEPT CERVICAL W MCC | $458,905 |
| MS460 | SPINAL FUSION EXCEPT CERVICAL W/O MCC | $298,884 |
| MS462 | BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC | $281,637 |
| MS463 | WND DEBRID SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC | $308,542 |
| MS464 | WND DEBRID SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC | $228,656 |
| MS465 | WND DEBRID SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC | $178,654 |
| MS466 | REVISION OF HIP OR KNEE REPLACEMENT W MCC | $396,001 |
| MS467 | REVISION OF HIP OR KNEE REPLACEMENT W CC | $262,443 |
| MS468 | REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC | $212,391 |
| MS469 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT | $264,446 |
| MS470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC | $156,543 |
| MS471 | CERVICAL SPINAL FUSION W MCC | $349,205 |
| MS472 | CERVICAL SPINAL FUSION W CC | $224,378 |
| MS473 | CERVICAL SPINAL FUSION W/O CC/MCC | $183,208 |
| MS474 | AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W MCC | $308,983 |
| MS475 | AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W CC | $177,006 |
| MS476 | AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W/O CC/MCC | $45,044 |
| MS477 | BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC | $366,150 |
| MS478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC | $211,601 |
| MS479 | BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC | $139,763 |
| MS480 | HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC | $216,019 |
| MS481 | HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC | $163,663 |
| MS482 | HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC | $125,268 |
| MS483 | MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | $179,970 |
| MS485 | KNEE PROCEDURES W PDX OF INFECTION W MCC | $289,470 |
| MS486 | KNEE PROCEDURES W PDX OF INFECTION W CC | $169,083 |
| MS487 | KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC | $117,139 |
| MS488 | KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC | $177,890 |
| MS489 | KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC | $130,823 |
| MS492 | LOWER EXTREM HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC | $272,515 |
| MS493 | LOWER EXTREM HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC | $200,317 |
| MS494 | LOWER EXTREM HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC | $154,154 |
| MS495 | LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W MCC | $267,592 |
| MS496 | LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W CC | $199,191 |
| MS497 | LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W/O CC/MCC | $103,758 |
| MS498 | LOCAL EXCISION REMOVAL INT FIX DEVICES OF HIP FEMUR W CC/MCC | $118,384 |
| MS499 | LOCAL EXCISION REMOVAL INT FIX DEVICES OF HIP FEMUR W/O CC/MCC | $107,552 |
| MS500 | SOFT TISSUE PROCEDURES W MCC | $246,845 |
| MS501 | SOFT TISSUE PROCEDURES W CC | $134,244 |
| MS502 | SOFT TISSUE PROCEDURES W/O CC/MCC | $111,943 |
| MS503 | FOOT PROCEDURES W MCC | $155,846 |
| MS504 | FOOT PROCEDURES W CC | $172,698 |
| MS505 | FOOT PROCEDURES W/O CC/MCC | $99,770 |
| MS506 | MAJOR THUMB OR JOINT PROCEDURES | $92,445 |
| MS507 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC | $159,510 |
| MS508 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC | $75,633 |
| MS510 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC | $214,690 |
| MS511 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC | $146,522 |
| MS512 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC | $106,170 |
| MS513 | HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC | $96,970 |
| MS514 | HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC | $78,429 |
| MS515 | OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W MCC | $304,833 |
| MS516 | OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W CC | $170,987 |
| MS517 | OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W/O CC/MCC | $124,429 |
| MS518 | BACK NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM | $265,899 |
| MS519 | BACK NECK PROC EXC SPINAL FUSION W CC | $144,153 |
| MS520 | BACK NECK PROC EXC SPINAL FUSION W/O CC/MCC | $95,970 |
| MS533 | FRACTURES OF FEMUR W MCC | $88,471 |
| MS534 | FRACTURES OF FEMUR W/O MCC | $51,695 |
| MS535 | FRACTURES OF HIP PELVIS W MCC | $95,399 |
| MS536 | FRACTURES OF HIP PELVIS W/O MCC | $60,384 |
| MS537 | SPRAINS, STRAINS, DISLOCATIONS OF HIP, PELVIS THIGH W CC/MCC | $77,666 |
| MS538 | SPRAINS, STRAINS, DISLOCATIONS OF HIP, PELVIS THIGH W/O CC/MCC | $41,956 |
| MS539 | OSTEOMYELITIS W MCC | $98,258 |
| MS540 | OSTEOMYELITIS W CC | $70,103 |
| MS541 | OSTEOMYELITIS W/O CC/MCC | $40,655 |
| MS542 | PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W MCC | $127,448 |
| MS543 | PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W CC | $92,963 |
| MS544 | PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W/O CC/MCC | $67,699 |
| MS545 | CONNECTIVE TISSUE DISORDERS W MCC | $158,656 |
| MS546 | CONNECTIVE TISSUE DISORDERS W CC | $80,198 |
| MS547 | CONNECTIVE TISSUE DISORDERS W/O CC/MCC | $55,518 |
| MS548 | SEPTIC ARTHRITIS W MCC | $122,743 |
| MS549 | SEPTIC ARTHRITIS W CC | $47,372 |
| MS550 | SEPTIC ARTHRITIS W/O CC/MCC | $61,938 |
| MS551 | MEDICAL BACK PROBLEMS W MCC | $89,418 |
| MS552 | MEDICAL BACK PROBLEMS W/O MCC | $60,451 |
| MS553 | BONE DISEASES ARTHROPATHIES W MCC | $128,605 |
| MS554 | BONE DISEASES ARTHROPATHIES W/O MCC | $44,667 |
| MS555 | SIGNS SYMPTOMS OF MUSCULOSKELETAL SYSTEM CONN TISSUE W MCC | $72,964 |
| MS556 | SIGNS SYMPTOMS OF MUSCULOSKELETAL SYSTEM CONN TISSUE W/O MCC | $54,850 |
| MS557 | TENDONITIS, MYOSITIS BURSITIS W MCC | $99,191 |
| MS558 | TENDONITIS, MYOSITIS BURSITIS W/O MCC | $64,953 |
| MS559 | AFTERCARE, MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC | $172,079 |
| MS560 | AFTERCARE, MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC | $145,192 |
| MS561 | AFTERCARE, MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC | $105,759 |
| MS562 | FX, SPRN, STRN DISL EXCEPT FEMUR, HIP, PELVIS THIGH W MCC | $93,381 |
| MS563 | FX, SPRN, STRN DISL EXCEPT FEMUR, HIP, PELVIS THIGH W/O MCC | $52,289 |
| MS564 | OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W MCC | $104,470 |
| MS565 | OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W CC | $75,033 |
| MS566 | OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC | $53,681 |
| MS570 | SKIN DEBRIDEMENT W MCC | $170,080 |
| MS571 | SKIN DEBRIDEMENT W CC | $109,176 |
| MS572 | SKIN DEBRIDEMENT W/O CC/MCC | $106,262 |
| MS573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC | $278,235 |
| MS574 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC | $152,467 |
| MS575 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC | $73,201 |
| MS576 | SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC | $455,388 |
| MS577 | SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC | $179,721 |
| MS578 | SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC | $123,390 |
| MS579 | OTHER SKIN, SUBCUT TISS BREAST PROC W MCC | $122,495 |
| MS580 | OTHER SKIN, SUBCUT TISS BREAST PROC W CC | $129,804 |
| MS581 | OTHER SKIN, SUBCUT TISS BREAST PROC W/O CC/MCC | $144,410 |
| MS582 | MASTECTOMY FOR MALIGNANCY W CC/MCC | $188,142 |
| MS583 | MASTECTOMY FOR MALIGNANCY W/O CC/MCC | $150,938 |
| MS584 | BREAST BIOPSY, LOCAL EXCISION OTHER BREAST PROCEDURES W CC/MCC | $153,980 |
| MS585 | BREAST BIOPSY, LOCAL EXCISION OTHER BREAST PROCEDURES W/O CC/MCC | $141,844 |
| MS592 | SKIN ULCERS W MCC | $85,586 |
| MS593 | SKIN ULCERS W CC | $61,525 |
| MS594 | SKIN ULCERS W/O CC/MCC | $25,351 |
| MS595 | MAJOR SKIN DISORDERS W MCC | $111,374 |
| MS596 | MAJOR SKIN DISORDERS W/O MCC | $46,925 |
| MS597 | MALIGNANT BREAST DISORDERS W MCC | $139,173 |
| MS598 | MALIGNANT BREAST DISORDERS W CC | $45,368 |
| MS600 | NON-MALIGNANT BREAST DISORDERS W CC/MCC | $72,452 |
| MS601 | NON-MALIGNANT BREAST DISORDERS W/O CC/MCC | $29,271 |
| MS602 | CELLULITIS W MCC | $96,183 |
| MS603 | CELLULITIS W/O MCC | $45,647 |
| MS604 | TRAUMA TO THE SKIN, SUBCUT TISS BREAST W MCC | $176,006 |
| MS605 | TRAUMA TO THE SKIN, SUBCUT TISS BREAST W/O MCC | $48,490 |
| MS606 | MINOR SKIN DISORDERS W MCC | $86,432 |
| MS607 | MINOR SKIN DISORDERS W/O MCC | $50,662 |
| MS614 | ADRENAL PITUITARY PROCEDURES W CC/MCC | $221,264 |
| MS615 | ADRENAL PITUITARY PROCEDURES W/O CC/MCC | $131,288 |
| MS616 | AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT, METABOL DIS W MCC | $258,086 |
| MS617 | AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT, METABOL DIS W CC | $154,652 |
| MS619 | O.R. PROCEDURES FOR OBESITY W MCC | $228,871 |
| MS620 | O.R. PROCEDURES FOR OBESITY W CC | $164,945 |
| MS621 | O.R. PROCEDURES FOR OBESITY W/O CC/MCC | $141,893 |
| MS622 | SKIN GRAFTS WOUND DEBRID FOR ENDOC, NUTRIT METAB DIS W MCC | $241,315 |
| MS623 | SKIN GRAFTS WOUND DEBRID FOR ENDOC, NUTRIT METAB DIS W CC | $127,644 |
| MS624 | SKIN GRAFTS WOUND DEBRID FOR ENDOC, NUTRIT METAB DIS W/O CC/MCC | $35,152 |
| MS625 | THYROID, PARATHYROID THYROGLOSSAL PROCEDURES W MCC | $139,768 |
| MS626 | THYROID, PARATHYROID THYROGLOSSAL PROCEDURES W CC | $123,281 |
| MS627 | THYROID, PARATHYROID THYROGLOSSAL PROCEDURES W/O CC/MCC | $100,285 |
| MS628 | OTHER ENDOCRINE, NUTRIT METAB O.R. PROC W MCC | $196,590 |
| MS629 | OTHER ENDOCRINE, NUTRIT METAB O.R. PROC W CC | $145,737 |
| MS630 | OTHER ENDOCRINE, NUTRIT METAB O.R. PROC W/O CC/MCC | $95,845 |
| MS637 | DIABETES W MCC | $94,696 |
| MS638 | DIABETES W CC | $60,795 |
| MS639 | DIABETES W/O CC/MCC | $41,210 |
| MS640 | MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC | $82,345 |
| MS641 | MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC | $49,908 |
| MS642 | INBORN AND OTHER DISORDERS OF METABOLISM | $60,222 |
| MS643 | ENDOCRINE DISORDERS W MCC | $110,100 |
| MS644 | ENDOCRINE DISORDERS W CC | $68,779 |
| MS645 | ENDOCRINE DISORDERS W/O CC/MCC | $43,957 |
| MS652 | KIDNEY TRANSPLANT | $712,408 |
| MS653 | MAJOR BLADDER PROCEDURES W MCC | $271,692 |
| MS654 | MAJOR BLADDER PROCEDURES W CC | $220,206 |
| MS655 | MAJOR BLADDER PROCEDURES W/O CC/MCC | $204,908 |
| MS656 | KIDNEY URETER PROCEDURES FOR NEOPLASM W MCC | $223,509 |
| MS657 | KIDNEY URETER PROCEDURES FOR NEOPLASM W CC | $165,029 |
| MS658 | KIDNEY URETER PROCEDURES FOR NEOPLASM W/O CC/MCC | $146,579 |
| MS659 | KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W MCC | $217,613 |
| MS660 | KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W CC | $124,305 |
| MS661 | KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC | $109,909 |
| MS662 | MINOR BLADDER PROCEDURES W MCC | $319,042 |
| MS663 | MINOR BLADDER PROCEDURES W CC | $191,822 |
| MS664 | MINOR BLADDER PROCEDURES W/O CC/MCC | $196,180 |
| MS665 | PROSTATECTOMY W MCC | $255,712 |
| MS666 | PROSTATECTOMY W CC | $137,306 |
| MS667 | PROSTATECTOMY W/O CC/MCC | $82,278 |
| MS668 | TRANSURETHRAL PROCEDURES W MCC | $234,757 |
| MS669 | TRANSURETHRAL PROCEDURES W CC | $104,896 |
| MS670 | TRANSURETHRAL PROCEDURES W/O CC/MCC | $84,105 |
| MS671 | URETHRAL PROCEDURES W CC/MCC | $393,749 |
| MS672 | URETHRAL PROCEDURES W/O CC/MCC | $148,053 |
| MS673 | OTHER KIDNEY URINARY TRACT PROCEDURES W MCC | $314,840 |
| MS674 | OTHER KIDNEY URINARY TRACT PROCEDURES W CC | $151,379 |
| MS675 | OTHER KIDNEY URINARY TRACT PROCEDURES W/O CC/MCC | $67,173 |
| MS682 | RENAL FAILURE W MCC | $96,894 |
| MS683 | RENAL FAILURE W CC | $61,592 |
| MS684 | RENAL FAILURE W/O CC/MCC | $212,573 |
| MS686 | KIDNEY URINARY TRACT NEOPLASMS W MCC | $127,260 |
| MS687 | KIDNEY URINARY TRACT NEOPLASMS W CC | $75,360 |
| MS688 | KIDNEY URINARY TRACT NEOPLASMS W/O CC/MCC | $44,276 |
| MS689 | KIDNEY URINARY TRACT INFECTIONS W MCC | $73,673 |
| MS690 | KIDNEY URINARY TRACT INFECTIONS W/O MCC | $49,747 |
| MS693 | URINARY STONES W/O ESW LITHOTRIPSY W MCC | $71,864 |
| MS694 | URINARY STONES W/O ESW LITHOTRIPSY W/O MCC | $30,181 |
| MS695 | KIDNEY URINARY TRACT SIGNS SYMPTOMS W MCC | $43,725 |
| MS696 | KIDNEY URINARY TRACT SIGNS SYMPTOMS W/O MCC | $39,709 |
| MS697 | URETHRAL STRICTURE | $75,529 |
| MS698 | OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC | $103,108 |
| MS699 | OTHER KIDNEY URINARY TRACT DIAGNOSES W CC | $70,746 |
| MS700 | OTHER KIDNEY URINARY TRACT DIAGNOSES W/O CC/MCC | $50,321 |
| MS707 | MAJOR MALE PELVIC PROCEDURES W CC/MCC | $195,625 |
| MS708 | MAJOR MALE PELVIC PROCEDURES W/O CC/MCC | $156,389 |
| MS709 | PENIS PROCEDURES W CC/MCC | $95,092 |
| MS710 | PENIS PROCEDURES W/O CC/MCC | $223,221 |
| MS711 | TESTES PROCEDURES W CC/MCC | $119,337 |
| MS712 | TESTES PROCEDURES W/O CC/MCC | $105,015 |
| MS713 | TRANSURETHRAL PROSTATECTOMY W CC/MCC | $84,041 |
| MS714 | TRANSURETHRAL PROSTATECTOMY W/O CC/MCC | $70,279 |
| MS715 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC | $165,553 |
| MS716 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W/O CC/MCC | $154,386 |
| MS717 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC | $210,078 |
| MS718 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC | $88,702 |
| MS722 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC | $60,094 |
| MS723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC | $88,103 |
| MS725 | BENIGN PROSTATIC HYPERTROPHY W MCC | $87,145 |
| MS726 | BENIGN PROSTATIC HYPERTROPHY W/O MCC | $50,256 |
| MS727 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC | $73,174 |
| MS728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC | $50,966 |
| MS729 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC | $120,042 |
| MS730 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC | $26,317 |
| MS734 | PELVIC EVISCERATION, RAD HYSTERECTOMY RAD VULVECTOMY W CC/MCC | $445,761 |
| MS736 | UTERINE ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC | $377,435 |
| MS737 | UTERINE ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC | $168,846 |
| MS738 | UTERINE ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC | $153,487 |
| MS739 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC | $265,373 |
| MS740 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC | $144,025 |
| MS741 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC | $121,633 |
| MS742 | UTERINE ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC | $110,554 |
| MS743 | UTERINE ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC | $85,605 |
| MS744 | DC, CONIZATION, LAPAROSCOPY TUBAL INTERRUPTION W CC/MCC | $121,856 |
| MS745 | DC, CONIZATION, LAPAROSCOPY TUBAL INTERRUPTION W/O CC/MCC | $102,313 |
| MS746 | VAGINA, CERVIX VULVA PROCEDURES W CC/MCC | $120,616 |
| MS747 | VAGINA, CERVIX VULVA PROCEDURES W/O CC/MCC | $150,580 |
| MS748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | $135,517 |
| MS749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC | $138,018 |
| MS754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC | $118,011 |
| MS755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC | $55,618 |
| MS756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC | $56,800 |
| MS757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC | $81,000 |
| MS758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC | $50,676 |
| MS759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC | $44,576 |
| MS760 | MENSTRUAL OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC | $56,056 |
| MS761 | MENSTRUAL OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC | $30,363 |
| MS768 | VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC | $36,873 |
| MS769 | POSTPARTUM POST ABORTION DIAGNOSES W O.R. PROCEDURE | $88,108 |
| MS770 | ABORTION W DC, ASPIRATION CURETTAGE OR HYSTEROTOMY | $54,789 |
| MS776 | POSTPARTUM POST ABORTION DIAGNOSES W/O O.R. PROCEDURE | $45,641 |
| MS779 | ABORTION W/O DC | $37,200 |
| MS783 | CESAREAN SECTION W STERILIZATION W MCC | $131,143 |
| MS784 | CESAREAN SECTION W STERILIZATION W CC | $81,559 |
| MS785 | CESAREAN SECTION W STERILIZATION W/O CC/MCC | $73,400 |
| MS786 | CESAREAN SECTION W/O STERILIZATION W MCC | $96,412 |
| MS787 | CESAREAN SECTION W/O STERILIZATION W CC | $72,723 |
| MS788 | CESAREAN SECTION W/O STERILIZATION W/O CC/MCC | $64,083 |
| MS789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $453,714 |
| MS790 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | $516,518 |
| MS791 | PREMATURITY W MAJOR PROBLEMS | $111,277 |
| MS792 | PREMATURITY W/O MAJOR PROBLEMS | $50,637 |
| MS793 | FULL TERM NEONATE W MAJOR PROBLEMS | $89,033 |
| MS794 | NEONATE W OTHER SIGNIFICANT PROBLEMS | $25,975 |
| MS795 | NORMAL NEWBORN | $22,951 |
| MS796 | VAGINAL DELIVERY W STERILIZATION/DC W MCC | $59,576 |
| MS797 | VAGINAL DELIVERY W STERILIZATION/DC W CC | $61,367 |
| MS798 | VAGINAL DELIVERY W STERILIZATION/DC WO CC/MCC | $54,733 |
| MS799 | SPLENECTOMY W MCC | $757,649 |
| MS800 | SPLENECTOMY W CC | $176,683 |
| MS801 | SPLENECTOMY W/O CC/MCC | $108,962 |
| MS802 | OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W MCC | $221,965 |
| MS803 | OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W CC | $132,804 |
| MS804 | OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W/O CC/MCC | $111,838 |
| MS805 | VAGINAL DELIVERY W/O STERILIZATION/DC W MCC | $37,355 |
| MS806 | VAGINAL DELIVERY W/O STERILIZATION/DC W CC | $32,225 |
| MS807 | VAGINAL DELIVERY W/O STERILIZATION/DC W/O CC/MCC | $28,181 |
| MS808 | MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W MCC | $165,917 |
| MS809 | MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W CC | $83,095 |
| MS810 | MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W/O CC/MCC | $128,580 |
| MS811 | RED BLOOD CELL DISORDERS W MCC | $72,285 |
| MS812 | RED BLOOD CELL DISORDERS W/O MCC | $51,139 |
| MS813 | COAGULATION DISORDERS | $105,035 |
| MS814 | RETICULOENDOTHELIAL IMMUNITY DISORDERS W MCC | $81,268 |
| MS815 | RETICULOENDOTHELIAL IMMUNITY DISORDERS W CC | $60,959 |
| MS816 | RETICULOENDOTHELIAL IMMUNITY DISORDERS W/O CC/MCC | $49,741 |
| MS817 | OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCC | $102,472 |
| MS818 | OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W CC | $89,671 |
| MS819 | OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W/O CC/MCC | $62,695 |
| MS820 | LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W MCC | $363,646 |
| MS821 | LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W CC | $256,831 |
| MS822 | LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC | $131,000 |
| MS823 | LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W MCC | $410,545 |
| MS824 | LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W CC | $175,454 |
| MS825 | LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC | $129,182 |
| MS826 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC | $353,137 |
| MS827 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC | $190,782 |
| MS828 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC | $179,743 |
| MS829 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC | $355,998 |
| MS830 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W/O CC/MCC | $194,575 |
| MS831 | OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W MCC | $67,311 |
| MS832 | OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC | $55,242 |
| MS833 | OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC | $44,663 |
| MS834 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC | $512,453 |
| MS835 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC | $339,095 |
| MS836 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC | $151,633 |
| MS837 | CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC | $227,092 |
| MS838 | CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT | $100,657 |
| MS839 | CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC | $76,942 |
| MS840 | LYMPHOMA NON-ACUTE LEUKEMIA W MCC | $188,893 |
| MS841 | LYMPHOMA NON-ACUTE LEUKEMIA W CC | $118,698 |
| MS842 | LYMPHOMA NON-ACUTE LEUKEMIA W/O CC/MCC | $83,878 |
| MS843 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC | $123,074 |
| MS844 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC | $66,035 |
| MS845 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC/MCC | $76,664 |
| MS846 | CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC | $124,310 |
| MS847 | CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC | $79,682 |
| MS849 | RADIOTHERAPY | $196,135 |
| MS853 | INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC | $363,640 |
| MS854 | INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CC | $136,353 |
| MS855 | INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC | $41,676 |
| MS856 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC | $301,538 |
| MS857 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC | $119,034 |
| MS858 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC | $77,567 |
| MS862 | POSTOPERATIVE POST-TRAUMATIC INFECTIONS W MCC | $96,561 |
| MS863 | POSTOPERATIVE POST-TRAUMATIC INFECTIONS W/O MCC | $62,065 |
| MS864 | FEVER AND INFLAMMATORY CONDITIONS | $52,044 |
| MS865 | VIRAL ILLNESS W MCC | $131,795 |
| MS866 | VIRAL ILLNESS W/O MCC | $50,826 |
| MS867 | OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W MCC | $92,244 |
| MS868 | OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W CC | $80,655 |
| MS869 | OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W/O CC/MCC | $46,440 |
| MS870 | SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $379,886 |
| MS871 | SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC | $120,723 |
| MS872 | SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC | $65,548 |
| MS876 | O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS | $214,739 |
| MS880 | ACUTE ADJUSTMENT REACTION PSYCHOSOCIAL DYSFUNCTION | $68,872 |
| MS881 | DEPRESSIVE NEUROSES | $46,339 |
| MS882 | NEUROSES EXCEPT DEPRESSIVE | $48,421 |
| MS883 | DISORDERS OF PERSONALITY IMPULSE CONTROL | $52,571 |
| MS884 | ORGANIC DISTURBANCES INTELLECTUAL DISABILITY | $77,949 |
| MS885 | PSYCHOSES | $80,668 |
| MS886 | BEHAVIORAL DEVELOPMENTAL DISORDERS | $39,278 |
| MS887 | OTHER MENTAL DISORDER DIAGNOSES | $64,567 |
| MS894 | ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA | $35,072 |
| MS895 | ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY | $32,606 |
| MS896 | ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC | $89,183 |
| MS897 | ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC | $45,779 |
| MS901 | WOUND DEBRIDEMENTS FOR INJURIES W MCC | $379,584 |
| MS902 | WOUND DEBRIDEMENTS FOR INJURIES W CC | $136,961 |
| MS903 | WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC | $62,274 |
| MS904 | SKIN GRAFTS FOR INJURIES W CC/MCC | $224,028 |
| MS905 | SKIN GRAFTS FOR INJURIES W/O CC/MCC | $103,377 |
| MS906 | HAND PROCEDURES FOR INJURIES | $57,260 |
| MS907 | OTHER O.R. PROCEDURES FOR INJURIES W MCC | $289,609 |
| MS908 | OTHER O.R. PROCEDURES FOR INJURIES W CC | $137,301 |
| MS909 | OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC | $93,503 |
| MS913 | TRAUMATIC INJURY W MCC | $70,779 |
| MS914 | TRAUMATIC INJURY W/O MCC | $46,180 |
| MS915 | ALLERGIC REACTIONS W MCC | $85,982 |
| MS916 | ALLERGIC REACTIONS W/O MCC | $34,681 |
| MS917 | POISONING TOXIC EFFECTS OF DRUGS W MCC | $92,500 |
| MS918 | POISONING TOXIC EFFECTS OF DRUGS W/O MCC | $47,270 |
| MS919 | COMPLICATIONS OF TREATMENT W MCC | $129,948 |
| MS920 | COMPLICATIONS OF TREATMENT W CC | $71,526 |
| MS921 | COMPLICATIONS OF TREATMENT W/O CC/MCC | $53,768 |
| MS922 | OTHER INJURY, POISONING TOXIC EFFECT DIAG W MCC | $128,367 |
| MS923 | OTHER INJURY, POISONING TOXIC EFFECT DIAG W/O MCC | $34,483 |
| MS934 | FULL THICKNESS BURN W/O SKIN GRAFT OR INHAL INJ | $102,650 |
| MS935 | NON-EXTENSIVE BURNS | $26,360 |
| MS939 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC | $400,117 |
| MS940 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC | $256,901 |
| MS941 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC | $148,448 |
| MS945 | REHABILITATION W CC/MCC | $182,975 |
| MS946 | REHABILITATION W/O CC/MCC | $115,592 |
| MS947 | SIGNS SYMPTOMS W MCC | $76,021 |
| MS948 | SIGNS SYMPTOMS W/O MCC | $55,494 |
| MS949 | AFTERCARE W CC/MCC | $157,317 |
| MS950 | AFTERCARE W/O CC/MCC | $109,236 |
| MS951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $32,562 |
| MS955 | CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA | $772,359 |
| MS956 | LIMB REATTACHMENT, HIP FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA | $314,155 |
| MS957 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC | $1,155,150 |
| MS958 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC | $259,260 |
| MS959 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC | $110,933 |
| MS963 | OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC | $244,677 |
| MS964 | OTHER MULTIPLE SIGNIFICANT TRAUMA W CC | $98,949 |
| MS965 | OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC | $58,152 |
| MS969 | HIV W EXTENSIVE O.R. PROCEDURE W MCC | $601,039 |
| MS970 | HIV W EXTENSIVE O.R. PROCEDURE W/O MCC | $135,444 |
| MS974 | HIV W MAJOR RELATED CONDITION W MCC | $307,064 |
| MS975 | HIV W MAJOR RELATED CONDITION W CC | $71,087 |
| MS976 | HIV W MAJOR RELATED CONDITION W/O CC/MCC | $48,639 |
| MS977 | HIV W OR W/O OTHER RELATED CONDITION | $157,733 |
| MS981 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC | $335,722 |
| MS982 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC | $188,234 |
| MS983 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC | $122,809 |
| MS987 | NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC | $327,240 |
| MS988 | NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC | $104,397 |
| MS989 | NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC | $90,878 |
| MS998 | PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS | $50,237 |
| IDENTIFIER | DESCRIPTION | CATEGORY OF SERVICE | CHARGE AMOUNT |
|---|---|---|---|
| 2022451 | HC KIDNEY TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $410,628.00 |
| 2022453 | HC LIVER TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $425,524.00 |
| 2022457 | HC KIDNEY/PANCREAS TRANSPLANT CAD | Acquisition of Body Components - Cadaver Donor | $466,664.70 |
| 2025007 | HC OTHER TRANSPLANT | Acquisition of Body Components - Cadaver Donor | $323,171.99 |
| 2025900 | HC LUNG TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $410,628.00 |
| 2025937 | HC HEART TRANSPLANT (CADAVER) | Acquisition of Body Components - Cadaver Donor | $544,000.00 |
| 2026787 | HC HEART/LUNG TRANSPLANT CAD | Acquisition of Body Components - Cadaver Donor | $711,765.60 |
| 2022452 | HC KIDNEY TRANSPLANT (LIVE) | Acquisition of Body Components - Living Donor | $387,140.00 |
| 2022454 | HC LIVER TRANSPLANT (LIVE) | Acquisition of Body Components - Living Donor | $589,632.00 |
| 2026257 | HC BMT AUTOLOGOUS BY NYBC | Acquisition of Body Components - Stem Cells - Allogeneic (Effective 1/1/17) | $5,277.00 |
| 2026261 | HC BMT ALLOGENEIC UNRELATED CORD BLOOD | Acquisition of Body Components - Stem Cells - Allogeneic (Effective 1/1/17) | $275,358.00 |
| 2022434 | HC BLOOD SPLIT UNIT | Administration, Processing, and Storage for Blood and Blood Components | $3,300.00 |
| 2022435 | HC CRYOPRECIPITATE EACH UNIT | Administration, Processing, and Storage for Blood and Blood Components | $396.72 |
| 2022436 | HC RBC LEUKOCYTES REDUCED | Administration, Processing, and Storage for Blood and Blood Components | $2,233.04 |
| 2022438 | HC RED BLOOD CELLS UNIT | Administration, Processing, and Storage for Blood and Blood Components | $2,722.80 |
| 2022439 | HC WASHED RED BLOOD CELLS UNIT | Administration, Processing, and Storage for Blood and Blood Components | $3,829.80 |
| 2022441 | HC PLATELET PHERES LEUKOREDUCED | Administration, Processing, and Storage for Blood and Blood Components | $7,729.92 |
| 2022442 | HC PLATE PHERES LEUKOREDU IRRAD | Administration, Processing, and Storage for Blood and Blood Components | $7,779.96 |
| 2022443 | HC RBC DEGLYCEROLIZED | Administration, Processing, and Storage for Blood and Blood Components | $9,230.76 |
| 2022447 | HC PLATELETS, HLA-M, L/R, UNIT | Administration, Processing, and Storage for Blood and Blood Components | $15,456.96 |
| 2022448 | HC PLASMA, FRZ BETWEEN 8-24HOUR | Administration, Processing, and Storage for Blood and Blood Components | $495.84 |
| 2025244 | HC DETERGNT TX FROZ PLASMA EA UNIT | Administration, Processing, and Storage for Blood and Blood Components | $1,177.68 |
| 2020472 | HC BLOOD TRANSFUSION SERVICE | Administration, Processing, and Storage for Blood and Blood Components - Administration (e.g., Transfusion) | $3,153.20 |
| 2025454 | HC GROUND MILEAGE PER STATUTE MILE | Ambulance | $51.75 |
| 2025455 | HC ALS1-EMERGENCY | Ambulance | $2,875.00 |
| 2025456 | HC BLS - EMERGENCY | Ambulance | $1,725.00 |
| 2025490 | HC AMB EKG | Ambulance | $621.00 |
| 2025763 | HC ALS 2 | Ambulance | $4,025.00 |
| 2010000 | HC OPERATING ROOM FLAT FEE | Ambulatory Surgical Care | $4,303.53 |
| 2010001 | HC OPERATING ROOM PER MINUTE | Ambulatory Surgical Care | $143.45 |
| 2022677 | HC TERMINATED PROCEDURE | Ambulatory Surgical Care | $4,620.96 |
| 2022680 | HC ROBOTIC SURGERY | Ambulatory Surgical Care | $43,176.00 |
| 2026244 | HC ROBOTIC SURGERY - DAVINCI SINGLE PORT | Ambulatory Surgical Care | $43,175.54 |
| 2026538 | HC ROBOTIC SURGERY - INTUITIVE ION | Ambulatory Surgical Care | $43,175.54 |
| 2026567 | HC COMPUTER ASSISTED NAVIGATION IMAGE-LESS | Ambulatory Surgical Care | $29,342.60 |
| 2026568 | HC COMPUTER ASSISTED NAVIGATION CT/MRI | Ambulatory Surgical Care | $29,342.60 |
| 2022685 | HC ANESTHESIA BASE FEE | Anesthesia | $521.05 |
| 2022686 | HC ANESTHESIA PER MINUTE | Anesthesia | $4.83 |
| 2025794 | HC MOD SED SAME PHYS/QHP <5 YRS | Anesthesia | $392.44 |
| 2025796 | HC MOD SED SAME PHYS/QHP EA | Anesthesia | $130.81 |
| 2026163 | HC MOD SED SAME PHYS/QHP 5/>YRS | Anesthesia | $254.34 |
| 2021990 | HC EVOKED AUDITORY TEST | Audiology | $315.13 |
| 2022766 | HC NEWBORN AUDITORY EP | Audiology | $531.30 |
| 2023067 | HC NASOPHARYNGOSCOPY W ENDOSCOPE | Audiology | $3,313.38 |
| 2021986 | HC PURE TONE AUDIOMETRY, AIR | Audiology - Diagnostic | $269.27 |
| 2021987 | HC COMPREHENSIVE HEARING TEST | Audiology - Diagnostic | $305.50 |
| 2021989 | HC AUDITOR EVOKE POTENT, COMPRE | Audiology - Diagnostic | $856.12 |
| 2022763 | HC TYMPANOMETRY & REFL THR | Audiology - Diagnostic | $186.05 |
| 2022765 | HC VRA | Audiology - Diagnostic | $362.25 |
| 2022922 | HC BASIC VESTIBULAR EVAL | Audiology - Diagnostic | $315.13 |
| 2022989 | HC SCREEN TONE AIR ONLY | Audiology - Diagnostic | $231.58 |
| 2025549 | HC CALORIC VSTBLR TEST W/REC BITHERMAL | Audiology - Diagnostic | $798.22 |
| 2021969 | HC ELECTROCONVULSIVE THERAPY | Behavior Health Treatments/Services - Electroshock Treatment | $2,058.15 |
| 2021964 | HC FAMILY PSYTX W/O PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $833.32 |
| 2021965 | HC FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2021966 | HC MULTIPLE FAMILY GROUP PSYTX | Behavioral Health Treatment/Services - Family Therapy | $304.60 |
| 2025660 | HC FQHC FAMILY PSYTX W/O PATIENT 50 MIN - SMI | Behavioral Health Treatment/Services - Family Therapy | $833.24 |
| 2025661 | HC FQHC FAMILY PSYTX W/O PATIENT 50 MIN - SED | Behavioral Health Treatment/Services - Family Therapy | $833.24 |
| 2025662 | HC FQHC FAMILY PSYTX W/PATIENT 50 MIN - SMI | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2025663 | HC FQHC FAMILY PSYTX W/PATIENT 50 MIN - SED | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2025968 | HC TELEHEALTH FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $981.71 |
| 2026596 | HC HLTH BHV IVNTJ FAM 1ST 30 MIN | Behavioral Health Treatment/Services - Family Therapy | $105.25 |
| 2026597 | HC HLTH BHV IVNTJ FAM WO PT 1ST 30 MIN | Behavioral Health Treatment/Services - Family Therapy | $172.12 |
| 2026598 | HC HLTH BHV IVNTJ FAM W/O PT EA ADDL 15 MIN | Behavioral Health Treatment/Services - Family Therapy | $86.06 |
| 2026682 | HC HLTH BHV IVNTJ FAM EA ADDL | Behavioral Health Treatment/Services - Family Therapy | $52.62 |
| 2026890 | HC FHC TELE SBH FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $981.34 |
| 2026891 | HC FHC TELE SBH PSYTX W/O PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $833.32 |
| 2026943 | HC SBHC/LCM AUDIO ONLY FAMILY PSYTX W/O PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $786.16 |
| 2026944 | HC SBHC/LCM AUDIO ONLY FAMILY PSYTX W/PT 50 MIN | Behavioral Health Treatment/Services - Family Therapy | $925.80 |
| 2021967 | HC COG REMED SKILLS GRP 90MIN | Behavioral Health Treatment/Services - Group Therapy | $260.47 |
| 2023030 | HC ENVIR INTERV GRP 30MIN | Behavioral Health Treatment/Services - Group Therapy | $89.04 |
| 2024622 | HC COG REMED SKILLS GRP 120MIN | Behavioral Health Treatment/Services - Group Therapy | $521.52 |
| 2025664 | HC FQHC COG REMED SKILLS GRP - SMI | Behavioral Health Treatment/Services - Group Therapy | $261.10 |
| 2025665 | HC FQHC COG REMED SKILLS GRP - SED | Behavioral Health Treatment/Services - Group Therapy | $261.10 |
| 2026594 | HC HLTH BHV IVNTJ GRP 1ST 30 | Behavioral Health Treatment/Services - Group Therapy | $106.00 |
| 2026595 | HC HLTH BHV IVNTJ GRP EA ADDL 15 MIN | Behavioral Health Treatment/Services - Group Therapy | $79.50 |
| 2026899 | HC FHC TELE SBH COG REMED SKILLS GRP 90MIN | Behavioral Health Treatment/Services - Group Therapy | $260.47 |
| 2026945 | HC SBHC/LCM AUDIO ONLY COG REMED SKILLS GRP | Behavioral Health Treatment/Services - Group Therapy | $245.73 |
| 2021949 | HC PSYTX W PT 30 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2021951 | HC PSYTX W PT 45 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2021953 | HC PSYTX W PT 60 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2021958 | HC PSYTX W PT 30 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2022558 | HC CONSULTATION WITH FAMILY | Behavioral Health Treatment/Services - Individual Therapy | $189.43 |
| 2024316 | HC PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $685.67 |
| 2024317 | HC PSYCH DIAG EVAL W/MED SRVCS | Behavioral Health Treatment/Services - Individual Therapy | $760.04 |
| 2024318 | HC PSYTX W PT W E/M 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2024319 | HC PSYTX W PT W E/M 45 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,349.07 |
| 2024320 | HC PSYTX W PT W E/M 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,762.49 |
| 2024322 | HC PSYTX COMPLEX INTERACTIVE | Behavioral Health Treatment/Services - Individual Therapy | $60.54 |
| 2025668 | HC FQHC PSYTX PTW/E&M 45 MIN - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,349.07 |
| 2025672 | HC FQHC PSYTX PT 60 MINUTES - SMI | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2025673 | HC FQHC PSYTX PT 60 MINUTES - SED | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2025678 | HC FQHC PSYCH DIAGNOSTIC EVALUATION - SMI | Behavioral Health Treatment/Services - Individual Therapy | $686.05 |
| 2025679 | HC FQHC PSYCH DIAGNOSTIC EVALUATION - SED | Behavioral Health Treatment/Services - Individual Therapy | $686.05 |
| 2025680 | HC FQHC PSYCH DIAG EVAL W/MED SRVCS - SMI | Behavioral Health Treatment/Services - Individual Therapy | $760.29 |
| 2025681 | HC FQHC PSYCH DIAG EVAL W/MED SRVCS - SED | Behavioral Health Treatment/Services - Individual Therapy | $760.29 |
| 2025682 | HC FQHC PSYTX PT 30 MINUTES - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2025683 | HC FQHC PSYTX PT 30 MINUTES - SED | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2025684 | HC FQHC PSYTX PT W/E&M 30 MIN - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2025686 | HC FQHC PSYTX PT 45 MINUTES - SMI | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2025687 | HC FQHC PSYTX PT45 MINUTES - SED | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2025729 | HC FQHC PSYCH THRPY FOR CRISIS 1ST 60 MIN -SED | Behavioral Health Treatment/Services - Individual Therapy | $574.35 |
| 2025730 | HC FQHC PSYCH THRPY FOR CRISIS EA ADDL 30 MIN -SED | Behavioral Health Treatment/Services - Individual Therapy | $274.81 |
| 2025736 | HC FQHC PSYCH THRPY FOR CRISIS EA ADDL 30 MIN -SMI | Behavioral Health Treatment/Services - Individual Therapy | $274.81 |
| 2025760 | HC FQHC PSYCH THRPY FOR CRISIS 1ST 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $574.35 |
| 2025761 | HC FQHC PSYCH THRPY FOR CRISIS EA ADDL 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $274.81 |
| 2025965 | HC TELEHEALTH PSYTX W PT W E/M 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2025966 | HC TELEHEALTH PSYTX W PT W E/M 45 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,349.07 |
| 2025969 | HC TELEHEALTH PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $686.05 |
| 2025970 | HC TELEHEALTH PSYCH DIAG EVAL W/MED SRVCS | Behavioral Health Treatment/Services - Individual Therapy | $760.29 |
| 2026587 | HC HLTH BHV ASSMT/REASSESSMENT | Behavioral Health Treatment/Services - Individual Therapy | $242.04 |
| 2026588 | HC HLTH BHV IVNTJ INDIV 1ST 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $302.54 |
| 2026589 | HC HLTH BHV IVNTJ INDIV EA ADDL 15 MIN | Behavioral Health Treatment/Services - Individual Therapy | $75.64 |
| 2026889 | HC FHC TELE SBH CONSULTATION WITH FAMILY | Behavioral Health Treatment/Services - Individual Therapy | $189.43 |
| 2026892 | HC FHC TELE SBH PSYTX W PT 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,047.00 |
| 2026893 | HC FHC TELE SBH PSYTX W PT 45 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,377.22 |
| 2026894 | HC FHC TELE SBH PSYTX W PT 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $2,051.75 |
| 2026895 | HC FHC TELE SBH PSYTX W PT W E/M 30 MIN | Behavioral Health Treatment/Services - Individual Therapy | $1,073.87 |
| 2026898 | HC FHC TELE SBH PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $685.67 |
| 2026901 | HC FHC TELE SBH PSYCH THRPY FOR CRISIS 1ST 60 MIN | Behavioral Health Treatment/Services - Individual Therapy | $574.35 |
| 2026939 | HC SBHC/LCM AUDIO ONLY PSYCH DIAGNOSTIC EVALUATION | Behavioral Health Treatment/Services - Individual Therapy | $646.86 |
| 2026940 | HC SBHC/LCM AUDIO ONLY PSYTX W PT 30 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $987.74 |
| 2026941 | HC SBHC/LCM AUDIO ONLY PSYTX W PT 45 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,299.27 |
| 2026942 | HC SBHC/LCM AUDIO ONLY PSYTX W PT 60 MINUTES | Behavioral Health Treatment/Services - Individual Therapy | $1,935.62 |
| 2026590 | HC PSY THER IVNTJ COG FUNC 1ST 15 MIN | Behavioral Health Treatment/Services - Rehabilitation | $243.19 |
| 2026591 | HC PSY THER IVNTJ COG FUNC EA ADDL 15 MIN | Behavioral Health Treatment/Services - Rehabilitation | $60.80 |
| 2022196 | HC NUBHVL XM PHYS/QHP 1ST HR | Behavioral Health Treatment/Services - Testing | $747.49 |
| 2026130 | HC BRIEF EMOTIONAL/BEHAV ASSMT | Behavioral Health Treatment/Services - Testing | $109.18 |
| 2026353 | HC NUBHVL XM PHY/QHP EA ADDL HR | Behavioral Health Treatment/Services - Testing | $498.32 |
| 2026361 | HC PSYCL TST EVAL PHYS/QHP 1ST | Behavioral Health Treatment/Services - Testing | $506.31 |
| 2026362 | HC PSYCL TST EVAL PHYS/QHP EA | Behavioral Health Treatment/Services - Testing | $337.54 |
| 2026363 | HC NRPSYC TST EVAL PHYS/QHP 1ST | Behavioral Health Treatment/Services - Testing | $506.31 |
| 2026364 | HC NRPSYC TST EACH 1HR | Behavioral Health Treatment/Services - Testing | $337.54 |
| 2026365 | HC PSYCL/NRPSYC TST PHY/QHP 1ST | Behavioral Health Treatment/Services - Testing | $63.94 |
| 2026366 | HC PSYCL/NRPSY EACH 30MIN | Behavioral Health Treatment/Services - Testing | $42.63 |
| 2026367 | HC PSYCL/NRPSYC TECH 1ST | Behavioral Health Treatment/Services - Testing | $63.94 |
| 2026368 | HC PSYCL/NRPSYC TST TECH EA | Behavioral Health Treatment/Services - Testing | $42.63 |
| 2022004 | HC HEART/LUNG RESUSCITATION CPR | Cardiology | $2,211.75 |
| 2022005 | HC CATH/EP CARDIOVERSION ELECTRIC, EXT | Cardiology | $7,673.94 |
| 2022033 | HC CATH/EP PM DEVICE PROGR EVAL, DUAL | Cardiology | $634.34 |
| 2022034 | HC CATH/EP PM DEVICE PROGR EVAL, MULTI | Cardiology | $716.32 |
| 2022035 | HC PRGRMG EVAL IMPLANTABLE DFB 1 SNGL | Cardiology | $1,531.70 |
| 2022036 | HC PRGRMG EVAL IMPLANTABLE DFB 1DUAL | Cardiology | $1,760.57 |
| 2022037 | HC PRGRMG EVAL IMPLANTABLE DFB MULT | Cardiology | $1,989.45 |
| 2022038 | HC PRGRMG DEV EVAL SCRMS IP | Cardiology | $2,143.59 |
| 2022039 | HC PERI-PX EVAL PM/LDLS PM IP | Cardiology | $2,143.59 |
| 2022040 | HC PERI-PX DEVICE EVAL & PRGR | Cardiology | $2,143.59 |
| 2022041 | HC INTERROG EVL PM/LDLS PM IP | Cardiology | $2,143.59 |
| 2022042 | HC INTERROG DEVICE EVAL HEART | Cardiology | $2,143.59 |
| 2022044 | HC INTERROG DEV EVAL SCRMS IP | Cardiology | $2,143.59 |
| 2022051 | HC DOPPLER ECHO EXAM, HEART | Cardiology | $1,694.71 |
| 2022080 | HC CATH/EP HEART FLOW RESERVE MEASURE | Cardiology | $6,674.93 |
| 2022083 | HC CATH/EP BUNDLE OF HIS RECORDING | Cardiology | $17,269.30 |
| 2022084 | HC CATH/EP INTRA-ATRIAL RECORDING | Cardiology | $17,269.30 |
| 2022085 | HC CATH/EP RIGHT VENTRICULAR RECORDING | Cardiology | $7,395.88 |
| 2022086 | HC CATH/EP MAP TACHYCARDIA, ADD-ON | Cardiology | $11,940.26 |
| 2022087 | HC CATH/EP INTRA-ATRIAL PACING | Cardiology | $17,269.30 |
| 2022088 | HC CATH/EP INTRAVENTRICULAR PACING | Cardiology | $17,269.30 |
| 2022089 | HC CATH/EP ELECTROPHYS MAP 3D, ADD-ON | Cardiology | $34,965.48 |
| 2022090 | HC CATH/EP ESOPHGL REC ATR EGRM +-VENTR EGRM | Cardiology | $1,205.71 |
| 2022092 | HC CATH/EP HEART RHYTHM PACING | Cardiology | $8,786.02 |
| 2022093 | HC CATH/EP COMPRE ELECTROPHYSIOLOGIC W/ ARRHYT HMIA INDUCT | Cardiology | $53,928.58 |
| 2022094 | HC CATH/EP COMPRE ELECTROPHYSIOLOGIC W/L ATR PAC/REC | Cardiology | $23,072.49 |
| 2022095 | HC CATH/EP COMPRE ELECTROPHYSIOLOGIC W/L VENTR PAC/REC | Cardiology | $21,306.15 |
| 2022096 | HC CATH/EP STIMULATION, PACING HEART | Cardiology | $18,492.49 |
| 2022100 | HC CATH/EP EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN | Cardiology | $11,165.52 |
| 2022101 | HC ELECTROPHYSIOLOGY EVALUATION | Cardiology | $15,183.92 |
| 2022102 | HC CATH/EP ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION | Cardiology | $71,485.76 |
| 2022105 | HC CATH/EP TILT TABLE EVALUATION | Cardiology | $9,507.24 |
| 2022106 | HC CATH/EP INTRACARDIAC ECG (ICE) | Cardiology | $8,104.00 |
| 2022107 | HC CATH/EP ANALYZE PACEMAKER SYSTEM | Cardiology | $1,819.75 |
| 2022770 | HC PRGRMG DEV EVAL PM/LDLS PM | Cardiology | $552.35 |
| 2022771 | HC PPM PROGRAM EVAL DUAL | Cardiology | $604.13 |
| 2022772 | HC PPM PROGRAM EVAL MULTI | Cardiology | $682.21 |
| 2022861 | HC CATH/EP EXER W/HEMODYNMIC MEAS | Cardiology | $1,727.93 |
| 2023066 | HC CATH/EP INTERROGATION VAD IN PERSON | Cardiology | $401.90 |
| 2024336 | HC EP & ABLATE SUPRAVENT ARRHYT | Cardiology | $59,446.44 |
| 2024337 | HC EP & ABLATE VENTRIC TACHY | Cardiology | $64,888.48 |
| 2024338 | HC ABLATE ARRHYTHMIA ADD ON | Cardiology | $24,399.36 |
| 2024339 | HC TX ATRIAL FIB PULM VEIN ISOL | Cardiology | $65,944.81 |
| 2024340 | HC TX L/R ATRIAL FIB ADDL | Cardiology | $25,059.24 |
| 2024811 | HC VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I | Cardiology | $33,327.21 |
| 2024812 | HC VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I | Cardiology | $33,327.21 |
| 2024844 | HC INTERROGATE SUBQ DEFIB | Cardiology | $191.43 |
| 2024982 | HC PERQ TRANSCATH CLOSURE PDA | Cardiology | $20,412.64 |
| 2025051 | HC AMBL BP MNTR W/SW REC ONLY | Cardiology | $320.05 |
| 2025986 | HC PAD REHAB PER SESSION | Cardiology | $204.02 |
| 2026133 | HC ELECTROPHYS EVAL COMP | Cardiology | $17,269.30 |
| 2020401 | HC CATH/EP INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR | Cardiology - Cardiac Cath Lab | $15,130.29 |
| 2020402 | HC CATH/EP INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD VENTR | Cardiology - Cardiac Cath Lab | $15,999.37 |
| 2020403 | HC CATH/EP INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR&VENTR | Cardiology - Cardiac Cath Lab | $17,390.67 |
| 2020404 | HC CATH/EP INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH | Cardiology - Cardiac Cath Lab | $7,347.35 |
| 2020408 | HC CATH/EP UPGRADE OF PACEMAKER SYSTEM | Cardiology - Cardiac Cath Lab | $16,902.83 |
| 2020409 | HC CATH/EP REPOSITION PACING-DEFIB LEAD | Cardiology - Cardiac Cath Lab | $3,407.91 |
| 2020410 | HC CATH/EP INSJ ELTRD 1CHMBR 1 ELTRD PRM PM/1CHMBR CVDFB | Cardiology - Cardiac Cath Lab | $7,347.35 |
| 2020411 | HC CATH/EP INSJ ELTRD 2CHMBR 2 ELTRDS PRM PM/2CHMBR CVDFB | Cardiology - Cardiac Cath Lab | $7,347.35 |
| 2020412 | HC CATH/EP REPAIR LEAD PACE-DEFIB, ONE | Cardiology - Cardiac Cath Lab | $3,761.00 |
| 2020413 | HC CATH/EP REVISE POCKET, PACEMAKER | Cardiology - Cardiac Cath Lab | $3,428.98 |
| 2020414 | HC CATH/EP REVISE POCKET, PACING-DEFIB | Cardiology - Cardiac Cath Lab | $4,114.78 |
| 2020415 | HC CATH/EP INSERT PACING LEAD & CONNECT | Cardiology - Cardiac Cath Lab | $16,902.83 |
| 2020416 | HC CATH/EP L VENTRIC PACING LEAD ADD-ON | Cardiology - Cardiac Cath Lab | $16,097.93 |
| 2020417 | HC CATH/EP REPOSITION L VENTRIC LEAD | Cardiology - Cardiac Cath Lab | $4,136.79 |
| 2020418 | HC CATH/EP REMOVAL PERMANENT PACEMAKER PULSE GENERATOR | Cardiology - Cardiac Cath Lab | $10,114.17 |
| 2020419 | HC CATH/EP RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR | Cardiology - Cardiac Cath Lab | $12,136.49 |
| 2020420 | HC CATH/EP REMOVAL PACEMAKER ELECTRODE | Cardiology - Cardiac Cath Lab | $15,171.25 |
| 2020422 | HC CATH/EP REMOVE PULSE GENERATOR | Cardiology - Cardiac Cath Lab | $5,720.09 |
| 2020423 | HC CATH/EP REMOVE ELTRD, TRANSVEN | Cardiology - Cardiac Cath Lab | $10,048.88 |
| 2020424 | HC CATH/EP ELTRD/INSERT PACE-DEFIB | Cardiology - Cardiac Cath Lab | $51,311.91 |
| 2020427 | HC CATH/EP INSERT IA PERCUT DEVICE | Cardiology - Cardiac Cath Lab | $2,454.94 |
| 2020441 | HC CATH/EP INJECTION EXT VENOGRAPHY | Cardiology - Cardiac Cath Lab | $13,017.09 |
| 2020445 | HC CATH/EP PLACE CATHETER IN VEIN | Cardiology - Cardiac Cath Lab | $1,679.29 |
| 2020450 | HC CATH/EP ESTABLISH ACCESS TO ARTERY | Cardiology - Cardiac Cath Lab | $1,442.50 |
| 2020452 | HC CATH/EP PLACE CATHETER IN AORTA | Cardiology - Cardiac Cath Lab | $2,154.15 |
| 2020456 | HC CATH/EP SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH | Cardiology - Cardiac Cath Lab | $2,882.44 |
| 2020457 | HC CATH/EP SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH | Cardiology - Cardiac Cath Lab | $3,458.93 |
| 2020462 | HC CATH/EP SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH | Cardiology - Cardiac Cath Lab | $5,618.98 |
| 2020464 | HC CATH/EP SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH | Cardiology - Cardiac Cath Lab | $9,414.02 |
| 2020466 | HC CATH/EP SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH | Cardiology - Cardiac Cath Lab | $11,202.12 |
| 2020482 | HC CATH/EP INSJ NON-TUN CTR CVC UNDER 5 YR | Cardiology - Cardiac Cath Lab | $3,875.68 |
| 2020497 | HC CATH/EP INSERTION CATHETER, ARTERY | Cardiology - Cardiac Cath Lab | $575.98 |
| 2020508 | HC CATH/EP TRANSCATH STENT, CCA W/EPS | Cardiology - Cardiac Cath Lab | $10,989.65 |
| 2022006 | HC CATH/EP CARDIOVERSION, ELECTRIC, INT | Cardiology - Cardiac Cath Lab | $2,992.85 |
| 2022007 | HC CATH/EP PERCUT CORONARY THROMBECTOMY | Cardiology - Cardiac Cath Lab | $7,212.51 |
| 2022009 | HC CATH/EP INTRAVASC US, HEART ADD-ON | Cardiology - Cardiac Cath Lab | $6,098.96 |
| 2022014 | HC CATH/EP REVISION OF AORTIC VALVE | Cardiology - Cardiac Cath Lab | $11,939.37 |
| 2022016 | HC CATH/EP REVISION OF PULMONARY VALVE | Cardiology - Cardiac Cath Lab | $14,483.91 |
| 2022017 | HC CATH/EP REVISION OF HEART CHAMBER | Cardiology - Cardiac Cath Lab | $8,191.68 |
| 2022021 | HC CATH/EP PRQ TRLUML P-ART BALO ANGIOP 1 VSL | Cardiology - Cardiac Cath Lab | $21,120.45 |
| 2022022 | HC CATH/EP PRQ TRLUML P-ART BALO ANGIOP EA VSL | Cardiology - Cardiac Cath Lab | $21,120.45 |
| 2022055 | HC CATH/EP INSERT/PLACE HEART CATHETER | Cardiology - Cardiac Cath Lab | $6,951.40 |
| 2022056 | HC CATH/EP BIOPSY OF HEART LINING | Cardiology - Cardiac Cath Lab | $7,867.32 |
| 2022063 | HC CATH/EP RT HEART CATH, CONGENITAL | Cardiology - Cardiac Cath Lab | $10,930.72 |
| 2022064 | HC CATH/EP CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMALY | Cardiology - Cardiac Cath Lab | $33,418.21 |
| 2022065 | HC CATH/EP CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN | Cardiology - Cardiac Cath Lab | $41,756.45 |
| 2022066 | HC CATH/EP CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN | Cardiology - Cardiac Cath Lab | $29,548.93 |
| 2022081 | HC CATH/EP TRANSCATH CLOSURE OF ASD | Cardiology - Cardiac Cath Lab | $32,494.08 |
| 2022082 | HC CATH/EP TRANSCATH CLOSURE OF VSD | Cardiology - Cardiac Cath Lab | $61,235.62 |
| 2022573 | HC CATH/EP SECONDY PERC THROMBECT | Cardiology - Cardiac Cath Lab | $5,510.18 |
| 2022699 | HC FEM/POPL REVSC STNT&ATHR | Cardiology - Cardiac Cath Lab | $24,758.07 |
| 2022826 | HC CATH/EP TRLUM PERIP ATHR ILC ART | Cardiology - Cardiac Cath Lab | $28,228.27 |
| 2022828 | HC CATH/EP P INSERTION CHEST TUBE | Cardiology - Cardiac Cath Lab | $1,507.78 |
| 2022832 | HC CATH/EP ILIAC REVASC | Cardiology - Cardiac Cath Lab | $11,936.81 |
| 2022833 | HC CATH/EP ILIAC REVASC W/STENT | Cardiology - Cardiac Cath Lab | $14,558.15 |
| 2022834 | HC CATH/EP ILIAC REVASC ADD-ON | Cardiology - Cardiac Cath Lab | $7,041.00 |
| 2022835 | HC CATH/EP ILIAC REVASC STENT ADDON | Cardiology - Cardiac Cath Lab | $21,120.45 |
| 2022836 | HC CATH/EP FEM/POPL REVAS W/TLA | Cardiology - Cardiac Cath Lab | $13,138.68 |
| 2022837 | HC CATH/EP FEM/POPL REVAS W/ATHER | Cardiology - Cardiac Cath Lab | $17,663.31 |
| 2022838 | HC CATH/EP FEM/POPL REVASC W/STENT | Cardiology - Cardiac Cath Lab | $14,597.83 |
| 2022839 | HC CATH/EP TIB/PER REVASC W/TLA | Cardiology - Cardiac Cath Lab | $15,926.41 |
| 2022840 | HC CATH/EP TIB/PER REVASC W/ATHER | Cardiology - Cardiac Cath Lab | $14,558.15 |
| 2022841 | HC CATH/EP TIB/PER REVASC W/STENT | Cardiology - Cardiac Cath Lab | $14,558.15 |
| 2022842 | HC CATH/EP TIB/PER REVSC STNT&ATHER | Cardiology - Cardiac Cath Lab | $74,271.65 |
| 2022843 | HC CATH/EP TIB/PER REVASC ADD-ON | Cardiology - Cardiac Cath Lab | $7,041.00 |
| 2022848 | HC CATH/EP RIGHT HEART CATH | Cardiology - Cardiac Cath Lab | $26,108.42 |
| 2022849 | HC CATH/EP L HRT CATH W/VENTGRPHY | Cardiology - Cardiac Cath Lab | $28,719.52 |
| 2022850 | HC CATH/EP R&L HRT CATH W/VENTGRPHY | Cardiology - Cardiac Cath Lab | $37,595.97 |
| 2022851 | HC CATH/EP CORONARY ART ANGIO S&I | Cardiology - Cardiac Cath Lab | $20,815.06 |
| 2022852 | HC CATH/EP CORO ART/GRFT ANGIO S&I | Cardiology - Cardiac Cath Lab | $24,246.62 |
| 2022853 | HC CATH/EP R HRT CORONARY ART ANGIO | Cardiology - Cardiac Cath Lab | $27,152.86 |
| 2022854 | HC CATH/EP R HRT ART/GRFT ANGIO | Cardiology - Cardiac Cath Lab | $30,808.40 |
| 2022855 | HC CATH/EP L HRT ART/VENTRCLE ANGIO | Cardiology - Cardiac Cath Lab | $26,108.42 |
| 2022856 | HC CATH/EP L HRT ART/GRFT ANGIO | Cardiology - Cardiac Cath Lab | $28,719.52 |
| 2022857 | HC CATH/EP R&L HRT ART/VENT ANGIO | Cardiology - Cardiac Cath Lab | $30,808.40 |
| 2022858 | HC CATH/EP R&L HRT ART/VENT ANGIO | Cardiology - Cardiac Cath Lab | $34,984.87 |
| 2022859 | HC CATH/EP L HRT CATH TRNSPTL PUNC | Cardiology - Cardiac Cath Lab | $10,930.72 |
| 2022860 | HC CATH/EP DRUG ADMN&HEMODYMIC MEAS | Cardiology - Cardiac Cath Lab | $4,246.87 |
| 2022862 | HC CATH/EP P INJ CONG CARD CATH | Cardiology - Cardiac Cath Lab | $9,108.12 |
| 2022864 | HC CATH/EP INJ L VENT/ATRIAL ANG | Cardiology - Cardiac Cath Lab | $7,157.48 |
| 2022865 | HC CATH/EP INJ R VENT/ATRIAL ANG | Cardiology - Cardiac Cath Lab | $7,157.48 |
| 2022866 | HC CATH/EP INJ SUPRVLV AORTGRAPY | Cardiology - Cardiac Cath Lab | $8,132.80 |
| 2022867 | HC CATH/EP INJ PULM ART HRT CATH | Cardiology - Cardiac Cath Lab | $7,320.03 |
| 2022909 | HC CATH/EP INSERT VENTRIC ASSIS DEV | Cardiology - Cardiac Cath Lab | $11,417.15 |
| 2022910 | HC CATH/EP PRIM ART MECH THROMBCTMY | Cardiology - Cardiac Cath Lab | $14,920.37 |
| 2023027 | HC CATH/EP IVUS ADDITIONAL VESSEL | Cardiology - Cardiac Cath Lab | $4,879.16 |
| 2023033 | HC CATH/EP IV DOPPLER; EA ADDTL VESSEL | Cardiology - Cardiac Cath Lab | $5,339.95 |
| 2023084 | HC TRANSCATH OCCLUSION CNS | Cardiology - Cardiac Cath Lab | $9,758.40 |
| 2023096 | HC INS CATH REN ART 1ST UNILAT | Cardiology - Cardiac Cath Lab | $13,488.30 |
| 2023097 | HC INS CATH REN ART 1ST BILAT | Cardiology - Cardiac Cath Lab | $17,747.79 |
| 2023410 | HC REMV&REPLC PM GEN DUAL LEAD | Cardiology - Cardiac Cath Lab | $19,302.92 |
| 2023411 | HC RMVL& REPLC PULSE GEN 1 LEAD | Cardiology - Cardiac Cath Lab | $20,029.94 |
| 2023420 | HC REMOVE&REPLACE PM GEN SINGL | Cardiology - Cardiac Cath Lab | $18,531.12 |
| 2023421 | HC REMV&REPLC PM GEN MULT LEADS | Cardiology - Cardiac Cath Lab | $20,268.00 |
| 2023422 | HC INSRT PULSE GEN W/DUAL LEADS | Cardiology - Cardiac Cath Lab | $15,350.57 |
| 2023423 | HC INSRT PULSE GEN W/MULT LEADS | Cardiology - Cardiac Cath Lab | $15,350.57 |
| 2023424 | HC RMVL & RPLCMT DFB GEN 2 LEAD | Cardiology - Cardiac Cath Lab | $20,273.12 |
| 2023425 | HC RMVL & RPLCMT DFB GEN MLT LD | Cardiology - Cardiac Cath Lab | $22,070.17 |
| 2023589 | HC REM IAB ASSIST DEVICE PERCUTANEOUS | Cardiology - Cardiac Cath Lab | $287.99 |
| 2023590 | HC PRIM ART M-THROMBECT ADD-ON | Cardiology - Cardiac Cath Lab | $5,520.53 |
| 2024310 | HC CATH/EP PLACE CATH THORACIC AORTA | Cardiology - Cardiac Cath Lab | $6,692.86 |
| 2024311 | HC CATH/EP PLACE CATH CAROTID/INOM ART | Cardiology - Cardiac Cath Lab | $9,168.27 |
| 2024313 | HC CATH/EP PLACE CATH CAROTD ART | Cardiology - Cardiac Cath Lab | $11,276.36 |
| 2024314 | HC CATH/EP PLACE CATH SUBCLAVIAN ART | Cardiology - Cardiac Cath Lab | $9,993.84 |
| 2024323 | HC PRQ CARD STENT W/ANGIO 1 VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024324 | HC PRQ CARD STENT/ATH/ANGIO | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024325 | HC PRQ REVASC BYP GRAFT 1 VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024326 | HC PRQ CARD REVASC MI 1 VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024327 | HC PRQ CARD REVASC CHRONIC 1VSL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024328 | HC PRQ CARD STENT W/ANGIO ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024329 | HC PRQ CARD STENT/ATH/ANGIO ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024330 | HC PRQ REVASC BYP GRAFT ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024331 | HC PRQ CARD REVASC CHRONIC ADDL | Cardiology - Cardiac Cath Lab | $22,336.40 |
| 2024332 | HC PRQ CARDIAC ANGIOPLAST 1 ART | Cardiology - Cardiac Cath Lab | $15,411.88 |
| 2024333 | HC PRQ CARD ANGIO/ATHRECT 1 ART | Cardiology - Cardiac Cath Lab | $31,047.74 |
| 2024334 | HC PRQ CARDIAC ANGIO ADDL ART | Cardiology - Cardiac Cath Lab | $15,411.88 |
| 2024335 | HC PRQ CARD ANGIO/ATHRECT ADDL | Cardiology - Cardiac Cath Lab | $31,047.74 |
| 2024353 | HC PERC DRUG-EL COR STENT SING | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024354 | HC PERC DRUG-EL COR STENT BRAN | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024355 | HC PERC D-E COR STENT ATHER S | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024356 | HC PERC D-E COR STENT ATHER BR | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024357 | HC PERC D-E COR REVASC T CABG S | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024359 | HC PERC D-E COR REVASC W AMI S | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024360 | HC PERC D-E COR REVASC CHRO SIN | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024361 | HC PERC D-E COR REVASC CHRO ADD | Cardiology - Cardiac Cath Lab | $27,027.42 |
| 2024623 | HC PERQ CLSR TCAT L ATR APNDGE | Cardiology - Cardiac Cath Lab | $28,777.11 |
| 2024807 | HC OPEN/PERQ PLACE STENT 1ST | Cardiology - Cardiac Cath Lab | $38,668.56 |
| 2024809 | HC OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST | Cardiology - Cardiac Cath Lab | $34,371.45 |
| 2024836 | HC INS/REP SUBQ DEFIBRILLATOR | Cardiology - Cardiac Cath Lab | $146,352.54 |
| 2024841 | HC RMVL OF SUBQ DEFIBRILLATOR | Cardiology - Cardiac Cath Lab | $10,615.92 |
| 2024869 | HC REPAIR TCAT MITRAL VALVE | Cardiology - Cardiac Cath Lab | $2,986.12 |
| 2024870 | HC REPAIR TCAT MITRAL VALVE | Cardiology - Cardiac Cath Lab | $302.06 |
| 2025017 | HC IMPLANTING PA SENSOR | Cardiology - Cardiac Cath Lab | $20,114.41 |
| 2025075 | HC ECMO/ECLS INITIATION VENOUS | Cardiology - Cardiac Cath Lab | $10,605.67 |
| 2025076 | HC ECMO/ECLS INITIATION ARTERY | Cardiology - Cardiac Cath Lab | $10,605.67 |
| 2025077 | HC ECMO/ECLS DAILY MGMT-VENOUS | Cardiology - Cardiac Cath Lab | $10,817.77 |
| 2025078 | HC ECMO/ECLS DAILY MGMT ARTERY | Cardiology - Cardiac Cath Lab | $10,817.77 |
| 2025080 | HC ECMO/ECLS INSJ PRPH CANNULA; PERCUTANEOUS 6 YRS & OLDER | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025081 | HC ECMO/ECLS INSJ PRPH CANNULA; OPEN BIRTH - 5 YRS OLD | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025082 | HC ECMO/ECLS INSJ PRPH CANNULA; OPEN 6 YRS & OLDER | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025083 | HC ECMO/ECLS INSJ PRPH CANNULA; STERNOTOMY OR THORACOTOMY BIRTH - 5 YRS OLD | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025084 | HC ECMO/ECLS INSJ PRPH CANNULA; STERNOTOMY OR THORACOTOMY 6 YRS & OLDER | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025158 | HC ECMO/ECLS REPOS PERPH CNULA >6 YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025163 | HC ECMO/ECLS RMVL PERPH CANNULA BIRTH - 5YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025164 | HC ECMO/ECLS RMVL PERPH CANNULA > 6YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025165 | HC TCAT IMPL WRLS P-ART PRS SNR | Cardiology - Cardiac Cath Lab | $50,470.84 |
| 2025182 | HC ECMO/ECLS RMVL PERPH CANNULA BIRTH - 5YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025183 | HC ECMO/ECLS RMVL PERPH CANNULA >6 YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025184 | HC ECMO/ECLS RMVL CTR CANNULA BIRTH - 5YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025185 | HC ECMO/ECLS RMVL CTR CANNULA >6 YRS | Cardiology - Cardiac Cath Lab | $4,253.27 |
| 2025255 | HC INSERT VAD ARTERY ACCESS | Cardiology - Cardiac Cath Lab | $25,740.05 |
| 2025256 | HC REMOVE VAD DIFFERENT SESSION | Cardiology - Cardiac Cath Lab | $25,740.05 |
| 2025257 | HC REPOSITION VAD DIFF SESSION | Cardiology - Cardiac Cath Lab | $25,740.05 |
| 2026279 | HC TCAT INSJ/RPL PERM LDLS PM | Cardiology - Cardiac Cath Lab | $57,185.55 |
| 2026280 | HC TCAT RMVL PERM LDLS PM | Cardiology - Cardiac Cath Lab | $9,837.96 |
| 2026281 | HC INSJ SUBQ CAR RHYTHM MNTR | Cardiology - Cardiac Cath Lab | $27,575.52 |
| 2026282 | HC RMVL SUBQ CAR RHYTHM MNTR | Cardiology - Cardiac Cath Lab | $2,265.54 |
| 2026390 | HC PERQ TRANSCATH SEPTAL REDUXN | Cardiology - Cardiac Cath Lab | $16,287.16 |
| 2026564 | HC PERQ TRANSCATH CLS AORTIC | Cardiology - Cardiac Cath Lab | $57,185.55 |
| 2026625 | HC PERICARDIOCENTESIS W/IMAGING | Cardiology - Cardiac Cath Lab | $6,280.50 |
| 2026626 | HC PRCRD DRG 6YR+ W/O CGEN CAR | Cardiology - Cardiac Cath Lab | $742.00 |
| 2026627 | HC PRCRD DRG 0-5YR OR W/ANOMLY | Cardiology - Cardiac Cath Lab | $742.00 |
| 2026965 | HC REVASC INTRAVASC LITHOTRIPSY | Cardiology - Cardiac Cath Lab | $18,004.98 |
| 2026966 | HC REVASC INTRA LITHOTRIP-STENT | Cardiology - Cardiac Cath Lab | $36,012.36 |
| 2026967 | HC REVASC INTRA LITHOTRIP-ATHER | Cardiology - Cardiac Cath Lab | $36,012.36 |
| 2022046 | HC TTE W/DOPPLER, COMPLETE | Cardiology - Echocardiology | $3,475.45 |
| 2022048 | HC CATH/EP TTE, F-UP OR LMTD | Cardiology - Echocardiology | $911.32 |
| 2022049 | HC TEE R-T IMG 2D W/PRB IMG ACQUISJ I&R | Cardiology - Echocardiology | $4,431.00 |
| 2022052 | HC DOPPLER COLOR FLOW ADD-ON | Cardiology - Echocardiology | $813.09 |
| 2022053 | HC STRESS TTE ONLY | Cardiology - Echocardiology | $2,680.22 |
| 2022409 | HC TTE W OR WO FOL WCON,DOPPLER | Cardiology - Echocardiology | $3,475.45 |
| 2022731 | HC FETAL CARDIOVASC 2-D FOLLOWUP US | Cardiology - Echocardiology | $1,777.85 |
| 2022732 | HC COMP FETAL DOPPLER ECHO | Cardiology - Echocardiology | $746.20 |
| 2022733 | HC LIMIT FETAL DOPPLER ECHOCARDIOGRAM | Cardiology - Echocardiology | $522.21 |
| 2022773 | HC TTE CONG ABN; COMPLETE | Cardiology - Echocardiology | $2,799.43 |
| 2022774 | HC TTE CONG ABN; LIMITED/F-UP | Cardiology - Echocardiology | $1,893.04 |
| 2022775 | HC TTE F-UP OR LMTD | Cardiology - Echocardiology | $956.89 |
| 2022776 | HC DOPPLER ECHO;LMITED F/UP | Cardiology - Echocardiology | $848.03 |
| 2022777 | HC STRESS TTE COMPLETE | Cardiology - Echocardiology | $2,814.23 |
| 2022888 | HC 2D TTE W OR W/O FOL W/CON FU | Cardiology - Echocardiology | $1,669.50 |
| 2025133 | HC ECHO TRANSESOPHAGEAL (TEE) | Cardiology - Echocardiology | $2,622.62 |
| 2025700 | HC TEE CONGENITAL; INT & REP | Cardiology - Echocardiology | $464.81 |
| 2026424 | HC ECHO TRANSESOPHAGEAL IMAGE I&R ONLY | Cardiology - Echocardiology | $3,602.38 |
| 2026783 | HC MYOCRD STRAIN IMG SPCKL TRCK | Cardiology - Echocardiology | $455.66 |
| 2022026 | HC CARDIOVASCULAR STRESS TEST | Cardiology - Stress Test | $1,804.91 |
| 2022687 | HC CARD REHAB STRESS TEST | Cardiology - Stress Test | $1,718.97 |
| 2020015 | HC DEBRIDE SKIN, FULL | Clinic | $3,003.05 |
| 2022153 | HC RAPID DESENSITIZATION, EA HR | Clinic | $928.57 |
| 2022304 | HC WOUND(S) CARE NON-SELECTIVE | Clinic | $389.00 |
| 2022305 | HC NEG PRESS WOUND TX <=50 CM | Clinic | $480.00 |
| 2022306 | HC NEG PRESS WOUND TX >50 CM | Clinic | $596.00 |
| 2022330 | HC OFFICE OUTPT NEW 10 MIN | Clinic | $458.70 |
| 2022331 | HC OFFICE OUTPT NEW 10 MIN 25 | Clinic | $458.70 |
| 2022332 | HC OFFICE OUTPT NEW 20 MINUTES | Clinic | $462.98 |
| 2022333 | HC OFFICE OUTPT NEW 20 MINUTES 25 | Clinic | $462.98 |
| 2022334 | HC OFFICE OUTPT NEW 30 MIN | Clinic | $688.06 |
| 2022335 | HC OFFICE OUTPT NEW 30 MIN 25 | Clinic | $688.06 |
| 2022336 | HC OFFICE OUTPT NEW 45 MIN | Clinic | $736.48 |
| 2022337 | HC OFFICE OUTPT NEW 45 MIN 25 | Clinic | $736.48 |
| 2022338 | HC OFFICE OUTPT NEW 60 MIN | Clinic | $1,236.50 |
| 2022339 | HC OFFICE OUTPT NEW 60 MIN 25 | Clinic | $1,236.50 |
| 2022340 | HC OFFICE O/P EST 5 MIN 25 | Clinic | $406.00 |
| 2022341 | HC OFFICE O/P EST 5 MIN | Clinic | $406.00 |
| 2022342 | HC OFFICE OUTPT EST 10 MIN | Clinic | $419.00 |
| 2022343 | HC OFFICE OUTPT EST 10 MIN 25 | Clinic | $418.82 |
| 2022344 | HC OFFICE OUTPT EST15 MIN | Clinic | $503.00 |
| 2022345 | HC OFFICE OUTPT EST15 MIN 25 | Clinic | $502.87 |
| 2022346 | HC OFFICE OUTPT EST 25 MIN | Clinic | $734.00 |
| 2022347 | HC OFFICE OUTPT EST 25 MIN 25 | Clinic | $733.64 |
| 2022348 | HC OFFICE OUTPT EST 40 MIN | Clinic | $1,115.00 |
| 2022349 | HC OFFICE OUTPT EST 40 MIN 25 | Clinic | $1,115.42 |
| 2022350 | HC PREV VISIT, NEW, AGE 18-39 | Clinic | $183.90 |
| 2022351 | HC PREV VISIT, NEW, AGE 40-64 | Clinic | $183.39 |
| 2022352 | HC PREV VISIT, EST, AGE 18-39 | Clinic | $1,396.70 |
| 2022353 | HC PREV VISIT, EST, AGE 40-64 | Clinic | $1,396.70 |
| 2022657 | HC PT FOLLOWUP EVAL FOOT PT LOP | Clinic | $218.89 |
| 2022787 | HC INIT PM E/M, NEW PT INF | Clinic | $183.39 |
| 2022788 | HC INIT PM E/M NEW PT 1-4YR | Clinic | $183.39 |
| 2022789 | HC PREV VISIT NEW AGE 5-11 | Clinic | $183.39 |
| 2022790 | HC PREV VISIT NEW AGE 12-17 | Clinic | $183.39 |
| 2022791 | HC PER PM REEVAL EST PT INF | Clinic | $624.28 |
| 2022792 | HC PREV VISIT EST AGE 1-4 | Clinic | $624.28 |
| 2022793 | HC PREV VISIT EST AGE 5-11 | Clinic | $624.28 |
| 2022794 | HC PREV VISIT EST AGE 12-17 | Clinic | $1,396.70 |
| 2022796 | HC PREVENTIVE CONSLT IND 30 MIN | Clinic | $206.01 |
| 2023132 | HC GENETIC COUNSEL NEW PATIENT 30MIN | Clinic | $733.64 |
| 2023133 | HC GENETIC COUNSEL EST PATIENT 30MIN | Clinic | $733.64 |
| 2023134 | HC GENETIC COUNSEL NEW PATIENT 60MIN | Clinic | $1,236.50 |
| 2023238 | HC PROLONGED SERVICE OFFICE | Clinic | $710.01 |
| 2023239 | HC PER PM REEVAL EST PAT 65+ YR | Clinic | $624.28 |
| 2025194 | HC PREV VISIT, NEW, AGE 65+ | Clinic | $183.39 |
| 2025441 | HC VISUAL FIELD EXAMINATION(S) | Clinic | $177.50 |
| 2025443 | HC INTERM EYE EXAM NEW PT | Clinic | $332.00 |
| 2025444 | HC EYE EXAM NEW PATIENT 1+ VISITS | Clinic | $332.06 |
| 2025445 | HC INTERM EYE EXAM EST PT | Clinic | $265.65 |
| 2025446 | HC EYE EXAM & TREATMENT 1+VISITS | Clinic | $265.65 |
| 2025451 | HC GONIOSCOPY | Clinic | $132.08 |
| 2025475 | HC DETERMINE REFRACTION | Clinic | $126.79 |
| 2025478 | HC VISUAL ACUITY SCREEN BILAT - QUAN | Clinic | $76.07 |
| 2025656 | HC FQHC MONITORING VST - ASYMPTOMATIC HIV DISEASE | Clinic | $265.65 |
| 2025657 | HC FQHC HIV COUNSELING VISIT (NO TESTING) | Clinic | $265.65 |
| 2025658 | HC FQHC HIV COUNSELING AND TESTING VISIT | Clinic | $265.65 |
| 2025659 | HC FQHC POST-TEST HIV COUNSELING VISIT - POSITIVE RESULTS | Clinic | $265.65 |
| 2025688 | HC FQHC OFFSITE BILLING | Clinic | $253.00 |
| 2025724 | HC TRANS CARE MGMT 14 DAY DISCH | Clinic | $436.33 |
| 2025725 | HC TRANS CARE MGMT 7 DAY DISCH | Clinic | $436.33 |
| 2025770 | HC OFFICE CONSULTATION 60 MIN | Clinic | $733.64 |
| 2025785 | HC CAREGIVER HEALTH RISK ASSMT | Clinic | $93.45 |
| 2025859 | HC ADVNCD CARE PLAN 30 MIN | Clinic | $629.31 |
| 2025860 | HC ADVNCD CARE PLAN ADDL 30 MIN | Clinic | $590.75 |
| 2025872 | HC NEG PRESS WND TX <=50 SQ CM | Clinic | $1,149.18 |
| 2025907 | HC FUNDUS PHOTOGRAPHY | Clinic | $370.57 |
| 2025961 | HC TELEHEALTH OFFICE OUTPT EST 10 MIN | Clinic | $418.82 |
| 2025962 | HC TELEHEALTH OFFICE OUTPT EST 15 MIN | Clinic | $502.87 |
| 2025963 | HC TELEHEALTH OFFICE OUTPT EST 25 MIN | Clinic | $733.64 |
| 2025964 | HC TELEHEALTH OFFICE OUTPT EST 40 MIN | Clinic | $1,115.42 |
| 2026013 | HC SLIT LAMP PHOTOGRAPHY (EXT) | Clinic | $196.86 |
| 2026128 | HC OCULAR INSTRUMNT SCREEN BIL | Clinic | $69.00 |
| 2026172 | HC FIT GLASSES; MONOFOCAL | Clinic | $396.30 |
| 2026174 | HC FIT GLASSES; MULTIFOCAL | Clinic | $562.14 |
| 2026179 | HC INIT PM E/M NEW PAT INF <1 YR 25 | Clinic | $183.39 |
| 2026180 | HC INIT PM E/M NEW PAT 1-4 YRS 25 | Clinic | $183.39 |
| 2026181 | HC PREV VISIT NEW AGE 5-11 25 | Clinic | $183.39 |
| 2026182 | HC PREV VISIT NEW AGE 12-17 25 | Clinic | $183.39 |
| 2026183 | HC PREV VISIT NEW AGE 18-39 25 | Clinic | $183.39 |
| 2026184 | HC PREV VISIT NEW AGE 40-64 25 | Clinic | $183.39 |
| 2026185 | HC INIT PM E/M NEW PAT 65+ YRS 25 | Clinic | $183.39 |
| 2026186 | HC PER PM REEVAL EST PAT INF <1 YR 25 | Clinic | $624.28 |
| 2026187 | HC PREV VISIT EST AGE 1-4 25 | Clinic | $624.28 |
| 2026188 | HC PREV VISIT EST AGE 5-11 25 | Clinic | $624.28 |
| 2026189 | HC PREV VISIT EST AGE 12-17 25 | Clinic | $624.28 |
| 2026190 | HC PREV VISIT EST AGE 18-39 25 | Clinic | $624.28 |
| 2026191 | HC PREV VISIT EST AGE 40-64 25 | Clinic | $624.28 |
| 2026192 | HC PER PM REEVAL EST PAT 65+ YR 25 | Clinic | $624.28 |
| 2026231 | HC SUBSEQUENT HOSPITAL CARE 15 | Clinic | $133.77 |
| 2026249 | HC OCULAR INSTRUMNT SCREEN BIL | Clinic | $69.00 |
| 2026356 | HC OFFICE CONSULTATION 30 MIN | Clinic | $418.82 |
| 2026357 | HC OFFICE CONSULTATION 40 MIN | Clinic | $502.87 |
| 2026489 | HC PHARMACY (ONLY) - CDTM AMBULATORY SERVICES | Clinic | $165.00 |
| 2026798 | HC FQHC PHONE E/M PHYS/QHP 5-10 MIN | Clinic | $406.00 |
| 2026799 | HC FQHC PHONE E/M PHYS/QHP 11-20 MIN | Clinic | $406.00 |
| 2026800 | HC FQHC PHONE E/M PHYS/QHP 21-30 MIN | Clinic | $406.00 |
| 2026938 | HC CLINIC VISIT SPEC COLLEC COVID-19, ANY SPEC SOURCE | Clinic | $83.55 |
| D000120 | HC PERIODIC ORAL EVALUATION - ESTABL | Clinic - Dental | $129.60 |
| D000140 | HC LIMITED ORAL EVALUATION - PROBLEM | Clinic - Dental | $162.00 |
| D000145 | HC ORAL EVALUATION FOR A PATIENT UND | Clinic - Dental | $140.40 |
| D000150 | HC COMPREHENSIVE ORAL EVALUATION - N | Clinic - Dental | $183.60 |
| D000160 | HC DETAILED AND EXTENSIVE ORAL EVALU | Clinic - Dental | $259.20 |
| D000170 | HC RE-EVALUATION - LIMITED, PROBLEM | Clinic - Dental | $162.00 |
| D000171 | HC RE-EVALUATION ? POST-OPERATIVE OFFICE VISIT | Clinic - Dental | $150.00 |
| D000180 | HC COMPREHENSIVE PERIODONTAL EVALUAT | Clinic - Dental | $185.76 |
| D000190 | HC SCREENING OF A PATIENT | Clinic - Dental | $0.00 |
| D000191 | HC DENTAL ASSESSMENT OF A PATIENT | Clinic - Dental | $0.00 |
| D000210 | HC INTRAORAL - COMPLETE SERIES (INCL | Clinic - Dental | $280.80 |
| D000220 | HC INTRAORAL - PERIAPICAL FIRST FILM | Clinic - Dental | $64.80 |
| D000230 | HC INTRAORAL - PERIAPICAL EACH ADDIT | Clinic - Dental | $54.00 |
| D000240 | HC INTRAORAL - OCCLUSAL FILM | Clinic - Dental | $86.40 |
| D000250 | HC EXTRAORAL - FIRST FILM | Clinic - Dental | $97.20 |
| D000251 | HC EXTRA-ORAL POSTERIOR DENTAL RADIOGRAPHIC IMAGE | Clinic - Dental | $0.00 |
| D000270 | HC BITEWING - SINGLE FILM | Clinic - Dental | $64.80 |
| D000272 | HC BITEWINGS - TWO FILMS | Clinic - Dental | $97.20 |
| D000273 | HC BITEWINGS - THREE FILMS | Clinic - Dental | $118.80 |
| D000274 | HC BITEWINGS - FOUR FILMS | Clinic - Dental | $140.40 |
| D000321 | HC OTHER TEMPOROMANDIBULAR JOINT FIL | Clinic - Dental | $406.08 |
| D000330 | HC PANORAMIC FILM | Clinic - Dental | $248.40 |
| D000340 | HC CEPHALOMETRIC FILM | Clinic - Dental | $246.24 |
| D000350 | HC ORAL/FACIAL PHOTOGRAPHIC IMAGES | Clinic - Dental | $140.40 |
| D000364 | HC CONE BEAM INTERP LIMITED VIEW | Clinic - Dental | $486.00 |
| D000365 | HC CONE BEAM INTERP FULL ARCH MAND | Clinic - Dental | $583.20 |
| D000366 | HC CONE BEAM INTERP FULL ARCH MAX | Clinic - Dental | $583.20 |
| D000367 | HC CONE BEAM INTERP BOTH JAWS | Clinic - Dental | $702.00 |
| D000368 | HC CONE BEAM INTERP TMJ SERIES | Clinic - Dental | $702.00 |
| D000380 | HC CONE BEAM CT IMAG-LIMITED FIEL | Clinic - Dental | $0.00 |
| D000381 | HC CONE BEAM FULL ARCH MAND | Clinic - Dental | $0.00 |
| D000382 | HC CONE BEAM FULL ARCH MAX | Clinic - Dental | $0.00 |
| D000384 | HC CONE BEAM TMJ SERIES | Clinic - Dental | $0.00 |
| D000415 | HC COLLECTION OF MICROORGANISMS FOR | Clinic - Dental | $237.60 |
| D000422 | HC COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORATORY ANALYSIS AND REPORT | Clinic - Dental | $540.00 |
| D000460 | HC PULP VITALITY TESTS | Clinic - Dental | $75.60 |
| D000470 | HC DIAGNOSTIC CASTS | Clinic - Dental | $213.84 |
| D000601 | HC CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF LOW RISK | Clinic - Dental | $0.00 |
| D000602 | HC CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF MODERATE RISK | Clinic - Dental | $0.00 |
| D000603 | HC CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF HIGH RISK | Clinic - Dental | $0.00 |
| D001000 | HC DENTAL CLINIC VISIT | Clinic - Dental | $196.00 |
| D001110 | HC PROPHYLAXIS - ADULT | Clinic - Dental | $194.40 |
| D001120 | HC PROPHYLAXIS - CHILD | Clinic - Dental | $162.00 |
| D001206 | HC TOPICAL FLUORIDE VARNISH, THERAPE | Clinic - Dental | $129.60 |
| D001208 | HC TOPICAL APPLICATION OF FLUORIDE | Clinic - Dental | $86.40 |
| D001310 | HC NUTRITIONAL COUNSELING FOR CONTRO | Clinic - Dental | $108.00 |
| D001330 | HC ORAL HYGIENE INSTRUCTIONS | Clinic - Dental | $108.00 |
| D001351 | HC SEALANT - PER TOOTH | Clinic - Dental | $129.60 |
| D001352 | HC PREVENTIVE RESIN RESTORATION | Clinic - Dental | $0.00 |
| D001353 | HC SEALANT REPAIR ? PER TOOTH | Clinic - Dental | $108.00 |
| D001354 | HC INTERIM CARIES ARRESTING MEDICAMENT APPLICATION | Clinic - Dental | $129.60 |
| D001510 | HC SPACE MAINTAINER - FIXED - UNILAT | Clinic - Dental | $589.68 |
| D001516 | HC FIXED BILAT SPACE MAINT, MAX | Clinic - Dental | $1,080.00 |
| D001517 | HC FIXED BILAT SPACE MAINT, MAN | Clinic - Dental | $1,080.00 |
| D001520 | HC SPACE MAINTAINER - REMOVABLE - UN | Clinic - Dental | $637.20 |
| D001526 | HC REMOVE BILAT SPACE MAIN, MAX | Clinic - Dental | $1,080.00 |
| D001527 | HC REMOVE BILAT SPACE MAIN, MAN | Clinic - Dental | $1,080.00 |
| D001999 | HC UNSPECIFIED PREVENTIVE PROCEDURE, BY REPORT | Clinic - Dental | $250.00 |
| D002140 | HC AMALGAM - ONE SURFACE, PRIMARY OR | Clinic - Dental | $302.40 |
| D002150 | HC AMALGAM - TWO SURFACES, PRIMARY O | Clinic - Dental | $302.40 |
| D002160 | HC AMALGAM - THREE SURFACES, PRIMARY | Clinic - Dental | $378.00 |
| D002161 | HC AMALGAM - FOUR OR MORE SURFACES, | Clinic - Dental | $475.20 |
| D002330 | HC RESIN-BASED COMPOSITE - ONE SURFA | Clinic - Dental | $304.56 |
| D002331 | HC RESIN-BASED COMPOSITE - TWO SURFA | Clinic - Dental | $406.08 |
| D002332 | HC RESIN-BASED COMPOSITE - THREE SUR | Clinic - Dental | $498.96 |
| D002335 | HC RESIN-BASED COMPOSITE - FOUR OR M | Clinic - Dental | $628.56 |
| D002390 | HC RESIN-BASED COMPOSITE CROWN, ANTE | Clinic - Dental | $680.40 |
| D002391 | HC RESIN-BASED COMPOSITE-ONE SUR2391 | Clinic - Dental | $378.00 |
| D002392 | HC RESIN-BASED COMPOSITE-TWO SUR2392 | Clinic - Dental | $442.80 |
| D002393 | HC RESIN-BASED COMPOSITE-THREE 2393 | Clinic - Dental | $576.72 |
| D002394 | HC RESIN-BASED COMPOSITE-FOUR OR2394 | Clinic - Dental | $691.20 |
| D002630 | HC INLAY - PORCELAIN/CERAMIC - THREE | Clinic - Dental | $1,944.00 |
| D002740 | HC CROWN - PORCELAIN/CERAMIC SUBSTRA | Clinic - Dental | $2,808.00 |
| D002750 | HC CROWN - PORCELAIN FUSED TO HIGH N | Clinic - Dental | $2,808.00 |
| D002751 | HC CROWN - PORCELAIN FUSED TO PR2751 | Clinic - Dental | $2,376.00 |
| D002752 | HC CROWN-PORCELAIN FUSED TO NOBLE | Clinic - Dental | $2,376.00 |
| D002790 | HC CROWN - FULL CAST HIGH NOBLE META | Clinic - Dental | $3,240.00 |
| D002791 | HC CROWN - FULL CAST PREDOMINANTLY B | Clinic - Dental | $2,376.00 |
| D002792 | HC CROWN - FULL CAST NOBLE METAL | Clinic - Dental | $2,376.00 |
| D002799 | HC PROVISIONAL CROWN | Clinic - Dental | $1,080.00 |
| D002910 | HC RECEMENT INLAY, ONLAY, OR PARTIAL | Clinic - Dental | $216.00 |
| D002915 | HC RECEMENT CAST OR PREFABRICATED PO | Clinic - Dental | $194.40 |
| D002920 | HC RECEMENT CROWN | Clinic - Dental | $216.00 |
| D002929 | HC PREFAB PORC/CERAM CROWN-PRIMARY | Clinic - Dental | $0.00 |
| D002930 | HC PREFABRICATED STAINLESS STEEL CRO | Clinic - Dental | $540.00 |
| D002931 | HC PREFABRICATED STAINLESS STEEL2931 | Clinic - Dental | $583.20 |
| D002932 | HC PREFABRICATED RESIN CROWN | Clinic - Dental | $609.12 |
| D002933 | HC PREFABRICATED STAINLESS STEEL2933 | Clinic - Dental | $667.44 |
| D002940 | HC PROTECTIVE RESTORATION | Clinic - Dental | $216.00 |
| D002941 | HC INTERIM THERAPEUTIC RESTORATION ? PRIMARY DENTITION | Clinic - Dental | $0.00 |
| D002950 | HC CORE BUILDUP, INCLUDING ANY PINS | Clinic - Dental | $552.96 |
| D002952 | HC POST AND CORE IN ADDITION TO CROW | Clinic - Dental | $842.40 |
| D002954 | HC PREFABRICATED POST AND CORE IN AD | Clinic - Dental | $682.56 |
| D002957 | HC EACH ADDITIONAL PREFABRICATED POS | Clinic - Dental | $308.88 |
| D002962 | HC LABIAL VENEER (PORCELAIN LAMINATE | Clinic - Dental | $3,456.00 |
| D002980 | HC CROWN REPAIR, BY REPORT | Clinic - Dental | $455.76 |
| D002990 | HC RESIN INFILTRATION INCIPIENT | Clinic - Dental | $0.00 |
| D002999 | HC UNSPECIFIED RESTORATIVE PROCEDURE | Clinic - Dental | $0.00 |
| D003110 | HC PULP CAP - DIRECT (EXCLUDING FINA | Clinic - Dental | $166.32 |
| D003120 | HC PULP CAP - INDIRECT (EXCLUDING FI | Clinic - Dental | $164.16 |
| D003220 | HC THERAPEUTIC PULPOTOMY (EXCLUDING | Clinic - Dental | $367.20 |
| D003221 | HC PULPAL DEBRIDEMENT, PRIMARY AND P | Clinic - Dental | $455.76 |
| D003222 | HC PARTIAL PULPOTOTOMY APEXOGEN | Clinic - Dental | $0.00 |
| D003240 | HC PULPAL THERAPY (RESORBABLE FI3240 | Clinic - Dental | $518.40 |
| D003310 | HC ANTERIOR (EXCLUDING FINAL RESTORA | Clinic - Dental | $1,933.20 |
| D003320 | HC BICUSPID (EXCLUDING FINAL RESTORA | Clinic - Dental | $2,160.00 |
| D003330 | HC MOLAR (EXCLUDING FINAL RESTORATIO | Clinic - Dental | $2,535.84 |
| D003332 | HC INCOMPLETE ENDODONTIC THERAPY, IN | Clinic - Dental | $732.24 |
| D003333 | HC INTERNAL ROOT REPAIR OF PERFORATI | Clinic - Dental | $650.16 |
| D003346 | HC RETREATMENT OF PREVIOUS ROOT CANA | Clinic - Dental | $2,170.80 |
| D003347 | HC RETREATMENT OF PREVIOUS ROOT 3347 | Clinic - Dental | $2,406.24 |
| D003348 | HC RETREATMENT OF PREVIOUS ROOT 3348 | Clinic - Dental | $2,754.00 |
| D003353 | HC APEXIFICATION/RECALCIFICATION - F | Clinic - Dental | $926.64 |
| D003355 | HC PULPAL REGENERATION - INITIAL VISIT | Clinic - Dental | $0.00 |
| D003357 | HC PULPAL REGENERATION - COMPLETION OF TREATMENT | Clinic - Dental | $0.00 |
| D003410 | HC APICOECTOMY/PERIRADICULAR SUR3410 | Clinic - Dental | $1,393.20 |
| D003421 | HC APICOECTOMY/PERIRADICULAR SUR3421 | Clinic - Dental | $1,566.00 |
| D003425 | HC APICOECTOMY/PERIRADICULAR SUR3425 | Clinic - Dental | $1,782.00 |
| D003426 | HC APICOECTOMY/PERIRADICULAR SURGERY | Clinic - Dental | $658.80 |
| D003428 | HC BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? PER TOOTH, SINGLE SITE | Clinic - Dental | $1,026.00 |
| D003429 | HC BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? EACH ADDITIONAL CONTIGUOUS TOOTH IN THE SA | Clinic - Dental | $0.00 |
| D003430 | HC RETROGRADE FILLING - PER ROOT | Clinic - Dental | $444.96 |
| D003431 | HC BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATION IN CONJUNCTION WITH PERIRADICUL | Clinic - Dental | $1,058.40 |
| D003432 | HC GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CONJUNCTION WITH PERIRADICULAR SURGE | Clinic - Dental | $0.00 |
| D003450 | HC ROOT AMPUTATION - PER ROOT | Clinic - Dental | $959.04 |
| D003470 | HC INTENTIONAL REIMPLANTATION (INCLU | Clinic - Dental | $1,615.68 |
| D004211 | HC GINGIVECTOMY OR GINGIVOPLASTY - O | Clinic - Dental | $486.00 |
| D004240 | HC GINGIVAL FLAP PROCEDURE, INCL4240 | Clinic - Dental | $1,358.64 |
| D004241 | HC GINGIVAL FLAP PROCEDURE, INCLUDIN | Clinic - Dental | $993.60 |
| D004245 | HC APICALLY POSITIONED FLAP | Clinic - Dental | $1,082.16 |
| D004249 | HC CLINICAL CROWN LENGTHENING - HARD | Clinic - Dental | $1,490.40 |
| D004260 | HC OSSEOUS SURGERY (INCLUDING FL4260 | Clinic - Dental | $2,300.40 |
| D004261 | HC OSSEOUS SURGERY (INCLUDING FLAP E | Clinic - Dental | $1,976.40 |
| D004263 | HC BONE REPLACEMENT GRAFT - FIRST SI | Clinic - Dental | $972.00 |
| D004264 | HC BONE REPLACEMENT GRAFT - EACH ADD | Clinic - Dental | $0.00 |
| D004266 | HC GUIDED TISSUE REGENERATION - RESO | Clinic - Dental | $1,058.40 |
| D004275 | HC SOFT TISSUE ALLOGRAFT | Clinic - Dental | $1,717.20 |
| D004277 | HC FREE SOFT TISSUE GRAFT,FIRST TTH | Clinic - Dental | $864.00 |
| D004278 | HC FREE SOFT TISSUE GRAFT,EACH ADD | Clinic - Dental | $864.00 |
| D004321 | HC PROVISIONAL SPLINTING - EXTRACORO | Clinic - Dental | $864.00 |
| D004341 | HC PERIODONTAL SCALING AND ROOT 4341 | Clinic - Dental | $486.00 |
| D004342 | HC PERIODONTAL SCALING AND ROOT PLAN | Clinic - Dental | $358.56 |
| D004346 | HC SCALING GINGIV INFLAMMATION | Clinic - Dental | $370.00 |
| D004355 | HC FULL MOUTH DEBRIDEMENT TO ENABLE | Clinic - Dental | $367.20 |
| D004910 | HC PERIODONTAL MAINTENANCE | Clinic - Dental | $276.48 |
| D005110 | HC COMPLETE DENTURE - MAXILLARY | Clinic - Dental | $3,024.00 |
| D005120 | HC COMPLETE DENTURE - MANDIBULAR | Clinic - Dental | $3,024.00 |
| D005130 | HC IMMEDIATE DENTURE - MAXILLARY | Clinic - Dental | $3,456.00 |
| D005140 | HC IMMEDIATE DENTURE - MANDIBULAR | Clinic - Dental | $3,456.00 |
| D005211 | HC MAXILLARY PARTIAL DENTURE - RESIN | Clinic - Dental | $1,963.44 |
| D005212 | HC MANDIBULAR PARTIAL DENTURE - RESI | Clinic - Dental | $1,963.44 |
| D005213 | HC DENTURES MAXILL PART METAL | Clinic - Dental | $3,564.00 |
| D005214 | HC DENTURES MANDIBL PART METAL | Clinic - Dental | $3,564.00 |
| D005221 | HC IMMEDIATE MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TE | Clinic - Dental | $3,456.00 |
| D005223 | HC IMMEDIATE MAXILLARY PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING AN | Clinic - Dental | $0.00 |
| D005224 | HC IMMEDIATE MANDIBULAR PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING A | Clinic - Dental | $0.00 |
| D005225 | HC MAXILLARY PARTIAL DENTURE - FLEXI | Clinic - Dental | $5,184.00 |
| D005226 | HC MANDIBULAR PARTIAL DENTURE - FLEX | Clinic - Dental | $5,184.00 |
| D005283 | HC REMOVE UNIL PART DENTURE,MAN | Clinic - Dental | $1,566.00 |
| D005410 | HC ADJUST COMPLETE DENTURE - MAXILLA | Clinic - Dental | $162.00 |
| D005411 | HC ADJUST COMPLETE DENTURE - MANDIBU | Clinic - Dental | $162.00 |
| D005421 | HC DJUST PARTIAL DENTURE - MAXILLAR | Clinic - Dental | $162.00 |
| D005422 | HC ADJUST PARTIAL DENTURE - MANDIBUL | Clinic - Dental | $162.00 |
| D005511 | HC REPAIR BROKEN COMPLETE DENTRURE BASE, MANDIBULAR | Clinic - Dental | $558.00 |
| D005512 | HC REPAIR BROKEN COMPLETE DENTRURE BASE, MAXILLARY | Clinic - Dental | $700.00 |
| D005520 | HC REPLACE MISSING OR BROKEN TEETH - | Clinic - Dental | $270.00 |
| D005611 | HC REPAIR RESIN PARTIAL DENTRUE BASE, MANDIBULAR | Clinic - Dental | $972.00 |
| D005612 | HC REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY | Clinic - Dental | $972.00 |
| D005621 | HC REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR | Clinic - Dental | $936.00 |
| D005622 | HC REPAIR CAST PARTIAL FRAMEWORK, MAXILLARY | Clinic - Dental | $936.00 |
| D005630 | HC REPAIR OR REPLACE BROKEN CLASP | Clinic - Dental | $810.00 |
| D005640 | HC REPLACE BROKEN TEETH - PER TOOTH | Clinic - Dental | $810.00 |
| D005650 | HC ADD TOOTH TO EXISTING PARTIAL DEN | Clinic - Dental | $810.00 |
| D005660 | HC ADD CLASP TO EXISTING PARTIAL DEN | Clinic - Dental | $810.00 |
| D005710 | HC REBASE COMPLETE MAXILLARY DENTURE | Clinic - Dental | $972.00 |
| D005711 | HC REBASE COMPLETE MANDIBULAR DENTUR | Clinic - Dental | $972.00 |
| D005730 | HC RELINE COMPLETE MAXILLARY DENTURE | Clinic - Dental | $756.00 |
| D005731 | HC RELINE COMPLETE MANDIBULAR DENTUR | Clinic - Dental | $756.00 |
| D005741 | HC RELINE MANDIBULAR PARTIAL DENTURE | Clinic - Dental | $552.96 |
| D005750 | HC RELINE COMPLETE MAXILLARY DEN5750 | Clinic - Dental | $1,620.00 |
| D005751 | HC RELINE COMPLETE MANDIBULAR DE5751 | Clinic - Dental | $1,620.00 |
| D005760 | HC RELINE MAXILLARY PARTIAL DEN 5760 | Clinic - Dental | $1,620.00 |
| D005810 | HC INTERIM COMPLETE DENTURE (MAXILLA | Clinic - Dental | $1,470.96 |
| D005820 | HC INTERIM PARTIAL DENTURE (MAXILLAR | Clinic - Dental | $1,512.00 |
| D005821 | HC INTERIM PARTIAL DENTURE (MANDIBUL | Clinic - Dental | $1,512.00 |
| D005865 | HC OVERDENTURE - COMPLETE MANDIBULAR | Clinic - Dental | $12,960.00 |
| D005867 | HC REPLACEMENT OF REPLACEABLE PART O | Clinic - Dental | $500.00 |
| D005986 | HC FLUORIDE GEL CARRIER | Clinic - Dental | $401.76 |
| D006010 | HC SURGICAL PLACEMENT OF IMPLANT BOD | Clinic - Dental | $3,000.00 |
| D006011 | HC SECOND STAGE IMPLANT SURGERY | Clinic - Dental | $200.00 |
| D006052 | HC SEMI-PRECISION ATTACHMENT ABUTMENT | Clinic - Dental | $2,160.00 |
| D006056 | HC PREFABRICATED ABUTMENT - INCLUDES | Clinic - Dental | $1,164.24 |
| D006057 | HC CUSTOM ABUTMENT - INCLUDES PLACEM | Clinic - Dental | $400.00 |
| D006058 | HC ABUTMENT SUPPORTED PORCELAIN/CERA | Clinic - Dental | $3,110.40 |
| D006059 | HC ABUTMENT SUPPORTED PORCELAIN 6059 | Clinic - Dental | $3,600.00 |
| D006060 | HC ABUTMENT SUPPORTED PORCELAIN 6060 | Clinic - Dental | $2,646.00 |
| D006065 | HC IMPLANT SUPPORTED PORCELAIN/CERAM | Clinic - Dental | $2,995.92 |
| D006066 | HC IMPLANT SUPPORTED MTL CROWN | Clinic - Dental | $4,000.00 |
| D006069 | HC ABUTMENT SUPPORTED RETAINER 6069 | Clinic - Dental | $4,000.00 |
| D006072 | HC ABUTMENT SUPPORTED RETAINER 6072 | Clinic - Dental | $2,900.88 |
| D006076 | HC IMPLANT SUPPORTED RETAINER FOR PO | Clinic - Dental | $4,000.00 |
| D006080 | HC IMPLANT MAINTENANCE PROCEDURES, I | Clinic - Dental | $373.68 |
| D006081 | HC SCALE & DEBRIDE, SINGLE IMP | Clinic - Dental | $0.00 |
| D006090 | HC REPAIR IMPLANT SUPPORTED PROSTHES | Clinic - Dental | $1,481.76 |
| D006091 | HC REPLACEMENT OF SEMI-PRECISION OR | Clinic - Dental | $500.00 |
| D006093 | HC RECEMENT IMPLANT/ABUTMENT SUP6093 | Clinic - Dental | $0.00 |
| D006100 | HC IMPLANT REMOVAL, BY REPORT | Clinic - Dental | $345.60 |
| D006104 | HC BONE GRAFT AT IMPLANT PLACEMENT | Clinic - Dental | $0.00 |
| D006111 | HC IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARCH ? MANDIBULAR | Clinic - Dental | $12,960.00 |
| D006119 | HC IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTRURE FOR EDENTULOUS ARCH - MAXILLARY | Clinic - Dental | $0.00 |
| D006190 | HC RADIOGRAPHIC/SURGICAL IMPLANT IND | Clinic - Dental | $1,400.00 |
| D006199 | HC UNSPECIFIED IMPLANT PROCEDURE, BY | Clinic - Dental | $0.00 |
| D006205 | HC PONTIC - INDIRECT RESIN BASED COM | Clinic - Dental | $1,959.12 |
| D006210 | HC PONTIC - CAST HIGH NOBLE METAL | Clinic - Dental | $2,160.00 |
| D006212 | HC PONTIC - CAST NOBLE METAL | Clinic - Dental | $1,974.24 |
| D006240 | HC PONTIC - PORCELAIN FUSED TO HIGH | Clinic - Dental | $2,808.00 |
| D006241 | HC PONTIC - PORCELAIN FUSED TO PREDO | Clinic - Dental | $2,376.00 |
| D006242 | HC PONTIC - PORCELAIN FUSED TO NOBLE | Clinic - Dental | $2,808.00 |
| D006245 | HC PONTIC - PORCELAIN/CERAMIC | Clinic - Dental | $2,808.00 |
| D006251 | HC PONTIC - RESIN WITH PREDOMINANTLY | Clinic - Dental | $1,913.76 |
| D006253 | HC PROVISIONAL PONTIC | Clinic - Dental | $1,080.00 |
| D006545 | HC RETAINER - CAST METAL FOR RESIN B | Clinic - Dental | $1,285.20 |
| D006548 | HC RETAINER - PORCELAIN/CERAMIC FOR | Clinic - Dental | $1,285.20 |
| D006740 | HC CROWN - PORCELAIN/CERAMIC | Clinic - Dental | $2,808.00 |
| D006750 | HC CROWN-PORCELAIN FUSED TO HIGH6750 | Clinic - Dental | $2,808.00 |
| D006751 | HC CROWN - PORCELAIN FUSED TO PREDOM | Clinic - Dental | $2,376.00 |
| D006752 | HC CROWN-PORCELAIN FUSED TO NOBL6752 | Clinic - Dental | $2,808.00 |
| D006791 | HC CROWN - FULL CAST PREDOMINANT6791 | Clinic - Dental | $2,376.00 |
| D006792 | HC CROWN - FULL CAST NOBLE METAL6792 | Clinic - Dental | $2,376.00 |
| D006930 | HC RECEMENT FIXED PARTIAL DENTURE | Clinic - Dental | $339.12 |
| D006950 | HC PRECISION ATTACHMENT | Clinic - Dental | $3,149.28 |
| D007111 | HC EXTRACTION, CORONAL REMNANTS - DE | Clinic - Dental | $265.68 |
| D007140 | HC EXTRACTION, ERUPTED TOOTH OR EXPO | Clinic - Dental | $343.44 |
| D007210 | HC SURGICAL REMOVAL OF ERUPTED TOOTH | Clinic - Dental | $561.60 |
| D007220 | HC REMOVAL OF IMPACTED TOOTH - SOFT | Clinic - Dental | $637.20 |
| D007230 | HC REMOVAL OF IMPACTED TOOTH - PARTI | Clinic - Dental | $842.40 |
| D007240 | HC REMOVAL OF IMPACTED TOOTH - COMPL | Clinic - Dental | $982.80 |
| D007241 | HC REMOVAL OF IMPACTED TOOTH - 7241 | Clinic - Dental | $1,144.80 |
| D007250 | HC SURGICAL REMOVAL OF RESIDUAL TOOT | Clinic - Dental | $561.60 |
| D007251 | HC CORONECTOMY | Clinic - Dental | $507.60 |
| D007270 | HC TOOTH REIMPLANTATION AND/OR STABI | Clinic - Dental | $723.60 |
| D007280 | HC SURGICAL ACCESS OF AN UNERUPTED T | Clinic - Dental | $972.00 |
| D007283 | HC PLACEMENT OF DEVICE TO FACILITATE | Clinic - Dental | $671.76 |
| D007285 | HC BIOPSY OF ORAL TISSUE - HARD (BON | Clinic - Dental | $853.20 |
| D007286 | HC BIOPSY OF ORAL TISSUE - SOFT | Clinic - Dental | $635.04 |
| D007311 | HC ALVEOLOPLASTY IN CONJUNCTION 7311 | Clinic - Dental | $648.00 |
| D007320 | HC ALVEOLOPLASTY NOT IN CONJUNCTION | Clinic - Dental | $648.00 |
| D007321 | HC ALVEOLOPLASTY NOT IN CONJUNC 7321 | Clinic - Dental | $648.00 |
| D007410 | HC EXCISION OF BENIGN LESION UP TO 1 | Clinic - Dental | $721.44 |
| D007411 | HC EXCISION OF BENIGN LESION GREATER | Clinic - Dental | $756.00 |
| D007451 | HC REMOVAL OF BENIGN ODONTOGENIC7451 | Clinic - Dental | $864.00 |
| D007473 | HC REMOVAL OF TORUS MANDIBULARIS | Clinic - Dental | $1,291.68 |
| D007510 | HC INCISION AND DRAINAGE OF ABSCESS | Clinic - Dental | $468.72 |
| D007511 | HC INCISION AND DRAINAGE OF ABS 7511 | Clinic - Dental | $546.48 |
| D007520 | HC INCISION AND DRAINAGE OF ABS 7520 | Clinic - Dental | $864.00 |
| D007670 | HC ALVEOLUS CLOSED REDUCTION MAY IN | Clinic - Dental | $1,944.00 |
| D007820 | HC CLOSED REDUCTION OF DISLOCATION | Clinic - Dental | $1,205.28 |
| D007870 | HC ARTHROCENTESIS | Clinic - Dental | $162.00 |
| D007880 | HC OCCLUSAL ORTHOTIC DEVICE, BY REPO | Clinic - Dental | $1,475.28 |
| D007951 | HC SINUS AUGMENTATION WITH BONE OR B | Clinic - Dental | $5,676.48 |
| D007952 | HC SINUS AUGMENTATION-VERTICAL APP | Clinic - Dental | $1,080.00 |
| D007953 | HC BONE REPLACEMENT GRAFT FOR RIDGE | Clinic - Dental | $1,026.00 |
| D007960 | HC FRENULECTOMY (FRENECTOMY OR FRENO | Clinic - Dental | $885.60 |
| D007963 | HC FRENULOPLASTY | Clinic - Dental | $987.12 |
| D007997 | HC APPLIANCE REMOVAL (NOT BY DENTIST | Clinic - Dental | $654.48 |
| D008020 | HC LIMITED ORTHODONTIC TREATMENT8020 | Clinic - Dental | $4,536.00 |
| D008060 | HC INTERCEPTIVE ORTHODONTIC TREA8060 | Clinic - Dental | $5,184.00 |
| D008090 | HC COMPREHENSIVE ORTHODONTIC TRE8090 | Clinic - Dental | $10,692.00 |
| D008210 | HC REMOVABLE APPLIANCE THERAPY | Clinic - Dental | $1,624.32 |
| D008220 | HC FIXED APPLIANCE THERAPY | Clinic - Dental | $1,836.00 |
| D008660 | HC PRE-ORTHODONTIC TREATMENT VISIT | Clinic - Dental | $622.08 |
| D008670 | HC PERIODIC ORTHODONTIC TREATMENT VI | Clinic - Dental | $514.08 |
| D008681 | HC REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT | Clinic - Dental | $0.00 |
| D008695 | HC REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN COMPLETION OF TREATMENT | Clinic - Dental | $0.00 |
| D008999 | HC UNSPECIFIED ORTHODONTIC PROCEDURE | Clinic - Dental | $0.00 |
| D009110 | HC PALLIATIVE (EMERGENCY) TREATMENT | Clinic - Dental | $248.40 |
| D009120 | HC FIXED PARTIAL DENTURE SECTIONING | Clinic - Dental | $308.88 |
| D009211 | HC REGIONAL BLOCK ANESTHESIA | Clinic - Dental | $177.12 |
| D009215 | HC LOCAL ANESTHESIA | Clinic - Dental | $32.40 |
| D009219 | HC EVALUATION FOR DEEP SEDATION OR GENERAL ANESTHESIA | Clinic - Dental | $432.00 |
| D009222 | HC DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MINS | Clinic - Dental | $0.00 |
| D009223 | HC DEEP SEDATION/GENERAL ANESTHESIA ? EACH 15 MINUTE INCREMENT | Clinic - Dental | $0.00 |
| D009230 | HC INHAL NITR OXIDE/ANXIOLYS,ANALGES | Clinic - Dental | $194.40 |
| D009239 | HC INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA - FIRST 15 MINS | Clinic - Dental | $0.00 |
| D009243 | HC INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA ? EACH 15 MINUTE INCREMENT | Clinic - Dental | $0.00 |
| D009248 | HC NON-INTRAVENOUS CONSCIOUS SEDATIO | Clinic - Dental | $583.20 |
| D009310 | HC CONSULTATION - DIAGNOSTIC SERVICE | Clinic - Dental | $237.60 |
| D009420 | HC HOSPITAL OR AMB SURG CTR CALL | Clinic - Dental | $557.28 |
| D009430 | HC OFFICE VISIT FOR OBSERVATION (DUR | Clinic - Dental | $97.20 |
| D009440 | HC OFFICE VISIT - AFTER REGULARLY SC | Clinic - Dental | $226.80 |
| D009610 | HC THERAPEUTIC PARENTERAL DRUG, SING | Clinic - Dental | $108.00 |
| D009910 | HC APPLICATION OF DESENSITIZING MEDI | Clinic - Dental | $97.20 |
| D009911 | HC APPLICATION OF DESENSITIZING RESI | Clinic - Dental | $108.00 |
| D009920 | HC BEHAVIOR MANAGEMENT, BY REPORT | Clinic - Dental | $108.00 |
| D009930 | HC TREATMENT OF COMPLICATIONS (POST- | Clinic - Dental | $97.20 |
| D009943 | HC OCCLUSAL GUARD ADJUSTMENT | Clinic - Dental | $0.00 |
| D009944 | HC OCC GUARD, HARD, FULL ARCH | Clinic - Dental | $1,400.00 |
| D009945 | HC OCC GUARD, SOFT, FULL ARCH | Clinic - Dental | $1,400.00 |
| D009946 | HC OCC GUARD, HARD, PART ARCH | Clinic - Dental | $1,400.00 |
| D009951 | HC OCCLUSAL ADJUSTMENT - LIMITED | Clinic - Dental | $237.60 |
| D009971 | HC ODONTOPLASTY 1 - 2 TEETH, INCLUDE | Clinic - Dental | $237.60 |
| D009972 | HC EXTERNAL BLEACHING - PER ARCH | Clinic - Dental | $527.04 |
| D009974 | HC INTERNAL BLEACHING - PER TOOTH | Clinic - Dental | $565.92 |
| D009975 | HC EXTERNAL BLEACHING-HOME,PER ARCH | Clinic - Dental | $324.00 |
| D009990 | HC TRANS OR SIGN LANGUAGE SVCS | Clinic - Dental | $0.00 |
| D009991 | HC CASE MGMT, APPT BARRIERS | Clinic - Dental | $0.00 |
| D009994 | HC CASE MGMT, PT EDUCATION | Clinic - Dental | $0.00 |
| D009995 | HC TELEDENTRISTRY - SYNCHRONOUS; REAL-TIME ENCOUNTER | Clinic - Dental | $0.00 |
| D009999 | HC UNSPECIFIED ADJUNCTIVE PROCEDURE, | Clinic - Dental | $0.00 |
| D011552 | HC RECEMENT SPACE MAINT - MAN BILAT | Clinic - Dental | $127.44 |
| D011553 | HC RECEMENT UNILAT SPACE MAINT | Clinic - Dental | $127.44 |
| D011556 | HC REMOVE FIXED UNILAT SPACE MAINT | Clinic - Dental | $164.16 |
| D011557 | HC REMOVE FIXED BILAT SPACE MAINT MAX | Clinic - Dental | $164.16 |
| D011558 | HC REMOVE FIXED BILAT MAN | Clinic - Dental | $164.16 |
| D019975 | HC EXTERNAL BLEACHING-HOME, NON-CUSTOM TRAY | Clinic - Dental | $540.00 |
| 2026235 | HC HOME VISIT NEW PATIENT 30 | Clinic - Other | $270.90 |
| 2026239 | HC HOME VISIT EST PATIENT 15 | Clinic - Other | $188.28 |
| 2026240 | HC HOME VISIT EST PATIENT 25 | Clinic - Other | $286.92 |
| 2026241 | HC HOME VISIT EST PATIENT 40 | Clinic - Other | $439.17 |
| 2026242 | HC HOME VISIT EST PATIENT 60 | Clinic - Other | $610.29 |
| 2026502 | HC DIALYSIS ONE EVALUATION (CAPD) | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate | $1,588.00 |
| 2026505 | HC DIALYSIS TRAINING INCOMPLETE (CAPD) | Continuous Ambulatory Peritoneal Dialysis (CAPD) - Outpatient or Home - CAPD/Composite or Other Rate | $2,330.00 |
| 2026503 | HC DIALYSIS ONE EVALUATION (CCPD) | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate | $1,588.00 |
| 2026506 | HC DIALYSIS TRAINING INCOMPLETE (CCPD) | Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - CCPD/Composite or Other Rate | $2,330.00 |
| 1010031 | HC RB SPECIAL CARE EPILEPSY | Coronary Care Unit - Other | $11,753.20 |
| 2020001 | HC CCTA W/WO, STRXR | CT Scan | $4,923.96 |
| 2020645 | HC CT HEAD/BRAIN W/O DYE | CT Scan | $4,425.50 |
| 2020646 | HC CT HEAD/BRAIN W/DYE | CT Scan | $4,718.06 |
| 2020647 | HC CT HEAD/BRAIN W/O & W/DYE | CT Scan | $5,007.44 |
| 2020648 | HC CT ORBIT/EAR/FOSSA W/O DYE | CT Scan | $3,530.10 |
| 2020649 | HC CT ORBIT/EAR/FOSSA W/DYE | CT Scan | $4,164.96 |
| 2020650 | HC CT ORBIT/EAR/FOSSA W/O&W/DYE | CT Scan | $4,554.06 |
| 2020651 | HC CT MAXILLOFACIAL W/O CONTRAST | CT Scan | $3,903.98 |
| 2020652 | HC CT MAXILLOFACIAL W/CONTRAST | CT Scan | $4,731.84 |
| 2020653 | HC CT MAXILLOFACIAL W/O & W/CONTRAST | CT Scan | $5,455.15 |
| 2020654 | HC CT SOFT TISSUE NECK W/O DYE | CT Scan | $3,871.85 |
| 2020655 | HC CT SOFT TISSUE NECK W/DYE | CT Scan | $4,721.73 |
| 2020656 | HC CT SFT TSUE NCK W/O & W/DYE | CT Scan | $5,571.62 |
| 2020695 | HC CT THORAX W/O DYE | CT Scan | $4,242.12 |
| 2020696 | HC CT THORAX W/DYE | CT Scan | $7,723.22 |
| 2020697 | HC CT THORAX W/O & W/DYE | CT Scan | $8,646.05 |
| 2020698 | HC CT ANGIOGRAPHY, CHEST | CT Scan | $6,056.72 |
| 2020719 | HC CT NECK SPINE W/O DYE | CT Scan | $3,732.26 |
| 2020720 | HC CT NECK SPINE W/DYE | CT Scan | $7,069.16 |
| 2020721 | HC CT NECK SPINE W/O & W/DYE | CT Scan | $7,913.92 |
| 2020722 | HC CT CHEST SPINE W/O DYE | CT Scan | $3,517.30 |
| 2020723 | HC CT CHEST SPINE W/DYE | CT Scan | $7,069.16 |
| 2020724 | HC CT CHEST SPINE W/O & W/DYE | CT Scan | $7,913.92 |
| 2020725 | HC CT LUMBAR SPINE W/O DYE | CT Scan | $3,623.53 |
| 2020728 | HC CT LUMBAR SPINE W/DYE | CT Scan | $7,282.92 |
| 2020729 | HC CT LUMBAR SPINE W/O & W/DYE | CT Scan | $8,153.28 |
| 2020744 | HC CT ANGIOGRAPH PELV W/O&W/DYE | CT Scan | $4,185.44 |
| 2020745 | HC CT PELVIS W/O DYE | CT Scan | $3,922.00 |
| 2020746 | HC CT PELVIS W/O DYE 52 | CT Scan | $2,461.34 |
| 2020747 | HC CT PELVIS W/DYE | CT Scan | $4,922.69 |
| 2020750 | HC CT PELVIS W/O & W/DYE | CT Scan | $5,514.02 |
| 2020967 | HC CT LOWER EXTREMITY W/CONTRAST | CT Scan | $3,896.16 |
| 2020971 | HC CT ANGIO LWR EXTR W/O&W/DYE | CT Scan | $4,240.00 |
| 2020992 | HC CT ABDOMEN W/O DYE | CT Scan | $3,959.10 |
| 2020993 | HC CT ABDOMEN W/DYE | CT Scan | $5,551.14 |
| 2020994 | HC CT ABDOMEN W/O & W/DYE | CT Scan | $6,301.19 |
| 2020995 | HC CT ANGIO ABDOM W/O & W/DYE | CT Scan | $7,499.22 |
| 2021039 | HC CT ANGIO ABDOMINAL ARTERIES | CT Scan | $4,240.00 |
| 2021131 | HC 3D RENDER W/O POSTPROCESS | CT Scan | $651.49 |
| 2021132 | HC 3D RENDERING W/POSTPROCESS | CT Scan | $3,594.46 |
| 2021172 | HC CT SCAN FOR NEEDLE BIOPSY | CT Scan | $3,463.55 |
| 2021173 | HC CT GUIDE FOR TISSUE ABLATION | CT Scan | $7,025.64 |
| 2021174 | HC CT SCAN FOR THERAPY GUIDE | CT Scan | $2,822.78 |
| 2022720 | HC CT HRT W/O DYE W/CA TEST | CT Scan | $4,185.44 |
| 2022721 | HC CT HRT W/3D IMAGE | CT Scan | $4,923.96 |
| 2022917 | HC CT ABD & PEL W/O CONT | CT Scan | $4,801.08 |
| 2022918 | HC CT ABD & PEL W/CONT | CT Scan | $7,501.78 |
| 2022919 | HC CT ABD & PEL W & W/O CON | CT Scan | $8,477.10 |
| 2023501 | HC CT; U EXTR WO CONTRAST | CT Scan | $3,523.70 |
| 2023502 | HC CT; U EXTR W CONTRAST | CT Scan | $4,369.75 |
| 2023503 | HC CT: U EXTR W AND WO CONTRAST | CT Scan | $5,461.54 |
| 2023504 | HC CT ANGIO UPR EXTRM W/O&W/DYE | CT Scan | $3,874.30 |
| 2023524 | HC CT L EXTR W AND WO CONTRAST | CT Scan | $4,730.69 |
| 2023570 | HC CT ANGIO ABD&PELV W/O&W/DYE | CT Scan | $9,493.39 |
| 2023571 | HC CT COLONOGRAPHY DX | CT Scan | $1,624.25 |
| 2023781 | HC CT LIMITED OR FOLLOW-UP STUDY | CT Scan | $1,105.87 |
| 2025033 | HC CT PERFUSION W/CONTRAST CBF | CT Scan | $1,002.19 |
| 2025722 | HC LDCT FOR LUNG CA SCREEN | CT Scan | $954.00 |
| 2026138 | HC CT COLONOGRAPHY SCREEN | CT Scan | $1,752.18 |
| 2026733 | HC CT CDSM NDSC | CT Scan | $1.06 |
| 2022884 | HC CT LOWER EXTREMITY W/O CONTR | CT Scan - Body Scan | $3,092.35 |
| 2020657 | HC CT ANGIOGRAPHY, HEAD | CT Scan - Head Scan | $6,554.62 |
| 2020658 | HC CT ANGIOGRAPHY, NECK | CT Scan - Head Scan | $6,723.58 |
| 2022154 | HC EEG EXTND MNTR 61-119 MIN | EEG (Electroencephalogram) | $4,367.34 |
| 2022155 | HC EEG, AWAKE AND ASLEEP | EEG (Electroencephalogram) | $3,862.38 |
| 2022665 | HC WADA ACTIVATION TEST | EEG (Electroencephalogram) | $7,434.84 |
| 2024302 | HC EEG EXTEND MONIT 41-60 MINUTES | EEG (Electroencephalogram) | $3,668.42 |
| 2024303 | HC EEG AWAKE & DROWSY | EEG (Electroencephalogram) | $3,375.37 |
| 2024468 | HC EEG COMA OR SLEEP ONLY | EEG (Electroencephalogram) | $3,276.67 |
| 2024593 | HC POLYSOM <6 YRS 4> PARAMTRS | EEG (Electroencephalogram) | $15,712.38 |
| 2024594 | HC POLYSOM <6 YRS CPAP/BILVL | EEG (Electroencephalogram) | $15,712.38 |
| 2024597 | HC POLYSOM 6/> YRS 4/> PARAM | EEG (Electroencephalogram) | $15,712.38 |
| 2024598 | HC POLYSOM 6/>YRS CPAP 4/> PARM | EEG (Electroencephalogram) | $15,712.38 |
| 2026444 | HC ACTIGRAPHY TESTING 73 HRS-14 CONS DAYS | EEG (Electroencephalogram) | $208.19 |
| 2026605 | HC EEG CONT REC W/VID EEG TECH 8 CH | EEG (Electroencephalogram) | $919.89 |
| 2026606 | HC EEG W/O VID 2-12 HR UNMNTR | EEG (Electroencephalogram) | $950.90 |
| 2026608 | HC EEG W/O VID 2-12HR CONT MNTR | EEG (Electroencephalogram) | $1,692.90 |
| 2026609 | HC EEG WO VID EA 12-26HR UNMNTR | EEG (Electroencephalogram) | $2,821.80 |
| 2026611 | HC EEG W/O VID EA 12-26HR CONT | EEG (Electroencephalogram) | $4,305.80 |
| 2026612 | HC VEEG 2-12 HR UNMONITORED | EEG (Electroencephalogram) | $11,206.51 |
| 2026614 | HC VEEG 2-12 HR CONT MNTR | EEG (Electroencephalogram) | $12,194.51 |
| 2026615 | HC VEEG EA 12-26 HR UNMNTR | EEG (Electroencephalogram) | $22,908.91 |
| 2026616 | HC VEEG EA 12-26HR INTMT MNTR | EEG (Electroencephalogram) | $23,402.91 |
| 2022023 | HC ELECTROCARDIOGRAM, TRACING | EKG/ECG (Electrocardiogram) | $641.30 |
| 2022024 | HC ELECTROCARDIOGRAM, TRACING 76 | EKG/ECG (Electrocardiogram) | $515.81 |
| 2022030 | HC ECG MONITOR/RECORD, 48 HRS | EKG/ECG (Electrocardiogram) - Holter Monitor | $629.73 |
| 2022031 | HC ECG MONITOR/REPORT, 48 HRS | EKG/ECG (Electrocardiogram) - Holter Monitor | $940.76 |
| 2023746 | HC EMERGENCY DEPT VISIT LVL 1 | Emergency Room | $2,624.00 |
| 2023747 | HC EMERGENCY DEPT VISIT LVL 2 | Emergency Room | $3,018.00 |
| 2023748 | HC EMERGENCY DEPT VISIT LVL 3 | Emergency Room | $4,364.00 |
| 2023749 | HC EMERGENCY DEPT VISIT LVL 4 | Emergency Room | $4,985.00 |
| 2023750 | HC EMERGENCY DEPT VISIT LVL 5 | Emergency Room | $5,904.00 |
| 2023751 | HC CRITICAL CARE 1ST HOUR | Emergency Room | $6,369.00 |
| 2023752 | HC CRITICAL CARE ADDL 30 MIN | Emergency Room | $3,185.00 |
| 2023783 | HC EMERG DEPT F/U VISIT LVL 1 | Emergency Room | $1,312.15 |
| 2023784 | HC EMERG DEPT F/U VISIT LVL 2 | Emergency Room | $1,508.80 |
| 2023785 | HC EMERG DEPT F/U VISIT LVL 3 | Emergency Room | $2,182.13 |
| 2023786 | HC EMERG DEPT F/U VISIT LVL 4 | Emergency Room | $2,492.63 |
| 2023787 | HC EMERG DEPT F/U VISIT LVL 5 | Emergency Room | $2,952.05 |
| 2023789 | HC ED TRIAGE VISIT | Emergency Room | $430.92 |
| 2025615 | HC ED SUTURE REMOVAL VISIT LVL 1 | Emergency Room | $430.92 |
| 2026978 | HC HOSP NOTIF TRAUMA RESPONS W OR W/O CC | Emergency Room | $7,511.03 |
| 2024430 | HC URGENT CARE NEW LVL 1 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024431 | HC URGENT CARE NEW LVL 1 | Emergency Room - Urgent Care | $1,495.00 |
| 2024434 | HC URGENT CARE NEW LVL 3 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024435 | HC URGENT CARE NEW LVL 3 | Emergency Room - Urgent Care | $1,495.00 |
| 2024436 | HC URGENT CARE NEW LVL 4 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024438 | HC URGENT CARE NEW LVL 5 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024440 | HC URGENT CARE EST LVL 1 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024441 | HC URGENT CARE EST LVL 1 | Emergency Room - Urgent Care | $1,495.00 |
| 2024444 | HC URGENT CARE EST LVL 3 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024445 | HC URGENT CARE EST LVL 3 | Emergency Room - Urgent Care | $1,495.00 |
| 2024446 | HC URGENT CARE EST LVL 4 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024447 | HC URGENT CARE EST LVL 4 | Emergency Room - Urgent Care | $1,495.00 |
| 2024448 | HC URGENT CARE EST LVL 5 - 25 | Emergency Room - Urgent Care | $1,495.00 |
| 2024449 | HC URGENT CARE EST LVL 5 | Emergency Room - Urgent Care | $1,495.00 |
| 2022762 | HC BREATH HYDROGEN TEST | Gastro-Intestinal (GI) Services | $1,317.38 |
| 2023730 | HC PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX | Gastro-Intestinal (GI) Services | $925.44 |
| 2025006 | HC GI TRACT CAPSULE ENDOSCOPY | Gastro-Intestinal (GI) Services | $5,212.35 |
| 0230001 | HH SOC | Health Insurance Prospective Payment System (HIPPS) - Home Health | $420.00 |
| 0230002 | HH F/U | Health Insurance Prospective Payment System (HIPPS) - Home Health | $420.00 |
| 0230004 | HH ROC | Health Insurance Prospective Payment System (HIPPS) - Home Health | $420.00 |
| 2026113 | HC DIALYSIS TRAINING INCOMPLETE | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $2,330.00 |
| 2026114 | HC ESRD SVC HOME DIALYSIS FULL MONTH 20+YRS | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $1,415.00 |
| 2026115 | HC UNLISTED DIALYSIS PROCEDURE | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $1,588.00 |
| 2026116 | HC DIALYSIS ACU KIDNEY NO ESRD | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $945.00 |
| 2026504 | HC HEMODIALYSIS REPEAT EVAL | Hemodialysis - Outpatient or Home - Hemodialysis Composite or Other Rate | $2,470.00 |
| 2021974 | HC HEMODIALYSIS, ONE EVALUATION | Hemodialysis - Outpatient or Home - Other OP Hemodialysis | $2,887.13 |
| 2024613 | HC EMERG DIALYSIS ESRD PT | Hemodialysis - Outpatient or Home - Other OP Hemodialysis | $2,469.00 |
| 2026573 | HC HH SVS OF CSW EA 15 MIN | Home Health (HH) - Medical Social Services - Visit Charge | $420.00 |
| 2026569 | HC HH RN TELEHEALTH PER DIEM GT | Home Health (HH) - Other Visits | $420.00 |
| 2026578 | HC HH NUTRITION COUNSELING DIETITIAN | Home Health (HH) - Other Visits - Other | $420.00 |
| 2026574 | HC HH SVS OF AIDE EA 15 MIN | Home Health (HH) Aide - Visit Charge | $420.00 |
| 2026200 | HC IP CAPD DIALYSIS 90945 | Inpatient Renal Dialysis - Continuous Ambulatory Peritoneal Dialysis (CAPD) | $1,500.00 |
| 2026199 | HC IP DIALYSIS CVVH | Inpatient Renal Dialysis - Hemodialysis | $2,469.00 |
| 2026204 | HC IP CVVHD | Inpatient Renal Dialysis - Hemodialysis | $2,469.00 |
| 2024850 | HC DIALYSIS ONE EVALUATION | Inpatient Renal Dialysis - Peritoneal Dialysis (Non-CAPD) | $1,588.00 |
| 1010025 | HC RB POST OP/STEPDOWN ICU | Intensive Care Unit - Intermediate ICU | $13,173.22 |
| 1010028 | HC RB SPECIAL CARE ICU/INTERMEDIATE | Intensive Care Unit - Intermediate ICU | $12,545.93 |
| 1010018 | HC RB ICU MEDICAL | Intensive Care Unit - Medical | $14,000.00 |
| 1010029 | HC RB SPECIAL CARE OTHER | Intensive Care Unit - Other | $11,753.20 |
| 1010020 | HC RB ICU PEDIATRICS | Intensive Care Unit - Pediatric | $11,753.20 |
| 1010019 | HC RB ICU SURGICAL | Intensive Care Unit - Surgical | $14,000.00 |
| 1010035 | HC RB ICU/TRAUMA | Intensive Care Unit - Trauma | $14,079.45 |
| 2021945 | HC NON CHEMO INFUSION, CONCURRENT | IV Therapy | $412.34 |
| 2021946 | HC NON CHEMO IV PUSH, SAME DRUG, REPEAT | IV Therapy | $289.38 |
| 2022190 | HC RFL&MAIN IMPLT PMP/RSVR RX DLVR SPI/BRN BY PHYS | IV Therapy | $3,780.11 |
| 2022202 | HC HYDRATION IV INFUSION, 1ST HOUR | IV Therapy | $2,718.90 |
| 2022203 | HC HYDRATION IV INFUSION, ADDITIONAL HOUR | IV Therapy | $921.14 |
| 2022204 | HC NON CHEMO INFUSION, 1ST HOUR | IV Therapy | $2,718.90 |
| 2022205 | HC NON CHEMO INFUSION, ADDITIONAL HOUR | IV Therapy | $921.14 |
| 2022206 | HC NON CHEMO INFUSION, SEQ 1ST HOUR | IV Therapy | $1,081.20 |
| 2022207 | HC INJECTION - SC/IM | IV Therapy | $1,246.56 |
| 2022209 | HC NON CHEMO IV PUSH 0-15 MINUTES, INITIAL | IV Therapy | $1,221.12 |
| 2022210 | HC NON CHEMO IV PUSH 0-15 MINUTES, SEQ | IV Therapy | $455.80 |
| 2022222 | HC REFILL/MAINT PUMP/RESVR SYST | IV Therapy | $1,402.38 |
| 2022223 | HC IRRIG DRUG DELIVERY DEVICE | IV Therapy | $429.30 |
| 2022427 | HC THER/PROPH/DIAG INJ, IV PUSH | IV Therapy | $1,221.12 |
| 2024829 | HC PROLONG IV INFUSION, REQ PUMP | IV Therapy | $798.68 |
| 2025836 | HC APPLICATON ON-BODY INJECTOR | IV Therapy | $286.20 |
| 2027040 | HC BAMLANIVIMAB-XXXX INFUSION | IV Therapy | $928.80 |
| 2020556 | HC FETAL MONITOR W/REPORT | Labor Room/Delivery | $120.75 |
| 2024288 | HC L&D OPERATING ROOM FLAT FEE | Labor Room/Delivery | $4,303.53 |
| 2024289 | HC L&D OPERATING ROOM PER MINUTE | Labor Room/Delivery | $143.45 |
| 2022469 | HC CIRCUMCISION | Labor Room/Delivery - Circumcision | $698.41 |
| 2022468 | HC LDR DELIVERY ROOM | Labor Room/Delivery - Delivery Room | $7,195.00 |
| 2022481 | HC MULTPLE BIRTH RESOURCES | Labor Room/Delivery - Delivery Room | $5,318.82 |
| 2025459 | HC ATTENDANCE AT DELIVERY | Labor Room/Delivery - Delivery Room | $289.80 |
| 2020470 | HC ROUTINE VENIPUNCTURE | Laboratory | $87.49 |
| 2020471 | HC CAPILLARY BLOOD DRAW | Laboratory | $308.09 |
| 2021286 | HC LIPID PANEL | Laboratory | $370.00 |
| 2021287 | HC RENAL FUNCTION PANEL | Laboratory | $176.30 |
| 2021289 | HC HEPATIC FUNCTION PANEL | Laboratory | $524.00 |
| 2021292 | HC ASSAY OF AMIKACIN | Laboratory | $431.00 |
| 2021295 | HC ASSAY, CARBAMAZEPINE, TOTAL | Laboratory | $271.00 |
| 2021298 | HC ASSAY OF DIGOXIN | Laboratory | $366.00 |
| 2021300 | HC ASSAY, DIPROPYLACETIC ACID | Laboratory | $179.92 |
| 2021302 | HC ASSAY OF GENTAMICIN | Laboratory | $313.00 |
| 2021306 | HC ASSAY OF LIDOCAINE | Laboratory | $330.00 |
| 2021307 | HC ASSAY OF LITHIUM | Laboratory | $159.39 |
| 2021309 | HC ASSAY OF PHENOBARBITAL | Laboratory | $295.00 |
| 2021310 | HC ASSAY OF PHENYTOIN, TOTAL | Laboratory | $295.00 |
| 2021311 | HC ASSAY OF PHENYTOIN, FREE | Laboratory | $126.00 |
| 2021312 | HC ASSAY OF PRIMIDONE | Laboratory | $357.00 |
| 2021315 | HC ASSAY OF QUINIDINE | Laboratory | $190.00 |
| 2021316 | HC ASSAY OF SIROLIMUS | Laboratory | $282.56 |
| 2021318 | HC ASSAY OF TACROLIMUS | Laboratory | $399.00 |
| 2021320 | HC ASSAY OF THEOPHYLLINE | Laboratory | $251.00 |
| 2021321 | HC ASSAY OF TOBRAMYCIN | Laboratory | $431.00 |
| 2021322 | HC ASSAY OF TOPIRAMATE | Laboratory | $234.00 |
| 2021323 | HC ASSAY OF VANCOMYCIN | Laboratory | $357.00 |
| 2021324 | HC QUANTITATIVE ASSAY, DRUG | Laboratory | $237.88 |
| 2021326 | HC URINALYSIS, AUTO, W/O SCOPE | Laboratory | $199.06 |
| 2021332 | HC TEST FOR ACETONE/KETONES | Laboratory | $97.00 |
| 2021333 | HC ACYLCARNITINES, QUANT | Laboratory | $267.00 |
| 2021334 | HC ASSAY OF ACTH | Laboratory | $757.00 |
| 2021335 | HC ASSAY OF SERUM ALBUMIN | Laboratory | $79.87 |
| 2021336 | HC ASSAY OF ALBUMIN | Laboratory | $62.79 |
| 2021339 | HC ASSAY OF ALDOLASE | Laboratory | $443.76 |
| 2021340 | HC ASSAY OF ALDOSTERONE | Laboratory | $1,072.00 |
| 2021341 | HC ALPHA-1-ANTITRYPSIN, TOTAL | Laboratory | $330.00 |
| 2021343 | HC ALPHA-FETOPROTEIN, SERUM | Laboratory | $360.00 |
| 2021349 | HC AMINO ACIDS, QUAN, 6 OR MORE | Laboratory | $1,133.00 |
| 2021350 | HC ASSAY OF AMMONIA | Laboratory | $202.86 |
| 2021351 | HC ASSAY OF AMYLASE | Laboratory | $203.00 |
| 2021353 | HC ASSAY OF ANDROSTENEDIONE | Laboratory | $808.00 |
| 2021354 | HC ANGIOTENSIN I ENZYME TEST | Laboratory | $512.00 |
| 2021355 | HC ASSAY OF APOLIPOPROTEIN | Laboratory | $206.48 |
| 2021356 | HC ASSAY OF ARSENIC | Laboratory | $454.00 |
| 2021357 | HC ASSAY OF ASCORBIC ACID | Laboratory | $195.00 |
| 2021359 | HC ASSAY OF BETA-2 PROTEIN | Laboratory | $462.00 |
| 2021361 | HC BILIRUBIN, TOTAL | Laboratory | $143.27 |
| 2021362 | HC BILIRUBIN, DIRECT | Laboratory | $126.00 |
| 2021363 | HC OCCULT BLOOD, FECES | Laboratory | $131.62 |
| 2021364 | HC OCCULT BLOOD, OTHER SOURCES | Laboratory | $57.96 |
| 2021367 | HC ASSAY OF CALCITONIN | Laboratory | $433.00 |
| 2021368 | HC CALCIUM TOT | Laboratory | $73.54 |
| 2021369 | HC CALCIUM IONIZED | Laboratory | $463.00 |
| 2021370 | HC CALCIUM URINE QUAN TMD SPEC | Laboratory | $178.00 |
| 2021371 | HC CALCULUS ASSAY, QUANT | Laboratory | $104.00 |
| 2021374 | HC ASSAY, BLOOD CARBON DIOXIDE | Laboratory | $56.75 |
| 2021380 | HC ASSAY, THREE CATECHOLAMINES | Laboratory | $689.00 |
| 2021381 | HC ASSAY OF CERULOPLASMIN | Laboratory | $224.00 |
| 2021382 | HC ASSAY OF BLOOD CHLORIDE | Laboratory | $103.85 |
| 2021383 | HC ASSAY OF URINE CHLORIDE | Laboratory | $178.00 |
| 2021384 | HC ASSAY, OTHER FLUID CHLORIDES | Laboratory | $178.00 |
| 2021385 | HC ASSAY, BLD/SERUM CHOLESTEROL | Laboratory | $91.00 |
| 2021391 | HC ASSAY OF CHROMIUM | Laboratory | $445.00 |
| 2021394 | HC ASSAY OF COPPER | Laboratory | $364.67 |
| 2021395 | HC CORTISOL, FREE | Laboratory | $313.95 |
| 2021396 | HC TOTAL CORTISOL | Laboratory | $360.00 |
| 2021397 | HC ASSAY OF CREATINE | Laboratory | $173.00 |
| 2021399 | HC ASSAY OF CK (CPK) | Laboratory | $251.00 |
| 2021400 | HC ASSAY OF CPK IN BLOOD | Laboratory | $366.00 |
| 2021401 | HC ASSAY OF CREATININE | Laboratory | $137.66 |
| 2021402 | HC ASSAY OF URINE CREATININE | Laboratory | $146.11 |
| 2021403 | HC CREATININE CLEARANCE TEST | Laboratory | $360.00 |
| 2021404 | HC ASSAY OF CRYOGLOBULIN | Laboratory | $145.00 |
| 2021406 | HC VITAMIN B-12 | Laboratory | $406.00 |
| 2021409 | HC DEHYDROEPIANDROSTERONE | Laboratory | $879.00 |
| 2021412 | HC DEOXYCORTISOL | Laboratory | $618.00 |
| 2021415 | HC ASSAY OF DIHYDROXYVITAMIN D | Laboratory | $677.41 |
| 2021416 | HC ASSAY OF ERYTHROPOIETIN | Laboratory | $334.48 |
| 2021417 | HC ASSAY OF ESTRADIOL | Laboratory | $469.38 |
| 2021418 | HC ASSAY OF ESTROGENS | Laboratory | $1,206.00 |
| 2021422 | HC ASSAY OF BLOOD FATTY ACIDS | Laboratory | $120.75 |
| 2021423 | HC LONG CHAIN FATTY ACIDS | Laboratory | $701.00 |
| 2021424 | HC ASSAY OF FERRITIN | Laboratory | $454.00 |
| 2021425 | HC ASSAY OF FETAL FIBRONECTIN | Laboratory | $960.00 |
| 2021429 | HC GG IGA IGD IGG IGM EA | Laboratory | $295.00 |
| 2021430 | HC GG IGE | Laboratory | $315.16 |
| 2021431 | HC IGG 1, 2, 3 OR 4, EACH | Laboratory | $450.40 |
| 2021435 | HC ASSAY OF GLUCAGON | Laboratory | $584.00 |
| 2021436 | HC GLUCOSE OTHER FLUID | Laboratory | $67.62 |
| 2021437 | HC ASSAY, GLUCOSE, BLOOD QUANT | Laboratory | $69.00 |
| 2021438 | HC GLUCOSE TEST | Laboratory | $97.00 |
| 2021439 | HC GLUCOSE TOLERANCE TEST (GTT) | Laboratory | $388.00 |
| 2021441 | HC ASSAY OF G6PD ENZYME | Laboratory | $245.97 |
| 2021443 | HC ASSAY OF GGT | Laboratory | $251.00 |
| 2021445 | HC GONADOTROPIN (FSH) | Laboratory | $370.70 |
| 2021448 | HC ASSAY OF HAPTOGLOBIN, QUANT | Laboratory | $360.00 |
| 2021457 | HC ASSAY OF HEMOSIDERIN, QUAL | Laboratory | $431.00 |
| 2021462 | HC ASSAY OF 5-HIAA | Laboratory | $207.69 |
| 2021463 | HC HYDROXYPROGST 17-D | Laboratory | $757.00 |
| 2021465 | HC IA ANAL OTH/THN NFCT AGT MLT STEP METH | Laboratory | $365.87 |
| 2021466 | HC RIA NONANTIBODY | Laboratory | $527.00 |
| 2021467 | HC IMMUNOASSAY QUANT NOS NONAB | Laboratory | $652.95 |
| 2021468 | HC ASSAY OF INSULIN | Laboratory | $240.29 |
| 2021469 | HC ASSAY OF IRON | Laboratory | $203.00 |
| 2021470 | HC IRON BINDING TEST | Laboratory | $360.00 |
| 2021472 | HC ASSAY OF LACTIC ACID | Laboratory | $249.00 |
| 2021473 | HC LACTATE (LD) (LDH) ENZYME | Laboratory | $125.93 |
| 2021474 | HC ASSAY OF LDH ENZYMES | Laboratory | $198.00 |
| 2021475 | HC LACTOFERRIN, FECAL (QUAL) | Laboratory | $287.81 |
| 2021476 | HC ASSAY OF LEAD | Laboratory | $218.07 |
| 2021478 | HC ASSAY OF LIPASE | Laboratory | $243.92 |
| 2021481 | HC ASSAY OF LIPOPROTEIN | Laboratory | $251.00 |
| 2021483 | HC ASSAY OF MAGNESIUM | Laboratory | $120.75 |
| 2021485 | HC ASSAY OF MERCURY | Laboratory | $313.00 |
| 2021486 | HC ASSAY OF METANEPHRINES | Laboratory | $1,439.00 |
| 2021489 | HC MUCOPOLYSACCHARIDES | Laboratory | $295.00 |
| 2021490 | HC ASSAY OF MYOGLOBIN | Laboratory | $271.33 |
| 2021492 | HC ASSAY, NEPHELOMETRY NOT SPEC | Laboratory | $553.00 |
| 2021512 | HC OLIGOCLONAL BANDS | Laboratory | $330.00 |
| 2021513 | HC ORGANIC ACIDS, TOTAL, QUANT | Laboratory | $311.54 |
| 2021515 | HC ASSAY OF BLOOD OSMOLALITY | Laboratory | $165.43 |
| 2021516 | HC ASSAY OF URINE OSMOLALITY | Laboratory | $178.00 |
| 2021519 | HC ASSAY OF PARATHORMONE | Laboratory | $590.47 |
| 2021522 | HC ASSAY ACID PHOSPHATASE | Laboratory | $251.00 |
| 2021523 | HC PHOSPHATASE ALKALINE | Laboratory | $145.80 |
| 2021525 | HC PHOSPHATASE ALKALINE ISOENZYMES | Laboratory | $194.41 |
| 2021526 | HC ASSAY OF PHOSPHORUS | Laboratory | $80.90 |
| 2021529 | HC ASSAY OF URINE PORPHYRINS | Laboratory | $224.00 |
| 2021530 | HC ASSAY OF SERUM POTASSIUM | Laboratory | $61.58 |
| 2021531 | HC ASSAY OF URINE POTASSIUM | Laboratory | $156.00 |
| 2021532 | HC ASSAY OF PREALBUMIN | Laboratory | $327.00 |
| 2021536 | HC PROGST | Laboratory | $340.52 |
| 2021537 | HC ASSAY OF PROLACTIN | Laboratory | $454.00 |
| 2021539 | HC ASSAY OF PSA, FREE | Laboratory | $308.03 |
| 2021540 | HC ASSAY OF PROTEIN, SERUM | Laboratory | $147.07 |
| 2021541 | HC ASSAY OF PROTEIN, URINE | Laboratory | $139.00 |
| 2021542 | HC ASSAY OF PROTEIN, OTHER | Laboratory | $67.20 |
| 2021543 | HC PROTEIN E-PHORESIS, SERUM | Laboratory | $313.00 |
| 2021546 | HC ASSAY OF PROINSULIN | Laboratory | $187.00 |
| 2021548 | HC ASSAY OF PYRUVATE | Laboratory | $249.00 |
| 2021549 | HC ASSAY OF ENDOCRINE HORMONE | Laboratory | $476.96 |
| 2021550 | HC ASSAY, NONENDOCRINE RECEPTOR | Laboratory | $333.27 |
| 2021555 | HC ASSAY OF SERUM SODIUM | Laboratory | $65.21 |
| 2021556 | HC ASSAY OF URINE SODIUM | Laboratory | $156.00 |
| 2021558 | HC ASSAY OF SOMATOMEDIN | Laboratory | $808.00 |
| 2021560 | HC BODY FLUID SPECIFIC GRAVITY | Laboratory | $49.00 |
| 2021564 | HC ASSAY OF THYROGLOBULIN | Laboratory | $527.00 |
| 2021565 | HC ASSAY OF TOTAL THYROXINE | Laboratory | $187.16 |
| 2021566 | HC ASSAY OF FREE THYROXINE | Laboratory | $283.62 |
| 2021567 | HC ASSAY OF THYROID ACTIVITY | Laboratory | $251.00 |
| 2021568 | HC ASSAY THYROID STIM HORMONE | Laboratory | $431.00 |
| 2021571 | HC TRANSFERASE (AST) (SGOT) | Laboratory | $92.98 |
| 2021572 | HC ALANINE AMINO (ALT) (SGPT) | Laboratory | $91.77 |
| 2021573 | HC ASSAY OF TRANSFERRIN | Laboratory | $326.03 |
| 2021574 | HC ASSAY OF TRIGLYCERIDES | Laboratory | $176.00 |
| 2021575 | HC ASSAY OF THYROID (T3 OR T4) | Laboratory | $96.60 |
| 2021576 | HC ASSAY, TRIIODOTHYRONINE (T3) | Laboratory | $255.99 |
| 2021577 | HC FREE ASSAY (FT-3) | Laboratory | $616.00 |
| 2021578 | HC T3 REVERSE | Laboratory | $801.00 |
| 2021579 | HC ASSAY OF TROPONIN, QUANT | Laboratory | $274.00 |
| 2021580 | HC UREA NITROGEN; QUAN | Laboratory | $68.83 |
| 2021581 | HC ASSAY OF URINE/UREA-N | Laboratory | $178.00 |
| 2021583 | HC ASSAY OF BLOOD/URIC ACID | Laboratory | $106.26 |
| 2021584 | HC ASSAY OF URINE/URIC ACID | Laboratory | $178.00 |
| 2021587 | HC ASSAY OF VASOPRESSIN | Laboratory | $757.00 |
| 2021590 | HC ASSAY OF ZINC | Laboratory | $249.00 |
| 2021592 | HC CHORIONIC GONADOTROPIN TEST | Laboratory | $335.69 |
| 2021593 | HC CHORIONIC GONADOTROPIN ASSAY | Laboratory | $223.15 |
| 2021643 | HC BLOOD PLATELET AGGREGATION | Laboratory | $469.00 |
| 2021654 | HC BLOOD VISCOSITY EXAMINATION | Laboratory | $145.00 |
| 2021666 | HC C-REACTIVE PROTEIN, HS | Laboratory | $262.03 |
| 2021672 | HC COMPLEMENT, TOTAL (CHBI) | Laboratory | $431.00 |
| 2021687 | HC IMMUNE COMPLEX ASSAY | Laboratory | $538.55 |
| 2021688 | HC IMMUNOFIX E-PHORESIS, SERUM | Laboratory | $471.00 |
| 2021689 | HC IMMUNFIX E-PHORSIS/URINE/CSF | Laboratory | $431.00 |
| 2021690 | HC INSULIN ANTIBODIES | Laboratory | $330.00 |
| 2021710 | HC BARTONELLA ANTIBODY | Laboratory | $187.00 |
| 2021714 | HC BRUCELLA ANTIBODY | Laboratory | $118.34 |
| 2021742 | HC HEP B SURFACE ANTIBODY | Laboratory | $205.28 |
| 2021745 | HC HEP A ANTIBODY, IGM | Laboratory | $229.43 |
| 2021746 | HC INFLUENZA VIRUS ANTIBODY | Laboratory | $388.00 |
| 2021753 | HC PROTOZOA ANTIBODY NOS | Laboratory | $178.71 |
| 2021762 | HC WEST NILE VIRUS AB, IGM | Laboratory | $564.00 |
| 2021771 | HC RBC ANTIBODY SCREEN | Laboratory | $376.56 |
| 2021773 | HC RBC ANTIBODY IDENTIFICATION | Laboratory | $815.06 |
| 2021774 | HC COOMBS TEST, DIRECT | Laboratory | $185.00 |
| 2021776 | HC COOMBS TEST, INDIRECT, TITER | Laboratory | $338.00 |
| 2021777 | HC AUTOLOGOUS BLOOD PROCESS | Laboratory | $1,078.96 |
| 2021782 | HC COMPATIBILITY TEST, SPIN | Laboratory | $340.00 |
| 2021785 | HC COMPATIBILITY TEST, ELECTRIC | Laboratory | $173.88 |
| 2021789 | HC BLOOD PRODUCT/IRRADIATION | Laboratory | $138.00 |
| 2021792 | HC POOLING BLOOD PLATELETS | Laboratory | $177.95 |
| 2021799 | HC CULTURE ANAEROBE IDENT, EACH | Laboratory | $512.00 |
| 2021812 | HC MICROBE SUSCEPTIBLE, MIC | Laboratory | $173.88 |
| 2021830 | HC GIARDIA AG, EIA | Laboratory | $654.00 |
| 2021831 | HC ENTAMOEB HIST GROUP, AG, EIA | Laboratory | $228.22 |
| 2021844 | HC CYTOMEG, DNA, QUANT | Laboratory | $781.25 |
| 2021848 | HC HEPATITIS C, RNA, QUANT | Laboratory | $879.06 |
| 2021857 | HC DETECT AGENT NOS, DNA, AMP | Laboratory | $698.60 |
| 2021860 | HC INFLUENZA ASSAY W/OPTIC | Laboratory | $51.92 |
| 2021862 | HC AGENT NOS ASSAY W/OPTIC | Laboratory | $146.11 |
| 2021863 | HC GENOTYPE, DNA, HIV REVERSE T | Laboratory | $1,877.66 |
| 2021864 | HC GENOTYPE, DNA, HEPATITIS C | Laboratory | $3,587.48 |
| 2021937 | HC C-CNT MISC BDY FLUS XCPT BLD DIFFIAL CNT | Laboratory | $237.09 |
| 2021938 | HC EXAM,SYNOVIAL FLUID CRYSTALS | Laboratory | $210.11 |
| 2022410 | HC PSA SCREENING | Laboratory | $363.46 |
| 2022528 | HC MISC SEND OUT / CHEM LAB TEST | Laboratory | $0.00 |
| 2022737 | HC ENZYME ACTIVITY BC NO RA | Laboratory | $403.08 |
| 2022738 | HC HEAVY METAL QUANTITATIVE | Laboratory | $490.00 |
| 2022739 | HC NMR LIPO PRFL | Laboratory | $315.16 |
| 2022743 | HC RIBOFLAVIN | Laboratory | $627.00 |
| 2022748 | HC INHIBIN A | Laboratory | $254.85 |
| 2022749 | HC CELL FUNCTION ASSAY STIM | Laboratory | $929.78 |
| 2022757 | HC SPUTUM SPEC INDUCTION | Laboratory | $248.75 |
| 2023022 | HC HEPARIN ASSAY | Laboratory | $561.49 |
| 2023301 | HC DRAW BLOOD OFF VENOUS DEVICE | Laboratory | $379.16 |
| 2023333 | HC URINALYSIS AUTO W/ MICROSCOPY | Laboratory | $129.00 |
| 2023651 | HC MONONUCLEAR CELL ANTIGEN QUANT NOS EA ANTG | Laboratory | $348.97 |
| 2023653 | HC FIBRINOGEN; ANTIGEN | Laboratory | $104.00 |
| 2025036 | HC AB; ENCEPHALITIS CALIF | Laboratory | $65.21 |
| 2025037 | HC AB; ENCEPHALITIS E EQUINE | Laboratory | $279.00 |
| 2025038 | HC AB; ENCEPHALITIS ST. LOUIS | Laboratory | $279.00 |
| 2025039 | HC AB; ENCEPHALITIS W EQUINE | Laboratory | $65.21 |
| 2025040 | HC AB; NEISSERIA MENINGITIDIS | Laboratory | $65.21 |
| 2025041 | HC CRYPTOCOCCUS NEOFORM AG EIA | Laboratory | $59.26 |
| 2025042 | HC GENOTYPE DNA HIV OTHER REGION | Laboratory | $636.18 |
| 2025204 | HC TRANSCUTANEOUS CARBOXYHB | Laboratory | $24.74 |
| 2025205 | HC TRANSCUTANEOUS METHB | Laboratory | $3,296.48 |
| 2025221 | HC DIPROPYLACETIC ACID FREE | Laboratory | $179.92 |
| 2025260 | HC IADNA-DNA/RNA PROBE TQ 12-25 | Laboratory | $2,157.34 |
| 2025310 | HC SECRETIONS FAT STAIN | Laboratory | $224.00 |
| 2025518 | HC MGMT GENE PRMTR MTHYLTN ALYS | Laboratory | $1,755.00 |
| 2025941 | HC TRICHOMONAS VAGINALIS AMPLIF | Laboratory | $586.73 |
| 2026042 | HC BILIRUBIN TOTAL TRANSCUT | Laboratory | $212.00 |
| 2026169 | HC ONCOLOGY PROSTATE PROB SCORE | Laboratory | $2,280.00 |
| 2026555 | HC FERN TEST | Laboratory | $78.20 |
| 2026904 | HC IA NFCT AB COVID19; MULTI STEP | Laboratory | $207.69 |
| 2026905 | HC IA NFCT AB COVID19; SGL STEP | Laboratory | $155.77 |
| 2026906 | HC IA INFECTIOUS AGENT SGL STEP | Laboratory | $155.77 |
| 2026937 | HC DRUG ASSAY VEDOLIZUMAB | Laboratory | $185.12 |
| 2026963 | HC NFCT DS 22 TRGT SARS-COV-2 | Laboratory | $2,000.54 |
| 2026972 | HC CORONAVIRUS AG IA | Laboratory | $53.13 |
| 2026973 | HC NFCT DS 22 TRGT SARS-COV-2 | Laboratory | $2,000.54 |
| 2026974 | HC ANTIBODY SARSCOV-2 TITER(S) | Laboratory | $207.69 |
| 2026984 | HC NEUTRLZG ANTB SARSCOV2 SCR | Laboratory | $410.55 |
| 2026985 | HC NEUTRLZG ANTB SARSCOV2 TITER | Laboratory | $410.55 |
| 2026987 | HC SVNT SARSCOV2 ELISA PLSM SRM | Laboratory | $2,000.54 |
| 2027006 | HC SARS-COV-2 ANTB QUANTITATIVE | Laboratory | $207.69 |
| 2027030 | HC NFCT DS VIR RESP RNA 4 TRGT | Laboratory | $427.89 |
| 2027031 | HC NFCT DS VIR RESP RNA 3 TRGT | Laboratory | $427.89 |
| 2027035 | HC SARSCOV & INF VIR A&B AG IA | Laboratory | $53.13 |
| 2021795 | HC BLOOD CULTURE FOR BACTERIA | Laboratory - Bacteriology & Microbiology | $462.00 |
| 2021796 | HC FECES CULTURE, BACTERIA | Laboratory - Bacteriology & Microbiology | $382.00 |
| 2021797 | HC CULTURE, BACTERIA, OTHER | Laboratory - Bacteriology & Microbiology | $338.91 |
| 2021798 | HC CULTR BACTERIA, EXCEPT BLOOD | Laboratory - Bacteriology & Microbiology | $166.64 |
| 2021800 | HC CULTURE SCREEN ONLY | Laboratory - Bacteriology & Microbiology | $214.94 |
| 2021801 | HC URINE CULTURE/COLONY COUNT | Laboratory - Bacteriology & Microbiology | $248.69 |
| 2021803 | HC SKIN FUNGI CULTURE | Laboratory - Bacteriology & Microbiology | $43.47 |
| 2021804 | HC FUNGUS ISOLATION CULTURE | Laboratory - Bacteriology & Microbiology | $382.00 |
| 2021806 | HC MYCOPLASMA | Laboratory - Bacteriology & Microbiology | $242.71 |
| 2021807 | HC CHLAMYDIA CULTURE | Laboratory - Bacteriology & Microbiology | $462.00 |
| 2021808 | HC MYCOBACTERIA CULTURE | Laboratory - Bacteriology & Microbiology | $382.00 |
| 2021810 | HC OVA AND PARASITES SMEARS | Laboratory - Bacteriology & Microbiology | $258.00 |
| 2021811 | HC MICROBE SUSCEPTIBLE, DISK | Laboratory - Bacteriology & Microbiology | $121.96 |
| 2021814 | HC SMEAR, GRAM STAIN | Laboratory - Bacteriology & Microbiology | $112.22 |
| 2021815 | HC SMEAR, FLUORESCENT/ACID STAI | Laboratory - Bacteriology & Microbiology | $97.81 |
| 2021816 | HC SMEAR, SPECIAL STAIN | Laboratory - Bacteriology & Microbiology | $187.16 |
| 2021817 | HC SMEAR, COMPLEX STAIN | Laboratory - Bacteriology & Microbiology | $277.66 |
| 2021818 | HC SMEAR, WET MOUNT, SALINE/INK | Laboratory - Bacteriology & Microbiology | $84.53 |
| 2021819 | HC TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT | Laboratory - Bacteriology & Microbiology | $97.00 |
| 2021820 | HC ASSAY, TOXIN OR ANTITOXIN | Laboratory - Bacteriology & Microbiology | $674.00 |
| 2021821 | HC VIRUS INOCULATION, TISSUE | Laboratory - Bacteriology & Microbiology | $582.02 |
| 2021822 | HC VIRUS INOCULATION, SHELL VIA | Laboratory - Bacteriology & Microbiology | $260.82 |
| 2021824 | HC INFLUENZA B, AG, IF | Laboratory - Bacteriology & Microbiology | $96.60 |
| 2021826 | HC LEGION PNEUMOPHILIA AG, IF | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2021828 | HC ASPERGILLUS AG, EIA | Laboratory - Bacteriology & Microbiology | $1,679.00 |
| 2021829 | HC CRYPTOSPORIDIUM AG, EIA | Laboratory - Bacteriology & Microbiology | $243.43 |
| 2021832 | HC HPYLORI, STOOL, EIA | Laboratory - Bacteriology & Microbiology | $217.35 |
| 2021834 | HC HEPATITIS B SURFACE AG, EIA | Laboratory - Bacteriology & Microbiology | $220.62 |
| 2021835 | HC HEPATITIS BE AG, EIA | Laboratory - Bacteriology & Microbiology | $214.94 |
| 2021839 | HC STREP A AG, EIA | Laboratory - Bacteriology & Microbiology | $111.09 |
| 2021840 | HC AG DETECT NOS, EIA, MULT | Laboratory - Bacteriology & Microbiology | $742.00 |
| 2021841 | HC LYME DIS, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $1,301.00 |
| 2021842 | HC CHYLMD TRACH, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2021843 | HC CYTOMEG, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $608.00 |
| 2021845 | HC ENTEROVIRUS, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $478.17 |
| 2021846 | HC HEPATITIS B, DNA, QUANT | Laboratory - Bacteriology & Microbiology | $1,679.00 |
| 2021849 | HC HSV, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $555.45 |
| 2021851 | HC HIV-1, DNA, QUANT | Laboratory - Bacteriology & Microbiology | $1,247.35 |
| 2021852 | HC M.PNEUMON, DNA, AMP PROBE | Laboratory - Bacteriology & Microbiology | $543.38 |
| 2021853 | HC N.GONORRHOEAE, DNA, AMP PROB | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2021855 | HC TRICHOMONAS VAGIN, DIR PROBE | Laboratory - Bacteriology & Microbiology | $294.15 |
| 2021858 | HC DETECT AGENT NOS, DNA, QUANT | Laboratory - Bacteriology & Microbiology | $607.31 |
| 2021861 | HC RSV ASSAY W/OPTIC | Laboratory - Bacteriology & Microbiology | $62.79 |
| 2021865 | HC MICROBIOLOGY PROCEDURE | Laboratory - Bacteriology & Microbiology | $130.41 |
| 2022648 | HC C DIFF AMPLIFIED PROBE | Laboratory - Bacteriology & Microbiology | $293.42 |
| 2022659 | HC SC STD ANTMCRB AGT AGAR DIL METH PR AGT | Laboratory - Bacteriology & Microbiology | $43.47 |
| 2022752 | HC CANDIDA NA DIRECT PROBE | Laboratory - Bacteriology & Microbiology | $280.14 |
| 2022753 | HC GARDNERELLA DIR NA PROBE | Laboratory - Bacteriology & Microbiology | $280.14 |
| 2023021 | HC STAPH A DNA AMP PROBE | Laboratory - Bacteriology & Microbiology | $543.38 |
| 2023034 | HC DNA/RNA; MULTI ORG - AMP PR | Laboratory - Bacteriology & Microbiology | $1,028.79 |
| 2023035 | HC HC INFLUENZA DNA AMP PROBE | Laboratory - Bacteriology & Microbiology | $2,862.98 |
| 2023039 | HC HISTOPLASMA CAPSUL AG EIA | Laboratory - Bacteriology & Microbiology | $303.00 |
| 2023061 | HC HIV-1 AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $660.50 |
| 2023064 | HC BARTONELLA AMPLIF NAP | Laboratory - Bacteriology & Microbiology | $248.75 |
| 2023068 | HC MYCOBACTERIA T AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $467.00 |
| 2023069 | HC CHLAMYDIA P AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $543.38 |
| 2023075 | HC HERPES 6 NA QUAN | Laboratory - Bacteriology & Microbiology | $1,659.00 |
| 2023631 | HC AEROBIC STOOL CULTR ADDTL PATHOG EA PLATE | Laboratory - Bacteriology & Microbiology | $53.13 |
| 2024459 | HC GENOTYPE DNA HEPATITIS B | Laboratory - Bacteriology & Microbiology | $2,466.92 |
| 2024605 | HC RESP VIRUS 3-5 TARGETS | Laboratory - Bacteriology & Microbiology | $637.56 |
| 2024607 | HC RESP VIRUS 12-25 TARGETS | Laboratory - Bacteriology & Microbiology | $2,671.00 |
| 2024653 | HC STREP A ASSAY W/OPTIC | Laboratory - Bacteriology & Microbiology | $224.91 |
| 2024654 | HC GENOTYPE CYTOMEGALOVIRUS | Laboratory - Bacteriology & Microbiology | $2,466.92 |
| 2024868 | HC HIV-1 AG W/HIV-1 & HIV-2 AB | Laboratory - Bacteriology & Microbiology | $405.82 |
| 2024992 | HC CANDIDA NA AMPLIFIED PROBE | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2025070 | HC GENOTYPE DNA HIV | Laboratory - Bacteriology & Microbiology | $636.18 |
| 2025118 | HC HPV HIGH-RISK TYPES | Laboratory - Bacteriology & Microbiology | $586.73 |
| 2025119 | HC HPV TYPES 16 & 18 ONLY | Laboratory - Bacteriology & Microbiology | $490.25 |
| 2025322 | HC CLOSTRIDIUM AG EIA | Laboratory - Bacteriology & Microbiology | $83.97 |
| 2025852 | HC CNS DNA AMP PROBE TYPE 12-25 | Laboratory - Bacteriology & Microbiology | $1,800.92 |
| 2025942 | HC MACROSCOPIC EXAM PARASITE | Laboratory - Bacteriology & Microbiology | $53.94 |
| 2026039 | HC STREP A AMPLIF NA PROBE | Laboratory - Bacteriology & Microbiology | $125.00 |
| 2026178 | HC IADNA-DNA/RNA PROBE TQ 6-11 | Laboratory - Bacteriology & Microbiology | $831.00 |
| 2026438 | HC VIRUS INOCULATE TISSUE ADDL | Laboratory - Bacteriology & Microbiology | $67.35 |
| 2026789 | HC COVID-19 LAB TEST NON-CDC | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026794 | HC 2019-NCOV DIAGNOSTIC P | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026802 | HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026907 | HC COVID-19 LAB TEST NON-CDC; HIGH THROUGHPUT TECH | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2026908 | HC IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ; HIGH THROUGHPUT TECH | Laboratory - Bacteriology & Microbiology | $195.62 |
| 2027007 | HC NFCT AGENT DETECTION GI | Laboratory - Bacteriology & Microbiology | $384.87 |
| 2027009 | HC SARSCOV2 & INF A&B AMP PRB | Laboratory - Bacteriology & Microbiology | $244.53 |
| 2027010 | HC SARSCOV2&INF A&B&RSV AMP PRB | Laboratory - Bacteriology & Microbiology | $293.43 |
| 2027027 | HC SARS-COV-2 COVID19 W/OPTIC | Laboratory - Bacteriology & Microbiology | $53.13 |
| 2027028 | HC COV-19 AMP PRB HGH THRUPUT WITHIN 2 DAYS COLLECT | Laboratory - Bacteriology & Microbiology | $1.00 |
| 2021282 | HC METABOLIC PANEL TOTAL CA | Laboratory - Chemistry | $252.00 |
| 2021283 | HC ELECTROLYTE PANEL | Laboratory - Chemistry | $202.00 |
| 2021284 | HC COMPREHEN METABOLIC PANEL | Laboratory - Chemistry | $896.00 |
| 2021296 | HC ASSAY OF CYCLOSPORINE | Laboratory - Chemistry | $699.00 |
| 2021303 | HC DRUG/SUBSTANCE NOS 1-3 | Laboratory - Chemistry | $96.36 |
| 2021314 | HC PROCAINAMIDE METABOLITES | Laboratory - Chemistry | $94.19 |
| 2021337 | HC URINE ALBUMIN, QUANTITATIVE | Laboratory - Chemistry | $160.00 |
| 2021342 | HC ALPHA-1-ANTITRYPSIN, PHENO | Laboratory - Chemistry | $381.63 |
| 2021345 | HC ALPHA-FETOPROTEIN L3 | Laboratory - Chemistry | $876.65 |
| 2021365 | HC ASSAY OF CADMIUM | Laboratory - Chemistry | $512.00 |
| 2021366 | HC ASSAY OF VITAMIN D | Laboratory - Chemistry | $498.72 |
| 2021372 | HC CALCULUS SPECTROSCOPY | Laboratory - Chemistry | $189.58 |
| 2021375 | HC CARCINOEMBRYONIC ANTIGEN | Laboratory - Chemistry | $313.95 |
| 2021376 | HC ASSAY OF CARNITINE | Laboratory - Chemistry | $611.00 |
| 2021377 | HC ASSAY OF CAROTENE | Laboratory - Chemistry | $224.00 |
| 2021392 | HC ASSAY OF CITRATE | Laboratory - Chemistry | $330.00 |
| 2021393 | HC COLLAGEN CROSSLINKS | Laboratory - Chemistry | $268.07 |
| 2021405 | HC ASSAY OF CYANIDE | Laboratory - Chemistry | $295.00 |
| 2021407 | HC B-12 BINDING CAPACITY | Laboratory - Chemistry | $360.00 |
| 2021408 | HC CYSTATIN C | Laboratory - Chemistry | $156.98 |
| 2021410 | HC DEHYDROEPIANDROSTERONE-SULFATE | Laboratory - Chemistry | $728.00 |
| 2021411 | HC DESOXYCORTICOSTERONE | Laboratory - Chemistry | $175.09 |
| 2021420 | HC FATS/LIPIDS, FECES, QUAL | Laboratory - Chemistry | $121.96 |
| 2021426 | HC BLOOD FOLIC ACID SERUM | Laboratory - Chemistry | $406.00 |
| 2021427 | HC ASSAY OF FOLIC ACID, RBC | Laboratory - Chemistry | $360.00 |
| 2021428 | HC ASSAY GALACTOSE TRANSFERASE | Laboratory - Chemistry | $1,223.00 |
| 2021432 | HC BLOOD PH | Laboratory - Chemistry | $150.00 |
| 2021433 | HC BLOOD GASES: PH, PO2 & PCO2 | Laboratory - Chemistry | $566.00 |
| 2021434 | HC ASSAY OF GASTRIN | Laboratory - Chemistry | $499.00 |
| 2021444 | HC GLYCATED PROTEIN | Laboratory - Chemistry | $200.45 |
| 2021446 | HC GONADOTROPIN (LH) | Laboratory - Chemistry | $355.01 |
| 2021447 | HC ASSAY, GROWTH HORMONE (HGH) | Laboratory - Chemistry | $295.00 |
| 2021450 | HC HEMOGLOBIN ELECTROPHORESIS | Laboratory - Chemistry | $184.00 |
| 2021451 | HC HEMOGLOBIN CHROMOTOGRAPHY | Laboratory - Chemistry | $239.09 |
| 2021453 | HC FETAL HEMOGLOBIN ASSAY, QUAL | Laboratory - Chemistry | $134.00 |
| 2021454 | HC GLYCOSYLATED HEMOGLOBIN TEST | Laboratory - Chemistry | $190.19 |
| 2021459 | HC ASSAY OF HOMOCYSTINE | Laboratory - Chemistry | $431.08 |
| 2021460 | HC ASSAY OF FOR HVA | Laboratory - Chemistry | $330.00 |
| 2021479 | HC ASSAY OF LIPOPROTEIN(A) | Laboratory - Chemistry | $527.00 |
| 2021480 | HC LIPOPRO BLD, ELECTROPHORETIC | Laboratory - Chemistry | $62.79 |
| 2021482 | HC ASSAY OF BLOOD LIPOPROTEIN | Laboratory - Chemistry | $132.83 |
| 2021484 | HC MASS SPECTROMETRY QUAL/QUAN | Laboratory - Chemistry | $514.40 |
| 2021487 | HC DRUG SCREENING METHADONE | Laboratory - Chemistry | $66.41 |
| 2021491 | HC NATRIURETIC PEPTIDE | Laboratory - Chemistry | $472.13 |
| 2021494 | HC ALKALOIDS NOS | Laboratory - Chemistry | $218.56 |
| 2021514 | HC ORGANIC ACID, SINGLE, QUANT | Laboratory - Chemistry | $422.63 |
| 2021517 | HC ASSAY OF OSTEOCALCIN | Laboratory - Chemistry | $438.32 |
| 2021518 | HC ASSAY OF OXALATE | Laboratory - Chemistry | $251.00 |
| 2021520 | HC ASSAY OF BODY FLUID ACIDITY | Laboratory - Chemistry | $117.00 |
| 2021521 | HC ASSAY FOR CALPROTECTIN FECAL | Laboratory - Chemistry | $740.00 |
| 2021527 | HC ASSAY OF URINE PHOSPHORUS | Laboratory - Chemistry | $178.00 |
| 2021528 | HC ASSAY OF PORPHOBILINOGEN | Laboratory - Chemistry | $214.00 |
| 2021534 | HC ASSAY OF PREGNENOLONE | Laboratory - Chemistry | $301.76 |
| 2021535 | HC ASSAY OF 17-HYDROXYPREGNENO | Laboratory - Chemistry | $334.48 |
| 2021538 | HC ASSAY OF PSA, TOTAL | Laboratory - Chemistry | $395.00 |
| 2021544 | HC PROTEIN E-PHORESIS/URINE/CSF | Laboratory - Chemistry | $236.67 |
| 2021545 | HC ASSAY RBC PROTOPORPHYRIN | Laboratory - Chemistry | $678.00 |
| 2021547 | HC ASSAY OF VITAMIN B-6 | Laboratory - Chemistry | $444.36 |
| 2021551 | HC ASSAY OF RENIN | Laboratory - Chemistry | $454.00 |
| 2021552 | HC ASSAY OF SELENIUM | Laboratory - Chemistry | $527.00 |
| 2021553 | HC ASSAY OF SEROTONIN | Laboratory - Chemistry | $554.00 |
| 2021554 | HC ASSAY OF SEX HORMONE GLOBUL | Laboratory - Chemistry | $366.70 |
| 2021557 | HC ASSAY OF SWEAT SODIUM | Laboratory - Chemistry | $44.00 |
| 2021559 | HC SPECTROPHOTOMETRY | Laboratory - Chemistry | $400.22 |
| 2021561 | HC ASSAY OF TESTOSTERONE | Laboratory - Chemistry | $932.00 |
| 2021562 | HC ASSAY OF TOTAL TESTOSTERONE | Laboratory - Chemistry | $584.00 |
| 2021563 | HC ASSAY OF VITAMIN B-1 | Laboratory - Chemistry | $382.00 |
| 2021569 | HC ASSAY OF TSI | Laboratory - Chemistry | $731.75 |
| 2021570 | HC ASSAY OF VITAMIN E | Laboratory - Chemistry | $327.00 |
| 2021585 | HC ASSAY OF URINE VMA | Laboratory - Chemistry | $313.00 |
| 2021586 | HC ASSAY OF VIP | Laboratory - Chemistry | $932.00 |
| 2021588 | HC ASSAY OF VITAMIN A | Laboratory - Chemistry | $251.00 |
| 2021591 | HC ASSAY OF C-PEPTIDE | Laboratory - Chemistry | $448.83 |
| 2022645 | HC HPYLORI BRTH NON-RADACT ISOTOPE | Laboratory - Chemistry | $585.64 |
| 2023009 | HC BLOODGASES W/02 SATURATN | Laboratory - Chemistry | $324.00 |
| 2023020 | HC PLASMA HEMOGLOBIN | Laboratory - Chemistry | $249.00 |
| 2023031 | HC ONCOPROTEIN DCP | Laboratory - Chemistry | $885.10 |
| 2023045 | HC PROTEIN WB; IM ID FOR BANDS | Laboratory - Chemistry | $496.28 |
| 2023046 | HC SUGARS; SINGLE QUAL EA SPECIMEN | Laboratory - Chemistry | $30.19 |
| 2023047 | HC SUGARS; SINGLE QUAN EA SPECIMEN | Laboratory - Chemistry | $105.05 |
| 2023056 | HC QUANT SERUM ACETONES/KETONES | Laboratory - Chemistry | $76.07 |
| 2023062 | HC ASSAY OF VOLATILES | Laboratory - Chemistry | $294.00 |
| 2023063 | HC ETHYLENE GLYCOL | Laboratory - Chemistry | $458.00 |
| 2023070 | HC ETHOSUXIMIDE | Laboratory - Chemistry | $336.00 |
| 2023072 | HC DELTA ALA | Laboratory - Chemistry | $251.00 |
| 2023073 | HC CC/MS; QUAL/QUAN SS & MP | Laboratory - Chemistry | $1,263.00 |
| 2023076 | HC SOMATOSTATIN | Laboratory - Chemistry | $102.64 |
| 2023079 | HC PROCALCITONIN (PCT) | Laboratory - Chemistry | $387.61 |
| 2023130 | HC DRUG SCREENING COCAINE | Laboratory - Chemistry | $81.14 |
| 2023302 | HC COLLECT BLOOD FROM PICC | Laboratory - Chemistry | $421.42 |
| 2023334 | HC STAT GLUCOSE/REAGENT STRIP II | Laboratory - Chemistry | $71.96 |
| 2023398 | HC ASSAY CARBOXYHB QUANT | Laboratory - Chemistry | $111.00 |
| 2023403 | HC MYELIN BASIC PROTEIN CSF | Laboratory - Chemistry | $330.00 |
| 2023561 | HC CARB DEFICIENT TRANSFERRIN | Laboratory - Chemistry | $1,108.00 |
| 2023563 | HC CHEMILUMINESCENT ASSAY | Laboratory - Chemistry | $421.42 |
| 2023626 | HC UNLISTED CHEMISTRY PROCEDURE | Laboratory - Chemistry | $178.00 |
| 2024425 | HC VITAMIN NOS | Laboratory - Chemistry | $163.01 |
| 2024428 | HC PHENOTYPE INFECT AGENT DRUG | Laboratory - Chemistry | $646.01 |
| 2024603 | HC HOMOGENIZ TISS FOR CULTURE | Laboratory - Chemistry | $382.00 |
| 2024698 | HC ACTH STIM; ADRENAL INSUFF | Laboratory - Chemistry | $122.49 |
| 2024710 | HC HLA I & II TYPE VERIFY LR | Laboratory - Chemistry | $839.82 |
| 2024720 | HC UR ALBUMIN SEMIQUANTITATIVE | Laboratory - Chemistry | $72.45 |
| 2024724 | HC OCCULT BLD FECES 1-3 TESTS | Laboratory - Chemistry | $50.72 |
| 2024730 | HC ELECTROPHORESIS NES | Laboratory - Chemistry | $313.00 |
| 2024739 | HC GLUCOSIDASE BETA | Laboratory - Chemistry | $137.66 |
| 2024741 | HC B-HEXOSAMINIDASE EA ASSAY | Laboratory - Chemistry | $330.86 |
| 2024854 | HC DRUG SCREEN QUAN LAMOTRIGINE | Laboratory - Chemistry | $66.41 |
| 2024855 | HC DRUG SCREEN QUANT EVEROLIMUS | Laboratory - Chemistry | $68.83 |
| 2024856 | HC DRUG SCREEN QUANT ZONISAMIDE | Laboratory - Chemistry | $66.41 |
| 2024857 | HC DRUG SCRN QUAN LEVETIRACETAM | Laboratory - Chemistry | $66.41 |
| 2024858 | HC DRUG SCRN QUANT OXCARBAZEPIN | Laboratory - Chemistry | $66.41 |
| 2024859 | HC AB; FRANCISELLA TULARENSIS | Laboratory - Chemistry | $52.50 |
| 2024864 | HC CLOZAPINE | Laboratory - Chemistry | $92.39 |
| 2024865 | HC MYCOPHENOLATE (MYCOPHENOLIC ACID) | Laboratory - Chemistry | $89.36 |
| 2024866 | HC TIAGABINE | Laboratory - Chemistry | $89.04 |
| 2024986 | HC HLA II TYPING 1 LOCUS LR | Laboratory - Chemistry | $684.65 |
| 2025094 | HC DRUG SCREEN QUANTALCOHOLS | Laboratory - Chemistry | $272.90 |
| 2025095 | HC ALCOHOLS BIOMARKERS 1OR 2 | Laboratory - Chemistry | $247.54 |
| 2025102 | HC ANALGESICS NON-OPIOID 1 OR 2 | Laboratory - Chemistry | $297.05 |
| 2025105 | HC ANTIDEPRESSANT TRICYCLIC 1/2 | Laboratory - Chemistry | $101.43 |
| 2025108 | HC ANTIEPILEPTICS NOS 1-3 | Laboratory - Chemistry | $173.70 |
| 2025111 | HC BENZODIAZEPINES1-12 | Laboratory - Chemistry | $258.41 |
| 2025112 | HC BENZODIAZEPINES 13 OR MORE | Laboratory - Chemistry | $271.33 |
| 2025113 | HC OPIATES 1 OR MORE | Laboratory - Chemistry | $177.50 |
| 2025116 | HC OPIOID &OPIATE ANALOG 5/MORE | Laboratory - Chemistry | $195.62 |
| 2025559 | HC DRUG TEST(S), DEFINITIVE, QUAL/QUANT 1-7 | Laboratory - Chemistry | $464.92 |
| 2025560 | HC DRUG TEST(S), DEFINITIVE, QUAL/QUANT 8-14 | Laboratory - Chemistry | $715.31 |
| 2025562 | HC DRUG TEST(S), DEFINITIVE, QUAL/QUANT 22+ | Laboratory - Chemistry | $1,251.77 |
| 2025704 | HC DRUG SCREENING FENTANYL | Laboratory - Chemistry | $77.28 |
| 2025790 | HC DRUG TEST PRSMV DIR OPT OBS | Laboratory - Chemistry | $345.00 |
| 2025798 | HC DRUG TEST PRSMV CHEM ANLYZR | Laboratory - Chemistry | $241.50 |
| 2025855 | HC DRUG/SUBSTANCE NOS 7/MORE | Laboratory - Chemistry | $370.60 |
| 2025890 | HC AORTIC DYSFUNCTION/DILATION | Laboratory - Chemistry | $5,094.75 |
| 2025891 | HC AORTIC DYSFUNCTION/DILATION | Laboratory - Chemistry | $3,299.25 |
| 2025958 | HC EVAL AMNIOTIC FLUID PROTEIN | Laboratory - Chemistry | $278.33 |
| 2026035 | HC VKORC1 GENE | Laboratory - Chemistry | $264.60 |
| 2026056 | HC BLOOD GASES O2 SAT ONLY | Laboratory - Chemistry | $122.00 |
| 2026059 | HC TPMT GENE COM VARIANTS | Laboratory - Chemistry | $438.00 |
| 2026061 | HC MLH1 GENE | Laboratory - Chemistry | $29.00 |
| 2026062 | HC FLT3 GENE ANALYSIS | Laboratory - Chemistry | $227.00 |
| 2026063 | HC ASXL1 GENE TARGET SEQ ALYS | Laboratory - Chemistry | $747.00 |
| 2026064 | HC IDH2 COMMON VARIANTS | Laboratory - Chemistry | $740.00 |
| 2026065 | HC DH1 COMMON VARIANTS | Laboratory - Chemistry | $485.00 |
| 2026256 | HC GENERAL HEALTH PANEL | Laboratory - Chemistry | $645.40 |
| 2026343 | HC DIHYDROTESTOSTERONE | Laboratory - Chemistry | $297.05 |
| 2026696 | HC DRUG SCREENING OXYCODONE | Laboratory - Chemistry | $464.92 |
| 2021597 | HC HEMATOCRIT | Laboratory - Hematology | $36.23 |
| 2021598 | HC HEMOGLOBIN | Laboratory - Hematology | $39.85 |
| 2021599 | HC COMPLETE CBC W/AUTO DIFF WBC | Laboratory - Hematology | $252.00 |
| 2021600 | HC COMPLETE CBC, AUTOMATED | Laboratory - Hematology | $192.00 |
| 2021602 | HC AUTOMATED RETICULOCYTE COUNT | Laboratory - Hematology | $139.00 |
| 2021603 | HC AUTOMATED LEUKOCYTE COUNT | Laboratory - Hematology | $195.00 |
| 2021604 | HC AUTOMATED PLATELET COUNT | Laboratory - Hematology | $48.18 |
| 2021605 | HC BLOOD SMEAR INTERPRETATION | Laboratory - Hematology | $101.18 |
| 2021608 | HC BLOOD CLOT FACTOR II TEST | Laboratory - Hematology | $512.00 |
| 2021609 | HC BLOOD CLOT FACTOR V TEST | Laboratory - Hematology | $512.00 |
| 2021610 | HC BLOOD CLOT FACTOR VII TEST | Laboratory - Hematology | $462.00 |
| 2021611 | HC CLTNG FACTOR VIII AHG 1 STG | Laboratory - Hematology | $563.90 |
| 2021612 | HC CLTNG FACTOR VIII VW FACTOR RISTOCETIN COFACTOR | Laboratory - Hematology | $728.00 |
| 2021613 | HC CLTNG FACTOR VIII VW FACTOR AG | Laboratory - Hematology | $746.00 |
| 2021614 | HC CLTNG FACTOR VIII MULTMTRIC ALYS | Laboratory - Hematology | $422.63 |
| 2021615 | HC BLOOD CLOT FACTOR IX TEST | Laboratory - Hematology | $512.00 |
| 2021616 | HC BLOOD CLOT FACTOR X TEST | Laboratory - Hematology | $512.00 |
| 2021617 | HC BLOOD CLOT FACTOR XI TEST | Laboratory - Hematology | $631.00 |
| 2021618 | HC BLOOD CLOT FACTOR XII TEST | Laboratory - Hematology | $512.00 |
| 2021619 | HC CLTNG FACTOR XIII FIBRIN STABILIZING | Laboratory - Hematology | $512.00 |
| 2021620 | HC CLTNG FACTOR XIII FIBRIN STABILIZING SCR SOLUB | Laboratory - Hematology | $220.97 |
| 2021622 | HC ANTITHROMBIN III TEST | Laboratory - Hematology | $392.44 |
| 2021625 | HC CLTNG NHBTORS PROTEIN C ACTV | Laboratory - Hematology | $686.00 |
| 2021627 | HC CLTNG NHBTORS PROTEIN S FR | Laboratory - Hematology | $686.00 |
| 2021628 | HC ASSAY ACTIVATED PROTEIN C | Laboratory - Hematology | $358.63 |
| 2021630 | HC FIBRIN DEGRADE, SEMIQUANT | Laboratory - Hematology | $125.52 |
| 2021632 | HC FIBRINOGEN | Laboratory - Hematology | $223.39 |
| 2021633 | HC FBRNLYC FACTORS&NHBTORS PLSMNG ACTIVATOR | Laboratory - Hematology | $1,939.00 |
| 2021634 | HC FBRNLYC FACTORS&NHBTORS PLSMNG XCPT AGIC ASSAY | Laboratory - Hematology | $330.00 |
| 2021636 | HC HGB/RBCS FTL F&MAT HEMRRG DIFFIAL LSS | Laboratory - Hematology | $357.00 |
| 2021637 | HC HGB/RBCS FTL F&MAT HEMRRG ROSETTE | Laboratory - Hematology | $114.71 |
| 2021641 | HC MURAMIDASE | Laboratory - Hematology | $276.52 |
| 2021644 | HC PROTHROMBIN TIME | Laboratory - Hematology | $164.22 |
| 2021646 | HC RUSSELL VIPER VENOM, DILUTED | Laboratory - Hematology | $393.65 |
| 2021649 | HC RBC SED RATE, AUTOMATED | Laboratory - Hematology | $126.00 |
| 2021650 | HC RBC SICKLE CELL TEST | Laboratory - Hematology | $156.00 |
| 2021651 | HC THROMBIN TIME, PLASMA | Laboratory - Hematology | $145.00 |
| 2021652 | HC THROMBOPLASTIN TM PRTL PLSM/WHL BLD | Laboratory - Hematology | $118.52 |
| 2021653 | HC THROMBOPLASTIN TM PRTL SUBJ PLSM FXJS EA | Laboratory - Hematology | $260.82 |
| 2021663 | HC BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REPRT | Laboratory - Hematology | $553.04 |
| 2021664 | HC BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT | Laboratory - Hematology | $386.40 |
| 2021778 | HC BLOOD TYPING, ABO | Laboratory - Hematology | $280.20 |
| 2021779 | HC BLOOD TYPING, RH (D) | Laboratory - Hematology | $280.20 |
| 2021781 | HC BLOOD TYPING, RBC ANTIGENS | Laboratory - Hematology | $656.00 |
| 2022646 | HC BLD# RETICULOCYTES AUTO 1+ CELL MEAS | Laboratory - Hematology | $50.72 |
| 2022745 | HC COAG TIME ACTIVATED | Laboratory - Hematology | $82.11 |
| 2022746 | HC FIBRINOLYS OR/COAG SCRN | Laboratory - Hematology | $469.00 |
| 2023048 | HC OSMOTIC FRAGILITY RBC; UNINCUBATED | Laboratory - Hematology | $618.00 |
| 2023404 | HC CLOTTING FUNCT ACTIVITY | Laboratory - Hematology | $785.00 |
| 2023550 | HC FACTOR INHIBITOR TEST | Laboratory - Hematology | $635.00 |
| 2025921 | HC UNLISTED HEMAT & COAG PROCED | Laboratory - Hematology | $249.00 |
| 2021656 | HC ALLERGEN SPECIFIC IGE | Laboratory - Immunology | $141.28 |
| 2021657 | HC WBC ANTIBODY IDENTIFICATION | Laboratory - Immunology | $410.55 |
| 2021658 | HC PLATELET ANTIBODIES | Laboratory - Immunology | $352.59 |
| 2021659 | HC IMMUNOGLOBULIN ASSAY | Laboratory - Immunology | $403.31 |
| 2021660 | HC ANA | Laboratory - Immunology | $399.00 |
| 2021661 | HC ANA TITER | Laboratory - Immunology | $295.00 |
| 2021662 | HC ANTISTREPTOLYSIN O, TITER | Laboratory - Immunology | $195.00 |
| 2021665 | HC C-REACTIVE PROTEIN | Laboratory - Immunology | $239.09 |
| 2021667 | HC GLYCOPROTEIN ANTIBODY | Laboratory - Immunology | $328.44 |
| 2021668 | HC CARDIOLIPIN ANTIBODY | Laboratory - Immunology | $913.00 |
| 2021669 | HC COLD AGGLUTININ, TITER | Laboratory - Immunology | $224.00 |
| 2021670 | HC COMPLEMENT, ANTIGEN | Laboratory - Immunology | $333.00 |
| 2021671 | HC COMPLEMENT/FUNCTION ACTIVITY | Laboratory - Immunology | $261.00 |
| 2021673 | HC CCP ANTIBODY | Laboratory - Immunology | $339.31 |
| 2021674 | HC DNA ANTIBODY | Laboratory - Immunology | $689.00 |
| 2021675 | HC NUCLEAR ANTIGEN ANTIBODY | Laboratory - Immunology | $399.00 |
| 2021676 | HC FLUORESCENT ANTIBODY, SCREEN | Laboratory - Immunology | $463.68 |
| 2021677 | HC FLUORESCENT ANTIBODY, TITER | Laboratory - Immunology | $390.02 |
| 2021678 | HC HEMAGGLUTINATION INHIBITION | Laboratory - Immunology | $57.96 |
| 2021679 | HC IMMUNOASSAY, TUMOR, CA 15-3 | Laboratory - Immunology | $408.14 |
| 2021680 | HC IMMUNOASSAY, TUMOR, CA 19-9 | Laboratory - Immunology | $288.59 |
| 2021681 | HC IMMUNOASSAY, TUMOR, CA 125 | Laboratory - Immunology | $462.00 |
| 2021682 | HC HTROPHL ANTIBODIES SCR | Laboratory - Immunology | $186.38 |
| 2021684 | HC IMMUNOASSAY, TUMOR OTHER | Laboratory - Immunology | $795.00 |
| 2021685 | HC IMMUNOASSAY,INFECTIOUS AGENT | Laboratory - Immunology | $315.16 |
| 2021686 | HC IMMUNODIFFUSION OUCHTERLONY | Laboratory - Immunology | $176.30 |
| 2021691 | HC INTRINSIC FACTOR ANTIBODY | Laboratory - Immunology | $454.00 |
| 2021692 | HC LYMPHOCYTE TRANSFORMATION | Laboratory - Immunology | $479.38 |
| 2021693 | HC B CELLS, TOTAL COUNT | Laboratory - Immunology | $555.45 |
| 2021694 | HC NK CELLS, TOTAL COUNT | Laboratory - Immunology | $562.70 |
| 2021695 | HC T CELLS, TOTAL COUNT | Laboratory - Immunology | $525.26 |
| 2021696 | HC T CELL, ABSOLUTE COUNT/RATIO | Laboratory - Immunology | $765.56 |
| 2021697 | HC T CELL, ABSOLUTE COUNT | Laboratory - Immunology | $243.92 |
| 2021698 | HC STEM CELLS, TOTAL COUNT | Laboratory - Immunology | $321.20 |
| 2021699 | HC MICROSOMAL ANTIBODY | Laboratory - Immunology | $419.00 |
| 2021701 | HC PART AGGLUJ SCR EA ANTB | Laboratory - Immunology | $258.00 |
| 2021704 | HC RHEUMATOID FACTOR, QUANT | Laboratory - Immunology | $135.24 |
| 2021705 | HC TB INTRADERMAL TEST | Laboratory - Immunology | $106.50 |
| 2021706 | HC BLOOD SEROLOGY, QUALITATIVE | Laboratory - Immunology | $112.30 |
| 2021708 | HC ASPERGILLUS ANTIBODY | Laboratory - Immunology | $297.00 |
| 2021709 | HC BACTERIUM ANTIBODY | Laboratory - Immunology | $134.00 |
| 2021711 | HC BLASTOMYCES ANTIBODY | Laboratory - Immunology | $235.00 |
| 2021712 | HC ANTB BORRELIA BURGDORFERI CONFIRMATORY TST | Laboratory - Immunology | $385.19 |
| 2021713 | HC ANTB BORRELIA BURGDORFERI LYME DISEASE | Laboratory - Immunology | $434.70 |
| 2021715 | HC CAMPYLOBACTER ANTIBODY | Laboratory - Immunology | $65.21 |
| 2021716 | HC CHLAMYDIA ANTIBODY | Laboratory - Immunology | $295.00 |
| 2021717 | HC CHLAMYDIA IGM ANTIBODY | Laboratory - Immunology | $319.00 |
| 2021718 | HC COCCIDIOIDES ANTIBODY | Laboratory - Immunology | $293.00 |
| 2021720 | HC CMV ANTIBODY | Laboratory - Immunology | $234.26 |
| 2021721 | HC CMV ANTIBODY, IGM | Laboratory - Immunology | $195.62 |
| 2021722 | HC ENTEROVIRUS ANTIBODY | Laboratory - Immunology | $293.42 |
| 2021723 | HC ANTB EPSTEIN-BARR EB VIRUS EARLY AG EA | Laboratory - Immunology | $274.10 |
| 2021724 | HC ANTB EPSTEIN-BARR EB VIRUS NUC AG EBNA | Laboratory - Immunology | $306.71 |
| 2021725 | HC ANTB EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA | Laboratory - Immunology | $294.63 |
| 2021726 | HC EHRLICHIA ANTIBODY | Laboratory - Immunology | $252.00 |
| 2021727 | HC FUNGUS ANTIBODY | Laboratory - Immunology | $254.78 |
| 2021732 | HC HTLV/HIV CONFIRMATORY TEST | Laboratory - Immunology | $361.35 |
| 2021733 | HC ANTB HERPES SMPLX NON-SPEC TYP TST | Laboratory - Immunology | $199.24 |
| 2021734 | HC ANTB HERPES SMPLX TYP 1 | Laboratory - Immunology | $240.29 |
| 2021735 | HC HERPES SIMPLEX TYPE 2 | Laboratory - Immunology | $322.70 |
| 2021736 | HC HISTOPLASMA | Laboratory - Immunology | $224.00 |
| 2021737 | HC HIV-1 | Laboratory - Immunology | $77.00 |
| 2021738 | HC HIV-2 | Laboratory - Immunology | $242.00 |
| 2021739 | HC HIV-1/HIV-2, SINGLE ASSAY | Laboratory - Immunology | $287.81 |
| 2021740 | HC HEP B CORE ANTIBODY, TOTAL | Laboratory - Immunology | $200.47 |
| 2021741 | HC HEP B CORE ANTIBODY, IGM | Laboratory - Immunology | $324.00 |
| 2021743 | HC HEP BE ANTIBODY | Laboratory - Immunology | $295.00 |
| 2021747 | HC LEGIONELLA ANTIBODY | Laboratory - Immunology | $213.73 |
| 2021748 | HC LEPTOSPIRA ANTIBODY | Laboratory - Immunology | $293.00 |
| 2021749 | HC MUMPS ANTIBODY | Laboratory - Immunology | $366.00 |
| 2021750 | HC MYCOPLASMA ANTIBODY | Laboratory - Immunology | $311.00 |
| 2021751 | HC PARVOVIRUS ANTIBODY | Laboratory - Immunology | $480.00 |
| 2021754 | HC RICKETTSIA ANTIBODY | Laboratory - Immunology | $199.24 |
| 2021755 | HC RUBELLA ANTIBODY | Laboratory - Immunology | $191.99 |
| 2021756 | HC RUBEOLA ANTIBODY | Laboratory - Immunology | $360.00 |
| 2021757 | HC TOXOPLASMA ANTIBODY | Laboratory - Immunology | $191.99 |
| 2021758 | HC TOXOPLASMA ANTIBODY, IGM | Laboratory - Immunology | $189.58 |
| 2021759 | HC TREPONEMA PALLIDUM, CONFIRM | Laboratory - Immunology | $220.02 |
| 2021760 | HC TRICHINELLA ANTIBODY | Laboratory - Immunology | $224.00 |
| 2021761 | HC VARICELLA-ZOSTER ANTIBODY | Laboratory - Immunology | $255.99 |
| 2021763 | HC VIRUS ANTIBODY NOS | Laboratory - Immunology | $249.95 |
| 2021764 | HC THYROGLOBULIN ANTIBODY | Laboratory - Immunology | $335.99 |
| 2021765 | HC HEPATITIS C AB TEST | Laboratory - Immunology | $310.33 |
| 2021767 | HC HLA TYPING B/C 1 AG | Laboratory - Immunology | $547.00 |
| 2021772 | HC RBC ANTIBODY ELUTION | Laboratory - Immunology | $340.00 |
| 2021780 | HC BLOOD TYPING, ANTIGEN SCREEN | Laboratory - Immunology | $343.35 |
| 2021783 | HC COMPATIBILITY TEST, INCUBATE | Laboratory - Immunology | $173.85 |
| 2021784 | HC COMPATIBILITY TEST, ANTIGLOB | Laboratory - Immunology | $340.00 |
| 2021836 | HC HEPATITIS DELTA AG, EIA | Laboratory - Immunology | $166.64 |
| 2022650 | HC TUBERCULOSIS TST CELL MEDIATED IMMUNITY | Laboratory - Immunology | $1,041.44 |
| 2022747 | HC ANTI-PHOSPHATIDYLSER AB | Laboratory - Immunology | $144.90 |
| 2022750 | HC ANTIBODY SALMONELLA | Laboratory - Immunology | $44.68 |
| 2022751 | HC WEST NILE VIRUS ANTIBODY | Laboratory - Immunology | $564.00 |
| 2023038 | HC ISLET CELL AB | Laboratory - Immunology | $224.60 |
| 2023040 | HC AB HELMINTH NES | Laboratory - Immunology | $654.00 |
| 2023049 | HC ALLERG SP IGG QUAN OR SEMIQUAN | Laboratory - Immunology | $44.68 |
| 2023050 | HC DNA AB | Laboratory - Immunology | $399.00 |
| 2023051 | HC IEP; NOT SERUM | Laboratory - Immunology | $512.00 |
| 2023052 | HC AB; BORDETELLA | Laboratory - Immunology | $184.75 |
| 2023053 | HC AB; HEPATITIS D | Laboratory - Immunology | $195.62 |
| 2023058 | HC AB; COXIELLA BRUNETII | Laboratory - Immunology | $445.00 |
| 2023560 | HC HUMAN EPIDIDYMIS PROTEIN 4 | Laboratory - Immunology | $217.35 |
| 2024641 | HC JOHN CUNNINGHAM ANTIBODY | Laboratory - Immunology | $70.93 |
| 2024643 | HC HLA CLASS1 & 2 ANTIBODY QUALITATIVE | Laboratory - Immunology | $220.00 |
| 2024749 | HC SYPHILIS TEST NON-TREP QUANT | Laboratory - Immunology | $21.70 |
| 2024752 | HC CULTURE AEROBIC IDENTIFY | Laboratory - Immunology | $136.90 |
| 2024756 | HC CULTURE TYPE IMMUNOFLUORESC | Laboratory - Immunology | $28.71 |
| 2024758 | HC DNA/RNA SEQUENCING | Laboratory - Immunology | $569.87 |
| 2024759 | HC MICROBE SUSCEPTIBLE ENZYME | Laboratory - Immunology | $23.40 |
| 2024763 | HC VANOMYCIN DNA AMP PROBE | Laboratory - Immunology | $187.16 |
| 2024774 | HC M.AVIUM-INTRA DNA AMP PROB | Laboratory - Immunology | $173.01 |
| 2024851 | HC ALLERGEN SPECIFIC IGE | Laboratory - Immunology | $40.51 |
| 2025984 | HC TB AG RESPONSE T-CELL SUSP | Laboratory - Immunology | $308.37 |
| 2024453 | HC GLUCOSE; BLD BY MONITOR DEVICE | Laboratory - Other | $22.83 |
| 2021329 | HC MICROSCOPIC EXAM OF URINE | Laboratory - Urology | $16.49 |
| 2023222 | HC N-AUTOM URINALYS WO MICRO | Laboratory - Urology | $40.57 |
| 2024638 | HC URINE PREGNANCY TEST, BY VISUAL COLOR COMPARISON METHODS | Laboratory - Urology | $87.49 |
| 2021606 | HC BONE MARROW INTERPRETATION | Laboratory Pathology | $1,455.00 |
| 2021879 | HC CELL MARKER STUDY | Laboratory Pathology | $1,189.00 |
| 2021883 | HC TISSUE CULTURE, LYMPHOCYTE | Laboratory Pathology | $916.49 |
| 2021884 | HC TISSUE CULTURE, SKIN/BIOPSY | Laboratory Pathology | $1,312.55 |
| 2021885 | HC TISSUE CULTURE, PLACENTA | Laboratory Pathology | $629.11 |
| 2021886 | HC TISSUE CULTURE, BONE MARROW | Laboratory Pathology | $1,052.94 |
| 2021887 | HC TISSUE CULTURE, TUMOR | Laboratory Pathology | $699.14 |
| 2021890 | HC CHROMOSOME ANALYSIS, BI-100 | Laboratory Pathology | $2,309.00 |
| 2021892 | HC CHROMOSOME ANALYSIS, 5 | Laboratory Pathology | $2,463.30 |
| 2021893 | HC CHROMOSOME ANALYSIS, 15-20 | Laboratory Pathology | $1,828.16 |
| 2021894 | HC CHROMOSOME ANALYSIS, 45 | Laboratory Pathology | $2,448.81 |
| 2021896 | HC CHROMOSOME ANALYS, PLACENTA | Laboratory Pathology | $2,783.29 |
| 2021902 | HC CHROMOSOME KARYOTYPE STUDY | Laboratory Pathology | $536.13 |
| 2021904 | HC CHROMOSOME COUNT, ADDITIONAL | Laboratory Pathology | $414.17 |
| 2021905 | HC CHROMOSOME STUDY, ADDITIONAL | Laboratory Pathology | $553.00 |
| 2021907 | HC SURGICAL PATH, GROSS | Laboratory Pathology | $1,047.99 |
| 2021908 | HC LVL II-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,204.41 |
| 2021909 | HC LEVEL III-SURG PATH GROSS&MICROSCOPIC XM | Laboratory Pathology | $1,360.83 |
| 2021910 | HC LVL IV-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,564.17 |
| 2021911 | HC LVL V-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,742.94 |
| 2021912 | HC LVL VI-SURG PATH GROSS&MCRSCP XM | Laboratory Pathology | $1,981.29 |
| 2021913 | HC DECALCIFY TISSUE | Laboratory Pathology | $173.00 |
| 2021914 | HC SPEC STAINS GRP I MICROORGANISMS EA | Laboratory Pathology | $981.70 |
| 2021915 | HC SPEC STAINS GRP II STAINS EA | Laboratory Pathology | $603.51 |
| 2021916 | HC HISTOCHEMICAL STAIN | Laboratory Pathology | $524.06 |
| 2021917 | HC ENZYME HISTOCHEMISTRY | Laboratory Pathology | $1,365.68 |
| 2021918 | HC CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE | Laboratory Pathology | $548.21 |
| 2021919 | HC CONSLTJ&REPRT MATRL REQ PREPJ SLIDES | Laboratory Pathology | $618.00 |
| 2021920 | HC PATH CONSULT INTROP | Laboratory Pathology | $231.84 |
| 2021921 | HC PATH CONSULT INTRAOP, 1 BLOC | Laboratory Pathology | $629.00 |
| 2021922 | HC PATH CONSULT INTRAOP, ADD'L | Laboratory Pathology | $295.00 |
| 2021925 | HC IMMUNOHISTOCHEMISTRY | Laboratory Pathology | $770.41 |
| 2021926 | HC IMFLUOR STD DIR METH 1ST STAIN | Laboratory Pathology | $1,115.73 |
| 2021928 | HC ELECTRON MICROSCOPY | Laboratory Pathology | $6,724.57 |
| 2021930 | HC ANALYSIS, TUMOR | Laboratory Pathology | $418.51 |
| 2021931 | HC TUMOR IMMUNOHISTOCHEM/MANUAL | Laboratory Pathology | $886.24 |
| 2021932 | HC TUMOR IMMUNOHISTOCHEM/COMPUT | Laboratory Pathology | $692.00 |
| 2021933 | HC INSITU HYBRIDIZATION (FISH) | Laboratory Pathology | $1,120.00 |
| 2021934 | HC INSITU HYBRIDIZATION, MANUAL | Laboratory Pathology | $725.71 |
| 2022423 | HC PROSTATE BIOPSY, ANY MTHD | Laboratory Pathology | $5,756.15 |
| 2022653 | HC TISS EXAM MOLECULAR STUDY | Laboratory Pathology | $66.41 |
| 2022920 | HC INSITU HYBRIDIZATION AUTO | Laboratory Pathology | $2,277.10 |
| 2023013 | HC CYT FNA EVAL SPEC EA ADD | Laboratory Pathology | $78.61 |
| 2023014 | HC CYT URINE 3-5 PROBE COMP | Laboratory Pathology | $3,420.85 |
| 2023015 | HC XM ARCHIVE TISSUE MOL AN | Laboratory Pathology | $177.32 |
| 2023444 | HC NERVE TEASING PREP | Laboratory Pathology | $783.84 |
| 2023568 | HC HBA1/HBA2 GENE | Laboratory Pathology | $1,391.04 |
| 2024487 | HC NPM1 | Laboratory Pathology | $1,496.00 |
| 2024488 | HC JAK2 | Laboratory Pathology | $1,396.69 |
| 2024489 | HC IGH GENE REARRANGE AMP METH | Laboratory Pathology | $1,754.39 |
| 2024490 | HC TRG GENE REARRANGEMENT ANAL | Laboratory Pathology | $1,783.37 |
| 2024491 | HC MOPATH PROCEDURE LEVEL 2 | Laboratory Pathology | $2,523.00 |
| 2024492 | HC FLT3 GENE | Laboratory Pathology | $1,509.00 |
| 2024493 | HC UNLISTED MOLECULAR PATHOLOGY | Laboratory Pathology | $1,002.00 |
| 2024495 | HC BCR-ABL (CML) | Laboratory Pathology | $1,643.70 |
| 2024496 | HC BCR-ABL (ALL) | Laboratory Pathology | $1,643.70 |
| 2024497 | HC MOPATH PROCEDURE LEVEL 6 | Laboratory Pathology | $3,509.00 |
| 2024498 | HC PML-RARA | Laboratory Pathology | $2,864.52 |
| 2024504 | HC IGK REARRANGEABN CLONAL POP | Laboratory Pathology | $1,754.39 |
| 2024505 | HC KRAS GENE | Laboratory Pathology | $5,416.06 |
| 2024506 | HC BRAF GENE | Laboratory Pathology | $1,893.29 |
| 2024525 | HC CFTR GENE COM VARIANTS | Laboratory Pathology | $1,282.00 |
| 2024528 | HC CFTR GENE FULL SEQUENCE | Laboratory Pathology | $8,690.52 |
| 2024532 | HC CYP2C9 GENE COM VARIANTS | Laboratory Pathology | $1,719.99 |
| 2024534 | HC CYTOGEN M ARRAY COPY NO&SNP | Laboratory Pathology | $8,412.00 |
| 2024535 | HC F2 GENE | Laboratory Pathology | $1,012.05 |
| 2024536 | HC F5 GENE | Laboratory Pathology | $314.41 |
| 2024538 | HC FMR1 GENE DETECTION | Laboratory Pathology | $588.43 |
| 2024545 | HC HFE GENE | Laboratory Pathology | $748.57 |
| 2024546 | HC IKBKAP GENE | Laboratory Pathology | $2,070.79 |
| 2024547 | HC IGH GENE REARRANG DIR PROBE | Laboratory Pathology | $2,263.16 |
| 2024548 | HC IGH VARI REGIONAL MUTATION | Laboratory Pathology | $2,828.95 |
| 2024550 | HC CHIMERISM ANAL NO CELL SELEC | Laboratory Pathology | $796.64 |
| 2024554 | HC MTHFR GENE | Laboratory Pathology | $434.53 |
| 2024567 | HC UGT1A1 GENE COMMON VARIANTS | Laboratory Pathology | $1,348.84 |
| 2024570 | HC HLA I TYPING COMPLETE HR | Laboratory Pathology | $5,584.75 |
| 2024571 | HC HLA I TYPING 1 LOCUS HR | Laboratory Pathology | $2,480.43 |
| 2024572 | HC HLA I TYPING 1 ALLELE HR | Laboratory Pathology | $724.21 |
| 2024573 | HC HLA II TYPING 1 LOC HR | Laboratory Pathology | $1,701.90 |
| 2024574 | HC HLA II TYPING 1 ALLELE HR | Laboratory Pathology | $1,378.27 |
| 2024575 | HC MOPATH PROCEDURE LEVEL 1 | Laboratory Pathology | $1,267.01 |
| 2024576 | HC MOPATH PROCEDURE LVL 3 | Laboratory Pathology | $2,163.00 |
| 2024577 | HC MOPATH PROCEDURE LEVEL 4 | Laboratory Pathology | $2,243.00 |
| 2024578 | HC MOPATH PROCEDURE LEVEL 5 | Laboratory Pathology | $2,863.00 |
| 2024579 | HC MOPATH PROCEDURE LEVEL 7 | Laboratory Pathology | $6,783.00 |
| 2024580 | HC MOPATH PROCEDURE LEVEL 8 | Laboratory Pathology | $6,056.00 |
| 2024581 | HC MOPATH PROCEDURE LEVEL 9 | Laboratory Pathology | $6,352.00 |
| 2024582 | HC MICRODISSECTION MANUAL | Laboratory Pathology | $2,160.69 |
| 2024663 | HC EGFR GENE COM VARIANTS | Laboratory Pathology | $891.19 |
| 2025120 | HC IMMUNOHISTO ANTIBODY ADDL SLIDE | Laboratory Pathology | $654.84 |
| 2025150 | HC ISH, ADDTL SINGLE PROBE STAIN/SPECIMEN | Laboratory Pathology | $314.43 |
| 2025151 | HC ISH, MULTIPLEX PROBE STAIN/SPECIMEN | Laboratory Pathology | $728.12 |
| 2025152 | HC ISH, COMPUTER ASSISTED, ADDT?L SINGLE PROBE STAIN/SPECIMEN | Laboratory Pathology | $1,259.00 |
| 2025153 | HC ISH, COMPUTER ASSISTED, MULTIPLEX PROBE STAIN/SPECIMEN | Laboratory Pathology | $823.52 |
| 2025220 | HC TARGETED GENOMIC SEQ ANALYS 5-50 | Laboratory Pathology | $3,622.50 |
| 2025548 | HC IIMMUNOFLUOR ANTB ADDL STAIN | Laboratory Pathology | $532.51 |
| 2025644 | HC ABL1 GENE | Laboratory Pathology | $1,916.47 |
| 2025645 | HC CEBPA GENE FULL SEQUENCE | Laboratory Pathology | $1,916.47 |
| 2025646 | HC CALR GENE COM VARIANTS | Laboratory Pathology | $963.59 |
| 2025647 | HC KIT GENE TARGETED SEQ ANALYS | Laboratory Pathology | $1,916.47 |
| 2025648 | HC KIT GENE ANALYS D816 VARIANT | Laboratory Pathology | $726.29 |
| 2025649 | HC KRAS GENE ADDL VARIANTS | Laboratory Pathology | $1,146.86 |
| 2025650 | HC NRAS GENE VARIANTS EXON 2&3 | Laboratory Pathology | $1,720.33 |
| 2025651 | HC PDGFRA GENE | Laboratory Pathology | $1,916.47 |
| 2026022 | HC TARGETED GENOMIC SEQ ANALYS > 50 | Laboratory Pathology | $8,759.00 |
| 2026029 | HC ONC BREAST MRNA 58 GENES | Laboratory Pathology | $9,297.06 |
| 2026030 | HC MICROSATELLITE INSTABILITY | Laboratory Pathology | $1,072.44 |
| 2026043 | HC MICRODISSECTION LASER | Laboratory Pathology | $272.00 |
| 2026317 | HC AR GENE CHARAC ALLELES | Laboratory Pathology | $1,839.17 |
| 2026318 | HC BTK GENE COMMON VARIANTS | Laboratory Pathology | $1,893.29 |
| 2026329 | HC MYD88 GENE P.LEU265PRO VRNT | Laboratory Pathology | $1,893.29 |
| 2026330 | HC NUDT15 GENE COMMON VARIANTS | Laboratory Pathology | $2,263.16 |
| 2026333 | HC SMN1 GENE DOS/DELETION ALYS | Laboratory Pathology | $1,839.17 |
| 2026936 | HC DPYD GENE COMMON VARIANTS | Laboratory Pathology | $839.08 |
| 2021866 | HC CYTOPATH FL NONGYN, SMEARS | Laboratory Pathology - Cytology | $382.78 |
| 2021867 | HC CYTOPATH, CONCENTRATE TECH | Laboratory Pathology - Cytology | $514.40 |
| 2021869 | HC CYTOPATH, C/V, THIN LAYER | Laboratory Pathology - Cytology | $269.27 |
| 2021872 | HC CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ | Laboratory Pathology - Cytology | $471.00 |
| 2021877 | HC CYTOPATHOLOGY EVAL OF FNA | Laboratory Pathology - Cytology | $433.00 |
| 2021878 | HC CYTOPATH EVAL, FNA, REPORT | Laboratory Pathology - Cytology | $1,067.00 |
| 2021880 | HC FLOWCYTOMETRY/ TC, 1 MARKER | Laboratory Pathology - Cytology | $692.00 |
| 2021881 | HC FLOWCYTOMETRY/TC, ADD-ON | Laboratory Pathology - Cytology | $608.00 |
| 2021891 | HC CHROMOSOME ANALYSIS, 100 | Laboratory Pathology - Cytology | $1,234.07 |
| 2021895 | HC CHROMOSOME ANALYSIS, 20-25 | Laboratory Pathology - Cytology | $1,448.00 |
| 2021897 | HC CYTOGENETICS, DNA PROBE | Laboratory Pathology - Cytology | $414.17 |
| 2021899 | HC CYTOGENETICS, 10-30 | Laboratory Pathology - Cytology | $376.74 |
| 2021900 | HC CYTOGENETICS, 25-99 | Laboratory Pathology - Cytology | $528.89 |
| 2021901 | HC CYTOGENETICS, 100-300 | Laboratory Pathology - Cytology | $638.77 |
| 2021923 | HC INTRAOP CYTO PATH CONSULT, 1 | Laboratory Pathology - Cytology | $1,455.00 |
| 2021924 | HC INTRAOP CYTO PATH CONSULT, 2 | Laboratory Pathology - Cytology | $172.67 |
| 2023648 | HC CYTOGENETICS AND MOLEC CYTOGENETICS, INTERP & RPT | Laboratory Pathology - Cytology | $164.83 |
| 2024629 | HC CYTOPATH C/V AUTO FLUID REDO | Laboratory Pathology - Cytology | $444.93 |
| 2024661 | HC OBTAINING SCREEN PAP SMEAR | Laboratory Pathology - Cytology | $142.73 |
| 2024682 | HC CYTOPATH CELL ENHANCE TECH | Laboratory Pathology - Cytology | $554.30 |
| 2025329 | HC CHROM ANALY; SITU AF CELLS FROM 6-12 COL | Laboratory Pathology - Cytology | $1,406.00 |
| 2024867 | HC IMMUNOHISTO ANTIBODY SLIDE | Laboratory Pathology - Histology | $1,248.05 |
| 2025582 | HC M/PHMTRC ALYS ISH QUANT/SEMIQ EACH | Laboratory Pathology - Histology | $894.76 |
| 2020643 | HC MAGNETIC IMAGE, JAW JOINT | Magnetic Resonance Technology (MRT) | $3,345.36 |
| 2020659 | HC MRI ORBIT/FACE/NECK W/O DYE | Magnetic Resonance Technology (MRT) | $5,762.34 |
| 2020660 | HC MRI ORBIT/FACE/NECK W/DYE | Magnetic Resonance Technology (MRT) | $8,594.86 |
| 2020661 | HC MRI ORBT/FAC/NCK W/O & W/DYE | Magnetic Resonance Technology (MRT) | $9,767.29 |
| 2020662 | HC MR ANGIOGRAPHY HEAD W/O DYE | Magnetic Resonance Technology (MRT) | $6,644.21 |
| 2020663 | HC MR ANGIOGRAPH HEAD W/O&W/DYE | Magnetic Resonance Technology (MRT) | $11,229.00 |
| 2020664 | HC MR ANGIOGRAPHY NECK W/O DYE | Magnetic Resonance Technology (MRT) | $5,780.25 |
| 2020665 | HC MR ANGIOGRAPH NECK W/O&W/DYE | Magnetic Resonance Technology (MRT) | $9,798.01 |
| 2020667 | HC MRI BRAIN W/DYE | Magnetic Resonance Technology (MRT) | $8,924.14 |
| 2020668 | HC MRI BRAIN W/O & W/DYE | Magnetic Resonance Technology (MRT) | $12,540.86 |
| 2020700 | HC MRI CHEST W/O DYE | Magnetic Resonance Technology (MRT) | $5,777.00 |
| 2020701 | HC MRI CHEST W/DYE | Magnetic Resonance Technology (MRT) | $8,614.06 |
| 2020702 | HC MRI CHEST W/O & W/DYE | Magnetic Resonance Technology (MRT) | $9,789.05 |
| 2020703 | HC MRA W/O FOL W/CONT, CHEST | Magnetic Resonance Technology (MRT) | $6,637.82 |
| 2020730 | HC MRI NECK SPINE W/O DYE | Magnetic Resonance Technology (MRT) | $7,017.20 |
| 2020731 | HC MRI NECK SPINE W/DYE | Magnetic Resonance Technology (MRT) | $8,067.66 |
| 2020732 | HC MRI CHEST SPINE W/O DYE | Magnetic Resonance Technology (MRT) | $7,651.08 |
| 2020751 | HC MRI PELVIS W/O DYE | Magnetic Resonance Technology (MRT) | $4,616.30 |
| 2020752 | HC MRI PELVIS W/DYE | Magnetic Resonance Technology (MRT) | $6,052.88 |
| 2020753 | HC MRI PELVIS W/O & W/DYE | Magnetic Resonance Technology (MRT) | $6,878.45 |
| 2020871 | HC MR ANGIO UPR EXTR W/O&W/DYE | Magnetic Resonance Technology (MRT) | $5,817.90 |
| 2020996 | HC MRI ABDOMEN W/O DYE | Magnetic Resonance Technology (MRT) | $8,157.76 |
| 2020997 | HC MRI ABDOMEN W/DYE | Magnetic Resonance Technology (MRT) | $9,385.24 |
| 2020998 | HC MRI ABDOMEN W/O & W/DYE | Magnetic Resonance Technology (MRT) | $11,263.56 |
| 2021030 | HC CARDIAC MRI FOR MORPH W/DYE | Magnetic Resonance Technology (MRT) | $10,879.57 |
| 2022396 | HC MRA W/O FOL W/CONT, ABD | Magnetic Resonance Technology (MRT) | $6,813.68 |
| 2022399 | HC MRI W/O FOL W/CONT, BRST, UN | Magnetic Resonance Technology (MRT) | $7,488.86 |
| 2022402 | HC MRI W/O FOL W/CONT, BRST, BI | Magnetic Resonance Technology (MRT) | $11,427.39 |
| 2023505 | HC MRI U EXT NOT JOINT WO CONTRAST | Magnetic Resonance Technology (MRT) | $5,009.72 |
| 2023506 | HC MRI U EXT NOT JOINT W CONTRAST | Magnetic Resonance Technology (MRT) | $7,464.66 |
| 2023507 | HC MRI U EXTR; NOT JOINT W&WO CONTR | Magnetic Resonance Technology (MRT) | $8,466.86 |
| 2023508 | HC MRI U EXTR; ANY JOINT WO CONTRAST | Magnetic Resonance Technology (MRT) | $6,325.51 |
| 2023509 | HC MRI U EXTR; ANY JOINT W CONTRAST | Magnetic Resonance Technology (MRT) | $9,425.55 |
| 2023510 | HC MRI UE ANY JOINT W & WO CONTRAST | Magnetic Resonance Technology (MRT) | $10,690.14 |
| 2023525 | HC MRI - LEXTREM WO CONTR | Magnetic Resonance Technology (MRT) | $6,464.38 |
| 2023526 | HC MRI - LEXTREM W CONTR | Magnetic Resonance Technology (MRT) | $9,632.07 |
| 2023527 | HC MRI LEXTREM W&WO CONTR | Magnetic Resonance Technology (MRT) | $10,924.82 |
| 2023528 | HC MRI - LE JNT WO CONTR | Magnetic Resonance Technology (MRT) | $6,325.51 |
| 2023529 | HC MRI LE JNT W CONTR | Magnetic Resonance Technology (MRT) | $9,425.55 |
| 2023530 | HC MRI LE JNT W&WO CONTR | Magnetic Resonance Technology (MRT) | $10,690.14 |
| 2023572 | HC CARDIAC MRI FOR MORPH | Magnetic Resonance Technology (MRT) | $9,465.22 |
| 2023574 | HC UNLISTED MAGNETIC RESONANCE PROCED | Magnetic Resonance Technology (MRT) | $5,141.00 |
| 2025616 | HC MRA ABD W/WO CONTR | Magnetic Resonance Technology (MRT) | $5,274.67 |
| 2025617 | HC MR ANGIO PELVIS W/WO CONTRAST | Magnetic Resonance Technology (MRT) | $6,468.87 |
| 2026012 | HC CARD MRI VEL FLW MAP ADD-ON | Magnetic Resonance Technology (MRT) | $587.24 |
| 2026384 | HC CAD BREAST MRI | Magnetic Resonance Technology (MRT) | $433.90 |
| 2026735 | HC MRT GEN CDSM NDSC | Magnetic Resonance Technology (MRT) | $1.06 |
| 2020666 | HC MRI BRAIN W/O DYE | Magnetic Resonance Technology (MRT) - Brain/Brainstem | $8,597.66 |
| 2020669 | HC FMRI BRAIN BY TECH | Magnetic Resonance Technology (MRT) - Brain/Brainstem | $6,604.86 |
| 2022407 | HC MRA W/O FOL W/CONT, LWR EXT | Magnetic Resonance Technology (MRT) - MRA - Lower Extremities | $9,835.77 |
| 2025630 | HC MRA LEXTREM W/WO CONTR | Magnetic Resonance Technology (MRT) - MRA - Lower Extremities | $6,366.47 |
| 2022408 | HC MRA W/O FOL W/CONT, PELVIS | Magnetic Resonance Technology (MRT) - MRA - Other | $5,810.92 |
| 2026737 | HC MRA CDSM NDSC | Magnetic Resonance Technology (MRT) - MRA - Other | $1.06 |
| 2026779 | HC MRA CDSM QUALIFIED NOS | Magnetic Resonance Technology (MRT) - MRA - Other | $1.06 |
| 2022401 | HC MRI BREAST C- BILATERAL | Magnetic Resonance Technology (MRT) - MRI - Other | $1,288.04 |
| 2025720 | HC MRI FETAL SNGL/1ST GESTATION | Magnetic Resonance Technology (MRT) - MRI - Other | $1,238.84 |
| 2025721 | HC MRI FETAL EA ADDL GESTATION | Magnetic Resonance Technology (MRT) - MRI - Other | $389.28 |
| 2026736 | HC MRI CDSM NDSC | Magnetic Resonance Technology (MRT) - MRI - Other | $1.06 |
| 2020733 | HC MRI CHEST SPINE W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $8,803.30 |
| 2020734 | HC MRI LUMBAR SPINE W/O DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $7,272.66 |
| 2020735 | HC MRI LUMBAR SPINE W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $8,890.53 |
| 2020736 | HC MRI NECK SPINE W/O & W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $9,685.22 |
| 2020737 | HC MRI THORAC SPINE W & WO CONTR | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $9,685.22 |
| 2020738 | HC MRI LUMBAR SPINE W/O & W/DYE | Magnetic Resonance Technology (MRT) - Spinal Cord/Spine | $10,084.72 |
| 2021975 | HC DIALYSIS PROCEDURE | Miscellaneous Dialysis | $4,087.03 |
| 2026112 | HC ULTRAFILTRATION ONLY | Miscellaneous Dialysis - Ultrafiltration | $2,470.00 |
| 2026201 | HC IP ULTRAFILTRATION | Miscellaneous Dialysis - Ultrafiltration | $2,469.00 |
| 2020517 | HC IDENTIFY SENTINEL NODE | Nuclear Medicine | $3,305.00 |
| 2021207 | HC THYROID MET IMAGING, BODY | Nuclear Medicine | $5,013.18 |
| 2026732 | HC NUC MED CDSM NDSC | Nuclear Medicine | $1.00 |
| 2021201 | HC THYROID, SINGLE UPTAKE | Nuclear Medicine - Diagnostic Procedures | $1,491.02 |
| 2021204 | HC THYROID IMAGING WITH UPTAKE | Nuclear Medicine - Diagnostic Procedures | $2,982.04 |
| 2021211 | HC THYROID MET UPTAKE | Nuclear Medicine - Diagnostic Procedures | $1,643.25 |
| 2021213 | HC BONE MARROW IMAGING, BODY | Nuclear Medicine - Diagnostic Procedures | $2,687.90 |
| 2021214 | HC BLOOD VOLUME | Nuclear Medicine - Diagnostic Procedures | $1,819.40 |
| 2021215 | HC RED CELL SEQUESTRATION | Nuclear Medicine - Diagnostic Procedures | $1,697.68 |
| 2021216 | HC SPLEEN IMAGING | Nuclear Medicine - Diagnostic Procedures | $1,668.15 |
| 2021217 | HC LYMPH SYSTEM IMAGING | Nuclear Medicine - Diagnostic Procedures | $4,727.91 |
| 2021221 | HC SERIAL SALIVARY IMAGING | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2021222 | HC ESOPHAGEAL MOTILITY STUDY | Nuclear Medicine - Diagnostic Procedures | $3,714.88 |
| 2021223 | HC GASTROESOPHAGEAL REFLUX EXAM | Nuclear Medicine - Diagnostic Procedures | $1,892.97 |
| 2021224 | HC GASTRIC EMPTYING IMAG STUDY | Nuclear Medicine - Diagnostic Procedures | $4,130.74 |
| 2021226 | HC ACUTE GI BLOOD LOSS IMAGING | Nuclear Medicine - Diagnostic Procedures | $3,574.20 |
| 2021227 | HC MECKEL'S DIVERT EXAM | Nuclear Medicine - Diagnostic Procedures | $3,203.92 |
| 2021228 | HC BONE IMAGING, LIMITED AREA | Nuclear Medicine - Diagnostic Procedures | $2,463.48 |
| 2021230 | HC BONE IMAGING, WHOLE BODY | Nuclear Medicine - Diagnostic Procedures | $3,581.55 |
| 2021231 | HC BONE IMAGING, 3 PHASE | Nuclear Medicine - Diagnostic Procedures | $4,720.30 |
| 2021238 | HC HEART IMAGE (3D), SINGLE | Nuclear Medicine - Diagnostic Procedures | $4,828.07 |
| 2021239 | HC HEART IMAGE (3D), MULTIPLE | Nuclear Medicine - Diagnostic Procedures | $5,817.01 |
| 2021240 | HC HEART INFARCT IMAGE (3D) | Nuclear Medicine - Diagnostic Procedures | $1,510.16 |
| 2021241 | HC GATED HEART, PLANAR, SINGLE | Nuclear Medicine - Diagnostic Procedures | $2,928.80 |
| 2021242 | HC GATED HEART, MULTIPLE | Nuclear Medicine - Diagnostic Procedures | $3,660.35 |
| 2021246 | HC LUNG PERFUSION IMAGING | Nuclear Medicine - Diagnostic Procedures | $2,389.95 |
| 2021253 | HC BRAIN IMAGE W/FLOW 4 + VIEWS | Nuclear Medicine - Diagnostic Procedures | $5,275.63 |
| 2021255 | HC CEREBSP FLU FLO IMG X INTRO MATRL CISTRNG | Nuclear Medicine - Diagnostic Procedures | $3,300.28 |
| 2021256 | HC CSF SHUNT EVALUATION | Nuclear Medicine - Diagnostic Procedures | $3,733.89 |
| 2021260 | HC K FLOW/FUNCT IMAGE W/O DRUG | Nuclear Medicine - Diagnostic Procedures | $3,158.27 |
| 2021261 | HC K FLOW/FUNCT IMAGE W/DRUG | Nuclear Medicine - Diagnostic Procedures | $2,730.00 |
| 2021262 | HC K FLOW/FUNCT IMAGE, MULTIPLE | Nuclear Medicine - Diagnostic Procedures | $4,934.57 |
| 2021264 | HC KIDNEY FUNCTION STUDY | Nuclear Medicine - Diagnostic Procedures | $1,489.75 |
| 2021265 | HC URINARY BLADDER RETENTION | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2021269 | HC RP LOCLZJ TUM 1 AREA 1 D IMG | Nuclear Medicine - Diagnostic Procedures | $2,206.10 |
| 2021270 | HC RP LOCLZJ TUM 2+AREA 1+D IMG | Nuclear Medicine - Diagnostic Procedures | $3,022.37 |
| 2021271 | HC RP LOCLZJ TUM/DSTRBJ AGT WHBDY 1 D IMG | Nuclear Medicine - Diagnostic Procedures | $3,938.03 |
| 2021273 | HC RP LOCLZJ TUM SPECT 1 AREA | Nuclear Medicine - Diagnostic Procedures | $4,623.27 |
| 2021274 | HC RP LOCLZJ TUM/DSTRBJ AGT WHBDY REQ 2/> D IMG | Nuclear Medicine - Diagnostic Procedures | $6,949.23 |
| 2022966 | HC BRAIN VASCULAR FLOW ONLY | Nuclear Medicine - Diagnostic Procedures | $1,418.81 |
| 2023109 | HC HEPATOBILIARY SYSTEM IMAGING | Nuclear Medicine - Diagnostic Procedures | $4,679.72 |
| 2023110 | HC HEPATOBIL SYST IMAGE W/DRUG | Nuclear Medicine - Diagnostic Procedures | $11,170.95 |
| 2023113 | HC LUNG VENTILAT&PERFUS IMAGING | Nuclear Medicine - Diagnostic Procedures | $4,128.60 |
| 2023114 | HC LUNG PERFUSION DIFFERENTIAL | Nuclear Medicine - Diagnostic Procedures | $5,398.62 |
| 2023575 | HC LIVER IMAGE; W VASC FLOW | Nuclear Medicine - Diagnostic Procedures | $2,493.91 |
| 2023576 | HC VT VENOGRAM; UNIL | Nuclear Medicine - Diagnostic Procedures | $1,787.71 |
| 2024467 | HC PARATHYRD PLANAR W/WO SUBTRJ | Nuclear Medicine - Diagnostic Procedures | $3,644.87 |
| 2025340 | HC HEART FIRST PASS SINGLE | Nuclear Medicine - Diagnostic Procedures | $1,407.95 |
| 2026034 | HC PARATHYRD PLANAR W/SPECT&CT | Nuclear Medicine - Diagnostic Procedures | $3,891.20 |
| 2026473 | HC MUGA SGL W RV EF BY 1ST PASS | Nuclear Medicine - Diagnostic Procedures | $1,754.55 |
| 2026622 | HC RP LOCLZJ TUM SPECT W/CT 1 | Nuclear Medicine - Diagnostic Procedures | $4,623.27 |
| 2026623 | HC RP LOCLZJ TUM SPECT 2 AREAS | Nuclear Medicine - Diagnostic Procedures | $5,085.60 |
| 2022358 | HC TC99M SESTAMIBI | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $945.00 |
| 2022359 | HC TC99M MEDRONATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $494.04 |
| 2022361 | HC TL201 THALLIUM PER 1 MCI | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $203.11 |
| 2022365 | HC TC99M PERTECHNETATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $11.35 |
| 2022366 | HC IODINE I-123 SOD IODIDE MIC | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $780.57 |
| 2022369 | HC I131 SERUM ALBUMIN, DX | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $819.00 |
| 2022373 | HC TC99M MEBROFENIN | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $420.21 |
| 2022374 | HC TC99M PYROPHOSPHATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $967.68 |
| 2022375 | HC TC99M PENTETATE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $2,770.99 |
| 2022377 | HC TC99M FILT SULFUR COLLOID | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $11,740.68 |
| 2022386 | HC TC99M MERTIATIDE | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $4,953.31 |
| 2023753 | HC AMYVID FLORBETAPIR F 18 INJ | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $56,485.80 |
| 2026553 | HC TC99M UNFILT SULFUR COLLOID | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $1,153.02 |
| 5020037 | HC TC99M TETROFOSMIN | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $548.10 |
| 5020042 | HC F18 FDG =< 45 MCI | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $1,877.40 |
| 5020046 | HC TECHNETIUM TC-99M AEROSOL | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $3,425.62 |
| 5020053 | HC NEURACEQ RADIOPHARM DX BETA AMYLOID PET | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $35,280.00 |
| 5020058 | HC FLUCICLOVINE F-18 | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $5,351.22 |
| 5020059 | HC GALLIUM GA-68 | Nuclear Medicine - Diagnostic Radiopharmaceuticals | $816.66 |
| 2021279 | HC NUCLEAR RX, ORAL ADMIN | Nuclear Medicine - Therapeutic Procedures | $2,875.95 |
| 2021280 | HC NUCLEAR RX, IV ADMIN | Nuclear Medicine - Therapeutic Procedures | $2,159.19 |
| 2021281 | HC HEMATOPOIETIC NUCLEAR TX | Nuclear Medicine - Therapeutic Procedures | $4,947.60 |
| 2023124 | HC INTRA-ARTERIAL RPHARM RX | Nuclear Medicine - Therapeutic Procedures | $2,875.95 |
| 2023328 | HC HDR RDNCL NTRSTL/ICAV BRCHTX 1 CHAN | Nuclear Medicine - Therapeutic Procedures | $6,382.49 |
| 2023329 | HC HDR RDNCL NTRSTL/ICAV BRCHTX 2-12 CHAN | Nuclear Medicine - Therapeutic Procedures | $7,020.23 |
| 2023620 | HC HDR RDNCL NTRSTL/ICAV BRCHTX 12+ CHAN | Nuclear Medicine - Therapeutic Procedures | $7,659.24 |
| 2022367 | HC I131 IODIDE CAP, RX | Nuclear Medicine - Therapeutic Radiopharmaceuticals | $198.45 |
| 2025134 | HC RADIUM RA223 DICHLORIDE THER PER MICROCURIE | Nuclear Medicine - Therapeutic Radiopharmaceuticals | $1,725.95 |
| 1010022 | HC RB NURSERY/NEWBORN LEVEL I | Nursery - Newborn - Level I | $10,660.50 |
| 1010034 | HC RB NURSERY/NEWBORN LEVEL II | Nursery - Newborn - Level II | $11,311.97 |
| 1010024 | HC RB NURSERY/NEWBORN LEVEL IV | Nursery - Newborn - Level IV | $13,500.00 |
| 2020292 | HC OT APPLICATION OF LONG ARM CAST GO | Occupational Therapy | $297.05 |
| 2022236 | HC OT HOT OR COLD PACKS THERAPY GO | Occupational Therapy | $77.28 |
| 2022242 | HC OT PARAFFIN BATH THERAPY GO | Occupational Therapy | $102.64 |
| 2022255 | HC OT ULTRASOUND THERAPY GO | Occupational Therapy | $140.07 |
| 2022257 | HC OT THERAPEUTIC EXERCISES GO | Occupational Therapy | $397.27 |
| 2022260 | HC THERAPEUTIC EXERCISES | Occupational Therapy | $397.27 |
| 2022262 | HC OT NEUROMUSCULAR REEDUCATION GO | Occupational Therapy | $431.08 |
| 2022264 | HC OT AQUATIC THERAPY/EXERCISES GO | Occupational Therapy | $379.16 |
| 2022271 | HC OT MASSAGE THERAPY EA 15 MINS - GO | Occupational Therapy | $272.90 |
| 2022277 | HC OT MANUAL THERAPY EA 15 MINS - GO | Occupational Therapy | $365.87 |
| 2022278 | HC OT GROUP THERAPEUTIC PROCEDURES GO | Occupational Therapy | $216.14 |
| 2022281 | HC OT THERAPEUTIC ACTIVITIES GO EA 15 MINS | Occupational Therapy | $363.46 |
| 2022291 | HC OT SENSORY INTEGRATION GO EA 15 MINS | Occupational Therapy | $385.19 |
| 2022293 | HC OT SELF CARE MNGMENT TRAINING GO EA 15 MINS | Occupational Therapy | $420.21 |
| 2022296 | HC OT COMMUNITY/WORK REINTEGRATION GO EA 15 MINS | Occupational Therapy | $324.82 |
| 2022299 | HC OT WHEELCHAIR MNGMENT TRAINING GO EA 15 MINS | Occupational Therapy | $276.52 |
| 2022300 | HC WORK HARDENING | Occupational Therapy | $1,100.03 |
| 2022311 | HC OT INI ORTH MGMT/TRAINING GO | Occupational Therapy | $458.85 |
| 2022318 | HC OT C/O FOR ORTHOTIC/PROSTH USE 15 MIN GO | Occupational Therapy | $310.33 |
| 2022421 | HC OT ELEC STIM OTHER THAN WOUND GO | Occupational Therapy | $188.37 |
| 2022913 | HC CANALITH REPOSITIONING PROC GO | Occupational Therapy | $350.18 |
| 2026250 | HC OT GAIT TRAINING THERAPY EA 15 MINS GO | Occupational Therapy | $345.35 |
| 2026592 | HC OT THER IVNTJ COG FUNC 1ST 15 MIN GO | Occupational Therapy | $243.19 |
| 2026593 | HC OT THER IVNTJ COG FUNC EA ADDL 15 MIN GO | Occupational Therapy | $60.80 |
| 2026633 | HC OT OTA WHEELCHAIR MNGMENT TRAINING EA 15 MINS GOCO | Occupational Therapy | $276.52 |
| 2026635 | HC OT OTA THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN GOCO | Occupational Therapy | $363.46 |
| 2026637 | HC OT OTA ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS GOCO | Occupational Therapy | $458.85 |
| 2026643 | HC OT OTA SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES GOCO | Occupational Therapy | $420.21 |
| 2026645 | HC OT OTA NEUROMUSCULAR REEDUCATION EA 15 MINS GOCO | Occupational Therapy | $431.08 |
| 2026647 | HC OT OTA THERAPEUTIC EXERCISES EA 15 MINS GOCO | Occupational Therapy | $397.27 |
| 2026650 | HC OT OTA COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN GOCO | Occupational Therapy | $324.82 |
| 2026653 | HC OT OTA MANUAL THERAPY EA 15 MINS GOCO | Occupational Therapy | $365.87 |
| 2026659 | HC OT OTA MASSAGE THERAPY EA 15 MINS GOCO | Occupational Therapy | $272.90 |
| 2026948 | HC OT HCPRO PHONE CALL 5-10MIN GO | Occupational Therapy | $19.29 |
| 2026951 | HC OT HCPRO PHONE CALL 11-20MIN GO | Occupational Therapy | $38.09 |
| 2026954 | HC OT HCPRO PHONE CALL 21-30MIN GO | Occupational Therapy | $55.00 |
| 2026960 | HC OTA THER IVNTJ COG FUNC 1ST 15 MIN GO CO | Occupational Therapy | $243.19 |
| 2026961 | HC OTA THER IVNTJ COG FUNC EA ADDL 15 MIN GO CO | Occupational Therapy | $60.80 |
| 2022235 | HC OT RE-EVAL EST PLAN CARE GO | Occupational Therapy - Evaluation or Reevaluation | $559.07 |
| 2025788 | HC OT EVAL MOD COMPLEX GO | Occupational Therapy - Evaluation or Reevaluation | $1,351.37 |
| 2025789 | HC OT EVAL HIGH COMPLEX GO | Occupational Therapy - Evaluation or Reevaluation | $1,801.59 |
| 2025793 | HC OT EVAL LOW COMPLEX GO | Occupational Therapy - Evaluation or Reevaluation | $900.80 |
| 2022248 | HC OT ELECTRICAL STIMULATION GO | Occupational Therapy - Visit Charge | $144.90 |
| 2026571 | HC HH SERV OF OT EA 15 MIN | Occupational Therapy - Visit Charge | $420.00 |
| 2026412 | HC REPLACE AORTIC VALVE PERQ | Operating Room Services | $33,900.00 |
| 2026413 | HC REPLACE AORTIC VALVE OPEN | Operating Room Services | $35,595.00 |
| 2026414 | HC REPLACE AORTIC VALVE OPEN AXILLARY | Operating Room Services | $37,375.00 |
| 2026416 | HC REPLACE AORTIC VALVE OPEN TRANS | Operating Room Services | $41,206.00 |
| 2026417 | HC TRCATH REPLACE AORTIC VALVE | Operating Room Services | $43,266.00 |
| 2026421 | HC TRANSCATH TMVR/REPLACE (OTHER CARDIAC SURG PROC) | Operating Room Services | $13,725.00 |
| 2026422 | HC TMVI TRANSTHORACIC EXPOSURE | Operating Room Services | $42,342.00 |
| 2010026 | HC S/P ABLATION | Operating Room Services - Minor Surgery | $11,461.59 |
| 2010027 | HC S/P ANGIOPLASTY | Operating Room Services - Minor Surgery | $9,353.30 |
| 2010028 | HC S/P ASPIRATION | Operating Room Services - Minor Surgery | $6,874.30 |
| 2010030 | HC S/P BILARY PROCEDURE | Operating Room Services - Minor Surgery | $7,915.16 |
| 2010031 | HC S/P BIOPSY | Operating Room Services - Minor Surgery | $8,567.82 |
| 2010032 | HC S/P CATH DECLOTTING PROC | Operating Room Services - Minor Surgery | $3,465.53 |
| 2010033 | HC S/P CATHETER REPOSITIONING | Operating Room Services - Minor Surgery | $1,107.06 |
| 2010034 | HC S/P DESTRUCT BY NEUROLYT AGENT | Operating Room Services - Minor Surgery | $1,817.45 |
| 2010035 | HC S/P DRAINAGE | Operating Room Services - Minor Surgery | $8,051.75 |
| 2010036 | HC S/P EMBOLIZATION | Operating Room Services - Minor Surgery | $30,889.06 |
| 2010037 | HC S/P INJECTION PROCEDURE | Operating Room Services - Minor Surgery | $6,685.93 |
| 2010038 | HC S/P INTRO TO NEEDLE | Operating Room Services - Minor Surgery | $7,541.47 |
| 2010039 | HC S/P KYPHOPLASTY | Operating Room Services - Minor Surgery | $26,379.05 |
| 2010040 | HC S/P OTHER PROCEDURE | Operating Room Services - Minor Surgery | $3,932.83 |
| 2010041 | HC S/P PERIPHERAL ANGIOPLASTY | Operating Room Services - Minor Surgery | $7,790.64 |
| 2010042 | HC S/P SELECTIVE CATH PLACEMENT | Operating Room Services - Minor Surgery | $20,572.18 |
| 2010044 | HC S/P STENT PROCEDURE | Operating Room Services - Minor Surgery | $6,632.80 |
| 2010045 | HC S/P THROMBECTOMY | Operating Room Services - Minor Surgery | $5,563.43 |
| 2010046 | HC S/P TIPS | Operating Room Services - Minor Surgery | $12,320.12 |
| 2010047 | HC S/P TRANSCATH THERAPY/PROC | Operating Room Services - Minor Surgery | $15,686.63 |
| 2010048 | HC S/P TUBE OR CATH PLACEMENT | Operating Room Services - Minor Surgery | $10,337.41 |
| 2010057 | HC S/P PERQ ART M-THROMBECT &/NFS | Operating Room Services - Minor Surgery | $6,425.41 |
| 2020002 | HC FNA BX W/O IMG GDN 1ST LES | Operating Room Services - Minor Surgery | $3,934.04 |
| 2020006 | HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | Operating Room Services - Minor Surgery | $1,226.39 |
| 2020007 | HC INCISION&DRAINAGE ABSCESS COMPLICATED/MULTIPLE | Operating Room Services - Minor Surgery | $2,133.92 |
| 2020008 | HC DRAINAGE OF HEMATOMA/FLUID | Operating Room Services - Minor Surgery | $2,755.52 |
| 2020010 | HC PUNCTURE DRAINAGE OF LESION | Operating Room Services - Minor Surgery | $2,472.36 |
| 2020011 | HC PUNCTURE DRAINAGE OF LESION | Operating Room Services - Minor Surgery | $2,472.36 |
| 2020012 | HC DEBRIDE INFECTED SKIN | Operating Room Services - Minor Surgery | $1,416.00 |
| 2020016 | HC DEBRIDE SKIN/TISSUE | Operating Room Services - Minor Surgery | $7,482.88 |
| 2020017 | HC DEBRIDE TISSUE/MUSCLE | Operating Room Services - Minor Surgery | $19,187.18 |
| 2020019 | HC DEBRIDE TISSUE/MUSCLE/BONE | Operating Room Services - Minor Surgery | $28,588.77 |
| 2020020 | HC TRIM SKIN LESION | Operating Room Services - Minor Surgery | $1,543.25 |
| 2020021 | HC TRIM SKIN LESIONS, 2 TO 4 | Operating Room Services - Minor Surgery | $2,175.73 |
| 2020022 | HC TRIM SKIN LESIONS, OVER 4 | Operating Room Services - Minor Surgery | $2,839.58 |
| 2020025 | HC REMOVAL OF SKIN TAGS | Operating Room Services - Minor Surgery | $603.75 |
| 2020029 | HC SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/< | Operating Room Services - Minor Surgery | $389.00 |
| 2020030 | HC SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM | Operating Room Services - Minor Surgery | $413.47 |
| 2020033 | HC EXC TR-EXT B9+MARG 0.5 < CM | Operating Room Services - Minor Surgery | $2,088.00 |
| 2020034 | HC EXC TR-EXT B9+MARG 0.6-1 CM | Operating Room Services - Minor Surgery | $3,401.53 |
| 2020035 | HC EXC TR-EXT B9+MARG 1.1-2 CM | Operating Room Services - Minor Surgery | $3,738.42 |
| 2020036 | HC EXC TR-EXT B9+MARG 2.1-3 CM | Operating Room Services - Minor Surgery | $4,822.76 |
| 2020037 | HC EXC TR-EXT B9+MARG 3.1-4 CM | Operating Room Services - Minor Surgery | $5,308.17 |
| 2020038 | HC EXC TR-EXT B9+MARG > 4.0 CM | Operating Room Services - Minor Surgery | $8,074.55 |
| 2020039 | HC EXC H-F-NK-SP B9+MARG 0.5 < | Operating Room Services - Minor Surgery | $3,499.34 |
| 2020040 | HC EXC H-F-NK-SP B9+MARG 0.6-1 | Operating Room Services - Minor Surgery | $4,086.18 |
| 2020042 | HC EXC H-F-NK-SP B9+MARG 2.1-3 | Operating Room Services - Minor Surgery | $5,802.37 |
| 2020044 | HC EXC H-F-NK-SP B9+MARG > 4 CM | Operating Room Services - Minor Surgery | $10,092.86 |
| 2020045 | HC EXC FACE-MM B9+MARG 0.5 < CM | Operating Room Services - Minor Surgery | $2,718.08 |
| 2020046 | HC EXC FACE-MM B9+MARG 0.6-1 CM | Operating Room Services - Minor Surgery | $2,904.04 |
| 2020047 | HC EXC FACE-MM B9+MARG 1.1-2 CM | Operating Room Services - Minor Surgery | $3,217.99 |
| 2020051 | HC EXC TR-EXT MLG+MARG 0.5 < CM | Operating Room Services - Minor Surgery | $4,307.15 |
| 2020052 | HC EXC TR-EXT MLG+MARG 0.6-1 CM | Operating Room Services - Minor Surgery | $5,368.55 |
| 2020053 | HC EXC TR-EXT MLG+MARG 1.1-2 CM | Operating Room Services - Minor Surgery | $5,899.85 |
| 2020056 | HC EXC H-F-NK-SP MLG+MARG 1.1-2 | Operating Room Services - Minor Surgery | $1,403.12 |
| 2020059 | HC EXC FACE-MM MALIG+MARG 1.1-2 | Operating Room Services - Minor Surgery | $2,083.37 |
| 2020061 | HC TRIM NAIL(S) | Operating Room Services - Minor Surgery | $208.90 |
| 2020062 | HC DEBRIDE NAIL, 1-5 | Operating Room Services - Minor Surgery | $2,878.05 |
| 2020063 | HC DEBRIDE NAIL, 6 OR MORE | Operating Room Services - Minor Surgery | $1,040.14 |
| 2020064 | HC REMOVAL OF NAIL PLATE | Operating Room Services - Minor Surgery | $1,477.98 |
| 2020066 | HC DRAIN BLOOD FROM UNDER NAIL | Operating Room Services - Minor Surgery | $265.65 |
| 2020067 | HC REMOVAL OF NAIL BED | Operating Room Services - Minor Surgery | $1,404.32 |
| 2020068 | HC BIOPSY, NAIL UNIT | Operating Room Services - Minor Surgery | $1,912.68 |
| 2020069 | HC EXCISION OF NAIL FOLD, TOE | Operating Room Services - Minor Surgery | $757.10 |
| 2020070 | HC INJECTION INTO SKIN LESIONS | Operating Room Services - Minor Surgery | $2,721.32 |
| 2020071 | HC ADDED SKIN LESIONS INJECTION | Operating Room Services - Minor Surgery | $3,991.27 |
| 2020074 | HC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< | Operating Room Services - Minor Surgery | $1,496.09 |
| 2020075 | HC SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM | Operating Room Services - Minor Surgery | $1,989.96 |
| 2020076 | HC SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM | Operating Room Services - Minor Surgery | $2,483.83 |
| 2020077 | HC SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< | Operating Room Services - Minor Surgery | $784.88 |
| 2020078 | HC SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM | Operating Room Services - Minor Surgery | $887.51 |
| 2020079 | HC CLOSURE OF SPLIT WOUND | Operating Room Services - Minor Surgery | $697.94 |
| 2020080 | HC INTMD WND REPAIR S/TR/EXT | Operating Room Services - Minor Surgery | $2,681.86 |
| 2020081 | HC INTMD WND REPAIR S/TR/EXT | Operating Room Services - Minor Surgery | $3,406.36 |
| 2020082 | HC INTMD WND REPAIR S/TR/EXT | Operating Room Services - Minor Surgery | $3,620.09 |
| 2020083 | HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/< | Operating Room Services - Minor Surgery | $1,800.00 |
| 2020084 | HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM | Operating Room Services - Minor Surgery | $2,400.00 |
| 2020085 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.5 CM/< | Operating Room Services - Minor Surgery | $2,450.02 |
| 2020086 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.6-5.0 CM | Operating Room Services - Minor Surgery | $2,916.11 |
| 2020087 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 5.1-7.5 CM | Operating Room Services - Minor Surgery | $3,111.73 |
| 2020088 | HC REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 12.6-20.0CM | Operating Room Services - Minor Surgery | $4,311.98 |
| 2020089 | HC REPAIR COMPLEX TRUNK 1.1 CM-2.5 CM | Operating Room Services - Minor Surgery | $2,011.66 |
| 2020090 | HC REPAIR COMPLEX TRUNK 2.6 CM-7.5 CM | Operating Room Services - Minor Surgery | $2,082.94 |
| 2020091 | HC REPAIR WOUND/LESION ADD-ON | Operating Room Services - Minor Surgery | $2,194.03 |
| 2020092 | HC REPAIR COMPLEX SCALP/ARM/LEG 1.1 CM-2.5 CM | Operating Room Services - Minor Surgery | $2,925.77 |
| 2020093 | HC REPAIR COMPLEX SCALP/ARM/LEG 2.6 CM-7.5 CM | Operating Room Services - Minor Surgery | $3,288.02 |
| 2020094 | HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1 CM-2.5 CM | Operating Room Services - Minor Surgery | $3,059.81 |
| 2020095 | HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 CM-7.5 CM | Operating Room Services - Minor Surgery | $3,824.15 |
| 2020097 | HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM | Operating Room Services - Minor Surgery | $2,341.34 |
| 2020100 | HC ATT/REARRANGEMENT SCALP/ARM/LEG 10 CM/< | Operating Room Services - Minor Surgery | $4,710.46 |
| 2020102 | HC ATT/REARRANGEMENT F/C/C/M/N/AX/G/H/F 10 CM/< | Operating Room Services - Minor Surgery | $5,221.23 |
| 2020103 | HC ATT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0CM | Operating Room Services - Minor Surgery | $6,422.12 |
| 2020104 | HC ATT/REARGMT E/N/E/L DFCT 10 CM/< | Operating Room Services - Minor Surgery | $5,548.46 |
| 2020105 | HC ATT/REARGMT EYELID/NOSE/EAR/LIP 10.1-30.0 CM | Operating Room Services - Minor Surgery | $6,824.61 |
| 2020106 | HC WOUND PREP, TRK/ARM/LEG | Operating Room Services - Minor Surgery | $4,874.68 |
| 2020123 | HC DESTRUCT PREMALG LESION | Operating Room Services - Minor Surgery | $1,402.95 |
| 2020124 | HC DESTRUCT PREMALG LES, 2-14 | Operating Room Services - Minor Surgery | $140.42 |
| 2020125 | HC DESTROY PREMLG LESIONS 15+ | Operating Room Services - Minor Surgery | $3,675.12 |
| 2020128 | HC DESTRUCT B9 LESION, 1-14 | Operating Room Services - Minor Surgery | $3,045.32 |
| 2020129 | HC DESTRUCT LESION, 15 OR MORE | Operating Room Services - Minor Surgery | $1,186.97 |
| 2020130 | HC CHEMICAL CAUTERY, TISSUE | Operating Room Services - Minor Surgery | $1,292.05 |
| 2020131 | HC DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/< | Operating Room Services - Minor Surgery | $2,325.24 |
| 2020133 | HC DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM | Operating Room Services - Minor Surgery | $2,953.00 |
| 2020134 | HC DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM | Operating Room Services - Minor Surgery | $3,248.30 |
| 2020135 | HC DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM | Operating Room Services - Minor Surgery | $3,484.54 |
| 2020137 | HC DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/< | Operating Room Services - Minor Surgery | $2,325.24 |
| 2020151 | HC NEEDLE BIOPSY, MUSCLE | Operating Room Services - Minor Surgery | $5,041.31 |
| 2020152 | HC BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL | Operating Room Services - Minor Surgery | $8,822.00 |
| 2020153 | HC BIOPSY BONE TROCAR/NEEDLE DEEP | Operating Room Services - Minor Surgery | $7,986.41 |
| 2020154 | HC THER INJECTION, CARP TUNNEL BI | Operating Room Services - Minor Surgery | $1,563.71 |
| 2020155 | HC INJ TENDON SHEATH/LIGAMENT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2020156 | HC INJ TENDON SHEATH/LIGAMENT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2020157 | HC INJ TRIGGER POINT, 1/2 MUSCL | Operating Room Services - Minor Surgery | $3,500.61 |
| 2020158 | HC INJ TRIGGER POINT, 1/2 MUSCL | Operating Room Services - Minor Surgery | $3,500.61 |
| 2020159 | HC INJECT TRIGGER POINTS, =/> 3 | Operating Room Services - Minor Surgery | $3,990.69 |
| 2020161 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,918.53 |
| 2020162 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020163 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020164 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020166 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020167 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $4,919.15 |
| 2020169 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020170 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020171 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020174 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020175 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020176 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $5,158.33 |
| 2020177 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020178 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020179 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020180 | HC DRAIN/INJ JOINT/BURSA W/O US | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020181 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA RT | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020182 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA LT | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020183 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA BI | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020184 | HC ARTHROCENTESIS ASPIR&/INJECTION MAJOR JT/BURSA | Operating Room Services - Minor Surgery | $6,402.30 |
| 2020185 | HC ASPIRATE/INJ GANGLION CYST | Operating Room Services - Minor Surgery | $685.00 |
| 2020186 | HC ASPIRATE/INJ GANGLION CYST | Operating Room Services - Minor Surgery | $388.82 |
| 2020189 | HC ABLATE, BONE TUMOR(S) PERQ | Operating Room Services - Minor Surgery | $6,420.28 |
| 2020196 | HC INJECTION FOR SHOULDER X-RAY | Operating Room Services - Minor Surgery | $6,388.88 |
| 2020205 | HC TREAT SHOULDER DISLOCATION | Operating Room Services - Minor Surgery | $6,281.42 |
| 2020206 | HC TREAT SHOULDER DISLOCATION RT | Operating Room Services - Minor Surgery | $6,281.42 |
| 2020207 | HC TREAT SHOULDER DISLOCATION LT | Operating Room Services - Minor Surgery | $6,281.42 |
| 2020208 | HC INJECTION FOR ELBOW X-RAY | Operating Room Services - Minor Surgery | $1,299.27 |
| 2020212 | HC CL TX "NURSEMAID ELBOW" W MANIP | Operating Room Services - Minor Surgery | $751.07 |
| 2020216 | HC INJECTION FOR WRIST X-RAY RT | Operating Room Services - Minor Surgery | $1,615.64 |
| 2020217 | HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ RT | Operating Room Services - Minor Surgery | $2,931.81 |
| 2020218 | HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MNPJ LT | Operating Room Services - Minor Surgery | $2,931.81 |
| 2020219 | HC CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ RT | Operating Room Services - Minor Surgery | $4,258.85 |
| 2020220 | HC CLTX DSTL RDL FX/EPIPHYSL SEP +-W/MNPJ LT | Operating Room Services - Minor Surgery | $4,258.85 |
| 2020221 | HC CLTX MTCRPL FX 1 W/O MNPJ EA B1 | Operating Room Services - Minor Surgery | $2,319.61 |
| 2020222 | HC CLTX MTCRPL FX 1 W/MNPJ EA B1 | Operating Room Services - Minor Surgery | $2,319.61 |
| 2020259 | HC INJECTION FOR HIP X-RAY | Operating Room Services - Minor Surgery | $2,094.30 |
| 2020264 | HC NJX CNTRST KNE ARTHG/CT/MRI | Operating Room Services - Minor Surgery | $3,494.51 |
| 2020265 | HC TREAT KNEECAP FRACTURE LT | Operating Room Services - Minor Surgery | $2,466.92 |
| 2020269 | HC INCISION OF ACHILLES TENDON BI | Operating Room Services - Minor Surgery | $7,243.79 |
| 2020271 | HC INCISION OF ACHILLES TENDON LT | Operating Room Services - Minor Surgery | $7,243.79 |
| 2020273 | HC CLTX TIBL SHFT FX W/O MNPJ RT | Operating Room Services - Minor Surgery | $2,648.05 |
| 2020280 | HC CLTX DSTL FIBULAR FX LAT MALLS W/MNPJ LT | Operating Room Services - Minor Surgery | $3,033.24 |
| 2020281 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ RT | Operating Room Services - Minor Surgery | $2,517.64 |
| 2020282 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ LT | Operating Room Services - Minor Surgery | $2,517.64 |
| 2020283 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ LT | Operating Room Services - Minor Surgery | $3,531.94 |
| 2020284 | HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ RT | Operating Room Services - Minor Surgery | $3,531.94 |
| 2020285 | HC REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS | Operating Room Services - Minor Surgery | $3,359.27 |
| 2020286 | HC REMOVAL FOREIGN BODY FOOT DEEP | Operating Room Services - Minor Surgery | $5,418.05 |
| 2020287 | HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION | Operating Room Services - Minor Surgery | $1,903.39 |
| 2020294 | HC APPLICATION OF LONG ARM CAST LT | Operating Room Services - Minor Surgery | $297.05 |
| 2020295 | HC APPLICATION OF LONG ARM CAST RT | Operating Room Services - Minor Surgery | $297.05 |
| 2020299 | HC APPLICATION OF FOREARM CAST LT | Operating Room Services - Minor Surgery | $357.54 |
| 2020300 | HC APPLICATION OF FOREARM CAST RT | Operating Room Services - Minor Surgery | $357.54 |
| 2020303 | HC APPLY LONG ARM SPLINT RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020304 | HC APPLY LONG ARM SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020307 | HC APPLY FOREARM SPLINT BI | Operating Room Services - Minor Surgery | $340.52 |
| 2020308 | HC APPLY FOREARM SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020309 | HC APPLY FOREARM SPLINT RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020312 | HC APPLICATION FINGER SPLINT STATIC | Operating Room Services - Minor Surgery | $340.52 |
| 2020313 | HC APPLICATION FINGER SPLINT STATIC F2 | Operating Room Services - Minor Surgery | $340.52 |
| 2020314 | HC APPLICATION FINGER SPLINT STATIC F3 | Operating Room Services - Minor Surgery | $340.52 |
| 2020315 | HC APPLICATION FINGER SPLINT STATIC F4 | Operating Room Services - Minor Surgery | $340.52 |
| 2020316 | HC APPLICATION FINGER SPLINT STATIC FA | Operating Room Services - Minor Surgery | $340.52 |
| 2020317 | HC APPLICATION FINGER SPLINT STATIC F6 | Operating Room Services - Minor Surgery | $340.52 |
| 2020318 | HC APPLICATION FINGER SPLINT STATIC F7 | Operating Room Services - Minor Surgery | $340.52 |
| 2020320 | HC APPLICATION FINGER SPLINT STATIC F9 | Operating Room Services - Minor Surgery | $340.52 |
| 2020321 | HC APPLICATION FINGER SPLINT STATIC F5 | Operating Room Services - Minor Surgery | $340.52 |
| 2020324 | HC APPLICATION FINGER SPLINT DYNAMIC F1 | Operating Room Services - Minor Surgery | $398.48 |
| 2020325 | HC APPLICATION FINGER SPLINT DYNAMIC F2 | Operating Room Services - Minor Surgery | $398.48 |
| 2020326 | HC APPLICATION FINGER SPLINT DYNAMIC F3 | Operating Room Services - Minor Surgery | $398.48 |
| 2020328 | HC APPLICATION FINGER SPLINT DYNAMIC F7 | Operating Room Services - Minor Surgery | $398.48 |
| 2020329 | HC APPLICATION FINGER SPLINT DYNAMIC F9 | Operating Room Services - Minor Surgery | $398.48 |
| 2020332 | HC STRAPPING OF SHOULDER | Operating Room Services - Minor Surgery | $340.52 |
| 2020336 | HC STRAPPING OF HAND OR FINGER F1 | Operating Room Services - Minor Surgery | $340.52 |
| 2020346 | HC APPLICATION OF LONG LEG CAST BI | Operating Room Services - Minor Surgery | $821.10 |
| 2020347 | HC APPLICATION OF LONG LEG CAST LT | Operating Room Services - Minor Surgery | $821.10 |
| 2020348 | HC APPLICATION OF LONG LEG CAST RT | Operating Room Services - Minor Surgery | $821.10 |
| 2020350 | HC APPLICATION OF LONG LEG CAST LT | Operating Room Services - Minor Surgery | $870.61 |
| 2020351 | HC APPLICATION OF LONG LEG CAST RT | Operating Room Services - Minor Surgery | $870.61 |
| 2020354 | HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE BI | Operating Room Services - Minor Surgery | $598.92 |
| 2020355 | HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE LT | Operating Room Services - Minor Surgery | $598.92 |
| 2020356 | HC APPLICATION SHORT LEG CAST BELOW KNEE-TOE RT | Operating Room Services - Minor Surgery | $598.92 |
| 2020359 | HC APPLICATION SHORT LEG CAST WALKING/AMBULATORY LT | Operating Room Services - Minor Surgery | $565.11 |
| 2020360 | HC APPLICATION SHORT LEG CAST WALKING/AMBULATORY RT | Operating Room Services - Minor Surgery | $565.11 |
| 2020364 | HC APPLY RIGID LEG CAST RT | Operating Room Services - Minor Surgery | $716.10 |
| 2020365 | HC APPLY RIGID LEG CAST LT | Operating Room Services - Minor Surgery | $716.10 |
| 2020366 | HC APPLICATION OF LEG CAST BI | Operating Room Services - Minor Surgery | $565.11 |
| 2020367 | HC APPLICATION OF LEG CAST RT | Operating Room Services - Minor Surgery | $565.11 |
| 2020368 | HC APPLICATION OF LEG CAST LT | Operating Room Services - Minor Surgery | $565.11 |
| 2020369 | HC APPLICATION, LONG LEG SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020374 | HC APPLICATION LOWER LEG SPLINT RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020375 | HC APPLICATION LOWER LEG SPLINT LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020378 | HC STRAPPING OF KNEE | Operating Room Services - Minor Surgery | $340.52 |
| 2020379 | HC STRAPPING OF ANKLE AND/OR FT | Operating Room Services - Minor Surgery | $340.52 |
| 2020380 | HC STRAPPING OF TOES | Operating Room Services - Minor Surgery | $227.01 |
| 2020381 | HC APPLICATION OF PASTE BOOT BI | Operating Room Services - Minor Surgery | $800.78 |
| 2020382 | HC APPLICATION OF PASTE BOOT RT | Operating Room Services - Minor Surgery | $800.78 |
| 2020383 | HC APPLICATION OF PASTE BOOT LT | Operating Room Services - Minor Surgery | $800.78 |
| 2020384 | HC APPLICATION OF PASTE BOOT | Operating Room Services - Minor Surgery | $800.78 |
| 2020386 | HC REMOVAL/REVISION OF CAST BI | Operating Room Services - Minor Surgery | $340.52 |
| 2020387 | HC REMOVAL/REVISION OF CAST RT | Operating Room Services - Minor Surgery | $340.52 |
| 2020388 | HC REMOVAL/REVISION OF CAST LT | Operating Room Services - Minor Surgery | $340.52 |
| 2020391 | HC INSERT EMERGENCY AIRWAY | Operating Room Services - Minor Surgery | $1,096.41 |
| 2020392 | HC LARYNGOSCOPY FLEXIBLE DIAGNOSTIC | Operating Room Services - Minor Surgery | $8,186.85 |
| 2020395 | HC IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ | Operating Room Services - Minor Surgery | $4,349.42 |
| 2020396 | HC BIOPSY, LUNG OR MEDIASTINUM | Operating Room Services - Minor Surgery | $1,497.09 |
| 2020448 | HC ESTABLISH ACCESS TO ARTERY | Operating Room Services - Minor Surgery | $3,110.00 |
| 2020451 | HC PLACE CATHETER IN AORTA | Operating Room Services - Minor Surgery | $6,345.00 |
| 2020460 | HC PLACE CATHETER IN ARTERY LT | Operating Room Services - Minor Surgery | $6,220.00 |
| 2020463 | HC PLACE CATHETER IN ARTERY RT | Operating Room Services - Minor Surgery | $9,414.02 |
| 2020465 | HC SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH | Operating Room Services - Minor Surgery | $11,202.12 |
| 2020469 | HC NON-ROUTINE BL DRAW > 3 YRS | Operating Room Services - Minor Surgery | $76.07 |
| 2020476 | HC APHERESIS WBC | Operating Room Services - Minor Surgery | $7,044.00 |
| 2020477 | HC APHERESIS RBC | Operating Room Services - Minor Surgery | $7,044.00 |
| 2020479 | HC APHERESIS PLASMA | Operating Room Services - Minor Surgery | $7,044.00 |
| 2020480 | HC APHERESIS, SELECTIVE | Operating Room Services - Minor Surgery | $14,274.00 |
| 2020481 | HC PHOTOPHERESIS | Operating Room Services - Minor Surgery | $10,871.12 |
| 2020483 | HC INSJ NON-TUN CTR CVC AGE 5 YR/> | Operating Room Services - Minor Surgery | $3,284.35 |
| 2020486 | HC INSJ TUN CTR CTR VAD W/SUBQ PORT AGE 5 YR/> | Operating Room Services - Minor Surgery | $3,366.51 |
| 2020487 | HC INSJ PICC 5 YR+ W/O IMAGING | Operating Room Services - Minor Surgery | $7,000.00 |
| 2020489 | HC REPLACE CVAD CATH | Operating Room Services - Minor Surgery | $1,229.97 |
| 2020491 | HC COMPL RPLCMT PICC RS&I | Operating Room Services - Minor Surgery | $6,343.00 |
| 2020492 | HC RMVL TUN CVC W/O SUBQ PORT/PMP | Operating Room Services - Minor Surgery | $1,142.30 |
| 2020493 | HC RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ | Operating Room Services - Minor Surgery | $2,078.98 |
| 2020495 | HC DECLOT VASCULAR DEVICE | Operating Room Services - Minor Surgery | $1,362.00 |
| 2020500 | HC TRANSCATHETER RETRIEVAL | Operating Room Services - Minor Surgery | $4,587.34 |
| 2020509 | HC INTRVASC US NONCORONARY 1ST | Operating Room Services - Minor Surgery | $7,628.99 |
| 2020513 | HC DIAG BONE ASPIRATION | Operating Room Services - Minor Surgery | $6,360.61 |
| 2020514 | HC DIAG BONE BIOPSY | Operating Room Services - Minor Surgery | $6,241.45 |
| 2020516 | HC NEEDLE BIOPSY, LYMPH NODES | Operating Room Services - Minor Surgery | $1,497.09 |
| 2020518 | HC IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ | Operating Room Services - Minor Surgery | $4,210.55 |
| 2020520 | HC NEEDLE BIOPSY OF LIVER | Operating Room Services - Minor Surgery | $1,497.09 |
| 2020532 | HC BIOPSY, ABDOMINAL MASS | Operating Room Services - Minor Surgery | $3,789.14 |
| 2020534 | HC PLACE GASTROSTOMY TUBE PERC | Operating Room Services - Minor Surgery | $3,925.95 |
| 2020536 | HC BIOPSY OF KIDNEY | Operating Room Services - Minor Surgery | $7,856.00 |
| 2020538 | HC INJECTION FOR BLADDER X-RAY | Operating Room Services - Minor Surgery | $4,994.22 |
| 2020539 | HC INSERT TEMP BLADDER CATH | Operating Room Services - Minor Surgery | $679.82 |
| 2020545 | HC BIOPSY OF VULVA/PERINEUM | Operating Room Services - Minor Surgery | $5,094.44 |
| 2020547 | HC BIOPSY OF VAGINA | Operating Room Services - Minor Surgery | $4,491.90 |
| 2020548 | HC EXAM OF CERVIX W/SCOPE | Operating Room Services - Minor Surgery | $2,203.69 |
| 2020549 | HC BX/CURETT OF CERVIX W/SCOPE | Operating Room Services - Minor Surgery | $3,401.70 |
| 2020550 | HC ENDOCERV CURETTAGE W/SCOPE | Operating Room Services - Minor Surgery | $1,250.97 |
| 2020553 | HC BIOPSY OF UTERUS LINING | Operating Room Services - Minor Surgery | $3,815.79 |
| 2020558 | HC REMOVE CERCLAGE SUTURE | Operating Room Services - Minor Surgery | $7,881.35 |
| 2020559 | HC OMMAYA RESERVOIR W/OUT CHEMO | Operating Room Services - Minor Surgery | $7,874.90 |
| 2020560 | HC SPI PNXR LMBR DX | Operating Room Services - Minor Surgery | $5,987.31 |
| 2020561 | HC SPI PNXR LMBR DX | Operating Room Services - Minor Surgery | $5,987.31 |
| 2020562 | HC THER SPI PNXR DRG CSF | Operating Room Services - Minor Surgery | $3,460.59 |
| 2020563 | HC INJECT EPIDURAL PATCH | Operating Room Services - Minor Surgery | $4,155.01 |
| 2020567 | HC NJX INTERLAMINAR CRV/THRC | Operating Room Services - Minor Surgery | $6,941.65 |
| 2020568 | HC NJX INTERLAMINAR LMBR/SAC W/O IMG GDN | Operating Room Services - Minor Surgery | $6,630.66 |
| 2020570 | HC ELEC ALYS PRGRBL PMP W/O REPRGRMG | Operating Room Services - Minor Surgery | $5,656.81 |
| 2020571 | HC ELEC ALYS PRGRBL PMP REPRGRMG | Operating Room Services - Minor Surgery | $7,749.05 |
| 2020572 | HC IMPLANT NEUROELECTRODES | Operating Room Services - Minor Surgery | $40,739.36 |
| 2020574 | HC NJX AA&/STRD OTHER PN/BRANCH | Operating Room Services - Minor Surgery | $8,351.07 |
| 2020575 | HC INJ PARAVERTEBRAL C/T | Operating Room Services - Minor Surgery | $11,760.87 |
| 2020576 | HC INJ PARAVERTEBRAL C/T ADD-ON | Operating Room Services - Minor Surgery | $14,112.32 |
| 2020577 | HC INJ PARAVERTEBRAL L/S | Operating Room Services - Minor Surgery | $16,053.59 |
| 2020578 | HC INJ PARAVERTEBRAL L/S ADD-ON | Operating Room Services - Minor Surgery | $9,508.25 |
| 2020579 | HC INJ FORAMEN EPIDURAL C/T | Operating Room Services - Minor Surgery | $15,086.51 |
| 2020580 | HC INJ FORAMEN EPIDURAL ADD-ON | Operating Room Services - Minor Surgery | $2,628.73 |
| 2020581 | HC INJ FORAMEN EPIDURAL L/S | Operating Room Services - Minor Surgery | $4,410.00 |
| 2020582 | HC INJ FORAMEN EPIDURAL ADD-ON | Operating Room Services - Minor Surgery | $5,556.60 |
| 2020583 | HC N BLOCK, STELLATE GANGLION | Operating Room Services - Minor Surgery | $2,187.99 |
| 2020584 | HC CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA | Operating Room Services - Minor Surgery | $915.29 |
| 2020591 | HC INJECTION TREATMENT OF NERVE RT | Operating Room Services - Minor Surgery | $3,155.20 |
| 2020592 | HC LASER SURGERY OF EYE RT | Operating Room Services - Minor Surgery | $5,879.32 |
| 2020593 | HC LASER SURGERY OF EYE LT | Operating Room Services - Minor Surgery | $5,879.32 |
| 2020601 | HC REVISION OF IRIS RT | Operating Room Services - Minor Surgery | $9,937.73 |
| 2020602 | HC REVISION OF IRIS LT | Operating Room Services - Minor Surgery | $9,937.73 |
| 2020607 | HC AFTER CATARACT LASER SURGERY RT | Operating Room Services - Minor Surgery | $3,268.70 |
| 2020608 | HC AFTER CATARACT LASER SURGERY LT | Operating Room Services - Minor Surgery | $3,268.70 |
| 2020617 | HC REPAIR DETACHED RETINA RT | Operating Room Services - Minor Surgery | $5,378.21 |
| 2020618 | HC REPAIR DETACHED RETINA LT | Operating Room Services - Minor Surgery | $5,378.21 |
| 2020620 | HC TREATMENT OF RETINA RT | Operating Room Services - Minor Surgery | $4,164.67 |
| 2020626 | HC EXTENSIVE RETINOPATHY 1+ SESS PHOTOCOAGULATION RT | Operating Room Services - Minor Surgery | $7,921.20 |
| 2020627 | HC EXTENSIVE RETINOPATHY 1+ SESS PHOTOCOAGULATION LT | Operating Room Services - Minor Surgery | $7,921.20 |
| 2022601 | HC SFT TISS BX - NECK/THORAX | Operating Room Services - Minor Surgery | $4,742.00 |
| 2022619 | HC BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL | Operating Room Services - Minor Surgery | $1,662.90 |
| 2022628 | HC BX THYR PRQ CORE NDL | Operating Room Services - Minor Surgery | $1,043.28 |
| 2022690 | HC CL TX RADIAL & ULNA FX | Operating Room Services - Minor Surgery | $3,694.95 |
| 2022693 | HC BRONCOSCOPY THERAPEUTIC | Operating Room Services - Minor Surgery | $1,500.63 |
| 2022695 | HC NON-ROUTINE BL DRAW 3/> YRS | Operating Room Services - Minor Surgery | $76.07 |
| 2022697 | HC FEM/POPL REVAS W/TLA | Operating Room Services - Minor Surgery | $13,138.68 |
| 2022698 | HC FEM/POPL REVAS W/TLA | Operating Room Services - Minor Surgery | $13,771.54 |
| 2022700 | HC FEM/POPL REVAS STN ATHER | Operating Room Services - Minor Surgery | $23,356.67 |
| 2022701 | HC TIB/PER REVASC W/ATHER | Operating Room Services - Minor Surgery | $13,734.11 |
| 2022702 | HC TIB/PER REVASC W/STENT | Operating Room Services - Minor Surgery | $13,734.11 |
| 2022704 | HC TIB/PER REVASC ADD-ON | Operating Room Services - Minor Surgery | $6,642.46 |
| 2022706 | HC REVSC OP/PRQ TIBPERO STN | Operating Room Services - Minor Surgery | $19,924.96 |
| 2022710 | HC EXT CEPHALIC VERSION | Operating Room Services - Minor Surgery | $4,733.40 |
| 2022712 | HC NJX AA&/STRD NTRCOST NRV 1 | Operating Room Services - Minor Surgery | $1,311.35 |
| 2022713 | HC INJ PARAVERT F JNT 3 LVL | Operating Room Services - Minor Surgery | $9,508.25 |
| 2022847 | HC INTRVASC US NONCORONARY ADDL | Operating Room Services - Minor Surgery | $6,422.69 |
| 2022893 | HC DEB SUBQ TISSUE ADD<20CM | Operating Room Services - Minor Surgery | $3,261.46 |
| 2022894 | HC DEB MUSC/FASCIA ADD<20CM | Operating Room Services - Minor Surgery | $6,716.12 |
| 2022898 | HC ADT'L NAIL AVLUSION | Operating Room Services - Minor Surgery | $591.68 |
| 2022902 | HC APP MULT COMP LWR LEG RT | Operating Room Services - Minor Surgery | $353.73 |
| 2022903 | HC APP MULT COMP LWR LEG LT | Operating Room Services - Minor Surgery | $2,859.15 |
| 2022904 | HC APP MULT COMP LWR L BIL | Operating Room Services - Minor Surgery | $2,723.00 |
| 2022905 | HC APP TTL CONTACT CAST RT | Operating Room Services - Minor Surgery | $1,308.30 |
| 2022906 | HC APP TTL CONTACT CAST LT | Operating Room Services - Minor Surgery | $1,308.30 |
| 2022907 | HC APP TTL CONTACT CAST BIL | Operating Room Services - Minor Surgery | $1,964.55 |
| 2022908 | HC REM BOOT OR BODY CAST | Operating Room Services - Minor Surgery | $297.36 |
| 2022915 | HC REPAIR OF NAIL BED | Operating Room Services - Minor Surgery | $2,172.29 |
| 2022943 | HC REMOVE IMPACTED EAR WAX | Operating Room Services - Minor Surgery | $705.18 |
| 2022946 | HC DX NASAL ENDOSCOPY | Operating Room Services - Minor Surgery | $3,042.90 |
| 2022947 | HC NASAL HEMORRH ANT SMP | Operating Room Services - Minor Surgery | $1,238.90 |
| 2022948 | HC REM FB INTRANASAL OFFICE | Operating Room Services - Minor Surgery | $1,081.92 |
| 2022953 | HC NONSEL CATH PLC IN VEIN | Operating Room Services - Minor Surgery | $92.98 |
| 2022954 | HC INSERT BLADDER CATHETER | Operating Room Services - Minor Surgery | $216.14 |
| 2022965 | HC REM FB AUD CANAL WO ANES | Operating Room Services - Minor Surgery | $719.67 |
| 2022968 | HC CHEMODENERVATION | Operating Room Services - Minor Surgery | $1,017.92 |
| 2022969 | HC CONT NAS HEMORRH ANT COM | Operating Room Services - Minor Surgery | $1,721.90 |
| 2022970 | HC NASAL ENDO W BLD CNTRL | Operating Room Services - Minor Surgery | $1,876.46 |
| 2022971 | HC NAS ENDO W BX POLY/DEBRI | Operating Room Services - Minor Surgery | $1,791.38 |
| 2023006 | HC BIOPSY OF CERVIX | Operating Room Services - Minor Surgery | $6,390.09 |
| 2023008 | HC UNLISTD PROC NERVOUS SYS | Operating Room Services - Minor Surgery | $5,192.25 |
| 2023083 | HC INJ PARAVERT F JNT C/T 2 LEV | Operating Room Services - Minor Surgery | $12,936.40 |
| 2023087 | HC SKIN SUB GRAFT TRNK/ARM/LEG | Operating Room Services - Minor Surgery | $6,705.25 |
| 2023088 | HC SKIN SUB GRAFT T/A/L ADD-ON | Operating Room Services - Minor Surgery | $421.00 |
| 2023091 | HC SKIN SUB GRAFT FACE/NK/HF/G | Operating Room Services - Minor Surgery | $4,699.00 |
| 2023092 | HC SKIN SUB GRAFT F/N/HF/G ADDL | Operating Room Services - Minor Surgery | $536.13 |
| 2023100 | HC INS ENDOVAS VENA CAVA FILTR | Operating Room Services - Minor Surgery | $29,799.89 |
| 2023101 | HC ABD PARACENTESIS | Operating Room Services - Minor Surgery | $4,887.96 |
| 2023102 | HC ABD PARACENTESIS W/IMAGING | Operating Room Services - Minor Surgery | $7,083.20 |
| 2023103 | HC PERITONEAL LAVAGE | Operating Room Services - Minor Surgery | $952.14 |
| 2023104 | HC DESTROY CERV/THOR FACET JNT | Operating Room Services - Minor Surgery | $4,546.27 |
| 2023105 | HC DESTROY C/TH FACET JNT ADDL | Operating Room Services - Minor Surgery | $1,285.63 |
| 2023106 | HC DESTROY LUMB/SAC FACET JNT | Operating Room Services - Minor Surgery | $4,816.09 |
| 2023107 | HC DESTROY L/S FACET JNT ADDL | Operating Room Services - Minor Surgery | $1,238.60 |
| 2023138 | HC INJ TENDON ORIGIN/INSERT | Operating Room Services - Minor Surgery | $3,030.83 |
| 2023141 | HC NJX AA&/STRD GR OCPL NRV | Operating Room Services - Minor Surgery | $1,092.79 |
| 2023143 | HC INJ DUPUYTREN CORD W/ENZYME | Operating Room Services - Minor Surgery | $484.21 |
| 2023145 | HC I&D CPLX POSTOP WND INF | Operating Room Services - Minor Surgery | $6,752.34 |
| 2023146 | HC DEB SKIN BONE AT FX SITE | Operating Room Services - Minor Surgery | $3,408.77 |
| 2023147 | HC CARPAL TUNNEL TX INJ | Operating Room Services - Minor Surgery | $1,563.71 |
| 2023148 | HC REMOVAL OF SUPPORT IMPLANT | Operating Room Services - Minor Surgery | $2,016.04 |
| 2023159 | HC CL TX SCAPULAR FX; W MANIP | Operating Room Services - Minor Surgery | $3,131.82 |
| 2023162 | HC CL TX HUMERUS FX WO MANIP | Operating Room Services - Minor Surgery | $2,709.63 |
| 2023163 | HC CL TX HUMERUS FX W MANIP | Operating Room Services - Minor Surgery | $9,761.43 |
| 2023167 | HC CL TX RADIAL HD/NECK FX; WO MANIP | Operating Room Services - Minor Surgery | $9,960.67 |
| 2023170 | HC CL TX ULNAR SHAFT FX; WO MANIP | Operating Room Services - Minor Surgery | $1,980.30 |
| 2023171 | HC CL TX RADIAL & ULNAR SHFT FX; WO MANIP | Operating Room Services - Minor Surgery | $2,098.64 |
| 2023172 | HC CLTX DSTL RADIAL FX/EPIPHYSL SEP WO MNP | Operating Room Services - Minor Surgery | $2,931.81 |
| 2023173 | HC CLTX DSTL RDL FX/EPIPHYSL SEP W MNP | Operating Room Services - Minor Surgery | $4,258.85 |
| 2023174 | HC CL TX CARPAL SCAPHOID FX; WO MANIP | Operating Room Services - Minor Surgery | $2,315.99 |
| 2023175 | HC CL TX PHAL SHAFT FX; WO MANIP | Operating Room Services - Minor Surgery | $1,534.28 |
| 2023176 | HC CL TX PHALANG SHFT FX; W MANIP | Operating Room Services - Minor Surgery | $2,515.22 |
| 2023177 | HC CL TX ART FX MCP/IP JNT; WO MAN | Operating Room Services - Minor Surgery | $1,787.10 |
| 2023178 | HC CL TX D PHAL FX FGR/THMB; WO MANIP | Operating Room Services - Minor Surgery | $1,741.22 |
| 2023179 | HC CL TX D PHAL FX FGRR/THMB; W MANIP | Operating Room Services - Minor Surgery | $2,576.81 |
| 2023183 | HC CL TX PROX TIBIAL FX WO MANIP | Operating Room Services - Minor Surgery | $2,349.80 |
| 2023184 | HC CL TX TIB SHFT FX WO MANIP | Operating Room Services - Minor Surgery | $2,648.05 |
| 2023185 | HC CL TX TIB SHFT FX W MANIP | Operating Room Services - Minor Surgery | $4,130.95 |
| 2023186 | HC CL TX DSTL FIB FX WO MANIP | Operating Room Services - Minor Surgery | $2,393.27 |
| 2023187 | HC CL TX DISTL FIB FX W MANIP | Operating Room Services - Minor Surgery | $3,033.24 |
| 2023188 | HC CLTX BIMALLEOLAR ANKLE FRACT WO MNP | Operating Room Services - Minor Surgery | $2,517.64 |
| 2023189 | HC CLTX BIMALLEOLAR ANKLE FRACT W MNP | Operating Room Services - Minor Surgery | $3,531.94 |
| 2023192 | HC TX TARSAL BONE FX ; WO MANIPU | Operating Room Services - Minor Surgery | $1,608.39 |
| 2023194 | HC APPLY LONG ARM CAST | Operating Room Services - Minor Surgery | $297.05 |
| 2023195 | HC APPLY SHORT ARM CAST | Operating Room Services - Minor Surgery | $357.54 |
| 2023197 | HC APPLY FINGER CAST | Operating Room Services - Minor Surgery | $227.01 |
| 2023198 | HC APPLY LONG ARM SPLINT | Operating Room Services - Minor Surgery | $340.52 |
| 2023199 | HC APPLY SHORT ARM SPLINT; STATIC | Operating Room Services - Minor Surgery | $340.52 |
| 2023200 | HC APPLY SHORT ARM SPLINT; DYNAMIC | Operating Room Services - Minor Surgery | $422.63 |
| 2023201 | HC APPLY FINGER SPLINT; DYNAMIC | Operating Room Services - Minor Surgery | $398.48 |
| 2023202 | HC STRAPPING; ELBOW OR WRIST | Operating Room Services - Minor Surgery | $340.52 |
| 2023203 | HC STRAPPING; HAND OR FINGER | Operating Room Services - Minor Surgery | $340.52 |
| 2023204 | HC APPLY LONG LEG CAST | Operating Room Services - Minor Surgery | $821.10 |
| 2023206 | HC APPLY SH LEG CAST | Operating Room Services - Minor Surgery | $598.92 |
| 2023208 | HC APPLY LONG LEG SPLINT | Operating Room Services - Minor Surgery | $340.52 |
| 2023209 | HC APPLY SHORT LEG SPLINT | Operating Room Services - Minor Surgery | $340.52 |
| 2023211 | HC WEDGING OF CAST NOT CLUBFOOT CAST | Operating Room Services - Minor Surgery | $297.36 |
| 2023216 | HC CYSTO W MULTI OBSTR CLOT REM | Operating Room Services - Minor Surgery | $2,802.45 |
| 2023218 | HC NJX AA&/STRD NTRCOST NRV EA | Operating Room Services - Minor Surgery | $1,772.61 |
| 2023219 | HC INJ ANESTH; LUMB/THOR (SYMPATHETIC) | Operating Room Services - Minor Surgery | $1,772.61 |
| 2023221 | HC DESTR W NEUROLYTIC; OTHER PERIPH NRV | Operating Room Services - Minor Surgery | $3,155.20 |
| 2023240 | HC NJX PLATELET PLASMA | Operating Room Services - Minor Surgery | $2,698.76 |
| 2023294 | HC PUNCTURE ASPIR. CYST OF B | Operating Room Services - Minor Surgery | $1,565.82 |
| 2023303 | HC BIOPSY OF PALETE, UVULA | Operating Room Services - Minor Surgery | $1,467.97 |
| 2023304 | HC BIOPSY, OROPHARYNX | Operating Room Services - Minor Surgery | $2,396.10 |
| 2023305 | HC COLPOSCOPY W/LEEP OF CERVIX | Operating Room Services - Minor Surgery | $7,301.75 |
| 2023306 | HC ENDOCERVICAL CURETTAGE | Operating Room Services - Minor Surgery | $5,696.86 |
| 2023385 | HC DIAGNOSTIC COLONOSCOPY | Operating Room Services - Minor Surgery | $1,762.95 |
| 2023387 | HC COLONOSCOPY AND BIOPSY | Operating Room Services - Minor Surgery | $2,101.05 |
| 2023392 | HC COLONOSCOPY W/LESION REMOVAL | Operating Room Services - Minor Surgery | $2,500.25 |
| 2023394 | HC DIAGNOSTIC ANOSCOPY SPX | Operating Room Services - Minor Surgery | $336.89 |
| 2023396 | HC SCRN COLONOSCOPY PT NOT HI RISK | Operating Room Services - Minor Surgery | $1,762.95 |
| 2023442 | HC AMNIOCENTESIS DIAGNOSTIC | Operating Room Services - Minor Surgery | $908.47 |
| 2023443 | HC AMNIOCENTESIS THERAPEUTIC | Operating Room Services - Minor Surgery | $1,628.92 |
| 2023446 | HC CL TX PROX HUMERAL FX; W MANIP | Operating Room Services - Minor Surgery | $13,064.18 |
| 2023448 | HC ST BX U ARM/ELB; SUPERF | Operating Room Services - Minor Surgery | $4,932.64 |
| 2023450 | HC RX CL ELBOW DISLOC WO ANESTH | Operating Room Services - Minor Surgery | $2,625.11 |
| 2023451 | HC CL TX "NURSEMAID ELBOW" W MANIP | Operating Room Services - Minor Surgery | $751.07 |
| 2023452 | HC WRIST ARTHROGRAPHY INJ | Operating Room Services - Minor Surgery | $1,615.64 |
| 2023456 | HC CL TX POST HIP DISLOC WO ANESTH | Operating Room Services - Minor Surgery | $3,315.80 |
| 2023457 | HC SUPERF SFT TISS BX THIGH/KNEE | Operating Room Services - Minor Surgery | $2,016.04 |
| 2023462 | HC CL TX FX GT PHALANX(S); W MANIP | Operating Room Services - Minor Surgery | $1,269.32 |
| 2023465 | HC APPLY RIGID TOTAL CONTACT LEG CAST | Operating Room Services - Minor Surgery | $716.10 |
| 2023468 | HC OPEN BX OR EXC LN; SUPERFICIAL | Operating Room Services - Minor Surgery | $5,886.56 |
| 2023469 | HC OPEN BX/EXC LN; DEEP CERV NODE(S) | Operating Room Services - Minor Surgery | $3,414.81 |
| 2023470 | HC OPEN BX/EXC LN; AXILLARY NODE(S) | Operating Room Services - Minor Surgery | $3,562.13 |
| 2023472 | HC NJX AA&/STRD II IH NERVES | Operating Room Services - Minor Surgery | $3,042.90 |
| 2023473 | HC NJX AA&/STRD PUDENDAL NERVE | Operating Room Services - Minor Surgery | $2,556.28 |
| 2023474 | HC N BLOCK INJ PLANTAR DIGIT | Operating Room Services - Minor Surgery | $4,143.17 |
| 2023478 | HC REVISION OF IRIS LASER | Operating Room Services - Minor Surgery | $9,937.73 |
| 2023536 | HC SIJ ANESTH/STEROID INJ | Operating Room Services - Minor Surgery | $6,179.99 |
| 2023646 | HC IMPLANT TCAT PULM VLV PERQ | Operating Room Services - Minor Surgery | $19,933.41 |
| 2023668 | HC INCISION&REMOVAL FOREIGN BODY SUBQ TISS SIMPLE | Operating Room Services - Minor Surgery | $4,514.84 |
| 2023676 | HC BIOPSY OF LIP | Operating Room Services - Minor Surgery | $595.30 |
| 2023677 | HC BIOPSY VESTIBULE MOUTH | Operating Room Services - Minor Surgery | $924.95 |
| 2023678 | HC BIOPSY TONGUE ANTERIOR TWO-THIRDS | Operating Room Services - Minor Surgery | $2,344.97 |
| 2023679 | HC BIOPSY TONGUE POSTERIOR ONE-THIRD | Operating Room Services - Minor Surgery | $2,396.10 |
| 2023680 | HC BIOPSY FLOOR MOUTH | Operating Room Services - Minor Surgery | $1,362.90 |
| 2023681 | HC REMOVAL TUNNELED INTRAPERITONEAL CATHETER | Operating Room Services - Minor Surgery | $7,946.56 |
| 2023682 | HC I&D OF BARTHOLINS GLAND ABSCESS | Operating Room Services - Minor Surgery | $712.43 |
| 2023683 | HC BIOPSY VULVA/PERINEUM EACH ADDL LESION | Operating Room Services - Minor Surgery | $2,495.90 |
| 2023684 | HC COLPOSCOPY VULVA | Operating Room Services - Minor Surgery | $695.52 |
| 2023687 | HC COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX | Operating Room Services - Minor Surgery | $1,339.12 |
| 2023688 | HC COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX | Operating Room Services - Minor Surgery | $4,241.95 |
| 2023692 | HC REMOVAL INTRAUTERINE DEVICE IUD | Operating Room Services - Minor Surgery | $576.88 |
| 2023693 | HC PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST | Operating Room Services - Minor Surgery | $782.91 |
| 2023696 | HC EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESIONS | Operating Room Services - Minor Surgery | $7,381.45 |
| 2023703 | HC EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM/> | Operating Room Services - Minor Surgery | $7,020.41 |
| 2023704 | HC EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM | Operating Room Services - Minor Surgery | $7,788.38 |
| 2023706 | HC EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM/> | Operating Room Services - Minor Surgery | $1,739.86 |
| 2023720 | HC BONE MARROW ASPIRATE & BIOPSY | Operating Room Services - Minor Surgery | $6,704.25 |
| 2023735 | HC I&D OF VULVA OR PERINEAL ABSCESS | Operating Room Services - Minor Surgery | $810.23 |
| 2023738 | HC COLPOSCOPY VULVA W BX | Operating Room Services - Minor Surgery | $932.00 |
| 2023739 | HC COLPOSCOPY OF VAGINA | Operating Room Services - Minor Surgery | $950.30 |
| 2023740 | HC COLPOSCOPY VAGINA W BX | Operating Room Services - Minor Surgery | $1,284.78 |
| 2023760 | HC TRANSABD AMNIOINFUS W US | Operating Room Services - Minor Surgery | $2,565.94 |
| 2023764 | HC FETAL FLUID DRAINAGE W US | Operating Room Services - Minor Surgery | $2,557.49 |
| 2023768 | HC INS CATH ABD/L EXT ART 1ST | Operating Room Services - Minor Surgery | $5,618.98 |
| 2024296 | HC PARTICAL MASTECTOMY | Operating Room Services - Minor Surgery | $5,270.74 |
| 2024297 | HC MAST SIMPLE COMPLETE | Operating Room Services - Minor Surgery | $8,157.87 |
| 2024304 | HC UNLISTED PROCEDURE HUMERUS OR ELBOW | Operating Room Services - Minor Surgery | $2,824.34 |
| 2024307 | HC ASPIRATE PLEURA W/O IMAGING | Operating Room Services - Minor Surgery | $1,846.03 |
| 2024308 | HC ASPIRATE PLEURA W/ IMAGING | Operating Room Services - Minor Surgery | $2,422.90 |
| 2024450 | HC CL TX IP JNT D W MANIP ; WO ANESTH | Operating Room Services - Minor Surgery | $2,014.11 |
| 2024460 | HC CLOSED TX MCP DISLOC SGL W MANIP | Operating Room Services - Minor Surgery | $2,905.25 |
| 2024461 | HC CLOSED TX DSTL RADIOULNAR DISLOC W MANIP | Operating Room Services - Minor Surgery | $3,341.15 |
| 2024464 | HC INSERT CATH PLEURA W/O IMAGE | Operating Room Services - Minor Surgery | $1,721.81 |
| 2024509 | HC INJ PARAVERT F JNT C/T 3 LEV | Operating Room Services - Minor Surgery | $14,112.32 |
| 2024513 | HC ANL SP INF PMP W/MDREPRG&FIL | Operating Room Services - Minor Surgery | $652.05 |
| 2024516 | HC DESTR W NEUROLYTIC; PUDENDA NRV | Operating Room Services - Minor Surgery | $1,689.29 |
| 2024583 | HC CHEMODENERV MUSC MIGRAINE | Operating Room Services - Minor Surgery | $1,050.53 |
| 2024608 | HC CL TX RADIAL SHFT FX W MANIP | Operating Room Services - Minor Surgery | $3,801.21 |
| 2024609 | HC GALEAZZI FX/DISLOC | Operating Room Services - Minor Surgery | $4,417.04 |
| 2024610 | HC REPAIR ELBOW PERC | Operating Room Services - Minor Surgery | $9,331.56 |
| 2024624 | HC CL TX TRIMALL ANKLE FX; W MANIP | Operating Room Services - Minor Surgery | $3,586.28 |
| 2024627 | HC DRAIN FINGER ABSC SIMPLE | Operating Room Services - Minor Surgery | $1,346.36 |
| 2024628 | HC DRAIN FINGER ABSC COMPLICATED | Operating Room Services - Minor Surgery | $1,517.83 |
| 2024630 | HC DRESSINGS AND/OR DEBRIDEMENT OF PARTIAL-THICKNESS BURNS, INITIAL OR SUBS | Operating Room Services - Minor Surgery | $444.36 |
| 2024637 | HC FITTING AND INSERTION OF PESSARY OR OTHER INTRAVAGINAL SUPPORT DEVICE | Operating Room Services - Minor Surgery | $429.48 |
| 2024674 | HC DRESS/DEBRID P-THICK BURN M | Operating Room Services - Minor Surgery | $915.38 |
| 2024679 | HC INSERT IUD | Operating Room Services - Minor Surgery | $1,863.34 |
| 2024681 | HC SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM | Operating Room Services - Minor Surgery | $588.40 |
| 2024684 | HC CL TX POSTOP HIP DISLOC W ANESTH | Operating Room Services - Minor Surgery | $8,289.49 |
| 2024685 | HC REM SHOULDER OR HIP SPICA | Operating Room Services - Minor Surgery | $686.15 |
| 2024694 | HC NJX AA&/STRD TRIGEMINAL NRV | Operating Room Services - Minor Surgery | $3,290.44 |
| 2024746 | HC INF BURSA I&D - UA/ELBOW | Operating Room Services - Minor Surgery | $4,378.40 |
| 2024781 | HC BX BREAST W DEVICE 1ST LESION STEREOTACTIC GUIDE | Operating Room Services - Minor Surgery | $11,003.95 |
| 2024782 | HC BX BREAST W DEVICE ADDL LESION STEREOTACT GUIDE | Operating Room Services - Minor Surgery | $5,391.49 |
| 2024783 | HC BX BREAST W DEVICE 1ST LESION ULTRASOUND GUIDE | Operating Room Services - Minor Surgery | $11,003.95 |
| 2024784 | HC BX BREAST W DEVICE ADDL LESION ULTRASOUND GUIDE | Operating Room Services - Minor Surgery | $5,171.72 |
| 2024785 | HC BX BREAST W DEVICE 1ST LESION MAGNETIC RES GUIDE | Operating Room Services - Minor Surgery | $11,003.95 |
| 2024786 | HC BX BREAST W DEVICE ADDL LESION MAGNET RES GUIDE | Operating Room Services - Minor Surgery | $4,842.08 |
| 2024787 | HC PERQ DEVICE PLACEMT BREAST LOC 1ST LES W GUIDNCE | Operating Room Services - Minor Surgery | $3,577.11 |
| 2024788 | HC PERQ DEVICE PLACEMT BREAST LOC EA LES W GUIDNCE | Operating Room Services - Minor Surgery | $3,577.11 |
| 2024789 | HC PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GUID | Operating Room Services - Minor Surgery | $3,244.48 |
| 2024790 | HC PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC | Operating Room Services - Minor Surgery | $3,244.48 |
| 2024791 | HC PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG | Operating Room Services - Minor Surgery | $3,645.25 |
| 2024792 | HC PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE | Operating Room Services - Minor Surgery | $3,406.77 |
| 2024793 | HC PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID | Operating Room Services - Minor Surgery | $3,406.77 |
| 2024819 | HC CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE | Operating Room Services - Minor Surgery | $1,668.77 |
| 2024820 | HC CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE | Operating Room Services - Minor Surgery | $1,135.05 |
| 2024823 | HC CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES | Operating Room Services - Minor Surgery | $1,522.66 |
| 2024824 | HC CHEMODENERV TRUNK MUSC 6/> | Operating Room Services - Minor Surgery | $1,645.82 |
| 2024849 | HC INSERT CERVICAL DILATOR | Operating Room Services - Minor Surgery | $734.16 |
| 2024873 | HC DRAINAGE OF PILONIDAL CYST | Operating Room Services - Minor Surgery | $961.17 |
| 2024874 | HC DEBRIDE SKIN MUSC AT FX SITE | Operating Room Services - Minor Surgery | $2,420.23 |
| 2024875 | HC RPR S/N/A/GEN/TRK12.6-20.0CM | Operating Room Services - Minor Surgery | $3,350.81 |
| 2024876 | HC RPR S/N/A/GEN/TRK20.1-30.0CM | Operating Room Services - Minor Surgery | $967.21 |
| 2024877 | HC RPR F/E/E/N/L/M 5.1-7.5 CM | Operating Room Services - Minor Surgery | $1,114.52 |
| 2024878 | HC RPR F/E/E/N/L/M 7.6-12.5 CM | Operating Room Services - Minor Surgery | $1,397.08 |
| 2024879 | HC CLOSURE OF SPLIT WOUND | Operating Room Services - Minor Surgery | $8,073.35 |
| 2024880 | HC CMPLX RPR S/A/L ADDL 5 CM/> | Operating Room Services - Minor Surgery | $1,579.41 |
| 2024881 | HC CMPLX RPR E/N/E/L 2.6-7.5 CM | Operating Room Services - Minor Surgery | $12,913.09 |
| 2024882 | HC CMPLX RPR E/N/E/L ADDL 5CM/< | Operating Room Services - Minor Surgery | $1,170.68 |
| 2024883 | HC INITIAL TREATMENT OF BURN(S) | Operating Room Services - Minor Surgery | $502.32 |
| 2024884 | HC INCISION OF BREAST LESION | Operating Room Services - Minor Surgery | $4,547.45 |
| 2024885 | HC EXPLORE WOUND EXTREMITY | Operating Room Services - Minor Surgery | $3,059.39 |
| 2024886 | HC REPLANTATION DIGIT COMPLETE | Operating Room Services - Minor Surgery | $14,841.38 |
| 2024887 | HC INTERDENTAL FIXATION | Operating Room Services - Minor Surgery | $5,643.86 |
| 2024888 | HC CLOSED TX NOSE FX W/O STABLJ | Operating Room Services - Minor Surgery | $2,304.70 |
| 2024891 | HC RESET DISLOCATED JAW | Operating Room Services - Minor Surgery | $399.68 |
| 2024894 | HC TREAT DISLOCATION/FRACTURE | Operating Room Services - Minor Surgery | $3,266.29 |
| 2024896 | HC TREAT HUMERUS FRACTURE | Operating Room Services - Minor Surgery | $4,738.52 |
| 2024897 | HC TREAT HUMERUS FRACTURE | Operating Room Services - Minor Surgery | $4,019.77 |
| 2024898 | HC TREAT RADIUS FRACTURE | Operating Room Services - Minor Surgery | $3,301.31 |
| 2024899 | HC TREAT ULNAR FRACTURE | Operating Room Services - Minor Surgery | $3,434.13 |
| 2024903 | HC TREAT WRIST BONE FRACTURE | Operating Room Services - Minor Surgery | $3,327.87 |
| 2024904 | HC TREAT FINGER FRACTURE EACH | Operating Room Services - Minor Surgery | $2,787.88 |
| 2024905 | HC TREAT FINGER DISLOCATION | Operating Room Services - Minor Surgery | $2,879.89 |
| 2024907 | HC TREAT HIP DISLOCATION | Operating Room Services - Minor Surgery | $1,712.94 |
| 2024908 | HC TREAT KNEE DISLOCATION | Operating Room Services - Minor Surgery | $3,796.38 |
| 2024909 | HC TREAT KNEECAP DISLOCATION | Operating Room Services - Minor Surgery | $2,797.78 |
| 2024910 | HC CLTX MEDIAL ANKLE FX | Operating Room Services - Minor Surgery | $2,547.83 |
| 2024911 | HC CLTX MED ANKLE FX W/MNPJ | Operating Room Services - Minor Surgery | $3,628.54 |
| 2024912 | HC TREAT LOWER LEG FRACTURE | Operating Room Services - Minor Surgery | $4,535.92 |
| 2024914 | HC TREATMENT OF ANKLE FRACTURE | Operating Room Services - Minor Surgery | $3,628.54 |
| 2024915 | HC TREATMENT OF TOE FRACTURE | Operating Room Services - Minor Surgery | $7,310.21 |
| 2024916 | HC TREATMENT OF TOE FRACTURE | Operating Room Services - Minor Surgery | $8,626.04 |
| 2024917 | HC TREAT TOE DISLOCATION | Operating Room Services - Minor Surgery | $889.93 |
| 2024918 | HC TREAT TOE DISLOCATION | Operating Room Services - Minor Surgery | $730.54 |
| 2024921 | HC DRAINAGE OF NOSE LESION | Operating Room Services - Minor Surgery | $987.74 |
| 2024922 | HC CONTROL OF NOSEBLEED | Operating Room Services - Minor Surgery | $2,446.40 |
| 2024924 | HC REPAIR TONGUE LACERATION | Operating Room Services - Minor Surgery | $1,316.18 |
| 2024925 | HC REPAIR TONGUE LACERATION | Operating Room Services - Minor Surgery | $1,974.77 |
| 2024926 | HC REMOVE PHARYNX FOREIGN BODY | Operating Room Services - Minor Surgery | $1,109.69 |
| 2024927 | HC DRAINAGE OF RECTAL ABSCESS | Operating Room Services - Minor Surgery | $4,113.95 |
| 2024929 | HC REMOVE RECTAL OBSTRUCTION | Operating Room Services - Minor Surgery | $4,113.95 |
| 2024930 | HC INCISION OF RECTAL ABSCESS | Operating Room Services - Minor Surgery | $3,420.85 |
| 2024931 | HC INCISION OF RECTAL ABSCESS | Operating Room Services - Minor Surgery | $6,916.15 |
| 2024932 | HC INCISION OF ANAL ABSCESS | Operating Room Services - Minor Surgery | $6,926.22 |
| 2024933 | HC INCISE EXTERNAL HEMORRHOID | Operating Room Services - Minor Surgery | $877.85 |
| 2024934 | HC INJECTION FOR CHOLANGIOGRAM EXIST ACCESS | Operating Room Services - Minor Surgery | $4,632.82 |
| 2024935 | HC LAPAROSCOPIC CHOLECYSTECTOMY | Operating Room Services - Minor Surgery | $9,879.28 |
| 2024937 | HC EXCHANGE DRAINAGE CATHETER | Operating Room Services - Minor Surgery | $2,587.67 |
| 2024938 | HC REPLACE G/C TUBE PERC | Operating Room Services - Minor Surgery | $3,069.36 |
| 2024939 | HC REPLACE DUOD/JEJ TUBE PERC | Operating Room Services - Minor Surgery | $1,677.90 |
| 2024943 | HC EXCHANGE NEPHROSTOMY CATH | Operating Room Services - Minor Surgery | $4,443.60 |
| 2024944 | HC IRRIGATION OF BLADDER | Operating Room Services - Minor Surgery | $724.50 |
| 2024945 | HC CHANGE OF BLADDER TUBE | Operating Room Services - Minor Surgery | $1,541.98 |
| 2024949 | HC TREATMENT OF PENIS LESION | Operating Room Services - Minor Surgery | $1,056.56 |
| 2024950 | HC PENILE INJECTION | Operating Room Services - Minor Surgery | $920.12 |
| 2024951 | HC DRAINAGE OF SCROTUM | Operating Room Services - Minor Surgery | $5,028.03 |
| 2024952 | HC DRAINAGE OF SCROTUM ABSCESS | Operating Room Services - Minor Surgery | $1,558.96 |
| 2024953 | HC REPAIR OF VAGINA | Operating Room Services - Minor Surgery | $7,310.21 |
| 2024956 | HC CARE OF MISCARRIAGE | Operating Room Services - Minor Surgery | $3,984.75 |
| 2024957 | HC REMOVE FOREIGN BODY FROM EYE | Operating Room Services - Minor Surgery | $393.65 |
| 2024958 | HC REMOVE FOREIGN BODY FROM EYE | Operating Room Services - Minor Surgery | $668.96 |
| 2024959 | HC REMOVE FOREIGN BODY FROM EYE | Operating Room Services - Minor Surgery | $836.80 |
| 2024960 | HC DRAINAGE OF EYELID ABSCESS | Operating Room Services - Minor Surgery | $984.11 |
| 2024961 | HC REMOVE EYELID FOREIGN BODY | Operating Room Services - Minor Surgery | $980.49 |
| 2024962 | HC DRAIN EXTERNAL EAR LESION | Operating Room Services - Minor Surgery | $1,001.02 |
| 2024963 | HC DRAIN EXTERNAL EAR LESION | Operating Room Services - Minor Surgery | $3,059.39 |
| 2024967 | HC CLOSED TX OF ULNAR STYLOID FX | Operating Room Services - Minor Surgery | $2,497.11 |
| 2024972 | HC DX LARYNGOSCOPY EXCL NB | Operating Room Services - Minor Surgery | $5,233.24 |
| 2024974 | HC DR ABSC CYST HEMAT-MOUTH; SIMPLE | Operating Room Services - Minor Surgery | $1,127.81 |
| 2024975 | HC DR ABSC CYST HEMATOM - DENTOALVEOLAR | Operating Room Services - Minor Surgery | $1,220.78 |
| 2024976 | HC UNLISTED PROCEDURE DENTOALVEOLAR STRUCT | Operating Room Services - Minor Surgery | $288.59 |
| 2024977 | HC I&D ABSCESS; PERITONSILLAR | Operating Room Services - Minor Surgery | $1,094.00 |
| 2024979 | HC TX GASTRO INTUB W/ASP | Operating Room Services - Minor Surgery | $338.10 |
| 2024989 | HC DESTR W NEUROLYT TRIGEM NRV INF ALV BR | Operating Room Services - Minor Surgery | $5,700.00 |
| 2024999 | HC TRANSFUSION INTRAUTERINE FETAL | Operating Room Services - Minor Surgery | $1,226.98 |
| 2025012 | HC DRAINAGE OF ABSCESS OF PALATE UVULA | Operating Room Services - Minor Surgery | $1,123.37 |
| 2025013 | HC ESOPHAGUS MOTILITY STUDY | Operating Room Services - Minor Surgery | $1,258.22 |
| 2025046 | HC REP ET HAND; WO FG EA TENDON | Operating Room Services - Minor Surgery | $5,379.41 |
| 2025053 | HC INTMD WND REPAIR N-HF/GENIT 7.6-12.5 | Operating Room Services - Minor Surgery | $2,568.00 |
| 2025054 | HC INTMD WND REPAIR N-HF/GENIT 12.6-20 | Operating Room Services - Minor Surgery | $3,216.00 |
| 2025057 | HC EPIDRM AUTOGRFT TRNK/ARM/LEG 100 SQ CM/1% BA | Operating Room Services - Minor Surgery | $9,725.84 |
| 2025059 | HC EPIDRM A-GRFT FACE/NCK/HF/G 100 SQ CM/1% BA | Operating Room Services - Minor Surgery | $9,823.10 |
| 2025140 | HC DRAIN/INJ SMALL JOINT/BURSA W/US | Operating Room Services - Minor Surgery | $6,360.38 |
| 2025141 | HC DRAIN/INJ INTER JOINT/BURSA W/US | Operating Room Services - Minor Surgery | $7,323.25 |
| 2025142 | HC DRAIN/INJ MAJOR JOINT/BURSA W/US | Operating Room Services - Minor Surgery | $7,300.00 |
| 2025143 | HC MYELOGRAPHY LUMBAR INJECTION; CERVICAL | Operating Room Services - Minor Surgery | $2,620.95 |
| 2025145 | HC MYELOGRAPHY LUMBAR INJECTION; LUMBOSACRAL | Operating Room Services - Minor Surgery | $2,620.95 |
| 2025146 | HC MYELOGRAPHY LUMBAR INJECTION; 2 OR MORE REGIONS | Operating Room Services - Minor Surgery | $2,620.95 |
| 2025188 | HC EPIDURAL LYSIS OF ADH MULTI 1 DAY | Operating Room Services - Minor Surgery | $2,867.51 |
| 2025222 | HC I&D ABSC/CYS FOM; MASTIC SPACE | Operating Room Services - Minor Surgery | $1,550.07 |
| 2025245 | HC TX CL ELBOW DISLOC W ANESTH | Operating Room Services - Minor Surgery | $4,909.63 |
| 2025248 | HC NJX AA&/STRD SPRSCAP NRV | Operating Room Services - Minor Surgery | $1,618.43 |
| 2025250 | HC PLACE NEEDLE INTRAOSSEOUS INFUSION | Operating Room Services - Minor Surgery | $571.98 |
| 2025262 | HC GUIDE CATHET FLUID DRAINAGE | Operating Room Services - Minor Surgery | $3,759.72 |
| 2025270 | HC REMOVE VAGINAL FOREIGN BODY | Operating Room Services - Minor Surgery | $8,015.57 |
| 2025271 | HC INSERT DRUG IMPLANT | Operating Room Services - Minor Surgery | $571.96 |
| 2025272 | HC REMOVE DRUG IMPLANT | Operating Room Services - Minor Surgery | $571.96 |
| 2025273 | HC REMOVE W INS DRUG IMPLANT | Operating Room Services - Minor Surgery | $784.88 |
| 2025342 | HC I&D PILONID CYST; CPLX | Operating Room Services - Minor Surgery | $1,575.79 |
| 2025344 | HC CL TX ULNAR SHFT FX W MANIP | Operating Room Services - Minor Surgery | $1,020.34 |
| 2025345 | HC CL TX PROX FIB/SHAFT FX W MANIP | Operating Room Services - Minor Surgery | $3,272.33 |
| 2025347 | HC TRACH TUBE CHG BEFORE FISTULA TRACT | Operating Room Services - Minor Surgery | $1,074.68 |
| 2025354 | HC REM FB EXT AUDITORY CANAL; W ANESTH | Operating Room Services - Minor Surgery | $5,473.60 |
| 2025355 | HC REM IMPL CONTRACEP CAPS | Operating Room Services - Minor Surgery | $739.02 |
| 2025360 | HC SREP F/E/N/L/MM; 12.6-20.0CM | Operating Room Services - Minor Surgery | $1,883.70 |
| 2025361 | HC INTMD WND REPAIR S/A/T/EXT | Operating Room Services - Minor Surgery | $4,210.55 |
| 2025362 | HC INTMD WND REPAIR FACE/MM 7.6-12.5 CM | Operating Room Services - Minor Surgery | $3,259.04 |
| 2025363 | HC CREP H/A/G/EXTR; EA ADD 5 CM/< | Operating Room Services - Minor Surgery | $2,687.10 |
| 2025365 | HC CL TX CMC DISLOC THUMB W MANIP | Operating Room Services - Minor Surgery | $452.81 |
| 2025366 | HC CL TX CMC DISL W M EA | Operating Room Services - Minor Surgery | $452.81 |
| 2025367 | HC CL TX MCP DISLOC W MANIP & ANESTH | Operating Room Services - Minor Surgery | $1,563.24 |
| 2025368 | HC INS BLADDER CATH COMPLEX | Operating Room Services - Minor Surgery | $863.37 |
| 2025373 | HC CIRCUMCISION W/REGIONL BLOCK | Operating Room Services - Minor Surgery | $2,577.36 |
| 2025379 | HC POSTPARTUM CARE ONLY | Operating Room Services - Minor Surgery | $594.00 |
| 2025380 | HC SURG TX INCOMPL ABORTION | Operating Room Services - Minor Surgery | $4,734.07 |
| 2025381 | HC CL TX TRAUMA HIP DISLOC W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025382 | HC CL TX FEMORAL SHAFT FX W MANIP | Operating Room Services - Minor Surgery | $5,770.64 |
| 2025383 | HC CL TX PATELLAR DISLOCATION; W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025385 | HC CL TX ANKLE DISLOC W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025386 | HC CL TX IP JOINT DISL; W ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025388 | HC UNLISTED PROCEDURE STOMACH | Operating Room Services - Minor Surgery | $2,545.41 |
| 2025390 | HC REMOVAL OF HEMORRHOID CLOT | Operating Room Services - Minor Surgery | $7,350.05 |
| 2025394 | HC ABSC CYST CONSTRAST INJ | Operating Room Services - Minor Surgery | $132.83 |
| 2025396 | HC PLMT NEPHROSTOMY CATHETER | Operating Room Services - Minor Surgery | $7,841.40 |
| 2025399 | HC INSERT PLEURAL CATH | Operating Room Services - Minor Surgery | $5,445.83 |
| 2025401 | HC INJ W/FLUOR EVAL CV DEVICE | Operating Room Services - Minor Surgery | $2,008.02 |
| 2025404 | HC EGD PLACE GASTROSTOMY TUBE | Operating Room Services - Minor Surgery | $4,350.72 |
| 2025409 | HC CL TX OF MAND FX W ID FIX | Operating Room Services - Minor Surgery | $14,294.03 |
| 2025411 | HC AMPUTATE FING/TH SGL; W DIR CLOSE | Operating Room Services - Minor Surgery | $5,177.76 |
| 2025414 | HC LAPAROSCOPY; APPENDECTOMY | Operating Room Services - Minor Surgery | $15,181.54 |
| 2025494 | HC TX SHOULDER DISLOCATION W/ANESTH | Operating Room Services - Minor Surgery | $4,656.12 |
| 2025538 | HC EXCHANGE BILIARY DRG CATH | Operating Room Services - Minor Surgery | $5,003.19 |
| 2025542 | HC NJX PX NFROSGRM &/URTRGRM EXIST ACCESS | Operating Room Services - Minor Surgery | $3,846.74 |
| 2025572 | HC CONIZATION OF CERVIX LEEP | Operating Room Services - Minor Surgery | $7,952.08 |
| 2025614 | HC REMOVE LUNG CATHETER | Operating Room Services - Minor Surgery | $2,062.95 |
| 2025619 | HC CSF SHUNT REPROGRAM | Operating Room Services - Minor Surgery | $1,030.46 |
| 2025629 | HC CORDOCENTESIS (INTRAUTERINE) | Operating Room Services - Minor Surgery | $1,072.01 |
| 2025632 | HC FLUORO EXAM OF G/COLON TUBE | Operating Room Services - Minor Surgery | $2,299.93 |
| 2025633 | HC PERCUTANEOUS CHOLECYSTOSTOMY | Operating Room Services - Minor Surgery | $7,833.77 |
| 2025637 | HC RPR S/N/A/GEN/TKR > 30CM | Operating Room Services - Minor Surgery | $952.72 |
| 2025689 | HC CYSTOURETHROSCOPY | Operating Room Services - Minor Surgery | $2,241.12 |
| 2025701 | HC BIOPSY SALIVARY GLAND; INCISIONAL | Operating Room Services - Minor Surgery | $6,908.36 |
| 2025703 | HC CIRCUMCISION NEONATE <=28 DAYS | Operating Room Services - Minor Surgery | $6,436.31 |
| 2025709 | HC COLPOPEXY LAPAROSCOPY | Operating Room Services - Minor Surgery | $29,313.89 |
| 2025715 | HC UNLISTED PROCEDURE FEMALE GENITAL SYS | Operating Room Services - Minor Surgery | $600.68 |
| 2025718 | HC REMOVE IMPACTED EAR WAX UNI | Operating Room Services - Minor Surgery | $139.47 |
| 2025719 | HC TRANSPERI NEEDLE PLACE PROS | Operating Room Services - Minor Surgery | $9,585.53 |
| 2025726 | HC OPEN TX FINGER DISLOCATION,SINGLE | Operating Room Services - Minor Surgery | $7,881.35 |
| 2025737 | HC LASER TX SKIN < 250 SQ CM | Operating Room Services - Minor Surgery | $501.04 |
| 2025738 | HC LASER TX SKIN 250-500 SQ CM | Operating Room Services - Minor Surgery | $501.04 |
| 2025755 | HC ABLTJ PERC LXTR/PERPH NRV | Operating Room Services - Minor Surgery | $17,095.30 |
| 2025756 | HC EXC LES MOUTH VESTIBULE W SIMPLE REPAIR | Operating Room Services - Minor Surgery | $7,670.00 |
| 2025772 | HC INTRO CATH DIALYSIS CIRCUIT | Operating Room Services - Minor Surgery | $3,659.20 |
| 2025780 | HC TRLUML BALO ANGIOP 1ST ART | Operating Room Services - Minor Surgery | $11,912.90 |
| 2025781 | HC TRLUML BALO ANGIOP ADDL ART | Operating Room Services - Minor Surgery | $11,913.30 |
| 2025782 | HC TRLUML BALO ANGIOP 1ST VEIN | Operating Room Services - Minor Surgery | $11,912.90 |
| 2025783 | HC TRLUML BALO ANGIOP ADDL VEIN | Operating Room Services - Minor Surgery | $11,102.70 |
| 2025799 | HC EXC TONGUE LESION W CL; ANT 2/3 | Operating Room Services - Minor Surgery | $8,049.86 |
| 2025800 | HC TAP BLOCK BI INJECTION | Operating Room Services - Minor Surgery | $3,771.60 |
| 2025807 | HC NJX INTERLAMINAR LMBR/SAC W/IMG GDN | Operating Room Services - Minor Surgery | $7,367.12 |
| 2025808 | HC NJX INTERLAMINAR CRV/THRC | Operating Room Services - Minor Surgery | $7,713.25 |
| 2025837 | HC CYSTO W DIL OF URETHRAL STRICTURE | Operating Room Services - Minor Surgery | $6,102.75 |
| 2025851 | HC N BLOCK INJ COMMON DIGIT | Operating Room Services - Minor Surgery | $855.82 |
| 2025853 | HC BIOPSY INTRANASAL | Operating Room Services - Minor Surgery | $3,847.73 |
| 2025870 | HC BX DONE W/COLPOSCOPY ADD-ON | Operating Room Services - Minor Surgery | $2,756.73 |
| 2025903 | HC SIALOLITHOTOMY; SM UNCOMPLICATED | Operating Room Services - Minor Surgery | $8,053.32 |
| 2025913 | HC INC/REPL SPINE NSTIM PG/RCVR | Operating Room Services - Minor Surgery | $33,402.32 |
| 2025918 | HC EXC LES/TUMOR DENTOALVEOLAR WO REPAIR | Operating Room Services - Minor Surgery | $8,053.32 |
| 2025919 | HC TRACHEOBRONCH THRU OLD INCISION | Operating Room Services - Minor Surgery | $1,639.86 |
| 2025930 | HC EXC LESION PALATE UVULA; WO CLOSURE | Operating Room Services - Minor Surgery | $8,053.32 |
| 2025935 | HC EXCISE TONGUE LESION WO CLOSURE | Operating Room Services - Minor Surgery | $8,269.80 |
| 2025950 | HC DRAINAGE OF ABSCESS; PAROTID SIMPLE | Operating Room Services - Minor Surgery | $3,847.73 |
| 2025955 | HC CL TX ANKLE DISLOCATION; WO ANESTH | Operating Room Services - Minor Surgery | $740.34 |
| 2025993 | HC EXC LES MOUTH VESTIBULE WO REPAIR | Operating Room Services - Minor Surgery | $6,972.73 |
| 2026024 | HC CYSTO W REM FB/STNT URETH/BLDR; SIMPLE | Operating Room Services - Minor Surgery | $5,965.00 |
| 2026028 | HC EXC NECK LES SC < 3 CM | Operating Room Services - Minor Surgery | $4,742.00 |
| 2026040 | HC CL TX MONTEGGIA ELB FX W MANIP | Operating Room Services - Minor Surgery | $3,778.00 |
| 2026068 | HC REPAIR OF DIGIT NERVE 1 | Operating Room Services - Minor Surgery | $18,990.00 |
| 2026070 | HC FORESKIN MANIPULATION | Operating Room Services - Minor Surgery | $686.00 |
| 2026072 | HC REPAIR LIP FT; > 1/2 V HGT OR COMPLEX | Operating Room Services - Minor Surgery | $2,278.00 |
| 2026074 | HC REPAIR LIP FT; VERMILION ONLY | Operating Room Services - Minor Surgery | $4,406.00 |
| 2026075 | HC REPAIR CVA CATHETER | Operating Room Services - Minor Surgery | $1,595.00 |
| 2026077 | HC AMPUTATE FING/TH SGL; W LOC ADV FLAP | Operating Room Services - Minor Surgery | $8,503.00 |
| 2026080 | HC EXTENSOR TENDON REPAIR EACH | Operating Room Services - Minor Surgery | $4,806.00 |
| 2026082 | HC REP FLXR TENDON NOT ZONE 2 WO GRFT EA | Operating Room Services - Minor Surgery | $13,666.00 |
| 2026083 | HC REP T/M EXTENSOR FA/W ; 1' EA | Operating Room Services - Minor Surgery | $9,545.00 |
| 2026084 | HC REP TENDN/MSCL - FARM.WRIST | Operating Room Services - Minor Surgery | $7,500.00 |
| 2026089 | HC CL TX OF NASAL BONE FX; W STABILIZ | Operating Room Services - Minor Surgery | $5,340.00 |
| 2026092 | HC SKIN FULL GRFT FACE/GENIT/HF =< 20 SQ CM | Operating Room Services - Minor Surgery | $7,340.00 |
| 2026095 | HC INTMD WND RPR S/A/T/E 20.1-30.0 | Operating Room Services - Minor Surgery | $1,416.00 |
| 2026118 | HC SUTURE OF FACIAL NERVE; EXTRACRANIAL | Operating Room Services - Minor Surgery | $13,900.00 |
| 2026120 | HC INS VAG BRACHYTX DEVICE | Operating Room Services - Minor Surgery | $1,051.00 |
| 2026121 | HC PLACE RT DEVICE/MARKER PROS | Operating Room Services - Minor Surgery | $3,836.00 |
| 2026124 | HC MUSC MYOQ/FSCQ FLP H&N PEDCL | Operating Room Services - Minor Surgery | $8,145.00 |
| 2026137 | HC CL TX NASAL SEPTAL FX | Operating Room Services - Minor Surgery | $5,340.00 |
| 2026158 | HC TIS TRNFR ADDL 30 SQ CM | Operating Room Services - Minor Surgery | $4,036.00 |
| 2026162 | HC PERQ DEV SOFT TISS 1ST IMAG | Operating Room Services - Minor Surgery | $2,015.10 |
| 2026171 | HC EPILATION BY FORCEPS | Operating Room Services - Minor Surgery | $369.51 |
| 2026176 | HC BX; NASOPHARYNX VISIBLE LESION SIMPLE | Operating Room Services - Minor Surgery | $4,512.43 |
| 2026245 | HC THROMBOLYSIS CEREBRAL BY IV INFUSION | Operating Room Services - Minor Surgery | $1,046.76 |
| 2026252 | HC OPEN CHEST HEART MASSAGE | Operating Room Services - Minor Surgery | $6,829.35 |
| 2026263 | HC INTRAVITREAL INJECTION OF DRUG | Operating Room Services - Minor Surgery | $1,013.22 |
| 2026264 | HC FNA BX W/O IMG GDN EA ADDL | Operating Room Services - Minor Surgery | $2,754.00 |
| 2026265 | HC FNA BX W/US GDN 1ST LES | Operating Room Services - Minor Surgery | $4,331.00 |
| 2026266 | HC FNA BX W/US GDN EA ADDL | Operating Room Services - Minor Surgery | $2,887.33 |
| 2026267 | HC FNA BX W/FLUOR GDN 1ST LES | Operating Room Services - Minor Surgery | $4,331.00 |
| 2026269 | HC FNA BX W/CT GDN 1ST LES | Operating Room Services - Minor Surgery | $4,331.00 |
| 2026273 | HC TANGNTL BX SKIN SINGLE LES | Operating Room Services - Minor Surgery | $683.49 |
| 2026274 | HC TANGNTL BX SKIN EA SEP/ADDL | Operating Room Services - Minor Surgery | $413.30 |
| 2026275 | HC PUNCH BX SKIN SINGLE LESION | Operating Room Services - Minor Surgery | $619.95 |
| 2026276 | HC PUNCH BX SKIN EA SEP/ADDL | Operating Room Services - Minor Surgery | $413.30 |
| 2026277 | HC INCAL BX SKN SINGLE LES | Operating Room Services - Minor Surgery | $1,103.52 |
| 2026278 | HC INCAL BX SKN EA SEP/ADDL | Operating Room Services - Minor Surgery | $735.68 |
| 2026283 | HC RPLC GTUBE NO REVJ TRC | Operating Room Services - Minor Surgery | $813.09 |
| 2026284 | HC RPLC GTUBE REVJ GSTRST TRC | Operating Room Services - Minor Surgery | $1,084.12 |
| 2026370 | HC SKIN TISSUE REARRANGEMENT 30.1-60.0 SQ CM | Operating Room Services - Minor Surgery | $8,071.00 |
| 2026372 | HC CL TX LUNATE DISLOC W MANIP | Operating Room Services - Minor Surgery | $3,621.00 |
| 2026373 | HC REPR FOOT EXTENSOR TENDON EA | Operating Room Services - Minor Surgery | $7,912.00 |
| 2026380 | HC RECONST NAIL BED W GRFT | Operating Room Services - Minor Surgery | $4,661.00 |
| 2026398 | HC REPAIR BLD VESSEL DIRECT; LWR EXTREM | Operating Room Services - Minor Surgery | $12,675.00 |
| 2026399 | HC INSJ PICC RS&I <5 YR | Operating Room Services - Minor Surgery | $8,584.12 |
| 2026400 | HC INSJ PICC RS&I 5 YR+ | Operating Room Services - Minor Surgery | $7,947.77 |
| 2026409 | HC MUSCLE FLAP; TRUNK | Operating Room Services - Minor Surgery | $9,718.92 |
| 2026429 | HC LOW COST SKIN SUB TRNK/ARM/LEG < 100 SQ CM | Operating Room Services - Minor Surgery | $6,705.25 |
| 2026430 | HC LOW COST SKIN SUB T/A/L < 100 SQ CM ADD-ON | Operating Room Services - Minor Surgery | $402.10 |
| 2026431 | HC LOW COST SKIN SUB TRNK/ARM/LEG > 100 SQ CM | Operating Room Services - Minor Surgery | $3,495.84 |
| 2026433 | HC LOW COST SKIN SUB FACE/NK/HF/G < 100 SQ CM | Operating Room Services - Minor Surgery | $2,011.70 |
| 2026434 | HC LOW COST SKIN SUB F/N/HF/G < 100 SQ CM ADD-ON | Operating Room Services - Minor Surgery | $536.13 |
| 2026442 | HC MYOMECTOMY VAG METHOD 1-4 MYOMAS | Operating Room Services - Minor Surgery | $8,296.41 |
| 2026446 | HC REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS LT | Operating Room Services - Minor Surgery | $3,359.27 |
| 2026452 | HC STRAPPING OF TOES LT | Operating Room Services - Minor Surgery | $227.01 |
| 2026453 | HC STRAPPING OF TOES RT | Operating Room Services - Minor Surgery | $227.01 |
| 2026454 | HC BONE MARROW ASPIRATE & BIOPSY BIL | Operating Room Services - Minor Surgery | $6,704.25 |
| 2026455 | HC BONE MARROW ASPIRATE & BIOPSY LT | Operating Room Services - Minor Surgery | $6,704.25 |
| 2026456 | HC BONE MARROW ASPIRATE & BIOPSY RT | Operating Room Services - Minor Surgery | $6,704.25 |
| 2026457 | HC REM FB AUD CANAL WO ANES BIL | Operating Room Services - Minor Surgery | $719.67 |
| 2026460 | HC REMOVE IMPACTED EAR WAX BIL | Operating Room Services - Minor Surgery | $705.18 |
| 2026462 | HC REMOVE IMPACTED EAR WAX RT | Operating Room Services - Minor Surgery | $705.18 |
| 2026463 | HC INJ TENDON SHEATH/LIGAMENT BIL | Operating Room Services - Minor Surgery | $4,243.50 |
| 2026464 | HC INJ TENDON SHEATH/LIGAMENT LT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2026465 | HC INJ TENDON SHEATH/LIGAMENT RT | Operating Room Services - Minor Surgery | $2,970.45 |
| 2026481 | HC DR ABSC/HEMATOMA NASAL SEPTUM | Operating Room Services - Minor Surgery | $1,711.56 |
| 2026482 | HC BIOPSY SALIVARY GLAND; NEEDLE | Operating Room Services - Minor Surgery | $2,035.53 |
| 2026486 | HC UNLISTED PROCEDURE PHARYNX ADENOIDS | Operating Room Services - Minor Surgery | $724.29 |
| 2026527 | HC SKIN FULL GRAFT EEN & LIPS =< 20 SQ CM | Operating Room Services - Minor Surgery | $4,660.00 |
| 2026535 | HC DRESS/DEBRID P-THICK BURN L | Operating Room Services - Minor Surgery | $1,876.00 |
| 2026537 | HC CL TX SHDR DISLOC W NK FX W MANIP | Operating Room Services - Minor Surgery | $4,614.00 |
| 2026676 | HC CL TX TMT JNT DISL; WO ANESTHESIA | Operating Room Services - Minor Surgery | $783.66 |
| 2026677 | HC DRAINAGE OF EYE | Operating Room Services - Minor Surgery | $7,347.66 |
| 2026678 | HC INJ ANTERIOR CHAMBER ; MEDICATION | Operating Room Services - Minor Surgery | $7,347.66 |
| 2026679 | HC TENDON SHEATH INCISION | Operating Room Services - Minor Surgery | $4,925.61 |
| 2026680 | HC CL TX ANKLE DISLOCATION; WO ANESTH | Operating Room Services - Minor Surgery | $783.66 |
| 2026681 | HC ASP VITREOUS SUBRETIN OR CHOROID FLUID | Operating Room Services - Minor Surgery | $7,347.66 |
| 2026698 | HC TRACHEOSTOMY EMERG; TRANSTRACHL | Operating Room Services - Minor Surgery | $4,904.19 |
| 2026784 | HC DX LMBR SPI PNXR W/FLUOR/CT | Operating Room Services - Minor Surgery | $5,702.20 |
| 2026785 | HC THER SPI PNXR CSF FLUOR/CT | Operating Room Services - Minor Surgery | $3,460.96 |
| 2026803 | HC LARYNGOSCOPY W/FB REMOVAL | Operating Room Services - Minor Surgery | $5,199.54 |
| 2026870 | HC NJX AA&/STRD NRV NRVTG SI JT | Operating Room Services - Minor Surgery | $8,768.62 |
| 2026871 | HC NJX AA&/STRD GNCLR NRV BRNCH | Operating Room Services - Minor Surgery | $8,768.62 |
| 2026872 | HC DSTRJ NULYT AGT GNCLR NRV | Operating Room Services - Minor Surgery | $6,428.97 |
| 2026873 | HC RF ABLTJ NRV NRVTG SI JT | Operating Room Services - Minor Surgery | $6,428.97 |
| 2026903 | HC REM TE WO INS PERM PROSTH | Operating Room Services - Minor Surgery | $8,428.02 |
| 2026962 | HC REPAIR RETINAL DETACHM; BY AIR INJ | Operating Room Services - Minor Surgery | $7,348.44 |
| 2026964 | HC ALVEOLECTOMY INCL CURETTAGE OF OSTEITIS | Operating Room Services - Minor Surgery | $9,519.81 |
| 2026971 | HC EXC LES MOUTH VESTIBULE; CPLX W EXCL | Operating Room Services - Minor Surgery | $8,437.00 |
| 2026983 | HC APPY PATELLAR TENDON BEARING CAST | Operating Room Services - Minor Surgery | $689.46 |
| 2026990 | HC EXPL P WND; ABD/FLANK | Operating Room Services - Minor Surgery | $5,897.85 |
| 2026991 | HC LIGATION/BAND ANGIOACCESS AV FISTULA | Operating Room Services - Minor Surgery | $10,072.23 |
| 2026994 | HC CL TX KNEE DISL; W ANESTHESIA | Operating Room Services - Minor Surgery | $4,656.12 |
| 2026996 | HC DISSECTION DEEP JUGULAR NODE | Operating Room Services - Minor Surgery | $17,568.12 |
| 2020511 | HC HARVEST AUTO STEM CELLS | Operating Room Services - Organ transplant - Other Than Kidney | $5,274.00 |
| 2020512 | HC CRYOPRESERVE STEM CELLS | Operating Room Services - Organ transplant - Other Than Kidney | $2,333.00 |
| 2020515 | HC BONE MARROW/STEM TRANSPLANT | Operating Room Services - Organ transplant - Other Than Kidney | $13,850.03 |
| 2026008 | HC TRANSPLT ALLO LYMPHOCYTES | Operating Room Services - Organ transplant - Other Than Kidney | $3,876.66 |
| 2020555 | HC FETAL NON-STRESS TEST | Other Diagnostic Services | $4,429.74 |
| 2022109 | HC DUP-SCAN XTRC ART COMPL BI STD | Other Diagnostic Services | $4,953.14 |
| 2022119 | HC DUP-SCAN XTR VEINS COMPL BI STD | Other Diagnostic Services | $3,172.58 |
| 2022177 | HC SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS | Other Diagnostic Services | $1,803.06 |
| 2022180 | HC C MOTOR EVOKED, UPPR LIMBS | Other Diagnostic Services | $1,926.32 |
| 2022183 | HC BLINK REFLEX TEST | Other Diagnostic Services | $1,361.04 |
| 2022782 | HC GLUCOSE MONITORING CONT | Other Diagnostic Services | $1,971.12 |
| 2023418 | HC C MOTOR EVOKED UPR&LWR LIMBS | Other Diagnostic Services | $3,295.86 |
| 2023441 | HC SOMATOSENSORY TESTING | Other Diagnostic Services | $2,424.23 |
| 2023643 | HC DUPLEX UE ART/BPG; BILAT | Other Diagnostic Services | $2,291.11 |
| 2023644 | HC DUPLEX A IVC IL/BPG; UNIL/LIM | Other Diagnostic Services | $1,582.28 |
| 2024349 | HC IONM REMOTE/>1 PT OR PER HR | Other Diagnostic Services | $2,355.10 |
| 2026109 | HC SLEEP STUDY UNATT&RESP EFFT | Other Diagnostic Services | $7,784.64 |
| 2026110 | HC MSLT/MWT; GLOBAL | Other Diagnostic Services | $15,712.38 |
| 2026467 | HC CONT INTRAOP NEURO MONITOR | Other Diagnostic Services | $588.77 |
| 2022148 | HC PERCUT ALLERGY SKIN TESTS | Other Diagnostic Services - Allergy Test | $1,101.19 |
| 2022150 | HC ALLERGY PATCH TESTS | Other Diagnostic Services - Allergy Test | $1,101.19 |
| 2022151 | HC PHOTO PATCH TEST | Other Diagnostic Services - Allergy Test | $152.31 |
| 2022152 | HC PHOTOSENSITIVITY TESTS | Other Diagnostic Services - Allergy Test | $499.18 |
| 2026025 | HC INGEST CHALLENGE INI 120 MIN | Other Diagnostic Services - Allergy Test | $1,657.00 |
| 2026026 | HC INGEST CHALLENGE ADDL 60 MIN | Other Diagnostic Services - Allergy Test | $828.39 |
| 2026508 | HC PERQ & ICUT ALLG TEST VENOMS | Other Diagnostic Services - Allergy Test | $119.63 |
| 2022162 | HC MUSCLE TEST, ONE LIMB | Other Diagnostic Services - Electromyogram | $1,046.22 |
| 2022163 | HC MUSCLE TEST, 2 LIMBS | Other Diagnostic Services - Electromyogram | $1,622.86 |
| 2022164 | HC MUSCLE TEST, 3 LIMBS | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2022166 | HC MUSCLE TEST CRAN NERV UNILAT | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2022167 | HC MUSCLE TEST CRAN NERVE BILAT | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2022168 | HC MUSCLE TEST, THOR PARASPINAL | Other Diagnostic Services - Electromyogram | $1,252.92 |
| 2022169 | HC MUSCLE TEST, NONPARASPINAL | Other Diagnostic Services - Electromyogram | $1,159.64 |
| 2022170 | HC MUSCLE TEST, ONE FIBER | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2022171 | HC GUIDE NERV DESTR, ELEC STIM | Other Diagnostic Services - Electromyogram | $490.21 |
| 2022178 | HC SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS | Other Diagnostic Services - Electromyogram | $1,803.06 |
| 2022182 | HC VISUAL EVOKED POTENTIAL TEST | Other Diagnostic Services - Electromyogram | $1,758.54 |
| 2022185 | HC NEUROMUSCULAR JUNCTION TEST | Other Diagnostic Services - Electromyogram | $1,631.34 |
| 2023415 | HC MUSC TST DONE W/NERV TST LIMTD | Other Diagnostic Services - Electromyogram | $4,726.91 |
| 2023416 | HC MUSC TEST DONE W/NERV TST COMPLETE | Other Diagnostic Services - Electromyogram | $4,726.91 |
| 2023417 | HC MUSC TST DONE W/N TST NONEXTREMITY | Other Diagnostic Services - Electromyogram | $5,944.53 |
| 2024341 | HC MOTOR&/SENS 1-2 NRV CNDJ TST | Other Diagnostic Services - Electromyogram | $1,362.10 |
| 2024342 | HC MOTOR&/SENS 3-4 NRV CNDJ TST | Other Diagnostic Services - Electromyogram | $1,362.10 |
| 2024343 | HC MOTOR&/SENS 5-6 NRV CNDJ TST | Other Diagnostic Services - Electromyogram | $1,362.10 |
| 2024344 | HC MOTOR&SENS 7-8 NRV CNDJ TEST | Other Diagnostic Services - Electromyogram | $1,362.10 |
| 2024345 | HC MOTOR&SEN 9-10 NRV CNDJ TEST | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2024346 | HC MOTOR&SEN 11-12 NRV CND TEST | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2024347 | HC MOTOR&SENS 13/> NRV CND TEST | Other Diagnostic Services - Electromyogram | $1,507.32 |
| 2025477 | HC SPECIMEN HANDLING OFFICE-LAB | Other Diagnostic Services - Pap Smear | $32.00 |
| 2022110 | HC DUP-SCAN XTRC ART UNI/LMTD STD | Other Diagnostic Services - Peripheral Vascular Lab | $3,165.23 |
| 2022111 | HC N-INVAS PHYSIOLOGIC STD UPR/LXTR ART 1 LVL BI | Other Diagnostic Services - Peripheral Vascular Lab | $1,304.26 |
| 2022113 | HC N-INVAS PHYSIOLOGIC STD UPR/LXTR BLAT MLT LVL BI | Other Diagnostic Services - Peripheral Vascular Lab | $2,006.96 |
| 2022115 | HC DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STD | Other Diagnostic Services - Peripheral Vascular Lab | $2,236.07 |
| 2022116 | HC DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STD | Other Diagnostic Services - Peripheral Vascular Lab | $1,374.82 |
| 2022117 | HC UPPER EXTREMITY STUDY | Other Diagnostic Services - Peripheral Vascular Lab | $1,510.50 |
| 2022120 | HC DUP-SCAN XTR VEINS UNI/LMTD STD | Other Diagnostic Services - Peripheral Vascular Lab | $2,162.40 |
| 2022122 | HC EXTREMITY STUDY RT | Other Diagnostic Services - Peripheral Vascular Lab | $1,539.77 |
| 2022124 | HC DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COMPL | Other Diagnostic Services - Peripheral Vascular Lab | $4,394.76 |
| 2022125 | HC DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMTD | Other Diagnostic Services - Peripheral Vascular Lab | $2,701.94 |
| 2022126 | HC DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPL | Other Diagnostic Services - Peripheral Vascular Lab | $2,501.09 |
| 2022668 | HC DUP-SCAN OF HEMODIALYSIS ACCESS | Other Diagnostic Services - Peripheral Vascular Lab | $1,745.85 |
| 2024983 | HC INTRACRANIAL ARTERY DOPPLER; COMPL | Other Diagnostic Services - Peripheral Vascular Lab | $1,153.17 |
| 2024984 | HC INTRACRANIAL ARTERY DOPPLER; LIMITED | Other Diagnostic Services - Peripheral Vascular Lab | $537.42 |
| 2025003 | HC TCD VASOREACTIVITY STUDY | Other Diagnostic Services - Peripheral Vascular Lab | $884.04 |
| 2025004 | HC TCD EMBOLI DETECT W/O INJ | Other Diagnostic Services - Peripheral Vascular Lab | $727.16 |
| 2025005 | HC TCD EMBOLI DETECT W/INJ | Other Diagnostic Services - Peripheral Vascular Lab | $727.16 |
| 2026111 | HC NONINVAS VASC DX STUDY PROC | Other Diagnostic Services - Peripheral Vascular Lab | $913.72 |
| 2023341 | HC DX MAMMO INCL CAD BI | Other Imaging Services - Diagnostic Mammography | $1,562.77 |
| 2023535 | HC DX MAMMO INCL CAD UNI | Other Imaging Services - Diagnostic Mammography | $1,297.12 |
| 2025148 | HC BREAST TOMOSYNTHESIS UNI ADD ON | Other Imaging Services - Diagnostic Mammography | $124.32 |
| 2025274 | HC BREAST TOMOSYNTHESIS BI ADD ON | Other Imaging Services - Diagnostic Mammography | $124.32 |
| 2023330 | HC PET IM METABOLIC BRAIN W/O IVC | Other Imaging Services - Positron Emission Tomography | $14,838.00 |
| 2023331 | HC PET IMAGE W/CT SKULL-THIGH | Other Imaging Services - Positron Emission Tomography | $17,763.00 |
| 2023332 | HC PTCT IMAGE WHOLE BODY WOIVC | Other Imaging Services - Positron Emission Tomography | $17,763.00 |
| 2023577 | HC MYOCRD IMG PET SINGLE STUDY | Other Imaging Services - Positron Emission Tomography | $8,916.32 |
| 2023578 | HC MYOCRD IMG PET MLT RST&STRS | Other Imaging Services - Positron Emission Tomography | $10,799.76 |
| 2023579 | HC PET IMAGE W/CT LMTD | Other Imaging Services - Positron Emission Tomography | $17,763.00 |
| 2026734 | HC PET CDSM NDSC | Other Imaging Services - Positron Emission Tomography | $1.00 |
| 2023340 | HC SCR MAMMO BI INCL CAD | Other Imaging Services - Screening Mammography | $1,354.55 |
| 2025149 | HC BREAST TOMOSYNTHESIS BI | Other Imaging Services - Screening Mammography | $146.98 |
| 2020000 | HC CHD RISK IMT STUDY | Other Imaging Services - Ultrasound | $352.60 |
| 2021135 | HC ECHO EXAM OF HEAD | Other Imaging Services - Ultrasound | $1,250.97 |
| 2021136 | HC US EXAM OF HEAD AND NECK | Other Imaging Services - Ultrasound | $1,791.93 |
| 2021137 | HC US EXAM, CHEST | Other Imaging Services - Ultrasound | $1,320.00 |
| 2021141 | HC US EXAM, ABDOM, COMPLETE | Other Imaging Services - Ultrasound | $1,791.93 |
| 2021142 | HC ECHO EXAM OF ABDOMEN | Other Imaging Services - Ultrasound | $1,469.53 |
| 2021143 | HC US EXAM ABDO BACK WALL, COMP | Other Imaging Services - Ultrasound | $1,721.90 |
| 2021144 | HC US EXAM ABDO BACK WALL, LIM | Other Imaging Services - Ultrasound | $1,102.00 |
| 2021145 | HC US EXAM K TRANSPL W/DOPPLER | Other Imaging Services - Ultrasound | $1,300.00 |
| 2021146 | HC US EXAM, SPINAL CANAL | Other Imaging Services - Ultrasound | $1,279.00 |
| 2021147 | HC OB US < 14 WKS, SINGLE FETUS | Other Imaging Services - Ultrasound | $2,628.73 |
| 2021148 | HC OB US >/= 14 WKS, SNGL FETUS | Other Imaging Services - Ultrasound | $3,021.17 |
| 2021149 | HC OB US >/= 14 WKS, ADDL FETUS | Other Imaging Services - Ultrasound | $2,023.77 |
| 2021150 | HC FETAL BIOPHYS PROFILE W/NST | Other Imaging Services - Ultrasound | $3,800.00 |
| 2021151 | HC FETAL BIOPHYS PROFIL W/O NST | Other Imaging Services - Ultrasound | $2,712.87 |
| 2021153 | HC TRANSVAGINAL US, NON-OB | Other Imaging Services - Ultrasound | $1,945.28 |
| 2021154 | HC US EXAM, PELVIC, COMPLETE | Other Imaging Services - Ultrasound | $1,911.47 |
| 2021155 | HC US EXAM, PELVIC, LIMITED | Other Imaging Services - Ultrasound | $1,299.27 |
| 2021156 | HC US SCROTUM AND CONTENTS | Other Imaging Services - Ultrasound | $1,686.88 |
| 2021157 | HC ECHOGRAP TRANS R, PROS STUDY | Other Imaging Services - Ultrasound | $1,199.00 |
| 2021158 | HC US COMPL JOINT R-T W/IMG | Other Imaging Services - Ultrasound | $2,604.58 |
| 2021161 | HC US EXAM INFANT HIPS, DYNAMIC | Other Imaging Services - Ultrasound | $1,379.44 |
| 2021165 | HC US GUIDE, VASCULAR ACCESS | Other Imaging Services - Ultrasound | $745.03 |
| 2021166 | HC US GUIDE, TISSUE ABLATION | Other Imaging Services - Ultrasound | $766.76 |
| 2021167 | HC US GUIDED NEEDLE PLACEMENT | Other Imaging Services - Ultrasound | $3,308.55 |
| 2021168 | HC US GUIDE, INTRAOP | Other Imaging Services - Ultrasound | $1,129.00 |
| 2022580 | HC OB US FOLLOW-UP PER FETUS | Other Imaging Services - Ultrasound | $4,212.45 |
| 2022587 | HC OB US LIMITED 1+ FETUS(S) | Other Imaging Services - Ultrasound | $3,079.66 |
| 2022729 | HC TRANSVAGINAL OB US | Other Imaging Services - Ultrasound | $3,556.02 |
| 2022730 | HC FETAL CARDIOVASC 2-D US | Other Imaging Services - Ultrasound | $1,677.22 |
| 2023137 | HC US LMTD JT/NONVASC XTR STRUX | Other Imaging Services - Ultrasound | $1,056.00 |
| 2023541 | HC OB US < 14 WKS ADDL FETUS | Other Imaging Services - Ultrasound | $1,389.83 |
| 2023638 | HC US GUIDED AMNIOCENTESIS | Other Imaging Services - Ultrasound | $268.07 |
| 2023765 | HC OB US NUCHAL MEAS 1 GEST | Other Imaging Services - Ultrasound | $557.49 |
| 2023766 | HC TRANSRECTAL US | Other Imaging Services - Ultrasound | $1,102.00 |
| 2024834 | HC UMBILICAL ARTERY ECHO | Other Imaging Services - Ultrasound | $309.12 |
| 2025034 | HC FETAL MIDL CEREBRAL ARTERY ECHO | Other Imaging Services - Ultrasound | $525.97 |
| 2025085 | HC ULTRASOUND BREAST COMPLETE | Other Imaging Services - Ultrasound | $1,350.00 |
| 2025086 | HC ULTRASOUND BREAST LIMITED | Other Imaging Services - Ultrasound | $1,232.86 |
| 2025427 | HC OB US DETAILED SNGL FETUS | Other Imaging Services - Ultrasound | $820.24 |
| 2025430 | HC US FOLLOW-UP STUDY | Other Imaging Services - Ultrasound | $546.02 |
| 2025622 | HC US FOR FETAL TRANSF/CORDOCENTESIS | Other Imaging Services - Ultrasound | $358.63 |
| 2026134 | HC US ABDL AORTA SCREEN AAA | Other Imaging Services - Ultrasound | $345.00 |
| 2026982 | HC US EXAM INFANT HIPS STATIC | Other Imaging Services - Ultrasound | $1,379.44 |
| 2022189 | HC RFL&MAIN IMPLT PMP/RSVR F/DRUG DLVR SPI/BRN | Other Therapeutic Services | $7,468.76 |
| 2022224 | HC ULTRAVIOLET LIGHT THERAPY | Other Therapeutic Services | $340.47 |
| 2022226 | HC PHOTOCHEMOTHERAPY WITH UV-B | Other Therapeutic Services | $1,103.32 |
| 2022245 | HC ULTRAVIOLET THERAPY | Other Therapeutic Services | $61.43 |
| 2022328 | HC PHLEBOTOMY | Other Therapeutic Services | $2,606.01 |
| 2024477 | HC ACUPUNCT W/O STIMUL 15 MIN | Other Therapeutic Services | $83.55 |
| 2024499 | HC ACUPUNCT W/O STIMUL ADDL 15 MIN | Other Therapeutic Services | $83.55 |
| 2024500 | HC ACUPUNCT W/STIMUL ADDL 15 MIN | Other Therapeutic Services | $88.55 |
| 2024658 | HC CHIRO MANIPULATIVE TREATMENT;CMT; SPINAL, 1-2 REGIONS | Other Therapeutic Services | $183.03 |
| 2024659 | HC CHIRO MANIPULATIVE TREATMENT;CMT; SPINAL, 3-4 REGIONS | Other Therapeutic Services | $271.34 |
| 2022108 | HC CARDIAC REHAB/MONITOR | Other Therapeutic Services - Cardiac Rehabilitation | $299.51 |
| 2026126 | HC ALCOHOL/DRUG SERVICE 15 MIN | Other Therapeutic Services - Drug Rehabilitation | $133.56 |
| 2026127 | HC ALCOHOL/DRUG SCREENING | Other Therapeutic Services - Drug Rehabilitation | $126.14 |
| 2022319 | HC MED NUTRITION THERAPY INIT, EA 15 MIN | Other Therapeutic Services - Education/Training | $260.76 |
| 2022320 | HC MED NUTRITION THERAPY INIT, EA 15 MIN | Other Therapeutic Services - Education/Training | $59.62 |
| 2022321 | HC MED NUTRITION THERAPY REASSES, EA 15 MIN | Other Therapeutic Services - Education/Training | $221.54 |
| 2022322 | HC MED NUTRITION THERAPY REASSES, EA 15 MIN | Other Therapeutic Services - Education/Training | $37.10 |
| 2022323 | HC MEDICAL NUTRITION, GROUP | Other Therapeutic Services - Education/Training | $121.90 |
| 2022324 | HC SELF-MGMT EDUC & TRAIN, 1 PT | Other Therapeutic Services - Education/Training | $198.22 |
| 2022325 | HC SELF-MGMT EDUC/TRAIN, 2-4 PT | Other Therapeutic Services - Education/Training | $265.00 |
| 2022354 | HC BEHAV CHNG SMOKING 3-10 MIN | Other Therapeutic Services - Education/Training | $96.46 |
| 2022355 | HC BEHAV CHNG SMOKING > 10 MIN | Other Therapeutic Services - Education/Training | $200.34 |
| 2022411 | HC DIAB MANAGE TRN PER INDIV | Other Therapeutic Services - Education/Training | $429.30 |
| 2022412 | HC DIAB MANAGE TRN IND/GROUP | Other Therapeutic Services - Education/Training | $151.58 |
| 2025464 | HC INSULIN PUMP INSTRUCTION | Other Therapeutic Services - Education/Training | $95.42 |
| 2025467 | HC DIABETES MANAGEMENT - GROUP | Other Therapeutic Services - Education/Training | $219.42 |
| 2025812 | HC DM PROGRAM NURSE VISIT | Other Therapeutic Services - Education/Training | $237.19 |
| 2025813 | HC DM PROGRAM DIETITIAN VISIT | Other Therapeutic Services - Education/Training | $237.19 |
| 2025814 | HC DM PROGRAM F/U TO NON-MD | Other Therapeutic Services - Education/Training | $237.19 |
| 2025816 | HC PT EDUCATION NOC INDIVID | Other Therapeutic Services - Education/Training | $237.19 |
| 2026145 | HC 2 EM CORE MS MO 7-9 NO WL | Other Therapeutic Services - Education/Training | $47.70 |
| 2026146 | HC 2 EM CORE MS MO 10-12 NO WL | Other Therapeutic Services - Education/Training | $47.70 |
| 2026147 | HC 2 EM CORE MS MO 7-9 WL | Other Therapeutic Services - Education/Training | $190.80 |
| 2026148 | HC 2 EM CORE MS MO 10-12 WL | Other Therapeutic Services - Education/Training | $190.80 |
| 2026149 | HC EM 5 PERCENT WL | Other Therapeutic Services - Education/Training | $508.80 |
| 2026150 | HC EM 9 PERCENT WL | Other Therapeutic Services - Education/Training | $79.50 |
| 2026151 | HC 2 EM ONGOING MS MO 13-15 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026152 | HC 2 EM ONGOING MS MO 16-18 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026153 | HC 2 EM ONGOING MS MO 19-21 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026154 | HC 2 EM ONGOING MS MO 22-24 WL | Other Therapeutic Services - Education/Training | $159.00 |
| 2026156 | HC EM SESSION REPORTING | Other Therapeutic Services - Education/Training | $1.06 |
| 2026382 | HC NM FAMILY PLANNING EDUC | Other Therapeutic Services - Education/Training | $126.14 |
| 2026383 | HC AUDIT/DAST OVER 30 MIN | Other Therapeutic Services - Education/Training | $437.78 |
| 2022664 | HC PULMONARY REHAB W EXER | Other Therapeutic Services - Pulmonary Rehabilitation | $119.97 |
| 2022489 | HC CHILD LIFE IND TRMNT 15MIN | Other Therapeutic Services - Recreational Therapy | $147.90 |
| 1011001 | HC RB STANDARD PRIVATE ROOM DIFFERENTIAL | Patient Convenience Items | $200.00 |
| 1011002 | HC RB PREMIUM PRIVATE ROOM DIFFERENTIAL | Patient Convenience Items | $200.00 |
| 2022496 | HC THERAPEUTIC REC 15M IND | Patient Convenience Items | $144.80 |
| 2022498 | HC THERAPEUTIC REC 15M GRP | Patient Convenience Items | $157.50 |
| 2022508 | HC COMMUNITY REINTEG 180M GRP | Patient Convenience Items | $276.60 |
| 2022514 | HC MUSIC THERAPY 30M EVAL | Patient Convenience Items | $154.61 |
| 2022516 | HC MUSIC THERAPY 15M IND | Patient Convenience Items | $158.06 |
| 2022518 | HC MUSIC THERAPY 15M GRP | Patient Convenience Items | $160.67 |
| 2022525 | HC THERAPEUTIC REC 30M EVAL | Patient Convenience Items | $133.42 |
| 2023244 | HC HEALTH AND FITNESS EVAL 90 MIN | Patient Convenience Items | $325.00 |
| 2023246 | HC GHF PRSNL TRAIN 60 MIN | Patient Convenience Items | $175.00 |
| 2023247 | HC GHF PRSNL TRAIN 30 MIN | Patient Convenience Items | $90.00 |
| 2023248 | HC SPORTS SPECIFIC TRAINING 60 MIN | Patient Convenience Items | $175.00 |
| 2023251 | HC MT LACTATE PROF 60 MIN | Patient Convenience Items | $225.00 |
| 2023252 | HC AEROBIC CAPACITY WITH LACTATE | Patient Convenience Items | $350.00 |
| 2023253 | HC MT REST MR 45 MIN | Patient Convenience Items | $175.00 |
| 2023255 | HC RUNNERS EVALUATION | Patient Convenience Items | $395.00 |
| 2023349 | HC PERSONAL TRAINING 30 MIN 8 SESSION PACKAGE | Patient Convenience Items | $570.00 |
| 2023351 | HC PERSONAL TRAINING 60 MIN 8 SESSION PACKAGE | Patient Convenience Items | $1,140.00 |
| 2023788 | HC FUNCTIONAL MVMT SCREEN 60 MIN | Patient Convenience Items | $200.00 |
| 2024298 | HC SPORTS NUTRIT ASSESS 60MIN | Patient Convenience Items | $225.00 |
| 2024299 | HC SPORTS NUTRIT FUP 30MIN | Patient Convenience Items | $75.00 |
| 2024480 | HC MASSAGE THERAPY (FULL BODY) 60 MIN | Patient Convenience Items | $91.22 |
| 2024689 | HC ACUPUNCTURE W/ OR W/O STIM - 1 HOUR | Patient Convenience Items | $91.22 |
| 2024860 | HC RUNNING LAB EVALUATION 180 MIN | Patient Convenience Items | $495.00 |
| 2024993 | HC WELLNESS EXE CLASS 60 MIN | Patient Convenience Items | $20.00 |
| 2025147 | HC MASSAGE THERAPY (FULL BODY) 30 MIN | Patient Convenience Items | $45.19 |
| 2025168 | HC CARD REHAB MAINT PRG 3X/WEEK | Patient Convenience Items | $200.67 |
| 2025169 | HC CARD REHAB MAINT PRG 2X/WEEK | Patient Convenience Items | $145.95 |
| 2025192 | HC RUNNERS EXERCISE CLASS 60 MIN | Patient Convenience Items | $40.00 |
| 2025223 | HC PERSONAL TRAINING 30 MIN 16 SESSION PACKAGE | Patient Convenience Items | $1,080.00 |
| 2025225 | HC PERSONAL TRAINING 60 MIN 16 SESSION PACKAGE | Patient Convenience Items | $2,160.00 |
| 2025227 | HC SPORTS PERFORMANCE EVALUATION 120 MIN | Patient Convenience Items | $425.00 |
| 2025230 | HC SPORTS SPECIFIC TRAINING 60 MIN 16 SESSION PACKAGE | Patient Convenience Items | $2,160.00 |
| 2025580 | HC GHF TRNG 30MIN 8 SES PKG | Patient Convenience Items | $570.00 |
| 2025581 | HC GHF TRAINING 60MIN 8 SES PKG | Patient Convenience Items | $1,140.00 |
| 2025751 | HC CARD REHAB MAINT PRG 1X/WEEK | Patient Convenience Items | $80.00 |
| 2025801 | HC SPORTS SPECIFIC TRAINING 30 MIN | Patient Convenience Items | $90.00 |
| 2025987 | HC SPORTS SPECIFIC EVALUATION W/LACTATE | Patient Convenience Items | $475.00 |
| 2026027 | HC COOLING CAP ADMINISTRATION | Patient Convenience Items | $72.51 |
| 2026202 | HC NW CARDIAC REHAB SESS PHASE III | Patient Convenience Items | $22.00 |
| 2026224 | HC ACL RETURN TO SPORT EVALUATION | Patient Convenience Items | $495.00 |
| 2026228 | HC GOLF EXERCISE CLASS | Patient Convenience Items | $40.00 |
| 2026401 | HC RUNNING 3D EVALUATION | Patient Convenience Items | $425.00 |
| 2026439 | HC INTENSIVE SPEECH LANGUAGE THERAPY FOR STROKE SURVIVORS | Patient Convenience Items | $10,000.00 |
| 2026557 | HC NW DIABETES PREVENTION IND COUNSEL | Patient Convenience Items | $140.00 |
| D015999 | HC PREMIUM DENTURE UP-CHARGE | Patient Convenience Items | $2,160.00 |
| D018999 | HC INVISALIGN WORK-UP | Patient Convenience Items | $540.00 |
| D025999 | HC ESSEX RETAINER | Patient Convenience Items | $500.00 |
| D038999 | HC INVISALIGN | Patient Convenience Items | $16,000.00 |
| RX-1 | 0.45% SODIUM ACETATE, HEPARIN 0.5 UNITS/ML IV INFUSION | Pharmacy | $63.00 |
| RX-10 | ACETIC ACID 2 % OTIC SOLN | Pharmacy | $47.04 |
| RX-1000 | IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,955.29 |
| RX-1002 | IPRATROPIUM BROMIDE 0.03 % NASAL SPRY | Pharmacy | $114.24 |
| RX-1003 | IPRATROPIUM BROMIDE 17 MCG/ACTUATION INHALATION HFAA | Pharmacy | $364.64 |
| RX-1005 | IPRATROPIUM-ALBUTEROL 20-100 MCG/ACTUATION INHALATION MIST | Pharmacy | $1,011.78 |
| RX-1006 | IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $31.20 |
| RX-1007 | IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS DISP | Pharmacy | $627.96 |
| RX-1008 | IRON DEXTRAN 50 MG/ML INJECTION SOLN | Pharmacy | $181.19 |
| RX-101 | ARGININE-LYSINE IN 0.9 % NACL 25-25 MG/ML INTRAVENOUS SOLN | Pharmacy | $3,024.00 |
| RX-1010 | ISAVUCONAZONIUM SULFATE 186 MG ORAL CAP | Pharmacy | $293.86 |
| RX-1012 | ISOPROTERENOL 200 MCG/50 ML D5W IVPB | Pharmacy | $67.81 |
| RX-1013 | ISOPROTERENOL HCL 0.2 MG/ML INJECTION SOLN | Pharmacy | $8,231.96 |
| RX-1014 | ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLN | Pharmacy | $77.01 |
| RX-1015 | IXABEPILONE 15 MG INTRAVENOUS SOLR | Pharmacy | $1,210.52 |
| RX-1016 | KETAMINE 50 MG/ML (1 ML) INTRAVENOUS SYRG | Pharmacy | $65.52 |
| RX-1019 | KETOCONAZOLE 2 % TOP CREA | Pharmacy | $56.18 |
| RX-102 | ARIPIPRAZOLE 300 MG IM SERS | Pharmacy | $86.21 |
| RX-1020 | KETOCONAZOLE 2 % TOP SHAM | Pharmacy | $37.80 |
| RX-1021 | KETOROLAC 0.4 % OPHTHALMIC DROP | Pharmacy | $161.88 |
| RX-1022 | KETOROLAC 0.5 % OPHTHALMIC DROP | Pharmacy | $88.90 |
| RX-1026 | KIT FOR OF PREP TC-99M-ALBUMIN 2.5 MG INTRAVENOUS SOLR | Pharmacy | $2,413.03 |
| RX-1027 | KIT FOR PREP OF GA 68-DOTATATE 40 MCG INTRAVENOUS SOLR | Pharmacy | $4,083.33 |
| RX-1028 | KIT FOR PREP TC-99M-BICISATE 0.9 MG INTRAVENOUS SOLR | Pharmacy | $17,019.45 |
| RX-1029 | KIT FOR TC 99M FILTERED SULFUR COLLOID | Pharmacy | $11,740.68 |
| RX-103 | ARIPIPRAZOLE 300 MG IM SSRR | Pharmacy | $64.66 |
| RX-1030 | KIT FOR TC 99M-SOD THIOSULFATE 2 MG MISC. SOLR | Pharmacy | $1,153.03 |
| RX-1031 | KIT FOR TC-99M-TILMANOCEPT 250 MCG INJECTION SOLR | Pharmacy | $18,798.26 |
| RX-1032 | KIT PREP OF TC-99M-MEBROFENIN 45 MG INTRAVENOUS SOLR | Pharmacy | $420.21 |
| RX-1033 | KIT PREP OF TC-99M-SOD PYROPH 12 MG INTRAVENOUS SOLR | Pharmacy | $967.05 |
| RX-1034 | KIT PREP OF TC-99M-TETROFOSMIN 1.38 MG INTRAVENOUS SOLR | Pharmacy | $548.10 |
| RX-1035 | KIT PREP TC 99M-PENTETIC ACID 20 MG AEROSOL | Pharmacy | $3,425.63 |
| RX-1036 | KIT PREP TC 99M-PENTETIC ACID 20 MG INTRAVENOUS SOLR | Pharmacy | $2,770.98 |
| RX-1037 | KIT PREP TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS KIT | Pharmacy | $20,278.57 |
| RX-1038 | KIT PREP TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS SOLR | Pharmacy | $25,779.60 |
| RX-1039 | KIT PREP TC-99M-MEDRONATE SOD 25 MG INTRAVENOUS SOLR | Pharmacy | $494.05 |
| RX-104 | ARIPIPRAZOLE 400 MG IM SERS | Pharmacy | $64.66 |
| RX-1043 | LACOSAMIDE 100 MG ORAL TAB | Pharmacy | $51.84 |
| RX-1044 | LACOSAMIDE 100 MG/50 ML NS | Pharmacy | $228.90 |
| RX-1045 | LACOSAMIDE 150 MG ORAL TAB | Pharmacy | $49.91 |
| RX-1046 | LACOSAMIDE 200 MG ORAL TAB | Pharmacy | $54.92 |
| RX-1048 | LACOSAMIDE 200 MG/50 ML NS | Pharmacy | $112.70 |
| RX-1049 | LACTATED RINGERS INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-105 | ARIPIPRAZOLE 400 MG IM SSRR | Pharmacy | $86.21 |
| RX-1050 | LACTATED RINGERS IV BOLUS | Pharmacy | $63.00 |
| RX-1051 | LACTATED RINGERS IV KVO | Pharmacy | $63.00 |
| RX-1052 | LANOLIN-MINERAL OIL TOP LOTN | Pharmacy | $181.72 |
| RX-1053 | LANOLIN-MINERAL OIL-NACL-W.PET TOP LOTN | Pharmacy | $117.60 |
| RX-1054 | LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $802.04 |
| RX-1055 | LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRG | Pharmacy | $802.04 |
| RX-1056 | LANSOPRAZOLE 3 MG/ML ORAL SUSR | Pharmacy | $3,867.26 |
| RX-1057 | LENALIDOMIDE 10 MG ORAL CAP | Pharmacy | $2,670.54 |
| RX-1058 | LEUCOVORIN CALCIUM 50 MG INJECTION SOLR | Pharmacy | $41.95 |
| RX-1059 | LEUCOVORIN CALCIUM 10 MG/ML INJECTION SOLN | Pharmacy | $41.96 |
| RX-106 | ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $555.33 |
| RX-1060 | LEUCOVORIN CALCIUM 100 MG INJECTION SOLR | Pharmacy | $41.95 |
| RX-1061 | LEUCOVORIN CALCIUM 350 MG INJECTION SOLR | Pharmacy | $41.95 |
| RX-1062 | LEUPROLIDE 3.75 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1063 | LEUPROLIDE 7.5 MG IM SYKT | Pharmacy | $2,898.93 |
| RX-1064 | LEUPROLIDE (3 MONTH) 11.25 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1065 | LEUPROLIDE (3 MONTH) 22.5 MG IM SYKT | Pharmacy | $2,898.94 |
| RX-1066 | LEUPROLIDE (3 MONTH) 22.5 MG SUBCUTANEOUS SYRG | Pharmacy | $2,898.94 |
| RX-1067 | LEUPROLIDE (4 MONTH) 30 MG IM SYKT | Pharmacy | $2,898.93 |
| RX-1068 | LEUPROLIDE (6 MONTH) 45 MG IM SYKT | Pharmacy | $2,898.93 |
| RX-1069 | LEUPROLIDE (6 MONTH) 45 MG SUBCUTANEOUS SYRG | Pharmacy | $2,898.93 |
| RX-107 | ARSENIC TRIOXIDE 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $555.33 |
| RX-1070 | LEUPROLIDE (PEDIATRIC 3 MONTH) 11.25 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1071 | LEUPROLIDE (PEDIATRIC 3 MONTH) 30 MG IM SYKT | Pharmacy | $16,015.87 |
| RX-1072 | LEUPROLIDE 1 MG/0.2 ML SUBCUTANEOUS KIT | Pharmacy | $127.61 |
| RX-1073 | LEUPROLIDE 11.25 MG IM KIT | Pharmacy | $15,999.86 |
| RX-1074 | LEUPROLIDE 15 MG IM KIT | Pharmacy | $2,898.93 |
| RX-1075 | LEUPROLIDE 7.5 MG (1 MONTH) SUBCUTANEOUS SYRG | Pharmacy | $2,898.93 |
| RX-1079 | LEVALBUTEROL TARTRATE 45 MCG/ACTUATION INHALATION HFAA | Pharmacy | $182.70 |
| RX-108 | ARTIFICIAL TEARS(HYPROMELLOSE) 0.5 % OPHTHALMIC DROP | Pharmacy | $81.90 |
| RX-1085 | LEVOCARNITINE 20 MG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $258.99 |
| RX-1086 | LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLN | Pharmacy | $249.73 |
| RX-109 | ASPARAGINASE (ERWINIA CHRYSAN) 10000 UNITS INJECTION SOLR | Pharmacy | $5,226.78 |
| RX-1091 | LEVONORGESTREL 1.5 MG ORAL TAB | Pharmacy | $103.25 |
| RX-1092 | LEVONORGESTREL 14 MCG/24 HRS (3 YRS) 13.5 MG INTRAUTERINE IUD | Pharmacy | $8,403.32 |
| RX-1093 | LEVONORGESTREL 17.5 MCG/24 HRS (5 YRS) 19.5 MG INTRAUTERINE IUD | Pharmacy | $10,091.97 |
| RX-1094 | LEVONORGESTREL 20 MCG/24 HOURS (5 YRS) 52 MG INTRAUTERINE IUD | Pharmacy | $10,091.97 |
| RX-1095 | LEVONORGESTREL 20.1 MCG/24 HRS (6 YRS) 52 MG INTRAUTERINE IUD | Pharmacy | $9,914.56 |
| RX-1096 | LEVOTHYROXINE 100 MCG INTRAVENOUS SOLR | Pharmacy | $1,049.71 |
| RX-1097 | LEVOTHYROXINE 20 MCG/ML INJECTION (PED-NEO) | Pharmacy | $1,041.64 |
| RX-1098 | LEVOTHYROXINE 200 MCG INTRAVENOUS SOLR | Pharmacy | $1,865.43 |
| RX-1099 | LEVOTHYROXINE 500 MCG INTRAVENOUS SOLR | Pharmacy | $4,515.59 |
| RX-11 | ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT | Pharmacy | $197.47 |
| RX-110 | ATAZANAVIR 200 MG ORAL CAP | Pharmacy | $82.36 |
| RX-1105 | LIDOCAINE (PF) 3.5 % OPHTHALMIC GEL | Pharmacy | $64.19 |
| RX-111 | ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLN | Pharmacy | $981.00 |
| RX-1113 | LIDOCAINE HCL 4 % (40 MG/ML) MUCOUS MEMBR SOLN | Pharmacy | $63.00 |
| RX-1118 | LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLN | Pharmacy | $10.33 |
| RX-112 | ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLN | Pharmacy | $981.00 |
| RX-1127 | LINACLOTIDE 145 MCG ORAL CAP | Pharmacy | $47.08 |
| RX-1128 | LINACLOTIDE 290 MCG ORAL CAP | Pharmacy | $47.08 |
| RX-1129 | LINDANE 1 % TOP SHAM | Pharmacy | $348.60 |
| RX-1130 | LINEZOLID 2 MG/ML IV DISPENSABLE | Pharmacy | $70.56 |
| RX-1131 | LINEZOLID IN DEXTROSE 5% 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $70.56 |
| RX-1132 | LINEZOLID IN DEXTROSE 5% 600 MG/300 ML INTRAVENOUS PGBK | Pharmacy | $70.56 |
| RX-1133 | LIOTHYRONINE 10 MCG/ML INTRAVENOUS SOLN | Pharmacy | $3,087.00 |
| RX-1134 | LIRAGLUTIDE 0.6 MG/0.1 ML (18 MG/3 ML) SUBCUTANEOUS PNIJ | Pharmacy | $3,688.52 |
| RX-1135 | LOMUSTINE 10 MG ORAL CAP | Pharmacy | $1,040.13 |
| RX-1136 | LOMUSTINE 40 MG ORAL CAP | Pharmacy | $1,155.67 |
| RX-1137 | LOMUSTINE 100 MG ORAL CAP | Pharmacy | $1,148.49 |
| RX-1141 | LOTEPREDNOL ETABONATE 0.5 % OPHTHALMIC DRPS | Pharmacy | $800.28 |
| RX-1142 | LURASIDONE 20 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1143 | LURASIDONE 40 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1144 | LURASIDONE 60 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1145 | LURASIDONE 80 MG ORAL TAB | Pharmacy | $131.78 |
| RX-1146 | LURASIDONE 120 MG ORAL TAB | Pharmacy | $196.74 |
| RX-1147 | LURBINECTEDIN 4 MG INTRAVENOUS SOLR | Pharmacy | $83,575.80 |
| RX-1148 | LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLR | Pharmacy | $433.59 |
| RX-1149 | LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLN | Pharmacy | $2,254.56 |
| RX-115 | ATROPINE 1 % OPHTHALMIC DROP | Pharmacy | $148.40 |
| RX-1150 | LYMPHOCYTE,ANTI-THYMO IMM GLOB 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $16,274.32 |
| RX-1151 | MACITENTAN 10 MG ORAL TAB | Pharmacy | $806.16 |
| RX-116 | ATROPINE 1 % OPHTHALMIC OINT | Pharmacy | $53.41 |
| RX-1164 | MANGANESE CHLORIDE 0.01 MG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $24.07 |
| RX-1165 | MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $24.07 |
| RX-1166 | MANGANESE SULFATE 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $28.22 |
| RX-1167 | MANNITOL 20 % 20 % INTRAVENOUS SOLP | Pharmacy | $25.83 |
| RX-1168 | MANNITOL 25 % 25 % INTRAVENOUS SOLN | Pharmacy | $25.83 |
| RX-1169 | MARAVIROC 150 MG ORAL TAB | Pharmacy | $82.39 |
| RX-1170 | MARAVIROC 300 MG ORAL TAB | Pharmacy | $82.39 |
| RX-1171 | MEASLES,MUMPS,RUB,VARICEL(PF) 10EXP3-4.3-3- 3.99 TCID50/0.5 SUBCUTANEOUS SUSR | Pharmacy | $5,388.77 |
| RX-1172 | MEASLES,MUMPS,RUBELLA VACC(PF) 1,000-12,500 TCID50/0.5 ML SUBCUTANEOUS SOLR | Pharmacy | $858.44 |
| RX-1175 | MELPHALAN HCL 50 MG INTRAVENOUS SOLR | Pharmacy | $7,980.69 |
| RX-1176 | MENING VAC A,C,Y,W135 DIP (PF) 10-5 MCG/0.5 ML IM KIT | Pharmacy | $1,142.32 |
| RX-1177 | MENING VAC A,C,Y,W135 DIP (PF) 4 MCG/0.5 ML IM SOLN | Pharmacy | $734.96 |
| RX-1178 | MENINGOCOCCAL B VACCINE,4-COMP 50-50-50-25 MCG/0.5 ML IM SYRG | Pharmacy | $1,740.56 |
| RX-1179 | MENTHOL-ZINC OXIDE 0.44-20.6 % TOP OINT | Pharmacy | $88.10 |
| RX-118 | AVELUMAB 20 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,059.86 |
| RX-1180 | MEPERIDINE (PF) 25 MG/ML INJECTION SOLN | Pharmacy | $59.52 |
| RX-1181 | MEPERIDINE (PF) 25 MG/ML INJECTION SYRG | Pharmacy | $59.52 |
| RX-1182 | MEPERIDINE (PF) 50 MG/ML INJECTION SOLN | Pharmacy | $59.52 |
| RX-1183 | MEPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLN | Pharmacy | $29.36 |
| RX-1184 | MEPIVACAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLN | Pharmacy | $29.36 |
| RX-1185 | MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLN | Pharmacy | $29.36 |
| RX-1186 | MEROPENEM 1 G INTRAVENOUS SOLR | Pharmacy | $10.04 |
| RX-1187 | MEROPENEM 500 MG INTRAVENOUS SOLR | Pharmacy | $10.04 |
| RX-1188 | MEROPENEM-0.9% SODIUM CHLORIDE 1 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.08 |
| RX-1189 | MEROPENEM-0.9% SODIUM CHLORIDE 500 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $10.04 |
| RX-119 | AZACITIDINE 100 MG INJECTION SOLR | Pharmacy | $12.89 |
| RX-1190 | MESALAMINE 1000 MG RECTAL SUPP | Pharmacy | $122.99 |
| RX-1191 | MESNA 100 MG/ML INTRAVENOUS SOLN | Pharmacy | $27.95 |
| RX-1192 | METFORMIN 1000 MG ORAL TG24 | Pharmacy | $44.10 |
| RX-1193 | METHADONE 10 MG/ML INJECTION SOLN | Pharmacy | $213.87 |
| RX-1194 | METHOCARBAMOL 100 MG/ML INJECTION SOLN | Pharmacy | $104.20 |
| RX-1195 | METHOHEXITAL 500 MG INJECTION SOLR | Pharmacy | $15.37 |
| RX-1197 | METHOTREXATE SODIUM (PF) 1 G INJECTION SOLR | Pharmacy | $31.37 |
| RX-12 | ACETYLCYSTEINE 100 MG/ML (10 %) MISC. SOLN | Pharmacy | $71.69 |
| RX-120 | AZACITIDINE INJ SUBQ 100 MG (CC) | Pharmacy | $12.89 |
| RX-1202 | METHOXSALEN 20 MCG/ML INJECTION SOLN | Pharmacy | $1,337.00 |
| RX-1203 | METHYL SALICYLATE-MENTHOL TOP OINT | Pharmacy | $90.16 |
| RX-1204 | METHYLENE BLUE (ANTIDOTE) 1 % (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $77.01 |
| RX-1205 | METHYLENE BLUE (ANTIDOTE) 5 MG/ML (0.5 %) INTRAVENOUS SOLN | Pharmacy | $77.01 |
| RX-1206 | METHYLERGONOVINE 0.2 MG ORAL TAB | Pharmacy | $139.76 |
| RX-1207 | METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLN | Pharmacy | $227.34 |
| RX-1211 | METHYLNALTREXONE 150 MG ORAL TAB | Pharmacy | $65.98 |
| RX-1213 | METHYLPHENIDATE HCL 27 MG ORAL TR24 | Pharmacy | $38.47 |
| RX-1214 | METHYLPHENIDATE HCL 54 MG ORAL TR24 | Pharmacy | $43.19 |
| RX-122 | AZELASTINE 0.15 % (205.5 MCG) NASAL SPRY | Pharmacy | $93.45 |
| RX-1220 | METHYLPREDNISOLONE ACETATE 40 MG/ML INJECTION SUSP | Pharmacy | $79.22 |
| RX-1221 | METHYLPREDNISOLONE ACETATE 80 MG/ML INJECTION SUSP | Pharmacy | $149.88 |
| RX-1222 | METHYLPREDNISOLONE SOD SUC(PF) 1000 MG/8 ML INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-1223 | METHYLPREDNISOLONE SOD SUC(PF) 125 MG/2 ML INJECTION SOLR | Pharmacy | $79.59 |
| RX-1224 | METHYLPREDNISOLONE SOD SUC(PF) 40 MG/ML INJECTION SOLR | Pharmacy | $57.73 |
| RX-1225 | METHYLPREDNISOLONE SOD SUC(PF) 500 MG/4 ML INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-1226 | METHYLPREDNISOLONE SODIUM SUCC 40 MG INJECTION SOLR | Pharmacy | $57.73 |
| RX-1227 | METHYLPREDNISOLONE SODIUM SUCC 125 MG INJECTION SOLR | Pharmacy | $79.59 |
| RX-1228 | METHYLPREDNISOLONE SODIUM SUCC 500 MG INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-1229 | METHYLPREDNISOLONE SODIUM SUCC 1000 MG INTRAVENOUS SOLR | Pharmacy | $79.59 |
| RX-123 | AZITHROMYCIN 1 G ORAL PACK | Pharmacy | $277.58 |
| RX-1230 | METHYLPREDNISOLONE SODIUM SUCC 40 MG/ML INJECTION SOLR | Pharmacy | $57.73 |
| RX-1231 | METOCLOPRAMIDE HCL 5 MG/ML INJECTION SOLN | Pharmacy | $15.15 |
| RX-1232 | METOCLOPRAMIDE HCL 5 MG/ML INJECTION SYRG | Pharmacy | $15.15 |
| RX-1233 | METOPROLOL IN 0.9 % NACL 5 MG/50 ML IVPB | Pharmacy | $31.50 |
| RX-1235 | METRONIDAZOLE 0.75 % TOP CREA | Pharmacy | $151.20 |
| RX-1236 | METRONIDAZOLE 0.75 % VAGINAL GEL | Pharmacy | $218.05 |
| RX-1237 | METRONIDAZOLE IN NACL (ISO-OS) 500 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-1239 | MICAFUNGIN 50 MG INTRAVENOUS SOLR | Pharmacy | $13.32 |
| RX-124 | AZITHROMYCIN 200 MG/5 ML ORAL SUSR | Pharmacy | $144.90 |
| RX-1240 | MICAFUNGIN 100 MG INTRAVENOUS SOLR | Pharmacy | $13.32 |
| RX-1241 | MICONAZOLE NITRATE 2 % TOP CREA | Pharmacy | $92.61 |
| RX-1242 | MICONAZOLE NITRATE 2 % TOP OINT | Pharmacy | $474.81 |
| RX-1243 | MICROFIBRIL. COLLAGEN HEMOSTAT TOP POWD | Pharmacy | $364.70 |
| RX-125 | AZITHROMYCIN 250 MG ORAL TAB | Pharmacy | $15.12 |
| RX-1255 | MIDOSTAURIN 25 MG ORAL CAP | Pharmacy | $508.62 |
| RX-1256 | MILRINONE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $19.22 |
| RX-1257 | MILRINONE IN 5 % DEXTROSE 40 MG/200 ML (200 MCG/ML) INTRAVENOUS PGBK | Pharmacy | $19.22 |
| RX-1258 | MILRINONE IN 5 % DEXTROSE 50 ML (200 MCG/ML) INTRAVENOUS | Pharmacy | $19.22 |
| RX-1259 | MINOCYCLINE 100 MG INTRAVENOUS SOLR | Pharmacy | $22.86 |
| RX-126 | AZITHROMYCIN 500 MG INTRAVENOUS SOLR | Pharmacy | $32.75 |
| RX-1260 | MIRABEGRON 25 MG ORAL TB24 | Pharmacy | $42.88 |
| RX-1261 | MIRABEGRON 50 MG ORAL TB24 | Pharmacy | $42.88 |
| RX-1262 | MITOMYCIN 0.2 MG OPHTHALMIC KIT | Pharmacy | $4,523.40 |
| RX-1263 | MITOMYCIN 20 MG INTRAVENOUS SOLR | Pharmacy | $1,006.60 |
| RX-1264 | MITOMYCIN 20 MG NON-ONCOLOGY USE IV SOLR | Pharmacy | $1,006.60 |
| RX-1265 | MITOMYCIN 40 MG IV SOLUTION | Pharmacy | $1,006.60 |
| RX-1266 | MITOMYCIN TOPICAL SOLUTION 0.4 MG/ML | Pharmacy | $278.67 |
| RX-1267 | MITOXANTRONE 2 MG/ML INTRAVENOUS CONC | Pharmacy | $350.34 |
| RX-1268 | MITOXANTRONE 2 MG/ML NON-ONCOLOGY USE IV CONC | Pharmacy | $350.34 |
| RX-1269 | MOGAMULIZUMAB-KPKC 4 MG/ML INTRAVENOUS SOLN | Pharmacy | $2,530.96 |
| RX-127 | AZITHROMYCIN 500 MG ORAL TAB | Pharmacy | $110.38 |
| RX-1270 | MOMETASONE 100 MCG/ACTUATION INHALATION HFAA | Pharmacy | $18.27 |
| RX-1271 | MOMETASONE 1350 MCG SINU IMPL | Pharmacy | $117.52 |
| RX-1272 | MOMETASONE-FORMOTEROL 200-5 MCG/ACTUATION INHALATION HFAA | Pharmacy | $273.80 |
| RX-1273 | MORPHINE 2 MG/ML INJECTION SYRG | Pharmacy | $25.58 |
| RX-1274 | MORPHINE 2 MG/ML INTRAVENOUS SYRG | Pharmacy | $25.58 |
| RX-1275 | MORPHINE 4 MG/ML INJECTION SYRG | Pharmacy | $25.58 |
| RX-1276 | MORPHINE 4 MG/ML INTRAVENOUS CRTG | Pharmacy | $25.57 |
| RX-1277 | MORPHINE 4 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.58 |
| RX-1278 | MORPHINE 4 MG/ML INTRAVENOUS SYRG | Pharmacy | $25.58 |
| RX-1279 | MORPHINE (PF) 0.5 MG/ML INJECTION SOLN | Pharmacy | $25.70 |
| RX-128 | AZITHROMYCIN 600 MG ORAL TAB | Pharmacy | $80.87 |
| RX-1280 | MORPHINE (PF) 1 MG/ML INJECTION SOLN | Pharmacy | $25.58 |
| RX-1281 | MORPHINE (PF) 10 MG/ML INJECTION SOLN | Pharmacy | $25.57 |
| RX-1282 | MORPHINE (PF) 25 MG/ML INJECTION SOLN | Pharmacy | $25.57 |
| RX-1283 | MORPHINE (PF) IN 0.9 % SOD CHL 0.5 MG/ML INTRAVENOUS SYRG | Pharmacy | $25.70 |
| RX-1284 | MORPHINE (PF) IN 0.9 % SOD CHL 100 MG/100 ML (1 MG/ML) INTRAVENOUS RESV | Pharmacy | $25.58 |
| RX-1285 | MORPHINE 0.5 MG/ML SUPER ORDERABLE | Pharmacy | $148.72 |
| RX-1286 | MORPHINE 10 MG/ML INJECTION SOLN | Pharmacy | $25.57 |
| RX-1287 | MORPHINE 10 MG/ML INJECTION SYRG | Pharmacy | $25.57 |
| RX-1288 | MORPHINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.57 |
| RX-1289 | MORPHINE 10 MG/ML SUPER ORDERABLE | Pharmacy | $25.57 |
| RX-129 | AZTREONAM 1 G INJECTION SOLR | Pharmacy | $154.60 |
| RX-1290 | MORPHINE 100 MG/4 ML INTRAVENOUS SOLN | Pharmacy | $25.57 |
| RX-1291 | MORPHINE 2 MG/ML SUPER ORDERABLE | Pharmacy | $25.58 |
| RX-1292 | MORPHINE 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.57 |
| RX-1293 | MORPHINE 4 MG/ML SUPER ORDERABLE | Pharmacy | $25.58 |
| RX-1294 | MORPHINE 8 MG/ML SUPER ORDERABLE | Pharmacy | $25.58 |
| RX-1295 | MORPHINE IN 0.9 % NACL 100 MG/100 ML (1 MG/ML) INFUSION | Pharmacy | $25.58 |
| RX-1296 | MORPHINE IN 0.9 % NACL 60 MG/30 ML (PED-NEO) PCA STANDARD | Pharmacy | $25.58 |
| RX-1297 | MORPHINE IN 0.9 % NACL 60 MG/30 ML (PED-NEO) PCA STANDARD FLAT DOSING | Pharmacy | $25.64 |
| RX-1298 | MORPHINE IN 0.9 % NACL 60 MG/30 ML PCA RESTRICTED | Pharmacy | $25.58 |
| RX-1299 | MORPHINE IN 0.9 % SODIUM CHLOR 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $25.58 |
| RX-13 | ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLN | Pharmacy | $11.44 |
| RX-130 | AZTREONAM 2 G INJECTION SOLR | Pharmacy | $154.57 |
| RX-1300 | MORPHINE IN 0.9 % SODIUM CHLOR 60 MG/30 ML (2 MG/ML) INTRAVENOUS SPCA | Pharmacy | $25.58 |
| RX-1301 | MOXIFLOXACIN 0.5 % OPHTHALMIC DROP | Pharmacy | $77.07 |
| RX-1302 | MOXIFLOXACIN-SOD.ACE,SUL-WATER 400 MG/250 ML INTRAVENOUS PGBK | Pharmacy | $113.40 |
| RX-1303 | MOXIFLOXACIN-SOD.CHLORIDE(ISO) 400 MG/250 ML INTRAVENOUS PGBK | Pharmacy | $113.40 |
| RX-1304 | MULTIVIT-MIN-FERROUS GLUCONATE 9 MG IRON/15 ML ORAL LIQD | Pharmacy | $46.73 |
| RX-1305 | MUPIROCIN CALCIUM 2 % TOP CREA | Pharmacy | $537.08 |
| RX-1306 | MVI ADULT TPN INJECTION | Pharmacy | $45.36 |
| RX-1308 | MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT- 200 MCG/5 ML INTRAVENOUS SOLN | Pharmacy | $20.16 |
| RX-1309 | MYCOPHENOLATE MOFETIL (HCL) 500 MG INTRAVENOUS SOLR | Pharmacy | $514.58 |
| RX-131 | BACITRACIN 500 UNIT/GRAM OPHTHALMIC OINT | Pharmacy | $313.48 |
| RX-1313 | MYCOPHENOLATE SODIUM 180 MG ORAL TBEC | Pharmacy | $33.57 |
| RX-1314 | MYCOPHENOLATE SODIUM 360 MG ORAL TBEC | Pharmacy | $33.57 |
| RX-1315 | N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML IM SYRG | Pharmacy | $1,527.06 |
| RX-1316 | NAFCILLIN 1 G INJECTION SOLR | Pharmacy | $65.27 |
| RX-1317 | NAFCILLIN 2 G INJECTION SOLR | Pharmacy | $92.11 |
| RX-1318 | NALBUPHINE 10 MG/ML INJECTION SOLN | Pharmacy | $39.63 |
| RX-1319 | NALOXONE 0.4 MG/ML INJECTION SOLN | Pharmacy | $167.33 |
| RX-132 | BACITRACIN 50000 UNITS IM SOLR | Pharmacy | $55.44 |
| RX-1320 | NALOXONE 1 MG/ML INJECTION SYRG | Pharmacy | $167.30 |
| RX-1321 | NALOXONE 1 MG/ML ORAL SOLUTION | Pharmacy | $48.58 |
| RX-1322 | NALTREXONE MICROSPHERES 380 MG IM SSRR | Pharmacy | $40.76 |
| RX-1323 | NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLN | Pharmacy | $263.37 |
| RX-1324 | NELARABINE 250 MG/50 ML INTRAVENOUS SOLN | Pharmacy | $1,924.27 |
| RX-1325 | NEOMYCIN-BACITRACNZN-POLYMYXNB 3.5MG-400 UNIT- 5,000 UNIT/GRAM TOP OINT | Pharmacy | $143.85 |
| RX-1326 | NEOMYCIN-POLYMYXIN B-DEXAMETH 3.5MG/ML-10,000 UNIT/ML-0.1 % OPHTHALMIC DRPS | Pharmacy | $47.08 |
| RX-1327 | NEOMYCIN-POLYMYXIN-GRAMICIDIN 1.75 MG-10,000 UNIT-0.025MG/ML OPHTHALMIC DROP | Pharmacy | $156.45 |
| RX-1328 | NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC DRPS | Pharmacy | $182.00 |
| RX-1329 | NEOMYCIN-POLYMYXIN-HC 3.5-10,000-1 MG/ML-UNIT/ML-% OTIC SOLN | Pharmacy | $199.15 |
| RX-133 | BACITRACIN ZINC 500 UNIT/GRAM TOP OINT | Pharmacy | $57.82 |
| RX-1330 | NEOMYCIN-POLYMYXIN-HC 3.5-10,000-10 MG-UNIT-MG/ML OPHTHALMIC DRPS | Pharmacy | $353.59 |
| RX-1331 | NEOMY-POLYMYXINB-BACITRACIN-HC 1 % TOP OINT | Pharmacy | $505.05 |
| RX-1335 | NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $18.27 |
| RX-1336 | NICARDIPINE IN D5W 25 MG/250 ML (CUPID OSM USE ONLY) | Pharmacy | $4,580.10 |
| RX-1337 | NICARDIPINE IN DEXTROSE,ISO-OS 20 MG/200 ML (0.1 MG/ML) INTRAVENOUS PGBK | Pharmacy | $1,159.20 |
| RX-1338 | NICARDIPINE IN NACL (ISO-OS) 20 MG/200 ML (0.1 MG/ML) INTRAVENOUS PGBK | Pharmacy | $630.00 |
| RX-1339 | NICARDIPINE IN NACL (ISO-OS) 40 MG/200 ML (0.2 MG/ML) INTRAVENOUS PGBK | Pharmacy | $1,033.20 |
| RX-134 | BACLOFEN 50 MCG/ML INTRATHECAL SOLN | Pharmacy | $756.86 |
| RX-1340 | NICARDIPINE IN NS 25 MG/250 ML (CUPID OSM USE ONLY) | Pharmacy | $4,580.10 |
| RX-1341 | NIMODIPINE 30 MG/10 ML ORAL SOLN | Pharmacy | $1,506.05 |
| RX-1342 | NIMODIPINE 30 MG/5 ML ORAL SYRG | Pharmacy | $27.46 |
| RX-1343 | NIMODIPINE 60 MG/10 ML ORAL SYRG | Pharmacy | $27.46 |
| RX-1344 | NIMODIPINE 60 MG/20 ML ORAL SOLN | Pharmacy | $263.20 |
| RX-1345 | NINTEDANIB 150 MG ORAL CAP | Pharmacy | $611.59 |
| RX-1346 | NITAZOXANIDE 500 MG ORAL TAB | Pharmacy | $460.25 |
| RX-1347 | NITROGLYCERIN 0.3 MG/HR TRANSDERMAL PT24 | Pharmacy | $99.72 |
| RX-1348 | NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL SPRY | Pharmacy | $425.66 |
| RX-1349 | NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $13.73 |
| RX-135 | BACLOFEN 500 MCG/ML INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1352 | NITROGLYCERIN IN 5 % DEXTROSE 100 MG/250 ML (400 MCG/ML) IV SOLN (CATHLAB ONLY) | Pharmacy | $157.50 |
| RX-1358 | NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $354.84 |
| RX-1359 | NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLN | Pharmacy | $354.84 |
| RX-136 | BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1360 | NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLN | Pharmacy | $354.84 |
| RX-1361 | NORELGESTROMIN-ETHIN.ESTRADIOL 150-35 MCG/24 HR TRANSDERMAL PTWK | Pharmacy | $129.33 |
| RX-1362 | NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $19.03 |
| RX-1363 | NOREPINEPHRINE BITARTRATE-NACL 16 MG/250 ML (64 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $598.50 |
| RX-1364 | NOREPINEPHRINE BITARTRATE-NACL 4 MG/250 ML (16 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $299.25 |
| RX-1365 | NUSINERSEN (PF) 12 MG/5 ML INTRATHECAL SOLN | Pharmacy | $6,169.83 |
| RX-1366 | NYSTATIN 100000 UNIT/GRAM TOP POWD | Pharmacy | $44.52 |
| RX-1367 | NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/G-% TOP CREA | Pharmacy | $84.00 |
| RX-1368 | NYSTATIN-TRIAMCINOLONE 100,000-0.1 UNIT/GRAM-% TOP OINT | Pharmacy | $284.97 |
| RX-1369 | OBINUTUZUMAB 1000 MG/40 ML INTRAVENOUS SOLN | Pharmacy | $800.29 |
| RX-137 | BACLOFEN 10,000 MCG/20ML (500 MCG/ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1370 | OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLN | Pharmacy | $723.45 |
| RX-1371 | OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1372 | OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1373 | OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1374 | OCTREOTIDE ACETATE 1000 MCG/ML INJECTION SOLN | Pharmacy | $11.82 |
| RX-1375 | OCTREOTIDE,MICROSPHERES 10 MG IM SSRR | Pharmacy | $2,596.67 |
| RX-1376 | OCTREOTIDE,MICROSPHERES 20 MG IM SSRR | Pharmacy | $2,596.67 |
| RX-1377 | OCTREOTIDE,MICROSPHERES 30 MG IM SSRR | Pharmacy | $2,596.67 |
| RX-1378 | OLANZAPINE 10 MG IM SOLR | Pharmacy | $32.94 |
| RX-1379 | OLARATUMAB 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $657.28 |
| RX-138 | BACLOFEN 10,000 MCG/5 ML (2,000 MCG/ML) IT SOLN | Pharmacy | $2,187.36 |
| RX-1380 | OLOPATADINE 0.1 % OPHTHALMIC DROP | Pharmacy | $125.65 |
| RX-1381 | OMALIZUMAB 150 MG SUBCUTANEOUS SOLR | Pharmacy | $470.70 |
| RX-1382 | OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $470.70 |
| RX-1383 | OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $470.70 |
| RX-1384 | ONABOTULINUMTOXINA (COSMETIC) 50 UNITS IM SOLR | Pharmacy | $77.14 |
| RX-1385 | ONABOTULINUMTOXINA 100 UNITS INJECTION SOLR | Pharmacy | $77.14 |
| RX-1386 | ONABOTULINUMTOXINA 200 UNITS INJECTION SOLR | Pharmacy | $77.14 |
| RX-139 | BACLOFEN 20,000 MCG/20ML (1,000 MCG/ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1396 | OXACILLIN 1 G INJECTION SOLR | Pharmacy | $16.47 |
| RX-1397 | OXACILLIN 2 G INJECTION SOLR | Pharmacy | $16.47 |
| RX-1399 | OXCARBAZEPINE 600 MG ORAL TB24 | Pharmacy | $57.79 |
| RX-14 | ACETYLCYSTEINE 200 MG/ML (20 %) MISC. SOLN | Pharmacy | $71.69 |
| RX-140 | BACLOFEN 2000 MCG/ML INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1400 | OXYCODONE 40 MG ORAL TR12 | Pharmacy | $35.14 |
| RX-1401 | OXYTOCIN 10 UNITS/ML INJECTION SOLN | Pharmacy | $34.27 |
| RX-1402 | OXYTOCIN IN LACTACTED RINGERS 20 UNITS/1,000 ML INFUSION (POST-PARTUM) NON TIT | Pharmacy | $18.90 |
| RX-1403 | OXYTOCIN IN LACTATED RINGERS 20 UNIT/1,000 ML INTRAVENOUS SOLN | Pharmacy | $18.90 |
| RX-1404 | OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML INTRAVENOUS SOLN | Pharmacy | $16.80 |
| RX-1406 | PACLITAXEL-PROTEIN BOUND 100 MG INTRAVENOUS SUSR | Pharmacy | $158.18 |
| RX-1407 | PALIPERIDONE 3 MG ORAL TR24 | Pharmacy | $38.22 |
| RX-1408 | PALIPERIDONE 6 MG ORAL TR24 | Pharmacy | $76.72 |
| RX-1409 | PALIPERIDONE PALMITATE 117 MG/0.75 ML IM SYRG | Pharmacy | $145.93 |
| RX-141 | BACLOFEN 40,000 MCG/20ML (2,000 MCG/ML) INTRATHECAL SOLN | Pharmacy | $2,187.36 |
| RX-1410 | PALIPERIDONE PALMITATE 156 MG/ML IM SYRG | Pharmacy | $145.93 |
| RX-1411 | PALIPERIDONE PALMITATE 234 MG/1.5 ML IM SYRG | Pharmacy | $145.93 |
| RX-1412 | PALIPERIDONE PALMITATE 39 MG/0.25 ML IM SYRG | Pharmacy | $145.93 |
| RX-1413 | PALIPERIDONE PALMITATE 78 MG/0.5 ML IM SYRG | Pharmacy | $145.93 |
| RX-1414 | PALIVIZUMAB 100 MG/ML IM SOLN | Pharmacy | $23,167.37 |
| RX-1415 | PALIVIZUMAB 50 MG/0.5 ML IM SOLN | Pharmacy | $23,167.37 |
| RX-1416 | PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $78.25 |
| RX-1417 | PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLN (PED-NEO) | Pharmacy | $78.25 |
| RX-1418 | PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLN | Pharmacy | $139.48 |
| RX-1419 | PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLN | Pharmacy | $139.42 |
| RX-142 | BACLOFEN 40,000 MCG/20ML (2,000 MCG/ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1420 | PAMIDRONATE 90 MG INTRAVENOUS SOLR | Pharmacy | $139.37 |
| RX-1421 | PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,493.33 |
| RX-1422 | PANTOPRAZOLE 2 MG/ML ORAL SUSP | Pharmacy | $45.22 |
| RX-1423 | PANTOPRAZOLE 4 MG/ML INJECTION (PED-NEO) | Pharmacy | $35.78 |
| RX-1424 | PANTOPRAZOLE 40 MG INTRAVENOUS SOLR | Pharmacy | $57.20 |
| RX-1425 | PANTOPRAZOLE 40 MG ORAL GRPS | Pharmacy | $45.22 |
| RX-1426 | PAPAVERINE 30 MG/ML INJECTION SOLN | Pharmacy | $350.53 |
| RX-1427 | PARENTERAL AMINO ACID 10% NO.4 10 % INTRAVENOUS SOLP | Pharmacy | $126.00 |
| RX-1428 | PARENTERAL AMINO ACID 15% NO.1 15 % INTRAVENOUS SOLP | Pharmacy | $756.00 |
| RX-143 | BACLOFEN 50 MCG/ML (1 ML) INTRATHECAL SYRG | Pharmacy | $2,187.36 |
| RX-1431 | PAROXETINE MESYLATE 20 MG ORAL TAB | Pharmacy | $35.35 |
| RX-1432 | PATIROMER CALCIUM SORBITEX 8.4 G ORAL PWPK | Pharmacy | $1,067.22 |
| RX-1433 | PATIROMER CALCIUM SORBITEX 16.8 G ORAL PWPK | Pharmacy | $1,597.01 |
| RX-1434 | PEG 3350-ELECTROLYTES 236-22.74-6.74 -5.86 GRAM ORAL SOLR | Pharmacy | $42.00 |
| RX-1435 | PEGASPARGASE 750 UNITS/ML INJECTION SOLN | Pharmacy | $221,402.48 |
| RX-1436 | PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYIN | Pharmacy | $53,639.42 |
| RX-1437 | PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRG | Pharmacy | $53,639.42 |
| RX-1438 | PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRG | Pharmacy | $4,240.16 |
| RX-1439 | PEGINTERFERON ALFA-2A 180 MCG/ML SUBCUTANEOUS SOLN | Pharmacy | $11,679.07 |
| RX-144 | BARIUM SULFATE 0.1 % ORAL SUSP | Pharmacy | $12.60 |
| RX-1440 | PEGLOTICASE 8 MG/ML INTRAVENOUS SOLN | Pharmacy | $33,034.31 |
| RX-1441 | PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $633.33 |
| RX-1442 | PEMETREXED 500 MG INTRAVENOUS SOLR | Pharmacy | $891.99 |
| RX-1443 | PENICILLIN G BENZATHIN,PROCAIN 1,200,000 UNIT/ 2 ML(600K/600K) IM SYRG | Pharmacy | $136.91 |
| RX-1444 | PENICILLIN G BENZATHINE 1200000 UNIT/2 ML IM SYRG | Pharmacy | $173.43 |
| RX-1445 | PENICILLIN G BENZATHINE 2400000 UNIT/4 ML IM SYRG | Pharmacy | $173.43 |
| RX-1446 | PENICILLIN G BENZATHINE 600000 UNITS/ML IM SYRG | Pharmacy | $173.43 |
| RX-1447 | PENICILLIN G POTASSIUM 5 MILLION UNIT INJECTION SOLR | Pharmacy | $13.22 |
| RX-1448 | PENICILLIN G POTASSIUM 5 MU/50 ML | Pharmacy | $13.23 |
| RX-1449 | PENICILLIN G SODIUM 5 MILLION UNIT INJECTION SOLR | Pharmacy | $317.39 |
| RX-145 | BARIUM SULFATE 40 % (W/V) ORAL SUSP | Pharmacy | $50.40 |
| RX-1450 | PENICILLIN G SODIUM IN D5W 2.5 MU/100 ML IVPB | Pharmacy | $13.31 |
| RX-1451 | PENICILLIN G SODIUM IN D5W 3 MU/100 ML IVPB | Pharmacy | $199.16 |
| RX-1452 | PENICILLIN G SODIUM IN D5W 5 MU/100 ML IVPB | Pharmacy | $13.31 |
| RX-1453 | PENTAMIDINE 300 MG INHALATION SOLR | Pharmacy | $1,527.26 |
| RX-1454 | PENTAMIDINE 300 MG INJECTION SOLR | Pharmacy | $86.18 |
| RX-1455 | PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLN | Pharmacy | $440.75 |
| RX-1456 | PEP PACK 1-DAY | Pharmacy | $393.60 |
| RX-1457 | PEP PACK 4-DAY | Pharmacy | $2,298.32 |
| RX-1458 | PERAMIVIR (PF) 200 MG/20 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $21.15 |
| RX-1459 | PERAMPANEL 2 MG ORAL TAB | Pharmacy | $54.01 |
| RX-146 | BARIUM SULFATE 60 % (W/V) ORAL SUSP | Pharmacy | $484.58 |
| RX-1460 | PERAMPANEL 4 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1461 | PERAMPANEL 6 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1462 | PERAMPANEL 10 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1463 | PERAMPANEL 12 MG ORAL TAB | Pharmacy | $106.72 |
| RX-1464 | PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSP | Pharmacy | $607.27 |
| RX-1465 | PERMETHRIN 1 % TOP LIQD | Pharmacy | $456.37 |
| RX-1466 | PERMETHRIN 5 % TOP CREA | Pharmacy | $48.30 |
| RX-1467 | PERPHENAZINE 2 MG ORAL TAB | Pharmacy | $21.67 |
| RX-147 | BARIUM SULFATE 40 % (W/V) 29% (W/W) ORAL SUSP | Pharmacy | $175.00 |
| RX-1471 | PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLN | Pharmacy | $158.97 |
| RX-1472 | PERTUZUMAB-TRASTUZUMAB-HY-ZZXF 600 MG-600 MG- 20000 UNIT/10ML SUBCUTANEOUS SOLN | Pharmacy | $106,734.60 |
| RX-1473 | PHENOBARB-HYOSCY-ATROPINE-SCOP 16.2-0.1037 -0.0194 MG/5 ML ORAL ELIX | Pharmacy | $51.63 |
| RX-1474 | PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLN | Pharmacy | $534.18 |
| RX-1475 | PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLN | Pharmacy | $534.17 |
| RX-1476 | PHENTOLAMINE 5 MG INJECTION SOLR | Pharmacy | $4,811.97 |
| RX-1477 | PHENYLEPH-MIN OIL-PETROLATUM 0.25-14-74.9 % RECTAL OINT | Pharmacy | $636.41 |
| RX-1478 | PHENYLEPHRINE HCL 0.25 % NASAL SPRY | Pharmacy | $302.40 |
| RX-1479 | PHENYLEPHRINE HCL 0.5 % NASAL SPRY | Pharmacy | $302.40 |
| RX-148 | BARIUM SULFATE 40 % (W/V), 30% (W/W) ORAL PSTE | Pharmacy | $177.10 |
| RX-1480 | PHENYLEPHRINE HCL 1 % NASAL DROP | Pharmacy | $132.30 |
| RX-1481 | PHENYLEPHRINE HCL 2.5 % OPHTHALMIC DROP | Pharmacy | $96.04 |
| RX-1482 | PHENYLEPHRINE HCL 10 % OPHTHALMIC DROP | Pharmacy | $109.73 |
| RX-1483 | PHENYLEPHRINE HCL 10 MG/ML INJECTION SOLN | Pharmacy | $34.65 |
| RX-1484 | PHENYLEPHRINE HCL IN 0.9% NACL 1 MG/10 ML (100 MCG/ML) INTRAVENOUS SYRG | Pharmacy | $53.26 |
| RX-1486 | PHENYLEPHRINE HCL IN 0.9% NACL 400 MCG/ML INTRAVENOUS SOLN | Pharmacy | $223.65 |
| RX-1487 | PHENYLEPHRINE IN 0.9 % NACL 100 MG/250 ML (400 MCG/ML) IVPB | Pharmacy | $223.65 |
| RX-1488 | PHENYLEPHRINE IN 0.9% NACL(PF) 1 MG/10 ML (100 MCG/ML) INTRAVENOUS SYRG | Pharmacy | $53.26 |
| RX-1489 | PHENYLEPHRINE-KETOROLAC 1-0.3 % INTRAOCULAR CONC | Pharmacy | $1,382.18 |
| RX-149 | BASILIXIMAB 20 MG INTRAVENOUS SOLR | Pharmacy | $47,981.81 |
| RX-1490 | PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $12.31 |
| RX-1491 | PHYSOSTIGMINE SALICYLATE 1 MG/ML INJECTION SOLN | Pharmacy | $447.55 |
| RX-1492 | PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SOLN | Pharmacy | $53.32 |
| RX-1493 | PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRG | Pharmacy | $53.32 |
| RX-1494 | PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLN | Pharmacy | $53.32 |
| RX-1495 | PHYTONADIONE (VITAMIN K1) 5 MG ORAL TAB | Pharmacy | $171.19 |
| RX-1496 | PHYTONADIONE 2.5 MG ORAL PARTIAL TAB | Pharmacy | $186.62 |
| RX-1497 | PILOCARPINE HCL 1 % OPHTHALMIC DROP | Pharmacy | $148.58 |
| RX-1498 | PILOCARPINE HCL 2 % OPHTHALMIC DROP | Pharmacy | $300.83 |
| RX-1499 | PILOCARPINE HCL 4 % OPHTHALMIC DROP | Pharmacy | $252.53 |
| RX-15 | ACYCLOVIR 5 % TOP OINT | Pharmacy | $134.93 |
| RX-150 | BECLOMETHASONE DIPROPIONATE 40 MCG/ACTUATION INHALATION AERO | Pharmacy | $419.56 |
| RX-1500 | PIPERACILLIN-TAZOBACTAM 2.25 G INTRAVENOUS SOLR | Pharmacy | $23.30 |
| RX-1501 | PIPERACILLIN-TAZOBACTAM 3.375 G INTRAVENOUS SOLR | Pharmacy | $23.30 |
| RX-1502 | PIPERACILLIN-TAZOBACTAM 4.5 G INTRAVENOUS SOLR | Pharmacy | $23.30 |
| RX-1503 | PIPERACILLIN-TAZOBACTAM-DEXTRS 2.25 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $23.30 |
| RX-1504 | PLASMA-LYTE WITH HEPARIN 32000 UNITS 1000 ML SOLUTION | Pharmacy | $45.50 |
| RX-1505 | PLERIXAFOR 24 MG/1.2 ML (20 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $4,381.35 |
| RX-1506 | PNEUMOC 13-VAL CONJ-DIP CR(PF) 0.5 ML IM SYRG | Pharmacy | $2,704.21 |
| RX-1507 | PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJECTION SOLN | Pharmacy | $1,439.06 |
| RX-1508 | PNEUMOCOCCAL 23-VAL PS VACCINE 25 MCG/0.5 ML INJECTION SYRG | Pharmacy | $1,439.06 |
| RX-1509 | POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLR | Pharmacy | $1,400.05 |
| RX-151 | BECLOMETHASONE DIPROPIONATE 80 MCG/ACTUATION INHALATION AERO | Pharmacy | $700.35 |
| RX-1510 | POLIOVIRUS VACCINE 40-8-32 UNIT/0.5 ML INJECTION SUSP | Pharmacy | $403.52 |
| RX-1511 | POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWD | Pharmacy | $441.49 |
| RX-1512 | POLYMYXIN B SULFATE 500000 UNITS INJECTION SOLR | Pharmacy | $47.50 |
| RX-1513 | PORACTANT ALFA 120 MG/1.5 ML INTRATRACH SUSP | Pharmacy | $1,449.47 |
| RX-1514 | PORACTANT ALFA 240 MG/3 ML INTRATRACH SUSP | Pharmacy | $2,820.93 |
| RX-1515 | POSACONAZOLE 100 MG ORAL TBEC | Pharmacy | $217.63 |
| RX-1516 | POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSP | Pharmacy | $43.54 |
| RX-1517 | POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLN | Pharmacy | $290.56 |
| RX-1519 | POTASSIUM CHLORID-D5-0.45%NACL 10 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-152 | BELATACEPT 250 MG INTRAVENOUS SOLR | Pharmacy | $47.53 |
| RX-1520 | POTASSIUM CHLORID-D5-0.45%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1521 | POTASSIUM CHLORID-D5-0.45%NACL 40 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1522 | POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-1523 | POTASSIUM CHLORIDE IN 0.9%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1524 | POTASSIUM CHLORIDE IN 0.9%NACL 40 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1525 | POTASSIUM CHLORIDE IN 5 % DEX 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1526 | POTASSIUM CHLORIDE IN SWFI 10 MEQ/100 ML IVPB | Pharmacy | $63.00 |
| RX-1527 | POTASSIUM CHLORIDE IN WATER 10 MEQ/100 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1528 | POTASSIUM CHLORIDE IN WATER 10 MEQ/50 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1529 | POTASSIUM CHLORIDE IN WATER 20 MEQ/100 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-153 | BELIMUMAB 120 MG INTRAVENOUS SOLR | Pharmacy | $573.19 |
| RX-1530 | POTASSIUM CHLORIDE IN WATER 20 MEQ/50 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1531 | POTASSIUM CHLORIDE IN WATER 40 MEQ/100 ML INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1532 | POTASSIUM CHLORIDE-0.45 % NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1533 | POTASSIUM CHLORIDE-D5-0.3%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1534 | POTASSIUM CHLORIDE-D5-0.9%NACL 20 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1535 | POTASSIUM CHLORIDE-D5-0.9%NACL 40 MEQ/L INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1536 | POTASSIUM IODIDE 1 G/ML ORAL SOLN | Pharmacy | $37.70 |
| RX-1537 | POTASSIUM PHOSPHATE M-/D-BASIC 3 MMOL/ML INTRAVENOUS SOLN | Pharmacy | $10.58 |
| RX-1538 | POVIDONE-IODINE 10 % TOP OINT | Pharmacy | $117.29 |
| RX-1539 | POVIDONE-IODINE 10 % TOP SOLN | Pharmacy | $467.68 |
| RX-154 | BELINOSTAT 500 MG INTRAVENOUS SOLR | Pharmacy | $514.42 |
| RX-1540 | PRALATREXATE 20 MG/ML (1 ML) INTRAVENOUS SOLN | Pharmacy | $3,723.59 |
| RX-1541 | PRAZIQUANTEL 600 MG ORAL TAB | Pharmacy | $186.38 |
| RX-1543 | PREDNISOLONE ACETATE 0.12 % OPHTHALMIC DRPS | Pharmacy | $485.10 |
| RX-1544 | PREDNISOLONE ACETATE 1 % OPHTHALMIC DRPS | Pharmacy | $152.95 |
| RX-1545 | PREDNISOLONE SODIUM PHOSPHATE 1 % OPHTHALMIC DROP | Pharmacy | $78.75 |
| RX-155 | BELLADONNA ALKALOIDS-OPIUM 16.2-30 MG RECTAL SUPP | Pharmacy | $69.93 |
| RX-1554 | PROCAINAMIDE 100 MG/ML INJECTION SOLN | Pharmacy | $1,225.48 |
| RX-1555 | PROCAINAMIDE 500 MG/ML INJECTION SOLN | Pharmacy | $1,225.43 |
| RX-1556 | PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLN | Pharmacy | $108.86 |
| RX-1557 | PROCHLORPERAZINE EDISYLATE 5 MG/ML INJECTION SOLN | Pharmacy | $108.86 |
| RX-156 | BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $273.74 |
| RX-1560 | PROGESTERONE 50 MG/ML IM OIL | Pharmacy | $23.21 |
| RX-1564 | PROMETHAZINE 25 MG/ML INJECTION SOLN | Pharmacy | $25.96 |
| RX-1565 | PROPARACAINE 0.5 % OPHTHALMIC DROP | Pharmacy | $108.68 |
| RX-1569 | PROPRANOLOL 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $23.66 |
| RX-157 | BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,148.19 |
| RX-1570 | PROTAMINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $13.68 |
| RX-1571 | PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLN | Pharmacy | $152.21 |
| RX-1572 | PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLN | Pharmacy | $83.21 |
| RX-1573 | PYRIMETHAMINE 25 MG ORAL TAB | Pharmacy | $997.50 |
| RX-1574 | RABIES IMMUNE GLOBULIN (PF) 150 UNITS/ML IM SOLN | Pharmacy | $3,494.48 |
| RX-1575 | RABIES IMMUNE GLOBULIN (PF) 300 UNITS/ML IM SOLN | Pharmacy | $3,494.48 |
| RX-1576 | RABIES VACC,HUMAN DIPLOID (PF) 2.5 UNITS IM SOLR | Pharmacy | $3,500.48 |
| RX-1577 | RABIES VACCINE, PCEC (PF) 2.5 UNITS IM SUSR | Pharmacy | $3,500.48 |
| RX-1578 | RADIUM RA 223 DICHLORIDE 1,100 KBQ/ML(30 MICROCURIE/ML) INTRAVENOUS SOLN | Pharmacy | $474,635.70 |
| RX-1579 | RALTEGRAVIR 400 MG ORAL TAB | Pharmacy | $93.07 |
| RX-158 | BENZOCAINE 20 % MUCOUS MEMBR SPRA | Pharmacy | $141.65 |
| RX-1580 | RAMELTEON 8 MG ORAL TAB | Pharmacy | $40.78 |
| RX-1581 | RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $751.84 |
| RX-1582 | RASAGILINE 0.5 MG ORAL TAB | Pharmacy | $43.68 |
| RX-1583 | RASBURICASE 1.5 MG INTRAVENOUS SOLR | Pharmacy | $3,683.37 |
| RX-1584 | RASBURICASE 7.5 MG INTRAVENOUS SOLR | Pharmacy | $3,683.37 |
| RX-1585 | RAVULIZUMAB-CWVZ 300 MG/30 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,787.57 |
| RX-1586 | REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRG | Pharmacy | $746.91 |
| RX-1587 | REGULAR INSULIN 100 UNITS IN 100ML NS IVPB | Pharmacy | $11.34 |
| RX-1588 | REMIFENTANIL (ULTIVA) IN 0.9 % NACL 2,000 MCG/100 ML (20 MCG/ML) INFUN | Pharmacy | $1,404.90 |
| RX-1589 | REMIFENTANIL 1 MG INTRAVENOUS SOLR | Pharmacy | $233.60 |
| RX-159 | BENZOCAINE 20 % MUCOUS MEMBR SPRY | Pharmacy | $62.48 |
| RX-1590 | REMIFENTANIL 2 MG INTRAVENOUS SOLR | Pharmacy | $280.35 |
| RX-1591 | RHO(D) IMMUNE GLOBULIN 250 UNIT (50 MCG) IM SYRG | Pharmacy | $318.10 |
| RX-1592 | RHO(D) IMMUNE GLOBULIN-MALTOSE 1,500 UNIT (300 MCG)/1.3 ML INJECTION SOLN | Pharmacy | $375.30 |
| RX-1593 | RHO(D) IMMUNE GLOBULIN-MALTOSE 5,000 UNIT(1000 MCG)/4.4 ML INJECTION SOLN | Pharmacy | $375.30 |
| RX-1594 | RIFAMPIN 600 MG INTRAVENOUS SOLR | Pharmacy | $36.04 |
| RX-1595 | RIFAXIMIN 200 MG ORAL TAB | Pharmacy | $70.98 |
| RX-1596 | RIFAXIMIN 550 MG ORAL TAB | Pharmacy | $135.28 |
| RX-1597 | RILPIVIRINE 25 MG ORAL TAB | Pharmacy | $123.38 |
| RX-1598 | RIOCIGUAT 0.5 MG ORAL TAB | Pharmacy | $426.15 |
| RX-1599 | RIOCIGUAT 1 MG ORAL TAB | Pharmacy | $426.15 |
| RX-160 | BENZOCAINE 40 MG/SPRAY (20 %) MUCOUS MEMBR SPRM | Pharmacy | $72.07 |
| RX-1600 | RIOCIGUAT 2.5 MG ORAL TAB | Pharmacy | $426.15 |
| RX-1601 | RISEDRONATE 30 MG ORAL TAB | Pharmacy | $157.40 |
| RX-1602 | RISPERIDONE MICROSPHERES 12.5 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1603 | RISPERIDONE MICROSPHERES 25 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1604 | RISPERIDONE MICROSPHERES 37.5 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1605 | RISPERIDONE MICROSPHERES 50 MG/2 ML IM SSRR | Pharmacy | $126.57 |
| RX-1606 | RITUXIMAB 10 MG/ML INTRAVENOUS CONC | Pharmacy | $1,189.58 |
| RX-1607 | RITUXIMAB 10 MG/ML NON-ONCOLOGY USE IV CONC | Pharmacy | $1,189.58 |
| RX-1608 | RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS CONC | Pharmacy | $1,097.36 |
| RX-1609 | RITUXIMAB-HYALURONIDASE,HUMAN 1400 MG/11.7 ML (120 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $540.15 |
| RX-161 | BENZOCAINE-MENTHOL 20-0.5 % TOP AERO | Pharmacy | $384.16 |
| RX-1610 | RITUXIMAB-HYALURONIDASE,HUMAN 1600 MG/13.4 ML (120 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $540.15 |
| RX-1611 | RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS CONC | Pharmacy | $930.26 |
| RX-1612 | RIVAROXABAN 10 MG ORAL TAB | Pharmacy | $37.31 |
| RX-1613 | RIVAROXABAN 15 MG ORAL TAB | Pharmacy | $37.31 |
| RX-1614 | RIVAROXABAN 20 MG ORAL TAB | Pharmacy | $37.31 |
| RX-1616 | ROMIDEPSIN 10 MG/2 ML INTRAVENOUS SOLR | Pharmacy | $2,783.05 |
| RX-1617 | ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLR | Pharmacy | $902.22 |
| RX-1618 | ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLR | Pharmacy | $935.68 |
| RX-1619 | ROMOSOZUMAB-AQQG 210MG/2.34ML ( 105MG/1.17MLX2) SUBCUTANEOUS SYRG | Pharmacy | $114.48 |
| RX-162 | BENZOIN TOP TINC | Pharmacy | $793.80 |
| RX-1623 | ROTAVIRUS VACCINE, LIVE, 89-12 10EXP6 CCID50/ML ORAL SUSR | Pharmacy | $1,137.40 |
| RX-1624 | ROTIGOTINE 1 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1625 | ROTIGOTINE 2 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1626 | ROTIGOTINE 3 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1627 | ROTIGOTINE 4 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1628 | ROTIGOTINE 6 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-1629 | ROTIGOTINE 8 MG/24 HOUR TRANSDERMAL PT24 | Pharmacy | $74.69 |
| RX-163 | BENZTROPINE 1 MG/ML INJECTION SOLN | Pharmacy | $223.41 |
| RX-1630 | RUFINAMIDE 200 MG ORAL TAB | Pharmacy | $40.22 |
| RX-1631 | RUFINAMIDE 400 MG ORAL TAB | Pharmacy | $80.47 |
| RX-1632 | SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLR | Pharmacy | $362.75 |
| RX-1633 | SALICYLIC ACID-SULFUR 2-2 % TOP SHAM | Pharmacy | $206.50 |
| RX-1634 | SARGRAMOSTIM 250 MCG INJECTION SOLR | Pharmacy | $548.15 |
| RX-1635 | SCOPOLAMINE BASE 1 MG OVER 3 DAYS TRANSDERMAL PT3D | Pharmacy | $59.47 |
| RX-1636 | SELENIUM 4 MCG/ML INTRAVENOUS SOLN FOR TPN | Pharmacy | $16.38 |
| RX-1637 | SELENIUM 40 MCG/ML INTRAVENOUS SOLN | Pharmacy | $16.38 |
| RX-1638 | SELENIUM SULFIDE 1 % TOP SHAM | Pharmacy | $304.29 |
| RX-1639 | SELENIUM SULFIDE 2.5 % TOP LOTN | Pharmacy | $697.20 |
| RX-164 | BENZYLPENICILLOYL POLYLYSINE 0.25 ML INTRADERMAL SOLN | Pharmacy | $460.51 |
| RX-1640 | SELEXIPAG 200 MCG ORAL TAB | Pharmacy | $757.37 |
| RX-1641 | SELEXIPAG 1000 MCG ORAL TAB | Pharmacy | $968.98 |
| RX-1642 | SEVELAMER CARBONATE 2.4 G ORAL PWPK | Pharmacy | $56.70 |
| RX-1643 | SEVOFLURANE INHALATION LIQD | Pharmacy | $253.75 |
| RX-1644 | SILDENAFIL (PULM.HYPERTENSION) 10 MG/12.5 ML INTRAVENOUS SOLN | Pharmacy | $153.09 |
| RX-1645 | SILDENAFIL (PULM.HYPERTENSION) 10 MG/ML ORAL SUSR | Pharmacy | $21.31 |
| RX-1646 | SINCALIDE 5 MCG INJECTION SOLR | Pharmacy | $1,397.71 |
| RX-1647 | SIPULEUCEL-T-LACTATED RINGERS 50 MILLION CELL/250 ML INTRAVENOUS SUSP | Pharmacy | $362,947.73 |
| RX-1648 | SIROLIMUS 0.5 MG ORAL TAB | Pharmacy | $75.63 |
| RX-1649 | SIROLIMUS 1 MG ORAL TAB | Pharmacy | $75.63 |
| RX-165 | BETAMETHASONE ACET,SOD PHOS 6 MG/ML INJECTION SUSP | Pharmacy | $89.11 |
| RX-1650 | SIROLIMUS 1 MG/ML ORAL SOLN | Pharmacy | $75.63 |
| RX-1651 | SITAGLIPTIN 25 MG ORAL TAB | Pharmacy | $50.12 |
| RX-1652 | SITAGLIPTIN 50 MG ORAL TAB | Pharmacy | $50.12 |
| RX-1653 | SITAGLIPTIN 100 MG ORAL TAB | Pharmacy | $50.12 |
| RX-1654 | SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLN | Pharmacy | $17.64 |
| RX-1655 | SODIUM BICARBONATE 1 MEQ/ML INTRAVENOUS SOLN | Pharmacy | $100.80 |
| RX-1656 | SODIUM BICARBONATE 10 MEQ/10 ML (8.4 %) INTRAVENOUS SYRG | Pharmacy | $693.00 |
| RX-1657 | SODIUM BICARBONATE 4.2 % (0.5 MEQ/ML) INTRAVENOUS SYRG | Pharmacy | $11.21 |
| RX-1658 | SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLN | Pharmacy | $18.65 |
| RX-1659 | SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRG | Pharmacy | $100.80 |
| RX-166 | BETAMETHASONE DIPROPIONATE 0.05 % TOP CREA | Pharmacy | $47.78 |
| RX-1660 | SODIUM BICARBONATE IN D5W 150 MEQ/1,000 ML INTRAVENOUS SOLN | Pharmacy | $302.40 |
| RX-1662 | SODIUM CHLORIDE 0.45 % 0.45 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1663 | SODIUM CHLORIDE 0.9 % INJECTION SOLN | Pharmacy | $63.00 |
| RX-1664 | SODIUM CHLORIDE 0.9 % INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-1665 | SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1666 | SODIUM CHLORIDE 0.9 % IV BOLUS | Pharmacy | $63.00 |
| RX-1667 | SODIUM CHLORIDE 0.9 % IV DISPENSABLE | Pharmacy | $63.00 |
| RX-1668 | SODIUM CHLORIDE 0.9 % IV KVO | Pharmacy | $16.29 |
| RX-1669 | SODIUM CHLORIDE 23.4 % (4 MEQ/ML) IV SOLP | Pharmacy | $30.24 |
| RX-167 | BETAMETHASONE VALERATE 0.1 % TOP CREA | Pharmacy | $40.43 |
| RX-1670 | SODIUM CHLORIDE 3 % 3 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-1671 | SODIUM CHLORIDE 3 % IV BOLUS | Pharmacy | $63.00 |
| RX-1672 | SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLP | Pharmacy | $30.24 |
| RX-1673 | SODIUM FERRIC GLUCONAT-SUCROSE 62.5 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $25.04 |
| RX-1674 | SODIUM HYALURONATE (VISCOSUP) 10 MG/ML INTRAARTICLR SYRG | Pharmacy | $1,043.88 |
| RX-1675 | SODIUM HYALURONATE (VISCOSUP) 10 MG/ML(MW 2.4 -3.6 MILLION) INTRAARTICLR SYRG | Pharmacy | $1,823.14 |
| RX-1676 | SODIUM HYALURONATE 10 MG/ML INTRAOCULAR SYRG | Pharmacy | $109.91 |
| RX-1677 | SODIUM HYALURONATE 23 MG/ML INTRAOCULAR SYRG | Pharmacy | $1,498.90 |
| RX-1678 | SODIUM HYPOCHLORITE 0.125 % MISC. SOLN | Pharmacy | $993.30 |
| RX-1679 | SODIUM HYPOCHLORITE 0.25 % MISC. SOLN | Pharmacy | $761.53 |
| RX-168 | BETAMETHASONE VALERATE 0.1 % TOP LOTN | Pharmacy | $109.20 |
| RX-1680 | SODIUM IODIDE I-123 2 MCI CAP PER MCI | Pharmacy | $6,696.02 |
| RX-1681 | SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) ORAL CAP | Pharmacy | $936.68 |
| RX-1682 | SODIUM IODIDE-131 1000 MCI/ML (1 ML) ORAL KIT | Pharmacy | $198.45 |
| RX-1684 | SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $743.27 |
| RX-1685 | SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLN | Pharmacy | $19.78 |
| RX-1686 | SODIUM PHOSPHATE IN 0.9 % NACL 15 MMOL/100 ML IVPB | Pharmacy | $214.20 |
| RX-1687 | SODIUM PHOSPHATES 19-7 GRAM/118 ML RECTAL ENEM | Pharmacy | $74.48 |
| RX-1688 | SODIUM PHOSPHATES 9.5-3.5 GRAM/59 ML RECTAL ENEM | Pharmacy | $113.19 |
| RX-1689 | SODIUM POLYSTYRENE SULFONATE 30 GRAM/120 ML RECTAL ENEM | Pharmacy | $46.20 |
| RX-169 | BETAMETHASONE, AUGMENTED 0.05 % TOP LOTN | Pharmacy | $141.75 |
| RX-1690 | SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLN | Pharmacy | $424.24 |
| RX-1691 | SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLN | Pharmacy | $22.43 |
| RX-1692 | SODIUM ZIRCONIUM CYCLOSILICATE 5 G ORAL PWPK | Pharmacy | $44.38 |
| RX-1693 | SODIUM ZIRCONIUM CYCLOSILICATE 10 G ORAL PWPK | Pharmacy | $44.38 |
| RX-1694 | SODIUM,POTASSIUM,MAG SULFATES 17.5-3.13-1.6 GRAM ORAL SOLR | Pharmacy | $234.17 |
| RX-1695 | SOLIFENACIN 5 MG ORAL TAB | Pharmacy | $40.81 |
| RX-1696 | SOLIFENACIN 10 MG ORAL TAB | Pharmacy | $40.81 |
| RX-1697 | STERILE TALC 4 G INTRAPLEURAL AERP | Pharmacy | $101.85 |
| RX-1698 | STERILE TALC 4 G INTRAPLEURAL SUSR | Pharmacy | $521.50 |
| RX-1699 | SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLN | Pharmacy | $20.79 |
| RX-17 | ADEFOVIR 10 MG ORAL TAB | Pharmacy | $89.92 |
| RX-170 | BETAXOLOL 0.25 % OPHTHALMIC DRPS | Pharmacy | $981.40 |
| RX-1700 | SUCCINYLCHOLINE CHLORIDE 100 MG/5 ML (20 MG/ML) INTRAVENOUS SYRG | Pharmacy | $21.24 |
| RX-1701 | SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLN | Pharmacy | $19.03 |
| RX-1703 | SUGAMMADEX 100 MG/ML INTRAVENOUS SOLN | Pharmacy | $598.63 |
| RX-1704 | SULFACETAMIDE SODIUM 10 % OPHTHALMIC DROP | Pharmacy | $116.03 |
| RX-1705 | SULFAMETHOXAZOLE-TRIMETHOPRIM 400-80 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $10.33 |
| RX-1706 | SULFUR HEXAFLUORIDE LIPID-TYPE A MICROSPHERES | Pharmacy | $246.77 |
| RX-1707 | SULFUR HEXAFLUORIDE MICROSPHR 25 MG INTRAVENOUS SUSR | Pharmacy | $246.77 |
| RX-1708 | SUMATRIPTAN 20 MG/ACTUATION NASAL SPRY | Pharmacy | $122.89 |
| RX-1709 | SUMATRIPTAN SUCCINATE 6 MG/0.5 ML SUBCUTANEOUS SOLN | Pharmacy | $79.88 |
| RX-171 | BEVACIZUMAB 1.25 MG/0.05 ML INTRAVITREAL INJECTION | Pharmacy | $1,016.10 |
| RX-1710 | TACROLIMUS 0.1 % TOP OINT | Pharmacy | $279.30 |
| RX-1713 | TACROLIMUS 0.75 MG ORAL TB24 | Pharmacy | $17.05 |
| RX-1715 | TACROLIMUS 1 MG ORAL TB24 | Pharmacy | $17.05 |
| RX-1717 | TACROLIMUS 4 MG ORAL TB24 | Pharmacy | $17.05 |
| RX-1719 | TACROLIMUS 5 MG/ML INTRAVENOUS SOLN | Pharmacy | $2,666.10 |
| RX-172 | BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,016.10 |
| RX-1720 | TALIGLUCERASE ALFA 200 UNITS INTRAVENOUS SOLR | Pharmacy | $503.53 |
| RX-1721 | TALIMOGENE LAHERPAREPVEC 10EXP6 (1 MILLION) PFU/ML INJECTION SUSP | Pharmacy | $648.12 |
| RX-1722 | TAPENTADOL 100 MG ORAL TB12 | Pharmacy | $44.24 |
| RX-1723 | TC 99M HDP | Pharmacy | $510.43 |
| RX-1724 | TC 99M MERTIATIDE =< 15 MCI | Pharmacy | $24,766.56 |
| RX-1725 | TC 99M SESTAMIBI | Pharmacy | $945.00 |
| RX-1726 | TC 99M SODIUM PERTECHNETATE 25 MCI | Pharmacy | $11.34 |
| RX-1727 | TC 99M TAGGED ULTRATAG RBC | Pharmacy | $1,738.80 |
| RX-1728 | TEMOZOLOMIDE 100 MG ORAL CAP | Pharmacy | $11.44 |
| RX-1729 | TEMOZOLOMIDE 140 MG ORAL CAP | Pharmacy | $11.44 |
| RX-173 | BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLN | Pharmacy | $879.13 |
| RX-1730 | TEMOZOLOMIDE ORAL SUSP 10 MG/ML | Pharmacy | $19.53 |
| RX-1731 | TEMSIROLIMUS 30 MG/3 ML (10 MG/ML) (FIRST) INTRAVENOUS SOLR | Pharmacy | $603.89 |
| RX-1732 | TENECTEPLASE 50 MG INTRAVENOUS SOLR | Pharmacy | $1,534.84 |
| RX-1733 | TENOFOVIR ALAFENAMIDE 25 MG ORAL TAB | Pharmacy | $124.15 |
| RX-1734 | TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLR | Pharmacy | $3,980.09 |
| RX-1735 | TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLN | Pharmacy | $26.70 |
| RX-1736 | TERBUTALINE INFUSION 1 MG/ML (PED-NEO) | Pharmacy | $26.70 |
| RX-1737 | TERIPARATIDE 20 MCG/DOSE - 600 MCG/2.4 ML SUBCUTANEOUS PNIJ | Pharmacy | $729.10 |
| RX-1738 | TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GLPK | Pharmacy | $67.73 |
| RX-174 | BEXAROTENE 75 MG ORAL CAP | Pharmacy | $591.95 |
| RX-1740 | TETANUS AND DIPHTHER. TOX (PF) 5 LF UNIT- 2 LF UNIT/0.5ML IM SUSP | Pharmacy | $316.34 |
| RX-1741 | TETANUS AND DIPHTHER. TOX (PF) 5-2 LF UNIT/0.5 ML IM SYRG | Pharmacy | $316.34 |
| RX-1742 | TETANUS IMMUNE GLOBULIN (PF) 250 UNITS IM SYRG | Pharmacy | $5,833.65 |
| RX-1743 | TETRABENAZINE 12.5 MG ORAL TAB | Pharmacy | $41.55 |
| RX-1744 | THALLOUS CHLORIDE TL-201 37 MBQ/ML (1 MCI/ML) INTRAVENOUS SOLN | Pharmacy | $203.11 |
| RX-1745 | THALLOUS CHLORIDE TL-201 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLN | Pharmacy | $228.19 |
| RX-1746 | THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLN | Pharmacy | $20.84 |
| RX-1747 | THIOTEPA 15 MG INJECTION SOLR | Pharmacy | $5,191.29 |
| RX-1748 | THIOTEPA 100 MG INJECTION SOLR | Pharmacy | $5,191.29 |
| RX-1749 | THROMB,HM-FIBRIN-APROTIN,S-CA 4 ML TOP SYRG | Pharmacy | $842.24 |
| RX-175 | BICTEGRAV-EMTRICIT-TENOFOV ALA 50-200-25 MG ORAL TAB | Pharmacy | $342.83 |
| RX-1750 | THROMB,HM-FIBRIN-APROTIN,S-CA 10 ML TOP SYRG | Pharmacy | $2,066.75 |
| RX-1751 | THROMB,HM-FIBRIN-APROTIN,S-CA 2.5 TO 6.5 UNIT/ML (10ML) TOP SYRG | Pharmacy | $1,976.21 |
| RX-1752 | THROMB,HM-FIBRIN-APROTIN,S-CA 2.5 TO 6.5 UNIT/ML (4 ML) TOP SYRG | Pharmacy | $1,976.21 |
| RX-1753 | THROMBIN (BOVINE) 5000 UNITS TOP SOLR | Pharmacy | $177.80 |
| RX-1754 | THROMBIN (RECOMBINANT) 5000 UNITS TOP SOLR | Pharmacy | $150.22 |
| RX-1755 | THROMBIN-FIBRINOGN-APROTIN-CAL 4 ML TOP SYRG | Pharmacy | $817.71 |
| RX-1756 | THROMBIN-FIBRINOGN-APROTIN-CAL 10 ML TOP SYRG | Pharmacy | $2,006.55 |
| RX-1757 | THYROTROPIN ALFA 1.1 MG (0.9 MG/ ML FINAL CONC.) IM SOLR | Pharmacy | $21,425.17 |
| RX-1758 | TIGECYCLINE 50 MG INTRAVENOUS SOLR | Pharmacy | $20.60 |
| RX-1759 | TIMOLOL 0.5 % OPHTHALMIC DROP | Pharmacy | $81.80 |
| RX-176 | BIMATOPROST 0.01 % OPHTHALMIC DROP | Pharmacy | $656.51 |
| RX-1760 | TIMOLOL MALEATE 0.5 % OPHTHALMIC DRPD | Pharmacy | $273.00 |
| RX-1761 | TIMOLOL MALEATE 0.5 % OPHTHALMIC SOLG | Pharmacy | $526.40 |
| RX-1762 | TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION INHALATION MIST | Pharmacy | $42.84 |
| RX-1763 | TOBRAMYCIN 0.3 % OPHTHALMIC OINT | Pharmacy | $677.43 |
| RX-1764 | TOBRAMYCIN IN 0.225 % NACL 300 MG/5 ML INHALATION NEBU | Pharmacy | $503.12 |
| RX-1765 | TOBRAMYCIN SULFATE 1.2 G INJECTION SOLR | Pharmacy | $46.51 |
| RX-1766 | TOBRAMYCIN SULFATE 40 MG/ML INJECTION SOLN | Pharmacy | $46.52 |
| RX-1767 | TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHTHALMIC DRPS | Pharmacy | $292.95 |
| RX-1768 | TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OPHTHALMIC OINT | Pharmacy | $721.16 |
| RX-1769 | TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $64.01 |
| RX-177 | BIMATOPROST 0.03 % OPHTHALMIC DROP | Pharmacy | $168.26 |
| RX-1770 | TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $64.01 |
| RX-1771 | TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $64.01 |
| RX-1772 | TOLNAFTATE 1 % TOP CREA | Pharmacy | $119.70 |
| RX-1773 | TOLVAPTAN 15 MG ORAL TAB | Pharmacy | $1,725.33 |
| RX-1774 | TOLVAPTAN 30 MG ORAL TAB | Pharmacy | $1,789.83 |
| RX-1775 | TOPOTECAN 4 MG INTRAVENOUS SOLR | Pharmacy | $12.34 |
| RX-1776 | TOPOTECAN 4 MG/4 ML (1 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.34 |
| RX-1777 | TRABECTEDIN 1 MG INTRAVENOUS SOLR | Pharmacy | $3,943.02 |
| RX-1778 | TRACE ELEMENTS CR-CU-MN-SE-ZN 10 MCG-1 MG-0.5 MG-60MCG-5MG/ML INTRAVENOUS SOLN | Pharmacy | $24.19 |
| RX-1782 | TRASTUZUMAB 150 MG INTRAVENOUS SOLR | Pharmacy | $1,333.77 |
| RX-1783 | TRASTUZUMAB 440 MG INTRAVENOUS SOLR | Pharmacy | $1,333.77 |
| RX-1784 | TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLR | Pharmacy | $1,142.45 |
| RX-1785 | TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLR | Pharmacy | $1,151.59 |
| RX-1786 | TRASTUZUMAB-HYALURONIDASE-OYSK 600 MG-10,000 UNIT/5 ML SUBCUTANEOUS SOLN | Pharmacy | $997.73 |
| RX-1787 | TRAVOPROST 0.004 % OPHTHALMIC DROP | Pharmacy | $616.09 |
| RX-1788 | TREPROSTINIL DIOLAMINE 0.25 MG ORAL TBSR | Pharmacy | $47.27 |
| RX-1789 | TREPROSTINIL DIOLAMINE 1 MG ORAL TBSR | Pharmacy | $189.08 |
| RX-1790 | TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1791 | TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1792 | TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1793 | TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLN | Pharmacy | $787.64 |
| RX-1794 | TRETINOIN (ANTINEOPLASTIC) 10 MG ORAL CAP | Pharmacy | $82.57 |
| RX-1795 | TRETINOIN 0.05 % TOP CREA | Pharmacy | $163.10 |
| RX-1796 | TRIAMCINOLONE ACETONIDE (PF) 40 MG/ML INTRAOCULAR INJECTION | Pharmacy | $48.38 |
| RX-1797 | TRIAMCINOLONE ACETONIDE 0.025 % TOP LOTN | Pharmacy | $56.70 |
| RX-1798 | TRIAMCINOLONE ACETONIDE 0.1 % DENT PSTE | Pharmacy | $204.75 |
| RX-1799 | TRIAMCINOLONE ACETONIDE 0.1 % TOP LOTN | Pharmacy | $73.50 |
| RX-180 | BLEOMYCIN 15 UNITS INJECTION SOLR | Pharmacy | $285.58 |
| RX-1800 | TRIAMCINOLONE ACETONIDE 10 MG/ML INJECTION | Pharmacy | $19.66 |
| RX-1801 | TRIAMCINOLONE ACETONIDE 40 MG/ML INJECTION SUSP | Pharmacy | $19.66 |
| RX-1802 | TRIFLURIDINE 1 % OPHTHALMIC DROP | Pharmacy | $622.65 |
| RX-1803 | TRIMETHOBENZAMIDE 100 MG/ML IM SOLN | Pharmacy | $459.42 |
| RX-1804 | TRIMETHOBENZAMIDE 300 MG ORAL CAP | Pharmacy | $10.92 |
| RX-1805 | TRIPTORELIN PAMOATE 11.25 MG IM SUSR | Pharmacy | $3,323.16 |
| RX-1806 | TRIPTORELIN PAMOATE 11.25 MG/2 ML IM SYRG | Pharmacy | $3,323.16 |
| RX-1807 | TUMESCENT LIPOSUCTION SOLUTION FOR SUBCUTANEOUS 1000 ML | Pharmacy | $403.20 |
| RX-1808 | UMECLIDINIUM-VILANTEROL 62.5-25 MCG/ACTUATION INHALATION DSDV | Pharmacy | $183.26 |
| RX-1809 | USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLN | Pharmacy | $150.34 |
| RX-181 | BLEOMYCIN 30 UNIT NON-ONCOLOGY INJ SOLR | Pharmacy | $285.58 |
| RX-1810 | USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SOLN | Pharmacy | $2,398.50 |
| RX-1811 | USTEKINUMAB 45 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $2,398.50 |
| RX-1812 | USTEKINUMAB 90 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,398.50 |
| RX-1814 | VANCOMYCIN 1.25 G INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1815 | VANCOMYCIN 10 G INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1816 | VANCOMYCIN 500 MG INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1817 | VANCOMYCIN 750 MG INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-1818 | VANCOMYCIN (BULK) 900 MCG/MG (NOT LESS THAN) MISC. POWD | Pharmacy | $84.21 |
| RX-1819 | VANCOMYCIN 1000 MG INTRAVENOUS SOLR | Pharmacy | $42.68 |
| RX-182 | BLEOMYCIN 30 UNITS INJECTION SOLR | Pharmacy | $285.58 |
| RX-1820 | VANCOMYCIN 1000 MG INTRAVENOUS SOLR FOR POWDER USE | Pharmacy | $42.68 |
| RX-1821 | VANCOMYCIN 500 MG IV SOLR (CUSTOM) | Pharmacy | $42.68 |
| RX-1823 | VANCOMYCIN IN 0.9 % SODIUM CHL 1 GRAM/250 ML INTRAVENOUS SOLN | Pharmacy | $44.10 |
| RX-1824 | VANCOMYCIN IN 0.9 % SODIUM CHL 1250 MG INTRAVENOUS SOLN | Pharmacy | $42.84 |
| RX-1825 | VANCOMYCIN IN 0.9 % SODIUM CHL 1500 MG INTRAVENOUS SOLN | Pharmacy | $43.05 |
| RX-1826 | VANCOMYCIN IN 0.9% SODIUM CL 1750 MG/500 ML IV SOLN | Pharmacy | $43.20 |
| RX-1827 | VANCOMYCIN IN 0.9% SODIUM CL 2000 MG/500 ML IV SOLN | Pharmacy | $44.10 |
| RX-1828 | VANCOMYCIN IN D5W 750 MG/250 ML IVPB | Pharmacy | $44.10 |
| RX-1829 | VANCOMYCIN IN DEXTROSE 5 % 1250 MG INTRAVENOUS SOLN | Pharmacy | $42.84 |
| RX-183 | BLINATUMOMAB 35 MCG INTRAVENOUS KIT | Pharmacy | $1,428.13 |
| RX-1830 | VANCOMYCIN IN DEXTROSE 5 % 1500 MG INTRAVENOUS SOLN | Pharmacy | $42.68 |
| RX-1831 | VANCOMYCIN IN NS 10 MG/ML 1ML SYG | Pharmacy | $42.84 |
| RX-1832 | VANCOMYCIN IN NS 750 MG/250 ML IVPB | Pharmacy | $42.68 |
| RX-1833 | VANCOMYCIN-HEPARIN ALT 2.5 MG-2500 UNIT/ML INJ | Pharmacy | $42.84 |
| RX-1834 | VARICELLA VIRUS VACC LIVE (PF) 1350 UNIT/0.5 ML SUBCUTANEOUS SUSR | Pharmacy | $3,420.14 |
| RX-1835 | VARICELLA-ZOSTER GE-AS01B (PF) 50 MCG/0.5 ML IM SUSR | Pharmacy | $1,696.59 |
| RX-1836 | VARICELLA-ZOSTER I.GLOB-MALTOS 125 UNIT/1.2 ML IM SOLN | Pharmacy | $21,486.97 |
| RX-1837 | VASOPRESSIN 20 UNITS/ML INJECTION SOLN | Pharmacy | $2,252.38 |
| RX-1838 | VASOPRESSIN 20 UNITS/ML INTRAVENOUS SOLN | Pharmacy | $2,252.38 |
| RX-1839 | VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLR | Pharmacy | $49.14 |
| RX-184 | BORTEZOMIB 2.5 MG INJ SOLR SUBCUT (CC) | Pharmacy | $565.17 |
| RX-1840 | VEDOLIZUMAB 300 MG INTRAVENOUS SOLR | Pharmacy | $255.05 |
| RX-1841 | VELAGLUCERASE ALFA 400 UNITS INTRAVENOUS SOLR | Pharmacy | $4,352.25 |
| RX-1842 | VERAPAMIL 2.5 MG/ML IA SOLN | Pharmacy | $74.47 |
| RX-1843 | VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLN | Pharmacy | $45.99 |
| RX-1844 | VIGABATRIN 500 MG ORAL PWPK | Pharmacy | $236.72 |
| RX-1845 | VINBLASTINE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $48.95 |
| RX-1846 | VINCRISTINE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $61.54 |
| RX-1847 | VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLN | Pharmacy | $61.54 |
| RX-1848 | VINCRISTINE 2 MG/2 ML IV SOLN FOR HODGKINS DISEASE | Pharmacy | $61.54 |
| RX-1849 | VINORELBINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $150.70 |
| RX-185 | BORTEZOMIB 3.5 MG INJECTION SOLR | Pharmacy | $565.17 |
| RX-1850 | VINORELBINE 50 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $150.70 |
| RX-1851 | VITAMIN A PALMITATE 50000 UNITS/ML ORAL SOLUTION | Pharmacy | $686.07 |
| RX-1852 | VORICONAZOLE 200 MG INTRAVENOUS SOLR | Pharmacy | $26.64 |
| RX-1856 | XE133 XENON PER 10 MCI | Pharmacy | $2,421.34 |
| RX-1857 | ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $19.08 |
| RX-1858 | ZILEUTON 600 MG ORAL TAB | Pharmacy | $99.47 |
| RX-1859 | ZINC CHLORIDE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $43.19 |
| RX-186 | BORTEZOMIB NON-ONCOLOGY USE 3.5 MG INJ SOLR | Pharmacy | $565.17 |
| RX-1860 | ZINC OXIDE 4 X 10 "-YARD TOP BNDG | Pharmacy | $44.03 |
| RX-1861 | ZINC SULFATE 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $17.89 |
| RX-1862 | ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) IM SOLR | Pharmacy | $226.25 |
| RX-1863 | ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $137.12 |
| RX-1864 | ZOLEDRONIC ACID-MANNITOL-WATER 5 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $137.34 |
| RX-1865 | ZOLEDRONIC AC-MANNITOL-0.9NACL 4 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $137.34 |
| RX-1866 | ZOSTER VACCINE LIVE (PF) 19400 UNIT/0.65 ML SUBCUTANEOUS SUSR | Pharmacy | $2,625.97 |
| RX-187 | BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLR | Pharmacy | $2,134.11 |
| RX-188 | BREXPIPRAZOLE 1 MG ORAL TAB | Pharmacy | $123.31 |
| RX-189 | BRIMONIDINE 0.1 % OPHTHALMIC DROP | Pharmacy | $533.23 |
| RX-190 | BRIMONIDINE 0.15 % OPHTHALMIC DROP | Pharmacy | $445.03 |
| RX-191 | BRIMONIDINE-TIMOLOL 0.2-0.5 % OPHTHALMIC DROP | Pharmacy | $587.83 |
| RX-192 | BRINZOLAMIDE 1 % OPHTHALMIC DRPS | Pharmacy | $1,027.95 |
| RX-193 | BRINZOLAMIDE-BRIMONIDINE 1-0.2 % OPHTHALMIC DRPS | Pharmacy | $542.64 |
| RX-194 | BRIVARACETAM 50 MG ORAL TAB | Pharmacy | $62.44 |
| RX-195 | BRIVARACETAM 100 MG ORAL TAB | Pharmacy | $62.44 |
| RX-196 | BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $57.83 |
| RX-197 | BROMFENAC 0.07 % OPHTHALMIC DROP | Pharmacy | $897.75 |
| RX-198 | BROMFENAC 0.09 % OPHTHALMIC DROP | Pharmacy | $421.58 |
| RX-199 | BUDESONIDE 90 MCG/ACTUATION INHALATION AEPB | Pharmacy | $33.26 |
| RX-200 | BUDESONIDE 0.25 MG/2 ML INHALATION NBSP | Pharmacy | $21.87 |
| RX-201 | BUDESONIDE 0.5 MG/2 ML INHALATION NBSP | Pharmacy | $21.87 |
| RX-202 | BUDESONIDE 1 MG/2 ML INHALATION NBSP | Pharmacy | $21.87 |
| RX-203 | BUDESONIDE 180 MCG/ACTUATION INHALATION AEPB | Pharmacy | $22.30 |
| RX-204 | BUDESONIDE 9 MG ORAL TADE | Pharmacy | $189.81 |
| RX-205 | BUDESONIDE-FORMOTEROL 160-4.5 MCG/ACTUATION INHALATION HFAA | Pharmacy | $388.46 |
| RX-206 | BUDESONIDE-FORMOTEROL 80-4.5 MCG/ACTUATION INHALATION HFAA | Pharmacy | $94.50 |
| RX-218 | BUPIVACAINE LIPOSOME (PF) 1.3 % (13.3 MG/ML) LINF SUSP | Pharmacy | $15.79 |
| RX-219 | BUPIVACAINE-DEXTROSE-WATER(PF) 0.75 % (7.5 MG/ML) INJECTION SOLN | Pharmacy | $12.22 |
| RX-222 | BUPRENORPHINE 5 MCG/HR TRANSDERMAL PTWK | Pharmacy | $153.48 |
| RX-223 | BUPRENORPHINE 15 MCG/HR TRANSDERMAL PTWK | Pharmacy | $477.23 |
| RX-224 | BUPRENORPHINE 20 MCG/HR TRANSDERMAL PTWK | Pharmacy | $452.83 |
| RX-225 | BUSULFAN 60 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $61.67 |
| RX-226 | BUTAMBEN-TETRACAINE-BENZOCAINE 2 %-2 %-14 % (200 MG/SEC) TOP SPRA | Pharmacy | $386.90 |
| RX-227 | BUTORPHANOL 1 MG/ML INJECTION SOLN | Pharmacy | $31.16 |
| RX-228 | BUTORPHANOL 2 MG/ML INJECTION SOLN | Pharmacy | $31.16 |
| RX-229 | C1 ESTERASE INHIBITOR 500 UNIT (5 ML) INTRAVENOUS SOLR | Pharmacy | $353.77 |
| RX-230 | CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLN | Pharmacy | $2,218.13 |
| RX-231 | CABERGOLINE 0.5 MG ORAL TAB | Pharmacy | $17.89 |
| RX-232 | CADEXOMER IODINE 0.9 % TOP GEL | Pharmacy | $315.98 |
| RX-233 | CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.95 |
| RX-234 | CALCIPOTRIENE 0.005 % TOP OINT | Pharmacy | $663.60 |
| RX-235 | CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRY | Pharmacy | $46.88 |
| RX-236 | CALCITONIN (SALMON) 200 UNITS/ML INJECTION | Pharmacy | $33,471.67 |
| RX-237 | CALCITONIN (SALMON) 200 UNITS/ML INJECTION SOLN | Pharmacy | $33,471.67 |
| RX-24 | ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLR | Pharmacy | $404.55 |
| RX-241 | CALCIUM GLUC IN NACL, ISO-OSM 1 GRAM/50 ML INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-242 | CALCIUM GLUCONATE 100 MG/ML (10%) INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-243 | CALCIUM GLUCONATE IN 0.9% NACL 1 G/100 ML INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-244 | CALCIUM GLUCONATE IN 0.9% NACL 1 GRAM/110 ML INTRAVENOUS SOLN | Pharmacy | $43.34 |
| RX-245 | CAMPHOR-MENTHOL 0.5-0.5 % TOP LOTN | Pharmacy | $279.72 |
| RX-246 | CANAKINUMAB (PF) 150 MG/ML SUBCUTANEOUS SOLN | Pharmacy | $1,398.63 |
| RX-247 | CANGRELOR 50 MG INTRAVENOUS SOLR | Pharmacy | $193.11 |
| RX-248 | CANNABIDIOL 100 MG/ML ORAL SOLN | Pharmacy | $45.85 |
| RX-249 | CAPLACIZUMAB-YHDP 11 MG INJECTION SOLR | Pharmacy | $8,686.25 |
| RX-25 | AGALSIDASE BETA 5 MG INTRAVENOUS SOLR | Pharmacy | $2,315.19 |
| RX-250 | CARBACHOL 0.01 % INTRAOCULAR SOLN | Pharmacy | $42.58 |
| RX-251 | CARBOPLATIN 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $33.89 |
| RX-252 | CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN | Pharmacy | $4,038.30 |
| RX-253 | CARFILZOMIB 60 MG INTRAVENOUS SOLR | Pharmacy | $473.00 |
| RX-254 | CARMUSTINE 100 MG INTRAVENOUS SOLR | Pharmacy | $32,994.62 |
| RX-255 | CASPOFUNGIN 50 MG INTRAVENOUS SOLR | Pharmacy | $88.59 |
| RX-256 | CASPOFUNGIN 70 MG INTRAVENOUS SOLR | Pharmacy | $88.59 |
| RX-257 | CEFAZOLIN 1 G INJECTION SOLR | Pharmacy | $10.29 |
| RX-258 | CEFAZOLIN 1 G INTRAVENOUS SOLR | Pharmacy | $10.29 |
| RX-259 | CEFAZOLIN 1,000 MG/50 ML D5W | Pharmacy | $11.34 |
| RX-26 | AGALSIDASE BETA 35 MG INTRAVENOUS SOLR | Pharmacy | $2,315.19 |
| RX-260 | CEFAZOLIN 2,000 MG/50 ML D5W | Pharmacy | $10.40 |
| RX-261 | CEFAZOLIN 500 MG INJECTION SOLR | Pharmacy | $10.29 |
| RX-262 | CEFAZOLIN IN DEXTROSE (ISO-OS) 1 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.29 |
| RX-263 | CEFAZOLIN IN DEXTROSE (ISO-OS) 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.29 |
| RX-264 | CEFAZOLIN IN DEXTROSE 5 % 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $10.29 |
| RX-265 | CEFEPIME 1 G INJECTION SOLR | Pharmacy | $22.42 |
| RX-266 | CEFEPIME 1 G INTRAVENOUS SOLR | Pharmacy | $22.42 |
| RX-267 | CEFEPIME 2 G INJECTION SOLR | Pharmacy | $22.42 |
| RX-268 | CEFEPIME 2 G INTRAVENOUS SOLR | Pharmacy | $22.42 |
| RX-269 | CEFEPIME IN DEXTROSE 5 % 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $22.42 |
| RX-27 | ALBENDAZOLE 200 MG ORAL TAB | Pharmacy | $157.22 |
| RX-270 | CEFOTAXIME 1 G INJECTION SOLR | Pharmacy | $29.38 |
| RX-271 | CEFOTAXIME 300 MG/ML IM INJECTION | Pharmacy | $29.40 |
| RX-272 | CEFOXITIN 1 G INTRAVENOUS SOLR | Pharmacy | $66.68 |
| RX-273 | CEFOXITIN 2 G INTRAVENOUS SOLR | Pharmacy | $66.68 |
| RX-274 | CEFOXITIN IN DEXTROSE, ISO-OSM 1 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $66.68 |
| RX-275 | CEFOXITIN IN DEXTROSE, ISO-OSM 2 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $66.68 |
| RX-276 | CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLR | Pharmacy | $40.04 |
| RX-277 | CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLR | Pharmacy | $40.04 |
| RX-278 | CEFTAZIDIME 1 G INJECTION SOLR | Pharmacy | $25.55 |
| RX-279 | CEFTAZIDIME 1000 MG INJ SOLR | Pharmacy | $25.55 |
| RX-28 | ALBUMIN, HUMAN 25 % 25 % INTRAVENOUS SOLP | Pharmacy | $660.87 |
| RX-280 | CEFTAZIDIME 2 G INJECTION SOLR | Pharmacy | $25.55 |
| RX-281 | CEFTAZIDIME 500 MG INJECTION SOLR | Pharmacy | $25.55 |
| RX-282 | CEFTAZIDIME-AVIBACTAM 2.5 G INTRAVENOUS SOLR | Pharmacy | $1,159.53 |
| RX-283 | CEFTOLOZANE-TAZOBACTAM 1.5 G INTRAVENOUS SOLR | Pharmacy | $74.66 |
| RX-29 | ALBUMIN, HUMAN 5 % 5 % INTRAVENOUS SOLP | Pharmacy | $661.50 |
| RX-293 | CEFUROXIME IN STERILE WATER 1.5 GRAM/50 ML INTRAVENOUS PGBK | Pharmacy | $28.00 |
| RX-294 | CEFUROXIME SODIUM 1.5 G INTRAVENOUS SOLR | Pharmacy | $28.00 |
| RX-295 | CEFUROXIME SODIUM 750 MG INJECTION SOLR | Pharmacy | $28.00 |
| RX-296 | CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $345.67 |
| RX-297 | CERTOLIZUMAB PEGOL 400 MG/2 ML (200 MG/ML X 2) SUBCUTANEOUS SYKT | Pharmacy | $103.41 |
| RX-298 | CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLN | Pharmacy | $796.45 |
| RX-299 | CHLORHEXIDINE GLUCONATE 4 % TOP LIQD | Pharmacy | $445.20 |
| RX-300 | CHLOROPROCAINE (PF) 10 MG/ML (1 %) INTRATHECAL SOLN | Pharmacy | $307.69 |
| RX-301 | CHLOROPROCAINE (PF) 20 MG/ML (2 %) INJECTION SOLN | Pharmacy | $307.69 |
| RX-302 | CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLN | Pharmacy | $307.69 |
| RX-303 | CHLOROPROCAINE 20 MG/ML (2 %) INJECTION SOLN | Pharmacy | $307.57 |
| RX-304 | CHLOROTHIAZIDE IV 27.8 MG/ML (PED-NEO) | Pharmacy | $631.83 |
| RX-305 | CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLR | Pharmacy | $631.80 |
| RX-306 | CHLORPROMAZINE 25 MG/ML INJECTION SOLN | Pharmacy | $397.61 |
| RX-307 | CHROMIUM CHLORIDE 0.4 MCG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $21.29 |
| RX-308 | CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLN | Pharmacy | $21.17 |
| RX-309 | CICLOPIROX 0.77 % TOP SUSP | Pharmacy | $147.00 |
| RX-310 | CIDOFOVIR 75 MG/ML INTRAVENOUS SOLN | Pharmacy | $7,980.90 |
| RX-314 | CIPROFLOXACIN HCL 0.2 % OTIC DPET | Pharmacy | $287.58 |
| RX-315 | CIPROFLOXACIN IN 5 % DEXTROSE 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $15.12 |
| RX-316 | CIPROFLOXACIN IN 5 % DEXTROSE 400 MG/200 ML INTRAVENOUS PGBK | Pharmacy | $15.12 |
| RX-317 | CIPROFLOXACIN-DEXAMETHASONE 0.3-0.1 % OTIC DRPS | Pharmacy | $787.24 |
| RX-318 | CISATRACURIUM 10 MG/ML CONC. (ICU USE ONLY) INTRAVENOUS SOLN | Pharmacy | $72.83 |
| RX-319 | CISATRACURIUM 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $10.58 |
| RX-320 | CISPLATIN 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $24.32 |
| RX-321 | CLADRIBINE 10 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $254.27 |
| RX-322 | CLEVIDIPINE 0.5 MG/ML INTRAVENOUS EMULSION WRAPPER | Pharmacy | $32.76 |
| RX-323 | CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMUL | Pharmacy | $32.76 |
| RX-324 | CLEVIDIPINE 50 MG/100 ML INTRAVENOUS EMUL | Pharmacy | $35.08 |
| RX-325 | CLINDAMYCIN 600 MG IN 1000 ML NS SOLUTION | Pharmacy | $25.20 |
| RX-326 | CLINDAMYCIN IN 5 % DEXTROSE 300 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $69.30 |
| RX-327 | CLINDAMYCIN IN 5 % DEXTROSE 600 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $69.30 |
| RX-328 | CLINDAMYCIN IN 5 % DEXTROSE 900 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $44.10 |
| RX-329 | CLINDAMYCIN PHOSPHATE 1 % TOP LOTN | Pharmacy | $216.30 |
| RX-33 | ALBUTEROL SULFATE 90 MCG/ACTUATION INHALATION HFAA | Pharmacy | $387.49 |
| RX-330 | CLINDAMYCIN PHOSPHATE 1 % TOP SOLN | Pharmacy | $39.90 |
| RX-331 | CLINDAMYCIN PHOSPHATE 150 MG/ML INJECTION SOLN | Pharmacy | $11.84 |
| RX-332 | CLINDAMYCIN PHOSPHATE 600 MG/4 ML INTRAVENOUS SOLN | Pharmacy | $18.14 |
| RX-333 | CLOBAZAM 5 MG PARTIAL TABLET | Pharmacy | $69.97 |
| RX-334 | CLOBETASOL 0.05 % SCALP SOLN | Pharmacy | $61.25 |
| RX-335 | CLOBETASOL 0.05 % TOP GEL | Pharmacy | $35.70 |
| RX-336 | CLOBETASOL 0.05 % TOP LOTN | Pharmacy | $214.97 |
| RX-337 | CLOMIPRAMINE 50 MG ORAL CAP | Pharmacy | $37.07 |
| RX-338 | CLONIDINE (PF) 1,000 MCG/10 ML (100 MCG/ML) EPIDURAL SOLN | Pharmacy | $215.33 |
| RX-339 | CLONIDINE 0.2 MG/24 HR TRANSDERMAL PTWK | Pharmacy | $46.52 |
| RX-34 | ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLN | Pharmacy | $15,398.44 |
| RX-340 | CLONIDINE 0.3 MG/24 HR TRANSDERMAL PTWK | Pharmacy | $59.08 |
| RX-341 | COAGULATION FACTOR IX (RECOMB) 2000 UNITS INTRAVENOUS SOLR | Pharmacy | $19.25 |
| RX-342 | COAGULATION FACTOR IX (RECOMB) 3000 UNITS INTRAVENOUS SOLR | Pharmacy | $19.25 |
| RX-343 | COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLR | Pharmacy | $27.18 |
| RX-344 | COAGULATION FACTOR VIIA RECOMB 2 MG (2,000 MCG) INTRAVENOUS SOLR | Pharmacy | $27.18 |
| RX-345 | COAGULATION FACTOR VIIA RECOMB IV SYRINGE 1 MG/ML | Pharmacy | $26.21 |
| RX-346 | COAGULATION FACTOR VIIA RECOMB IV SYRINGE 1 MG/ML (PED-NEO) | Pharmacy | $27.18 |
| RX-347 | COCAINE 4 % NASAL SOLN | Pharmacy | $10.80 |
| RX-348 | COCAINE 4 % TOP SOLN | Pharmacy | $558.32 |
| RX-349 | COLISTIN (COLISTIMETHATE NA) 150 MG INJECTION SOLR | Pharmacy | $248.45 |
| RX-35 | ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLR | Pharmacy | $2,157.23 |
| RX-350 | COLLAGENASE CLOSTRIDIUM HISTO. 0.9 MG INJECTION SOLR | Pharmacy | $613.96 |
| RX-351 | COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOP OINT | Pharmacy | $387.45 |
| RX-352 | COLLAGENASE CLOSTRIDIUM HISTO. 250 UNIT/GRAM TOP OINT (WOUND CARE CHARGE PER PT) | Pharmacy | $774.90 |
| RX-353 | CONJUGATED ESTROGENS 0.625 MG/GRAM VAGINAL CREA | Pharmacy | $1,245.30 |
| RX-354 | CONJUGATED ESTROGENS 25 MG INJECTION SOLR | Pharmacy | $3,889.67 |
| RX-355 | COPANLISIB 60 MG INTRAVENOUS SOLR | Pharmacy | $1,000.07 |
| RX-356 | COPPER 380 SQUARE MM INTRAUTERINE IUD | Pharmacy | $10,187.10 |
| RX-357 | CORTICORELIN OVINE TRIFLUTATE 100 MCG INTRAVENOUS SOLR | Pharmacy | $116.41 |
| RX-358 | CORTICOTROPIN 80 UNITS/ML INJECTION GEL | Pharmacy | $49,439.65 |
| RX-359 | COSYNTROPIN 0.25 MG INJECTION SOLR | Pharmacy | $477.79 |
| RX-36 | ALIROCUMAB 75 MG/ML SUBCUTANEOUS PNIJ | Pharmacy | $1,891.40 |
| RX-360 | CRIZANLIZUMAB-TMCA 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,542.71 |
| RX-361 | CROMOLYN 20 MG/2 ML INHALATION NEBU | Pharmacy | $61.70 |
| RX-362 | CUPRIC CHLORIDE 0.04 MG/ML INTRAVENOUS SOLN FOR NEONATAL TPN | Pharmacy | $21.29 |
| RX-363 | CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLN | Pharmacy | $21.17 |
| RX-365 | CYANOCOBALAMIN (VITAMIN B-12) 1000 MCG/ML INJECTION SOLN | Pharmacy | $27.87 |
| RX-366 | CYCLOPHOSPHAMIDE 50 MG ORAL CAP | Pharmacy | $33.40 |
| RX-367 | CYCLOPHOSPHAMIDE 1 G INTRAVENOUS SOLR | Pharmacy | $418.76 |
| RX-368 | CYCLOPHOSPHAMIDE 2 G INTRAVENOUS SOLR | Pharmacy | $418.76 |
| RX-369 | CYCLOPHOSPHAMIDE 500 MG INTRAVENOUS SOLR | Pharmacy | $418.76 |
| RX-37 | ALLOPURINOL SODIUM 500 MG INTRAVENOUS SOLR | Pharmacy | $23,174.55 |
| RX-370 | CYCLOPHOSPHAMIDE NON-ONCOLOGY USE 1 G IV SOLR | Pharmacy | $418.76 |
| RX-371 | CYCLOPHOSPHAMIDE NON-ONCOLOGY USE 50 MG ORAL CAP | Pharmacy | $33.40 |
| RX-373 | CYCLOSPORINE 0.05 % OPHTHALMIC DPET | Pharmacy | $77.46 |
| RX-374 | CYCLOSPORINE 100 MG ORAL CAP | Pharmacy | $30.00 |
| RX-375 | CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $740.19 |
| RX-377 | CYCLOSPORINE MODIFIED 100 MG ORAL CAP | Pharmacy | $30.00 |
| RX-378 | CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLN | Pharmacy | $30.00 |
| RX-379 | CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $82.91 |
| RX-38 | ALPHA-1 PROTEINASE INHIB.(HUM) 1000 MG (+/-)/20 ML INTRAVENOUS SOLN | Pharmacy | $56.08 |
| RX-380 | CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLN | Pharmacy | $10.21 |
| RX-381 | CYTARABINE (PF) 2 GRAM/20 ML (100 MG/ML) INJECTION SOLN | Pharmacy | $10.16 |
| RX-382 | CYTOMEGALOVIRUS IMMUNE GLOB 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $14,227.92 |
| RX-383 | D10 %-0.45 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-384 | D10-0.225 % NACL WITH POTASSIUM CHLORIDE 1.5 MEQ/50 ML INJ SYRINGE | Pharmacy | $63.00 |
| RX-385 | D10-0.225 % NACL WITH POTASSIUM CHLORIDE 15 MEQ/500 ML IVPB | Pharmacy | $63.00 |
| RX-386 | D2.5 %-0.45 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-387 | D5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-388 | D5 %-0.45 % SODIUM CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-389 | D5-0.45 % NACL WITH POTASSIUM CHLORIDE 1.5 MEQ/50 ML INJ SYRINGE | Pharmacy | $63.00 |
| RX-39 | ALPROSTADIL 20 MCG INTRACAVRNSL KIT | Pharmacy | $62.84 |
| RX-390 | D5-0.45 % NACL WITH POTASSIUM CHLORIDE 15 MEQ/500 ML IVPB | Pharmacy | $63.00 |
| RX-391 | DABRAFENIB 75 MG ORAL CAP | Pharmacy | $320.86 |
| RX-392 | DACARBAZINE 200 MG INTRAVENOUS SOLR | Pharmacy | $51.31 |
| RX-393 | DACTINOMYCIN 0.5 MG INTRAVENOUS SOLR | Pharmacy | $13,941.33 |
| RX-394 | DALBAVANCIN 500 MG INTRAVENOUS SOLN | Pharmacy | $189.72 |
| RX-395 | DANTROLENE 250 MG INTRAVENOUS SUSR | Pharmacy | $1,154.79 |
| RX-398 | DARATUMUMAB 20 MG/ML INTRAVENOUS SOLN | Pharmacy | $680.78 |
| RX-399 | DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-4 | ABACAVIR-DOLUTEGRAVIR-LAMIVUD 600-50-300 MG ORAL TAB | Pharmacy | $341.36 |
| RX-400 | DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/0.4 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-401 | DARBEPOETIN ALFA IN POLYSORBAT 40 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-402 | DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/0.3 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-403 | DARBEPOETIN ALFA IN POLYSORBAT 60 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-404 | DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/0.5 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-405 | DARBEPOETIN ALFA IN POLYSORBAT 100 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-406 | DARBEPOETIN ALFA IN POLYSORBAT 150 MCG/0.3 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-407 | DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/0.4 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-408 | DARBEPOETIN ALFA IN POLYSORBAT 200 MCG/ML INJECTION SOLN | Pharmacy | $48.13 |
| RX-409 | DARBEPOETIN ALFA IN POLYSORBAT 25 MCG/0.42 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-41 | ALTEPLASE 2 MG INTRACATHTR SOLR | Pharmacy | $1,106.94 |
| RX-410 | DARBEPOETIN ALFA IN POLYSORBAT 300 MCG/0.6 ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-411 | DARBEPOETIN ALFA IN POLYSORBAT 500 MCG/ML INJECTION SYRG | Pharmacy | $48.13 |
| RX-412 | DARIFENACIN 15 MG ORAL TB24 | Pharmacy | $40.36 |
| RX-413 | DARUNAVIR ETHANOLATE 600 MG ORAL TAB | Pharmacy | $99.40 |
| RX-414 | DARUNAVIR ETHANOLATE 800 MG ORAL TAB | Pharmacy | $198.80 |
| RX-415 | DARUNAVIR-COBICISTAT 800-150 MG-MG ORAL TAB | Pharmacy | $227.22 |
| RX-416 | DASATINIB 70 MG ORAL TAB | Pharmacy | $906.26 |
| RX-417 | DASATINIB 100 MG ORAL TAB | Pharmacy | $1,633.35 |
| RX-418 | DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLN | Pharmacy | $609.79 |
| RX-419 | DECITABINE 50 MG INTRAVENOUS SOLR | Pharmacy | $54.22 |
| RX-42 | ALTEPLASE 50 MG INTRAVENOUS SOLR | Pharmacy | $1,106.94 |
| RX-420 | DEFEROXAMINE 2 G INJECTION SOLR | Pharmacy | $99.67 |
| RX-421 | DEGARELIX 80 MG SUBCUTANEOUS SOLR | Pharmacy | $49.85 |
| RX-422 | DEGARELIX 120 MG SUBCUTANEOUS SOLR | Pharmacy | $49.85 |
| RX-423 | DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLN | Pharmacy | $242.90 |
| RX-424 | DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $242.90 |
| RX-425 | DESMOPRESSIN 4 MCG/ML INJECTION SOLN | Pharmacy | $145.18 |
| RX-426 | DESMOPRESSIN 4 MCG/ML ORAL SOLUTION | Pharmacy | $46.75 |
| RX-427 | DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRP | Pharmacy | $531.65 |
| RX-428 | DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRY | Pharmacy | $531.65 |
| RX-429 | DEXAMETHASONE 0.4 MG INCA INST | Pharmacy | $1,709.06 |
| RX-43 | ALTEPLASE 1 MG/ML IA SOLN | Pharmacy | $1,106.94 |
| RX-435 | DEXAMETHASONE 0.1 % OPHTHALMIC DRPS | Pharmacy | $44.56 |
| RX-44 | ALTEPLASE 100 MG INTRAVENOUS SOLR | Pharmacy | $1,106.94 |
| RX-445 | DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OPHTHALMIC DROP | Pharmacy | $162.58 |
| RX-447 | DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLN | Pharmacy | $18.52 |
| RX-45 | ALVIMOPAN 12 MG ORAL CAP | Pharmacy | $606.13 |
| RX-454 | DEXRAZOXANE HCL 250 MG INTRAVENOUS SOLR | Pharmacy | $2,488.79 |
| RX-455 | DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLR | Pharmacy | $2,488.79 |
| RX-456 | DEXTRAN 40 10 % IN 0.9 % NACL 10 % INTRAVENOUS SOLP | Pharmacy | $315.00 |
| RX-457 | DEXTROMETHORPHAN-QUINIDINE 20-10 MG ORAL CAP | Pharmacy | $66.19 |
| RX-458 | DEXTROSE 10 % IN WATER (D10W) 10 % INTRAVENOUS SOLP | Pharmacy | $15.75 |
| RX-459 | DEXTROSE 10% IN WATER (D10W) IV BOLUS | Pharmacy | $63.00 |
| RX-46 | AMBRISENTAN 5 MG ORAL TAB | Pharmacy | $259.49 |
| RX-460 | DEXTROSE 20 % IN WATER (D20W) 20 % INTRAVENOUS SOLP | Pharmacy | $126.00 |
| RX-461 | DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRG | Pharmacy | $90.72 |
| RX-462 | DEXTROSE 5 % IN WATER (D5W) 5 % INTRAVENOUS PGBK | Pharmacy | $63.00 |
| RX-463 | DEXTROSE 5 % IN WATER (D5W) 5 % INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-464 | DEXTROSE 5 % IN WATER (D5W) 5 % IV DISPENSABLE | Pharmacy | $63.00 |
| RX-465 | DEXTROSE 5 % IV BOLUS | Pharmacy | $63.00 |
| RX-466 | DEXTROSE 5 % IV KVO | Pharmacy | $63.00 |
| RX-467 | DEXTROSE 5 %-0.45 % NACL BOLUS | Pharmacy | $63.00 |
| RX-468 | DEXTROSE 5 %-0.45 % NACL IV KVO | Pharmacy | $63.00 |
| RX-469 | DEXTROSE 5 %-0.9 % NACL BOLUS | Pharmacy | $63.00 |
| RX-47 | AMBRISENTAN 10 MG ORAL TAB | Pharmacy | $259.49 |
| RX-470 | DEXTROSE 5 %-LACTATED RINGERS INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-471 | DEXTROSE 5%-0.2 % SOD CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-472 | DEXTROSE 5%-0.3 % SOD.CHLORIDE INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-473 | DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-474 | DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRG | Pharmacy | $63.00 |
| RX-475 | DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-48 | AMIFOSTINE CRYSTALLINE 500 MG INTRAVENOUS SOLR | Pharmacy | $12,749.80 |
| RX-480 | DIAZEPAM 2.5 MG RECTAL KIT | Pharmacy | $406.11 |
| RX-481 | DIAZEPAM 12.5-15-17.5-20 MG RECTAL KIT | Pharmacy | $463.17 |
| RX-482 | DIAZEPAM 5 MG/ML INJECTION SOLN | Pharmacy | $118.72 |
| RX-483 | DIAZEPAM 5 MG/ML INJECTION SYRG | Pharmacy | $118.72 |
| RX-484 | DIAZEPAM 5-7.5-10 MG RECTAL KIT | Pharmacy | $457.52 |
| RX-485 | DICLOFENAC EPOLAMINE 1.3 % TRANSDERMAL PT12 | Pharmacy | $39.10 |
| RX-486 | DICLOFENAC SODIUM 1 % TOP GEL | Pharmacy | $52.50 |
| RX-487 | DIFLUPREDNATE 0.05 % OPHTHALMIC DROP | Pharmacy | $621.95 |
| RX-488 | DIGOXIN 100 MCG/ML (0.1 MG/ML) INJECTION SOLN | Pharmacy | $70.37 |
| RX-489 | DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLN | Pharmacy | $70.33 |
| RX-49 | AMIKACIN 1000 MG/4 ML INJECTION SOLN | Pharmacy | $16.08 |
| RX-490 | DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SYRG | Pharmacy | $70.32 |
| RX-491 | DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLR | Pharmacy | $47,630.43 |
| RX-492 | DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLN | Pharmacy | $686.02 |
| RX-494 | DILTIAZEM HCL IN 0.9% NACL 125 MG/125 ML (1 MG/ML) INFUSION | Pharmacy | $64.58 |
| RX-497 | DIMERCAPROL 100 MG/ML IM SOLN | Pharmacy | $689.99 |
| RX-498 | DINOPROSTONE 10 MG VAGINAL INSR | Pharmacy | $1,347.71 |
| RX-499 | DINUTUXIMAB 3.5 MG/ML INTRAVENOUS SOLN | Pharmacy | $28,927.08 |
| RX-5 | ABACAVIR-LAMIVUDINE 600-300 MG ORAL TAB | Pharmacy | $145.43 |
| RX-50 | AMIKACIN 500 MG/2 ML INJECTION SOLN | Pharmacy | $16.08 |
| RX-500 | DIPH,PERTUS(ACEL),TET PED (PF) 15-10-5 LF-MCG-LF/0.5ML IM SUSP | Pharmacy | $365.59 |
| RX-501 | DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SUSP | Pharmacy | $229.70 |
| RX-502 | DIPH,PERTUS(ACEL),TET PED (PF) 25-58-10 LF-MCG-LF/0.5ML IM SYRG | Pharmacy | $229.70 |
| RX-503 | DIPH,PERTUS(ACEL),TET,POL (PF) 25 LF-58 MCG-10 LF/0.5 ML IM SUSP | Pharmacy | $247.53 |
| RX-504 | DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SUSP | Pharmacy | $423.83 |
| RX-505 | DIPH,PERTUSS(ACEL),TET VAC(PF) 2 LF-(2.5-5-3-5 MCG)-5LF/0.5 ML IM SYRG | Pharmacy | $423.83 |
| RX-508 | DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SOLN | Pharmacy | $11.33 |
| RX-509 | DIPHENHYDRAMINE HCL 50 MG/ML INJECTION SYRG | Pharmacy | $11.33 |
| RX-510 | DIPHENHYDRAMINE-0.9 % SOD.CHLR 50 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $11.34 |
| RX-511 | DIPHENHYDRAMINE-ZINC ACETATE 1-0.1 % TOP CREA | Pharmacy | $108.96 |
| RX-512 | DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SUSP | Pharmacy | $423.83 |
| RX-513 | DIPHTH,PERTUS(ACELL),TETANUS 2.5-8-5 LF-MCG-LF/0.5ML IM SYRG | Pharmacy | $423.83 |
| RX-514 | DIP-PERT(A)-TET-POLIO-HIB (PF) 15 LF UNIT-20 MCG-5 LF/0.5 ML IM KIT | Pharmacy | $2,293.96 |
| RX-515 | DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $76.86 |
| RX-516 | DOBUTAMINE IN D5W 1,000 MG/250 ML (4,000 MCG/ML) INTRAVENOUS SOLP | Pharmacy | $77.18 |
| RX-517 | DOBUTAMINE IN D5W 250 MG/250 ML (1 MG/ML) INTRAVENOUS SOLP | Pharmacy | $78.75 |
| RX-518 | DOBUTAMINE IN D5W 500 MG/250 ML (2,000 MCG/ML) INTRAVENOUS SOLP | Pharmacy | $77.18 |
| RX-519 | DOCETAXEL 160 MG/16 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-520 | DOCETAXEL 20 MG/ML (1 ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-521 | DOCETAXEL 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-522 | DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $12.16 |
| RX-523 | DOCOSANOL 10 % TOP CREA | Pharmacy | $42.56 |
| RX-524 | DOLUTEGRAVIR 50 MG ORAL TAB | Pharmacy | $205.63 |
| RX-528 | DORNASE ALFA 1 MG/ML INHALATION SOLN | Pharmacy | $602.19 |
| RX-529 | DORZOLAMIDE 2 % OPHTHALMIC DROP | Pharmacy | $69.30 |
| RX-530 | DORZOLAMIDE-TIMOLOL 22.3-6.8 MG/ML OPHTHALMIC DROP | Pharmacy | $79.28 |
| RX-531 | DOXORUBICIN 10 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $36.16 |
| RX-532 | DOXORUBICIN 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $36.16 |
| RX-533 | DOXORUBICIN 50 MG/25 ML INTRAVENOUS SOLN | Pharmacy | $36.16 |
| RX-534 | DOXORUBICIN FOR LC BEAD EMBOLIZATION | Pharmacy | $36.12 |
| RX-535 | DOXORUBICIN POWDER FOR EMBOLIZATION | Pharmacy | $36.12 |
| RX-536 | DOXORUBICIN, PEG-LIPOSOMAL 2 MG/ML INTRAVENOUS SUSP | Pharmacy | $3,723.55 |
| RX-537 | DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS SOLR | Pharmacy | $230.58 |
| RX-538 | DOXYCYCLINE MONOHYDRATE 40 MG ORAL CPID | Pharmacy | $60.03 |
| RX-542 | DROXIDOPA 100 MG ORAL CAP | Pharmacy | $108.85 |
| RX-543 | DROXIDOPA 200 MG ORAL CAP | Pharmacy | $217.70 |
| RX-544 | DROXIDOPA 300 MG ORAL CAP | Pharmacy | $326.59 |
| RX-545 | DUPILUMAB 300 MG/2 ML SUBCUTANEOUS SYRG | Pharmacy | $18,907.81 |
| RX-546 | DURVALUMAB 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $952.31 |
| RX-547 | ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLN | Pharmacy | $2,904.04 |
| RX-548 | EDARAVONE 30 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $245.55 |
| RX-549 | EFAVIRENZ 600 MG ORAL TAB | Pharmacy | $103.81 |
| RX-55 | AMINO ACIDS 4.25%-LYTES-CA-D5W 4.25 % INTRAVENOUS SOLP | Pharmacy | $210.00 |
| RX-550 | EFAVIRENZ-EMTRICITABIN-TENOFOV 600-200-300 MG ORAL TAB | Pharmacy | $337.16 |
| RX-551 | ELECTROLYTE-A INTRAVENOUS SOLP | Pharmacy | $35.00 |
| RX-553 | ELOTUZUMAB 300 MG INTRAVENOUS SOLR | Pharmacy | $82.93 |
| RX-554 | ELOTUZUMAB 400 MG INTRAVENOUS SOLR | Pharmacy | $82.93 |
| RX-555 | ELTROMBOPAG 25 MG ORAL TAB | Pharmacy | $614.99 |
| RX-556 | ELTROMBOPAG 50 MG ORAL TAB | Pharmacy | $1,040.13 |
| RX-557 | ELUXADOLINE 100 MG ORAL TAB | Pharmacy | $69.69 |
| RX-558 | ELVITEG-COB-EMTRI-TENOF ALAFEN 150-150-200-10 MG ORAL TAB | Pharmacy | $364.60 |
| RX-559 | ELVITEG-COB-EMTRI-TENOFO DISOP 150-150-200-300 MG ORAL TAB | Pharmacy | $382.45 |
| RX-56 | AMINO ACIDS-PROTEIN HYDROLYS 15-100 GRAM-KCAL/30 ML ORAL LIQD | Pharmacy | $66.15 |
| RX-560 | EMOLLIENT COMBINATION NO.10 TOP EMUL | Pharmacy | $58.28 |
| RX-561 | EMTRICITABINE 200 MG ORAL CAP | Pharmacy | $56.81 |
| RX-562 | EMTRICITABINE-TENOFOVIR (TDF) 200-300 MG ORAL TAB | Pharmacy | $207.41 |
| RX-563 | EMTRICITABINE-TENOFOVIR ALAFEN 200-25 MG ORAL TAB | Pharmacy | $207.41 |
| RX-564 | EMTRICITAB-RILPIVIR-TENOFO ALA 200-25-25 MG ORAL TAB | Pharmacy | $331.80 |
| RX-565 | EMTRICITA-RILPIVIRINE-TENOF DF 200-25-300 MG ORAL TAB | Pharmacy | $331.80 |
| RX-566 | ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLN | Pharmacy | $44.35 |
| RX-567 | ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLR | Pharmacy | $352.27 |
| RX-57 | AMINOCAPROIC ACID 500 MG ORAL TAB | Pharmacy | $50.33 |
| RX-577 | EPHEDRINE SULFATE 50 MG/ML INJECTION SOLN | Pharmacy | $168.58 |
| RX-578 | EPHEDRINE SULFATE-0.9%NACL(PF) 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRG | Pharmacy | $77.91 |
| RX-579 | EPHEDRINE SULFATE-0.9%NACL(PF) 50 MG/10 ML (5 MG/ML) INTRAVENOUS SYRG | Pharmacy | $14.18 |
| RX-58 | AMINOCAPROIC ACID 250 MG/ML (25 %) ORAL SOLN | Pharmacy | $37.52 |
| RX-580 | EPINEPHRINE 0.1 MG/ML INJECTION SYRG | Pharmacy | $10.31 |
| RX-581 | EPINEPHRINE 0.15 MG/0.3 ML INJECTION ATIN | Pharmacy | $10.31 |
| RX-582 | EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLN | Pharmacy | $10.31 |
| RX-583 | EPINEPHRINE 1 MG/ML INJECTION ATIN | Pharmacy | $10.31 |
| RX-584 | EPINEPHRINE 1 MG/ML INJECTION SOLN | Pharmacy | $10.31 |
| RX-585 | EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLN | Pharmacy | $10.31 |
| RX-586 | EPINEPHRINE HCL IN 0.9 % NACL 100 MCG/10 ML (10 MCG/ML) INTRAVENOUS SYRG | Pharmacy | $10.33 |
| RX-587 | EPINEPHRINE HCL IN 0.9 % NACL 16 MG/250 ML (64 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $10.32 |
| RX-588 | EPINEPHRINE HCL IN 5% DEXTROSE 4 MG/250 ML (16 MCG/ML) INTRAVENOUS SOLN | Pharmacy | $10.32 |
| RX-589 | EPINEPHRINE IN 0.9 % NACL 0.5 MG/50 ML INJ SYRINGE | Pharmacy | $10.33 |
| RX-590 | EPINEPHRINE IN 0.9 % NACL 0.5 MG/50 ML INJ SYRINGE | Pharmacy | $10.33 |
| RX-591 | EPINEPHRINE IN 0.9 % NACL 1 MG/10 ML INJ SYRINGE | Pharmacy | $10.31 |
| RX-592 | EPINEPHRINE IN 0.9 % NACL 1 MG/250 ML IVPB (CUPID) | Pharmacy | $10.40 |
| RX-593 | EPINEPHRINE IN 0.9 % NACL 4 MG/250 ML IVPB | Pharmacy | $10.32 |
| RX-594 | EPIRUBICIN 50 MG/25 ML INTRAVENOUS SOLN | Pharmacy | $14.11 |
| RX-595 | EPOETIN ALFA 2000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-596 | EPOETIN ALFA 4000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-597 | EPOETIN ALFA 10000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-598 | EPOETIN ALFA 20000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-599 | EPOETIN ALFA 40000 UNITS/ML INJECTION SOLN | Pharmacy | $133.11 |
| RX-6 | ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLR | Pharmacy | $691.10 |
| RX-60 | AMINOLEVULINIC ACID HCL 30 MG/ML ORAL SOLR | Pharmacy | $195.23 |
| RX-600 | EPOETIN ALFA-EPBX 2000 UNITS/ML INJECTION SOLN | Pharmacy | $117.50 |
| RX-601 | EPOETIN ALFA-EPBX 10000 UNITS/ML INJECTION SOLN | Pharmacy | $117.50 |
| RX-602 | EPOETIN ALFA-EPBX 40000 UNITS/ML INJECTION SOLN | Pharmacy | $117.50 |
| RX-603 | EPOPROSTENOL (ARGININE) 1.5 MG INTRAVENOUS SOLR | Pharmacy | $203.64 |
| RX-604 | EPOPROSTENOL (GLYCINE) 0.5 MG INTRAVENOUS SOLR | Pharmacy | $203.64 |
| RX-605 | EPOPROSTENOL (GLYCINE) 1.5 MG INTRAVENOUS SOLR | Pharmacy | $203.64 |
| RX-606 | EPTIFIBATIDE 0.75 MG/ML INTRAVENOUS SOLN | Pharmacy | $42.34 |
| RX-607 | EPTIFIBATIDE 2 MG/ML INTRAVENOUS SOLN | Pharmacy | $42.30 |
| RX-608 | EPTIFIBATIDE IA (INTERVENTIONAL RADIOLOGY) | Pharmacy | $42.30 |
| RX-609 | ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $1,464.59 |
| RX-61 | AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLN | Pharmacy | $132.80 |
| RX-610 | ERTAPENEM 1 G INJECTION SOLR | Pharmacy | $487.61 |
| RX-611 | ERTAPENEM 1 G INTRAVENOUS SOLR | Pharmacy | $487.61 |
| RX-612 | ERYTHROMYCIN 500 MG ORAL TAB | Pharmacy | $45.01 |
| RX-613 | ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLR | Pharmacy | $947.90 |
| RX-614 | ERYTHROMYCIN LACTOBIONATE 1000 MG INTRAVENOUS SOLR | Pharmacy | $947.90 |
| RX-615 | ERYTHROMYCIN-BENZOYL PEROXIDE 3-5 % TOP GEL | Pharmacy | $198.98 |
| RX-616 | ESLICARBAZEPINE 200 MG ORAL TAB | Pharmacy | $107.24 |
| RX-617 | ESLICARBAZEPINE 400 MG ORAL TAB | Pharmacy | $107.24 |
| RX-618 | ESLICARBAZEPINE 600 MG ORAL TAB | Pharmacy | $107.24 |
| RX-619 | ESLICARBAZEPINE 800 MG ORAL TAB | Pharmacy | $107.24 |
| RX-620 | ESMOLOL 10 MG/ML IV BOLUS FROM PUMP | Pharmacy | $24.44 |
| RX-623 | ESMOLOL IN NACL (ISO-OSM) 2,500 MG/250 ML (10 MG/ML) INTRAVENOUS SOLP | Pharmacy | $315.00 |
| RX-624 | ESTRADIOL VALERATE 20 MG/ML IM OIL | Pharmacy | $106.14 |
| RX-625 | ETELCALCETIDE 5 MG/ML INTRAVENOUS SOLN | Pharmacy | $30.82 |
| RX-626 | ETEPLIRSEN 50 MG/ML INTRAVENOUS SOLN | Pharmacy | $2,108.58 |
| RX-627 | ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLR | Pharmacy | $9,718.25 |
| RX-628 | ETHANOL (ETHYL ALCOHOL) 98 % INJECTION SOLN | Pharmacy | $283.78 |
| RX-629 | ETHIODIZED OIL 480 MG IODINE/ML INJECTION OIL | Pharmacy | $1,294.02 |
| RX-630 | ETHYL CHLORIDE 100 % TOP SPRA | Pharmacy | $101.43 |
| RX-632 | ETOMIDATE 2 MG/ML INTRAVENOUS SYRG | Pharmacy | $16.25 |
| RX-633 | ETONOGESTREL 68 MG SUBDERMAL IMPL | Pharmacy | $10,683.54 |
| RX-634 | ETONOGESTREL-ETHINYL ESTRADIOL 0.12-0.015 MG/24 HR VAGINAL RING | Pharmacy | $516.50 |
| RX-638 | ETRAVIRINE 100 MG ORAL TAB | Pharmacy | $36.61 |
| RX-639 | ETRAVIRINE 200 MG ORAL TAB | Pharmacy | $73.26 |
| RX-64 | AMIODARONE IN DEXTROSE 5 % 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $2,202.48 |
| RX-640 | EVEROLIMUS (ANTINEOPLASTIC) 5 MG ORAL TAB | Pharmacy | $1,963.33 |
| RX-641 | EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG ORAL TAB | Pharmacy | $112.95 |
| RX-642 | EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG ORAL TAB | Pharmacy | $112.95 |
| RX-643 | FACTOR VIII REC,FC FUSION PROT (ELOCTATE) INJ ORD/DISPENSABLE | Pharmacy | $25.44 |
| RX-644 | FACTOR VIII/VWF COMPLEX (ALPHANATE) INJ ORD/DISPENSABLE | Pharmacy | $13.49 |
| RX-645 | FACTOR VIII/VWF COMPLEX (HUMATE-P) INJ ORD/DISPENSABLE | Pharmacy | $14.69 |
| RX-647 | FAMOTIDINE (PF)-NACL (ISO-OS) 20 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $50.40 |
| RX-648 | FAMOTIDINE 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $11.34 |
| RX-651 | FAM-TRASTUZUMAB DERUXTECN-NXKI 100 MG INTRAVENOUS SOLR | Pharmacy | $304.79 |
| RX-652 | FAT EMULSION 20 % INTRAVENOUS EMUL | Pharmacy | $25.20 |
| RX-654 | FATTY ACID6-FISH OIL-GLY-P-LIP 10 % INTRAVENOUS EMUL | Pharmacy | $10.96 |
| RX-655 | FENOLDOPAM 10 MG/ML INTRAVENOUS SOLN | Pharmacy | $3,622.50 |
| RX-656 | FENTANYL 12 MCG/HR TRANSDERMAL PT72 | Pharmacy | $42.63 |
| RX-657 | FENTANYL (PF)-BUPIVACAINE-NACL 2 MCG/ML- 0.1 % INJECTION SOLN | Pharmacy | $12.60 |
| RX-659 | FENTANYL 500 MCG IN 10 ML INFUSION | Pharmacy | $10.46 |
| RX-66 | AMIODARONE IN DEXTROSE,ISO-OSM 150 MG/100 ML (1.5 MG/ML) INTRAVENOUS SOLN | Pharmacy | $80.64 |
| RX-660 | FENTANYL CITRATE (PF) 50 MCG/ML INJECTION SOLN | Pharmacy | $12.45 |
| RX-661 | FENTANYL CITRATE (PF)-0.9%NACL 750 MCG/30 ML INJECTION PCAS | Pharmacy | $12.45 |
| RX-662 | FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML INTRAVENOUS SOLN | Pharmacy | $12.47 |
| RX-663 | FENTANYL CITRATE (PF)-0.9%NACL 10 MCG/ML INTRAVENOUS SYRG | Pharmacy | $12.47 |
| RX-664 | FENTANYL CITRATE IN 0.9 % NACL 1250 MCG/50 ML PCA | Pharmacy | $12.45 |
| RX-665 | FENTANYL IN 0.9 % NACL 250 MCG/25 ML INJ SYR | Pharmacy | $12.47 |
| RX-666 | FENTANYL IN 0.9 % NACL 2500 MCG/250 ML (10 MCG/ML) INFUSION | Pharmacy | $12.47 |
| RX-667 | FENTANYL IN 0.9 % NACL 5 MCG/0.5 ML INJ SYR | Pharmacy | $12.47 |
| RX-668 | FENTANYL INFUSION 50 MCG/ML | Pharmacy | $12.45 |
| RX-669 | FENTANYL-BUPIVACAINE IN 0.9 % NACL 1250 MCG-312.5 MG/250 ML IVPB | Pharmacy | $94.50 |
| RX-67 | AMIODARONE IN DEXTROSE,ISO-OSM 360 MG/200 ML (1.8 MG/ML) INTRAVENOUS SOLN | Pharmacy | $46.20 |
| RX-670 | FENTANYL-BUPIVACAINE IN 0.9 % NACL 500 MCG-150 MG/250 ML IVPB | Pharmacy | $12.60 |
| RX-672 | FERRIC CARBOXYMALTOSE 50 IRON MG/ML INTRAVENOUS SOLN | Pharmacy | $13.92 |
| RX-673 | FERRIC PYROPHOSPHATE CITRATE 27.2 MG IRON/5 ML HEMODIALYSIS SOLN | Pharmacy | $2,038.40 |
| RX-674 | FERRIC PYROPHOSPHATE CITRATE 272 MG IRON HEMODIALYSIS PWPK | Pharmacy | $107.77 |
| RX-675 | FERRIC SUBSULFATE 259 MG/G TOP SOLN | Pharmacy | $45.92 |
| RX-676 | FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLN | Pharmacy | $13.13 |
| RX-677 | FIDAXOMICIN 200 MG ORAL TAB | Pharmacy | $315.84 |
| RX-678 | FILGRASTIM 300 MCG/0.5 ML INJECTION SYRG | Pharmacy | $12.03 |
| RX-679 | FILGRASTIM 300 MCG/ML INJECTION SOLN | Pharmacy | $12.03 |
| RX-68 | AMOBARBITAL 500 MG INJECTION SOLR | Pharmacy | $1,199.02 |
| RX-680 | FILGRASTIM 480 MCG/0.8 ML INJECTION SYRG | Pharmacy | $12.03 |
| RX-681 | FILGRASTIM 480 MCG/1.6 ML INJECTION SOLN | Pharmacy | $12.03 |
| RX-684 | FLU VAC QS 2016(4 YR UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $288.99 |
| RX-685 | FLU VAC QS 2017-18(6-35MO)(PF) 30 MCG (7.5 MCG X 4)/0.25 ML IM SYRG | Pharmacy | $274.84 |
| RX-686 | FLU VAC QS 2018(4 YR UP)CD(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $302.99 |
| RX-687 | FLU VAC QS2016-17 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.80 |
| RX-688 | FLU VAC QS2017-18 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-689 | FLU VAC QS2018-19 36MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-69 | AMPHOTERICIN B 50 MG INJECTION SOLR | Pharmacy | $479.77 |
| RX-690 | FLU VAC QV 2019(18YR UP)RC(PF) 180 MCG (45 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $705.68 |
| RX-691 | FLU VAC QV 2020(18YR UP)RC(PF) 180 MCG (45 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $768.37 |
| RX-692 | FLU VACC QS 2019-20 (6 MOS UP) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $224.73 |
| RX-693 | FLU VACC QS2018-19 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-694 | FLU VACC QS2019-20 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $239.81 |
| RX-695 | FLU VACC QS2020-21 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $246.72 |
| RX-696 | FLU VACC QS2020-21 6MOS UP(PF) 60 MCG (15 MCG X 4)/0.5 ML IM SYRG | Pharmacy | $246.72 |
| RX-697 | FLU VACC QS2020-21(65YR UP)-PF 240 MCG/0.7 ML IM SYRG | Pharmacy | $768.37 |
| RX-698 | FLU VACC QV LIVE 2019(2-49YRS) 10EXP6.5-7.5 FF UNIT/0.2 ML NASAL NSSY | Pharmacy | $338.64 |
| RX-699 | FLU VACC TS2016-17 65YR UP(PF) 180 MCG/0.5 ML IM SYRG | Pharmacy | $672.50 |
| RX-7 | ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLN | Pharmacy | $438.73 |
| RX-70 | AMPHOTERICIN B LIPOSOME 50 MG INJECTION | Pharmacy | $336.75 |
| RX-700 | FLU VACC TS2017-18 65YR UP(PF) 180 MCG/0.5 ML IM SYRG | Pharmacy | $672.50 |
| RX-701 | FLU VACC TS2018-19 65YR UP(PF) 180 MCG/0.5 ML IM SYRG | Pharmacy | $672.50 |
| RX-702 | FLU VACC TS2019-20(65YR UP)PF 180 MCG/0.5 ML IM SYRG | Pharmacy | $705.68 |
| RX-703 | FLU VACCINE QS2016-17(36MO,UP) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $230.19 |
| RX-704 | FLU VACCINE QS2020-21(6MOS UP) 60 MCG (15 MCG X 4)/0.5 ML IM SUSP | Pharmacy | $239.80 |
| RX-705 | FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLN | Pharmacy | $53,512.20 |
| RX-706 | FLUCONAZOLE IN DEXTROSE(ISO-O) 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $59.22 |
| RX-707 | FLUCONAZOLE IN NACL (ISO-OSM) 1,000 MG/500 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $59.22 |
| RX-708 | FLUCONAZOLE IN NACL (ISO-OSM) 1,200 MG/600 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $70.56 |
| RX-709 | FLUCONAZOLE IN NACL (ISO-OSM) 2 MG/ML IV DISPENSABLE | Pharmacy | $59.22 |
| RX-71 | AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSR | Pharmacy | $336.75 |
| RX-710 | FLUCONAZOLE IN NACL (ISO-OSM) 200 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $59.22 |
| RX-711 | FLUCONAZOLE IN NACL (ISO-OSM) 400 MG/200 ML INTRAVENOUS PGBK | Pharmacy | $59.22 |
| RX-712 | FLUCONAZOLE IN NACL (ISO-OSM) 600 MG/300 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $59.22 |
| RX-713 | FLUCONAZOLE IN NACL (ISO-OSM) 800 MG/400 ML INTRAVENOUS PGBK - RX MIXTURE | Pharmacy | $59.22 |
| RX-714 | FLUCYTOSINE 250 MG ORAL CAP | Pharmacy | $41.55 |
| RX-715 | FLUCYTOSINE 500 MG ORAL CAP | Pharmacy | $172.31 |
| RX-716 | FLUDARABINE 50 MG INTRAVENOUS SOLR | Pharmacy | $603.39 |
| RX-717 | FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $11.34 |
| RX-718 | FLUOCINOLONE 0.025 % TOP CREA | Pharmacy | $77.70 |
| RX-719 | FLUOCINONIDE 0.05 % TOP GEL | Pharmacy | $54.08 |
| RX-72 | AMPICILLIN IM INJECTION ORDERABLE | Pharmacy | $12.35 |
| RX-720 | FLUOCINONIDE 0.05 % TOP OINT | Pharmacy | $41.48 |
| RX-721 | FLUOCINONIDE 0.05 % TOP SOLN | Pharmacy | $182.70 |
| RX-722 | FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLN | Pharmacy | $106.47 |
| RX-723 | FLUORODEOXYGLUCOSE F-18 FDG =< 45 MCI | Pharmacy | $1,877.40 |
| RX-724 | FLUOROMETHOLONE 0.1 % OPHTHALMIC DRPS | Pharmacy | $218.05 |
| RX-725 | FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLN | Pharmacy | $19.15 |
| RX-726 | FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLN | Pharmacy | $19.15 |
| RX-727 | FLUOROURACIL 5 G/100 ML INTRAVENOUS SOLN | Pharmacy | $19.15 |
| RX-728 | FLUPHENAZINE DECANOATE 25 MG/ML INJECTION SOLN | Pharmacy | $125.75 |
| RX-729 | FLUPHENAZINE HCL 2.5 MG/ML INJECTION SOLN | Pharmacy | $103.82 |
| RX-73 | AMPICILLIN SODIUM 1 G INJECTION SOLR | Pharmacy | $12.35 |
| RX-730 | FLUTICASONE FUROATE-VILANTEROL 100-25 MCG/DOSE INHALATION DSDV | Pharmacy | $1,081.50 |
| RX-731 | FLUTICASONE PROPIONATE 44 MCG/ACTUATION INHALATION HFAA | Pharmacy | $187.74 |
| RX-732 | FLUTICASONE PROPIONATE 110 MCG/ACTUATION INHALATION HFAA | Pharmacy | $221.89 |
| RX-733 | FLUTICASONE PROPIONATE 220 MCG/ACTUATION INHALATION HFAA | Pharmacy | $344.74 |
| RX-734 | FLUTICASONE PROPION-SALMETEROL 100-50 MCG/DOSE INHALATION DSDV | Pharmacy | $59.85 |
| RX-735 | FLUTICASONE PROPION-SALMETEROL 115-21 MCG/ACTUATION INHALATION HFAA | Pharmacy | $1,242.36 |
| RX-736 | FLUTICASONE PROPION-SALMETEROL 230-21 MCG/ACTUATION INHALATION HFAA | Pharmacy | $1,633.80 |
| RX-737 | FLUTICASONE PROPION-SALMETEROL 250-50 MCG/DOSE INHALATION DSDV | Pharmacy | $74.34 |
| RX-738 | FLUTICASONE PROPION-SALMETEROL 500-50 MCG/DOSE INHALATION DSDV | Pharmacy | $97.78 |
| RX-739 | FOLIC ACID 5 MG/ML INJECTION SOLN | Pharmacy | $26.33 |
| RX-74 | AMPICILLIN SODIUM 2 G INJECTION SOLR | Pharmacy | $12.35 |
| RX-740 | FOMEPIZOLE 1 G/ML INTRAVENOUS SOLN | Pharmacy | $107.96 |
| RX-741 | FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-742 | FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-743 | FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-744 | FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SYRG | Pharmacy | $19.10 |
| RX-745 | FORMOTEROL FUMARATE 20 MCG/2 ML INHALATION NEBU | Pharmacy | $152.21 |
| RX-746 | FOSAMPRENAVIR 700 MG ORAL TAB | Pharmacy | $61.32 |
| RX-747 | FOSAPREPITANT 150 MG INTRAVENOUS SOLR | Pharmacy | $24.95 |
| RX-748 | FOSCARNET 24 MG/ML INJ | Pharmacy | $1,036.88 |
| RX-749 | FOSCARNET 24 MG/ML INTRAVENOUS SOLN | Pharmacy | $1,036.88 |
| RX-75 | AMPICILLIN SODIUM 500 MG INJECTION SOLR | Pharmacy | $12.35 |
| RX-750 | FOSFOMYCIN TROMETHAMINE 3 G ORAL PACK | Pharmacy | $289.87 |
| RX-751 | FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLN | Pharmacy | $17.39 |
| RX-752 | FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLN | Pharmacy | $17.39 |
| RX-753 | FULVESTRANT 250 MG/5 ML IM SYRG | Pharmacy | $1,070.46 |
| RX-76 | AMPICILLIN-SULBACTAM 1.5 G INJECTION SOLR | Pharmacy | $32.47 |
| RX-762 | GADODIAMIDE 10 MMOL/20 ML (287 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-763 | GADODIAMIDE 5 MMOL/10 ML (287 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-764 | GADODIAMIDE 7.5 MMOL/15 ML (287 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-765 | GADOPENTETATE DIMEGLUMINE 10 MMOL/20 ML (469.01 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-766 | GADOPENTETATE DIMEGLUMINE 2.5 MMOL/5 ML (469.01 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-767 | GADOPENTETATE DIMEGLUMINE 5 MMOL/10 ML (469.01 MG/ML) INTRAVENOUS SOLN | Pharmacy | $19.48 |
| RX-769 | GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLN | Pharmacy | $185.79 |
| RX-77 | AMPICILLIN-SULBACTAM 3 G INJECTION SOLR | Pharmacy | $32.47 |
| RX-770 | GALLIUM CITRATE GA-67 PER 1 MCI | Pharmacy | $743.27 |
| RX-771 | GALSULFASE 5 MG/5 ML INTRAVENOUS SOLN | Pharmacy | $5,013.04 |
| RX-772 | GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLR | Pharmacy | $436.50 |
| RX-773 | GATIFLOXACIN 0.5 % OPHTHALMIC DROP | Pharmacy | $130.11 |
| RX-774 | GEL DRESSING TOP GEL | Pharmacy | $44.63 |
| RX-775 | GELATIN SPONGE,ABSORB-PORCINE 100 TOP SPGE | Pharmacy | $60.55 |
| RX-776 | GEMCITABINE 1 G INTRAVENOUS SOLR | Pharmacy | $52.37 |
| RX-777 | GEMCITABINE 2 G INTRAVENOUS SOLR | Pharmacy | $52.37 |
| RX-778 | GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLN | Pharmacy | $52.42 |
| RX-779 | GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONC) INTRAVENOUS SOLR | Pharmacy | $2,514.36 |
| RX-78 | ANAKINRA 100 MG/0.67 ML IV SYRG (COVID19) | Pharmacy | $1,953.11 |
| RX-780 | GENTAMICIN 0.1 % TOP CREA | Pharmacy | $77.18 |
| RX-781 | GENTAMICIN 0.3 % (3 MG/GRAM) OPHTHALMIC OINT | Pharmacy | $90.04 |
| RX-782 | GENTAMICIN 20 MG/2 ML INJECTION SOLN | Pharmacy | $24.90 |
| RX-783 | GENTAMICIN 40 MG/ML INJECTION SOLN | Pharmacy | $24.85 |
| RX-784 | GENTAMICIN 5 MG/ML INJ IN NS (PF) | Pharmacy | $24.85 |
| RX-785 | GENTAMICIN IN NACL (ISO-OSM) 80 MG/100 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-786 | GENTAMICIN IN NACL (ISO-OSM) 80 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-787 | GENTAMICIN IN NACL (ISO-OSM) 100 MG/50 ML INTRAVENOUS PGBK | Pharmacy | $25.20 |
| RX-788 | GENTAMICIN IN NS INTRATHECAL 4MG IN 2ML SYG | Pharmacy | $25.20 |
| RX-789 | GENTAMICIN IV (PF) 10 MG/ML - DISPENSABLE (PED-NEO) | Pharmacy | $24.90 |
| RX-79 | ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRG | Pharmacy | $1,953.14 |
| RX-790 | GENTAMICIN SULFATE (PED) (PF) 20 MG/2 ML INJECTION SOLN | Pharmacy | $24.90 |
| RX-791 | GENTIAN VIOLET 1 % TOP SOLN | Pharmacy | $239.54 |
| RX-792 | GLATIRAMER 20 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,032.62 |
| RX-793 | GLATIRAMER 40 MG/ML SUBCUTANEOUS SYRG | Pharmacy | $2,032.62 |
| RX-794 | GLECAPREVIR-PIBRENTASVIR 100-40 MG ORAL TAB | Pharmacy | $530.74 |
| RX-795 | GLUCAGON (HUMAN RECOMBINANT) 1 MG INJECTION SOLR | Pharmacy | $2,741.31 |
| RX-796 | GLUCAGON (HUMAN RECOMBINANT) 1 MG/ML INJECTION SOLR | Pharmacy | $2,741.31 |
| RX-797 | GLUCARPIDASE 1000 UNITS INTRAVENOUS SOLR | Pharmacy | $3,988.91 |
| RX-798 | GLUCOSE (TOLERANCE TEST) 100 GRAM/180 ML ORAL LIQD | Pharmacy | $718.20 |
| RX-799 | GLUCOSE ORAL SOLN 5 GM/30 ML | Pharmacy | $76.13 |
| RX-80 | ANTIHEMOPHIL FVIII,FULL LENGTH (ADVATE) IV SOLR ORDER/DISPENSABLE | Pharmacy | $16.25 |
| RX-800 | GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLN | Pharmacy | $80.01 |
| RX-801 | GLYCOPYRROLATE 1 MG/5 ML (0.2 MG/ML) ORAL SOLN | Pharmacy | $1,562.79 |
| RX-802 | GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLN | Pharmacy | $260.30 |
| RX-803 | GOSERELIN 3.6 MG SUBCUTANEOUS IMPL | Pharmacy | $6,350.20 |
| RX-804 | GOSERELIN 10.8 MG SUBCUTANEOUS IMPL | Pharmacy | $6,350.20 |
| RX-808 | H PAPILLOMAVIRUS VAC,QVAL (PF) 20-40-40-20 MCG/0.5 ML IM SUSP | Pharmacy | $2,350.05 |
| RX-809 | HAEMOPH B POLY CONJ-TET TOX-PF 10 MCG/0.5 ML IM SOLR | Pharmacy | $197.95 |
| RX-81 | ANTIHEMOPHIL FVIII,FULL LENGTH 500 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $16.25 |
| RX-810 | HALOPERIDOL DECANOATE 50 MG/ML IM SOLN | Pharmacy | $205.12 |
| RX-811 | HALOPERIDOL DECANOATE 100 MG/ML IM SOLN | Pharmacy | $205.12 |
| RX-812 | HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLN | Pharmacy | $15.18 |
| RX-813 | HEMIN 350 MG INTRAVENOUS SOLR | Pharmacy | $298.86 |
| RX-814 | HEP B-DP(A)T-POLIO VAC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRG | Pharmacy | $705.92 |
| RX-815 | HEPARIN (PORCINE) 1000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-816 | HEPARIN (PORCINE) 5000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-817 | HEPARIN (PORCINE) 10,000 UNITS/10 ML INJ SYRG | Pharmacy | $63.00 |
| RX-818 | HEPARIN (PORCINE) 10,000 UNITS/20 ML NS SYRINGE | Pharmacy | $63.00 |
| RX-819 | HEPARIN (PORCINE) 100 UNITS/ML IV BOLUS FROM PUMP | Pharmacy | $63.00 |
| RX-82 | ANTIHEMOPHILIC FACTOR (RECOMB) 1,000 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $16.25 |
| RX-820 | HEPARIN (PORCINE) 10000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-821 | HEPARIN (PORCINE) 5000 UNIT/ML INJ(PRE-OP) NO DOSE CK | Pharmacy | $63.00 |
| RX-822 | HEPARIN (PORCINE) 5000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-823 | HEPARIN (PORCINE) IN 0.45 % SODIUM CHLORIDE 0.5 UNITS/ML INFUSION 500 ML | Pharmacy | $63.00 |
| RX-824 | HEPARIN (PORCINE) IN 0.45% SODIUM CHLORIDE 0.5 UNITS/ML INFUSION 500 ML | Pharmacy | $63.00 |
| RX-825 | HEPARIN (PORCINE) IN 0.9 % NACL 0.5 UNITS/ML INFUSION | Pharmacy | $63.00 |
| RX-826 | HEPARIN (PORCINE) IN 0.9 % NACL 1,000 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-827 | HEPARIN (PORCINE) IN 0.9 % NACL 4,000 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-828 | HEPARIN (PORCINE) IN 0.9 % NACL 4,000 UNITS/1,000 ML SOLUTION | Pharmacy | $63.00 |
| RX-829 | HEPARIN (PORCINE) IN 0.9 % NACL 7,500 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-83 | ANTIHEMOPHILIC FACTOR (RECOMB) 2,000 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $16.25 |
| RX-830 | HEPARIN (PORCINE) IN 0.9 % NACL 8,000 UNITS/1,000 ML IVPB | Pharmacy | $63.00 |
| RX-831 | HEPARIN (PORCINE) IN 0.9% NACL 10 UNITS/ML INTRAVENOUS KIT | Pharmacy | $63.00 |
| RX-832 | HEPARIN (PORCINE) IN 0.9% NACL 5000 UNIT/1,000 ML INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-833 | HEPARIN (PORCINE) IN 0.9% NACL 2,500 UNIT/500 ML (5 UNIT/ML) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-834 | HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/250 ML(100 UNIT/ML) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-835 | HEPARIN (PORCINE) IN 5 % DEX 25,000 UNIT/500 ML (50 UNIT/ML) INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-836 | HEPARIN (PORCINE) IN D10W 25 UNITS/50 ML INFUSION | Pharmacy | $63.00 |
| RX-837 | HEPARIN (PORCINE) IN D10W 250 UNITS/500 ML IVPB | Pharmacy | $63.00 |
| RX-838 | HEPARIN (PORCINE) IN D5W 0.5 UNITS/ML INFUSION 500 ML | Pharmacy | $63.00 |
| RX-839 | HEPARIN (PORCINE) IN NACL (PF) 2 UNITS/ML INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-84 | ANTIHEMOPHILIC FACTOR-VWF 1,000 (400 VWF) UNIT/10 ML INTRAVENOUS SOLR | Pharmacy | $13.49 |
| RX-840 | HEPARIN IA 100 UNIT/ML INFUSION | Pharmacy | $63.00 |
| RX-841 | HEPARIN LOCK FLUSH (PORCINE) 10 UNITS/ML INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-842 | HEPARIN LOCK FLUSH (PORCINE) 100 UNITS/ML INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-843 | HEPARIN(PORCINE) IN 0.45% NACL 25000 UNIT/250 ML INTRAVENOUS SOLP | Pharmacy | $63.00 |
| RX-844 | HEPARIN, PORCINE (PF) 10 UNITS/ML INTRAVENOUS SYRG | Pharmacy | $63.00 |
| RX-845 | HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS (CUSTOM 3 ML) | Pharmacy | $63.00 |
| RX-846 | HEPARIN, PORCINE (PF) 100 UNITS/ML INTRAVENOUS SYRG | Pharmacy | $63.00 |
| RX-847 | HEPARIN, PORCINE (PF) 100 UNIT/ML (1 ML) INTRAVENOUS SOLN | Pharmacy | $63.00 |
| RX-848 | HEPARIN, PORCINE (PF) 1000 UNITS/ML INJECTION SOLN | Pharmacy | $63.00 |
| RX-849 | HEPATITIS A AND B VACCINE (PF) 720 ELISA UNIT- 20 MCG/ML IM SYRG | Pharmacy | $1,047.69 |
| RX-85 | ANTIHEMOPHILIC FACTOR-VWF 1,000-2,400 UNIT INTRAVENOUS SOLR | Pharmacy | $14.69 |
| RX-850 | HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SUSP | Pharmacy | $754.83 |
| RX-851 | HEPATITIS A VIRUS VACCINE (PF) 1,440 ELISA UNIT/ML IM SYRG | Pharmacy | $754.83 |
| RX-852 | HEPATITIS A VIRUS VACCINE (PF) 25 UNIT/0.5 ML IM SUSP | Pharmacy | $345.74 |
| RX-853 | HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SUSP | Pharmacy | $301.77 |
| RX-854 | HEPATITIS A VIRUS VACCINE (PF) 720 ELISA UNIT/0.5 ML IM SYRG | Pharmacy | $301.77 |
| RX-855 | HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML IM SYRG | Pharmacy | $1,460.79 |
| RX-856 | HEPATITIS B IMMUNE GLOBULIN GREATER THAN 1,560 UNIT/5 ML IM SOLN | Pharmacy | $1,460.79 |
| RX-857 | HEPATITIS B IMMUNE GLOBULIN GREATR THAN 312 UNIT/ML IM SOLN | Pharmacy | $1,460.79 |
| RX-858 | HEPATITIS B VACC-CPG 1018 (PF) 20 MCG/0.5 ML IM SYRG | Pharmacy | $1,651.86 |
| RX-859 | HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SUSP | Pharmacy | $338.91 |
| RX-86 | ANTIHEMOPHILIC FACTOR-VWF 2,000 (800 VWF) UNIT/10 ML INTRAVENOUS SOLR | Pharmacy | $13.49 |
| RX-860 | HEPATITIS B VIRUS VACC.REC(PF) 5 MCG/0.5 ML IM SYRG | Pharmacy | $338.91 |
| RX-861 | HEPATITIS B VIRUS VACC.REC(PF) 10 MCG/0.5 ML IM SYRG | Pharmacy | $338.91 |
| RX-862 | HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SUSP | Pharmacy | $844.97 |
| RX-863 | HEPATITIS B VIRUS VACC.REC(PF) 20 MCG/ML IM SYRG | Pharmacy | $844.97 |
| RX-864 | HES 130/0.4 6 % IN 0.9 % NACL 6 % INTRAVENOUS SOLN | Pharmacy | $819.00 |
| RX-865 | HETASTARCH 6 % IN 0.9 % NACL 6 % INTRAVENOUS SOLN | Pharmacy | $189.00 |
| RX-866 | HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLR | Pharmacy | $14,429.02 |
| RX-867 | HISTRELIN 50 MG (65 MCG/DAY) IMPLANT KIT | Pharmacy | $462,099.14 |
| RX-868 | HUM PROTHROMBIN CPLX(PCC)4FACT 1,000 UNIT (800-1240 UNIT) INTRAVENOUS SOLR | Pharmacy | $25.29 |
| RX-869 | HUM PROTHROMBIN CPLX(PCC)4FACT 500 UNIT (400-620 UNIT) INTRAVENOUS SOLR | Pharmacy | $25.29 |
| RX-87 | ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLR | Pharmacy | $41.32 |
| RX-870 | HUMAN PAPILLOMAV VAC,9-VAL(PF) 0.5 ML IM SUSP | Pharmacy | $2,528.95 |
| RX-871 | HYALURONATE SOD, CROSS-LINKED 30 MG/3 ML INTRAARTICLR SYRG | Pharmacy | $14,691.61 |
| RX-872 | HYALURONATE SODIUM, STABILIZED 88 MG/4 ML INTRAARTICLR SYRG | Pharmacy | $9,843.98 |
| RX-874 | HYALURONIDASE 150 UNITS/ML INJECTION SOLN | Pharmacy | $384.55 |
| RX-876 | HYDRALAZINE 20 MG/ML INJECTION SOLN | Pharmacy | $47.26 |
| RX-877 | HYDROCORTISONE 1 % TOP OINT | Pharmacy | $191.10 |
| RX-878 | HYDROCORTISONE SOD SUCC (PF) 100 MG/2 ML INJECTION SOLR | Pharmacy | $164.43 |
| RX-879 | HYDROCORTISONE SOD SUCC (PF) 250 MG/2 ML INJECTION SOLR | Pharmacy | $164.43 |
| RX-88 | ANTI-THYMOCYTE GLOB (RABBIT) 25 MG INTRAVENOUS SOLR | Pharmacy | $9,648.29 |
| RX-880 | HYDROCORTISONE SOD SUCC (PF) 500 MG/4 ML INJECTION SOLR | Pharmacy | $164.43 |
| RX-881 | HYDROCORTISONE SOD SUCCINATE 100 MG INJECTION SOLR | Pharmacy | $164.43 |
| RX-882 | HYDROGEN PEROXIDE 3 % MISC. SOLN | Pharmacy | $215.22 |
| RX-883 | HYDROMORPHONE 1 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-884 | HYDROMORPHONE 2 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-885 | HYDROMORPHONE 2 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-886 | HYDROMORPHONE 4 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-887 | HYDROMORPHONE (DILAUDID) IN 0.9% NACL 25 MG/250 ML IV BOLUS FROM PUMP | Pharmacy | $39.31 |
| RX-888 | HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-889 | HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-89 | APRACLONIDINE 0.5 % OPHTHALMIC DROP | Pharmacy | $98.35 |
| RX-890 | HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-891 | HYDROMORPHONE (PF) 2 MG/ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-892 | HYDROMORPHONE (PF) 4 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-893 | HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-894 | HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLN | Pharmacy | $39.06 |
| RX-895 | HYDROMORPHONE 0.5 MG/0.5 ML INJECTION SYRG | Pharmacy | $39.06 |
| RX-896 | HYDROMORPHONE 1 MG/ML SUPER ORDERABLE | Pharmacy | $39.06 |
| RX-897 | HYDROMORPHONE 10 MG/250 ML NS EPIDURAL | Pharmacy | $39.06 |
| RX-898 | HYDROMORPHONE 2 MG/ML INJ SOLN SUPER ORDERABLE | Pharmacy | $39.06 |
| RX-899 | HYDROMORPHONE IN 0.9 % NACL 25 MG/250 ML (0.1 MG/ML) INFUSION | Pharmacy | $39.31 |
| RX-9 | ACETAZOLAMIDE SODIUM 500 MG INJECTION SOLR | Pharmacy | $178.14 |
| RX-90 | APRACLONIDINE 1 % OPHTHALMIC DPET | Pharmacy | $87.62 |
| RX-900 | HYDROMORPHONE IN 0.9 % NACL 25 MG/250 ML IVPB | Pharmacy | $39.31 |
| RX-901 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML (PED-NEO) PCA STANDARD | Pharmacy | $39.06 |
| RX-902 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML INFUSION | Pharmacy | $39.06 |
| RX-903 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML PCA RESTRICTED | Pharmacy | $39.06 |
| RX-904 | HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML PCA STANDARD | Pharmacy | $39.06 |
| RX-905 | HYDROMORPHONE IN 0.9 % NACL 50 MG/250 ML (0.2 MG/ML) INFUSION | Pharmacy | $39.06 |
| RX-906 | HYDROMORPHONE IN NS 100 MG/100 ML (1 MG/ML) | Pharmacy | $39.06 |
| RX-907 | HYDROXOCOBALAMIN 5 G INTRAVENOUS SOLR | Pharmacy | $2,712.78 |
| RX-908 | HYDROXYPROGEST(PF)(PREG PRESV) 250 MG/ML (1 ML) IM OIL | Pharmacy | $253.41 |
| RX-909 | HYDROXYPROGEST(PF)(PREG PRESV) 275 MG/1.1 ML SUBCUTANEOUS ATIN | Pharmacy | $253.41 |
| RX-91 | APREMILAST 30 MG ORAL TAB | Pharmacy | $202.20 |
| RX-910 | HYDROXYPROGESTERONE CAP(PPRES) 250 MG/ML IM OIL | Pharmacy | $253.41 |
| RX-911 | HYDROXYZINE HCL 25 MG/ML IM SOLN | Pharmacy | $88.45 |
| RX-912 | HYDROXYZINE HCL 50 MG/ML IM SOLN | Pharmacy | $88.45 |
| RX-915 | HYPROMELLOSE 2.5 % OPHTHALMIC DROP | Pharmacy | $56.12 |
| RX-916 | IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRG | Pharmacy | $557.80 |
| RX-917 | IBRUTINIB 140 MG ORAL CAP | Pharmacy | $518.63 |
| RX-918 | IBUPROFEN 400 MG/4 ML (100 MG/ML) INTRAVENOUS SOLR | Pharmacy | $13.97 |
| RX-919 | IBUPROFEN 800 MG/200 ML (4 MG/ML) INTRAVENOUS PGBK | Pharmacy | $30.87 |
| RX-92 | APREPITANT 40 MG ORAL CAP | Pharmacy | $61.35 |
| RX-920 | IBUPROFEN 800 MG/8 ML (100 MG/ML) INTRAVENOUS SOLR | Pharmacy | $24.82 |
| RX-921 | IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLN | Pharmacy | $15,327.90 |
| RX-922 | IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLN | Pharmacy | $3,253.57 |
| RX-923 | IDARUBICIN 1 MG/ML INTRAVENOUS SOLN | Pharmacy | $457.51 |
| RX-924 | IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLN | Pharmacy | $25,242.84 |
| RX-925 | IDURSULFASE 6 MG/3 ML INTRAVENOUS SOLN | Pharmacy | $6,840.41 |
| RX-926 | IFOSFAMIDE 1 G INTRAVENOUS SOLR | Pharmacy | $336.39 |
| RX-927 | ILOPROST 10 MCG/ML INHALATION NEBU | Pharmacy | $1,761.91 |
| RX-928 | ILOPROST 20 MCG/ML INHALATION NEBU | Pharmacy | $1,761.90 |
| RX-929 | IMATINIB 100 MG ORAL TAB | Pharmacy | $316.26 |
| RX-93 | APREPITANT 80 MG ORAL CAP | Pharmacy | $61.35 |
| RX-930 | IMIGLUCERASE 400 UNITS INTRAVENOUS SOLR | Pharmacy | $537.21 |
| RX-931 | IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLR | Pharmacy | $71.63 |
| RX-932 | IMMUN GLOB G(IGG)-GLY-IGA OV50 10 % INJECTION SOLN | Pharmacy | $503.06 |
| RX-933 | IMMUN GLOB G(IGG)-PRO-IGA 0-50 10 % INTRAVENOUS SOLN | Pharmacy | $514.65 |
| RX-934 | IMMUN GLOB G-GLY-GLUC-IGA 0-50 5 % INTRAVENOUS SOLR | Pharmacy | $796.17 |
| RX-935 | IMMUN GLOBG(IGG)-MALT-IGA OV50 5 % INTRAVENOUS SOLN | Pharmacy | $481.57 |
| RX-936 | IMMUN GLOBG(IGG)-MALT-IGA OV50 10 % INTRAVENOUS SOLN | Pharmacy | $481.57 |
| RX-937 | IMMUNE GLOB G (IGG)-GLYCINE 15-18 % RANGE IM SOLN | Pharmacy | $514.76 |
| RX-938 | IMMUNE GLOBUL G-GLY-IGA AVG 46 1 GRAM/10 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-939 | IMMUNE GLOBUL G-GLY-IGA AVG 46 10 GRAM/100 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-94 | APREPITANT 125 MG (25 MG/ ML FINAL CONC.) ORAL SUSR | Pharmacy | $61.35 |
| RX-940 | IMMUNE GLOBUL G-GLY-IGA AVG 46 20 GRAM/200 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-941 | IMMUNE GLOBUL G-GLY-IGA AVG 46 5 GRAM/50 ML (10 %) INJECTION SOLN | Pharmacy | $508.41 |
| RX-942 | IMMUNE GLOBULIN (10%) (IGA<1 MCG/ML) GAMMAGARD S-D INFUSION | Pharmacy | $796.17 |
| RX-943 | IMMUNE GLOBULIN (HUMAN) (IGG) 10 % IV SOLN (PRIVIGEN) | Pharmacy | $514.65 |
| RX-944 | INDIGOTINDISULFONATE SODIUM 8 MG/ML (0.8 %) INJECTION SOLN | Pharmacy | $460.43 |
| RX-945 | INDIUM 111 DTPA | Pharmacy | $17,921.04 |
| RX-946 | INDIUM 111-PENTETREOTIDE 3-10 MCI/ML-MCG INTRAVENOUS KIT | Pharmacy | $77,568.62 |
| RX-947 | INDIUM IN-111 LABELED WBC IV SOLUTION | Pharmacy | $41,328.00 |
| RX-948 | INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN | Pharmacy | $30,507.75 |
| RX-949 | INDOMETHACIN 50 MG RECTAL SUPP | Pharmacy | $270.76 |
| RX-95 | APREPITANT 125 MG ORAL CAP | Pharmacy | $61.35 |
| RX-950 | INDOMETHACIN SODIUM 1 MG INTRAVENOUS SOLR | Pharmacy | $3,104.14 |
| RX-951 | INFLIXIMAB 100 MG INTRAVENOUS SOLR | Pharmacy | $722.56 |
| RX-952 | INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLR | Pharmacy | $652.05 |
| RX-953 | INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLR | Pharmacy | $601.91 |
| RX-954 | INHALAT. SPACING DEV,SM. MASK MISC. SPCR | Pharmacy | $41.30 |
| RX-955 | INHALAT.SPACING DEV,LARGE MASK MISC. SPCR | Pharmacy | $44.49 |
| RX-956 | INHALAT.SPACING DEV,MED. MASK MISC. SPCR | Pharmacy | $41.30 |
| RX-957 | INHALATIONAL SPACING DEVICE MISC. SPCR | Pharmacy | $156.07 |
| RX-958 | INOTUZUMAB OZOGAMICIN 0.9 MG (0.25 MG/ML INITIAL) INTRAVENOUS SOLR | Pharmacy | $28,649.38 |
| RX-959 | INSULIN ASP PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-96 | APREPITANT 20 MG/ML ORAL SUSP | Pharmacy | $125.34 |
| RX-960 | INSULIN ASPART INJECTION ORDERABLE | Pharmacy | $10.85 |
| RX-961 | INSULIN ASPART U-100 100 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-962 | INSULIN ASPART U-100 100 UNITS/ML SUBCUTANEOUS CRTG | Pharmacy | $11.33 |
| RX-963 | INSULIN ASPART U-100 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-964 | INSULIN DEGLUDEC 100 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $102.48 |
| RX-965 | INSULIN DETEMIR U-100 100 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-966 | INSULIN DETEMIR U-100 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-967 | INSULIN GLARGINE 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-968 | INSULIN LISPRO 100 UNITS/ML SUBCUTANEOUS CRTG | Pharmacy | $11.33 |
| RX-969 | INSULIN LISPRO 100 UNITS/ML SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-97 | APREPITANT 7.2 MG/ML INTRAVENOUS EMUL | Pharmacy | $26.30 |
| RX-970 | INSULIN LISPRO 100 UNITS/ML SUBCUTANEOUS SOLN | Pharmacy | $11.33 |
| RX-971 | INSULIN NPH AND REGULAR HUMAN 100 UNIT/ML (70-30) SUBCUTANEOUS SUSP | Pharmacy | $11.33 |
| RX-972 | INSULIN NPH HUMAN RECOMB 100 UNIT/ML SUBQ SUSP (PED-NEO) | Pharmacy | $11.33 |
| RX-973 | INSULIN NPH ISOPH U-100 HUMAN 100 UNITS/ML SUBCUTANEOUS SUSP | Pharmacy | $11.33 |
| RX-974 | INSULIN REGULAR HUM U-500 CONC 500 UNIT/ML (3 ML) SUBCUTANEOUS INPN | Pharmacy | $11.33 |
| RX-975 | INSULIN REGULAR HUMAN 100 UNIT/ML INJECTION | Pharmacy | $11.21 |
| RX-976 | INSULIN REGULAR HUMAN 100 UNITS/ML INJECTION SOLN | Pharmacy | $11.33 |
| RX-977 | INSULIN REGULAR IN 0.9 % NACL 100 UNIT/100 ML (1 UNIT/ML) INTRAVENOUS SOLN | Pharmacy | $11.34 |
| RX-978 | INTERFERON ALFA-2B 10 MILLION UNIT (1 ML) INJECTION SOLR | Pharmacy | $431.03 |
| RX-979 | INTERFERON ALFA-2B 6 MILLION UNIT/ML INJECTION SOLN | Pharmacy | $431.03 |
| RX-98 | ARGATROBAN 100 MG/ML INTRAVENOUS SOLN | Pharmacy | $15.35 |
| RX-980 | IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN | Pharmacy | $214,987.50 |
| RX-981 | IODIDE I-131 DIAGNOSTIC CAP PER MCI | Pharmacy | $209.48 |
| RX-982 | IODINE I-131 IODINATED SERUM ALBUMIN DIAGNOSTIC IV SOLUTION | Pharmacy | $4,095.00 |
| RX-985 | IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5ML) INTRAVENOUS SOLN | Pharmacy | $31,210.93 |
| RX-986 | IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLN | Pharmacy | $11.13 |
| 2020349 | HC PT APPLICATION LONG LEG CAST THIGH-TOE GP | Physical Therapy | $821.10 |
| 2020352 | HC PT APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE | Physical Therapy | $870.61 |
| 2020357 | HC PT APPLICATION SHORT LEG CAST BELOW KNEE-TOE GP | Physical Therapy | $598.92 |
| 2020361 | HC PT APPLICATION SHORT LEG CAST WALKING/AMBULATORY GP | Physical Therapy | $565.11 |
| 2020362 | HC APPLICATION SHORT LEG CAST WALKING/AMBULATORY | Physical Therapy | $565.11 |
| 2022237 | HC PT HOT OR COLD PACKS THERAPY GP | Physical Therapy | $77.28 |
| 2022238 | HC PT HOT OR COLD PACKS THERAPY GP | Physical Therapy | $77.28 |
| 2022239 | HC PT MECHANICAL TRACTION THERAPY GP | Physical Therapy | $175.09 |
| 2022246 | HC PT ELECTRICAL STIMULATION GP | Physical Therapy | $144.90 |
| 2022249 | HC PT ELECTRIC CURRENT THERAPY GP | Physical Therapy | $246.33 |
| 2022252 | HC PT ULTRASOUND THERAPY GP | Physical Therapy | $140.07 |
| 2022258 | HC PT THERAPEUTIC EXERCISES GP | Physical Therapy | $397.27 |
| 2022259 | HC PT THERAPEUTIC EXERCISES GP | Physical Therapy | $397.27 |
| 2022261 | HC PT NEUROMUSCULAR REEDUCATION GP | Physical Therapy | $431.08 |
| 2022265 | HC AQUATIC THERAPY/EXERCISES GP | Physical Therapy | $379.16 |
| 2022268 | HC PT GAIT TRAINING THERAPY GP | Physical Therapy | $345.35 |
| 2022269 | HC PT MASSAGE THERAPY EA 15 MINS - GP | Physical Therapy | $272.90 |
| 2022275 | HC PT MANUAL THERAPY EA 15 MINS - GP | Physical Therapy | $365.87 |
| 2022279 | HC PT GROUP THERAPEUTIC PROCEDURES GP | Physical Therapy | $216.14 |
| 2022282 | HC PT THERAPEUTIC ACTIVITIES GP EA 15 MINS | Physical Therapy | $363.46 |
| 2022292 | HC PT SENSORY INTEGRATION GP EA 15 MINS | Physical Therapy | $385.19 |
| 2022294 | HC PT SELF CARE MNGMENT TRAINING GP EA 15 MINS | Physical Therapy | $420.21 |
| 2022297 | HC PT COMMUNITY/WORK REINTEGRATION GP EA 15 MINS | Physical Therapy | $324.82 |
| 2022298 | HC PT WHEELCHAIR MNGMENT TRAINING GP EA 15 MINS | Physical Therapy | $276.52 |
| 2022308 | HC PT PHYSICAL PERFORMANCE TEST GP | Physical Therapy | $329.65 |
| 2022312 | HC PT INI ORTH MGMT/TRAINING GP | Physical Therapy | $458.85 |
| 2022316 | HC PT C/O FOR ORTHOTIC/PROSTH USE 15 MIN GP | Physical Therapy | $310.33 |
| 2022420 | HC PT ELEC STIM OTHER THAN WOUND GP | Physical Therapy | $201.00 |
| 2022780 | HC PT EDUC PERCUSSION CHEST | Physical Therapy | $234.14 |
| 2022781 | HC PT MANIULATIONCHEST | Physical Therapy | $251.34 |
| 2023555 | HC CANALITH REPOSITIONING PROC GP | Physical Therapy | $350.18 |
| 2025433 | HC DEVELOPMENTAL SCREEN W/SCORE GP | Physical Therapy | $361.04 |
| 2025861 | HC NEG PRESS WND TX <=50 SQ CM PT | Physical Therapy | $1,149.18 |
| 2026632 | HC PT PTA WHEELCHAIR MNGMENT TRAINING EA 15 MINS GPCQ | Physical Therapy | $276.52 |
| 2026634 | HC PT PTA THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN GPCQ | Physical Therapy | $363.46 |
| 2026636 | HC PT PTA ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS GPCQ | Physical Therapy | $458.85 |
| 2026638 | HC PT PTA PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS CPCQ | Physical Therapy | $280.14 |
| 2026642 | HC PT PTA ULTRASOUND THERAPY EA 15 MINS GPCQ | Physical Therapy | $140.07 |
| 2026644 | HC PT PTA NEUROMUSCULAR REEDUCATION EA 15 MINS GPCQ | Physical Therapy | $431.08 |
| 2026646 | HC PT PTA THERAPEUTIC EXERCISES EA 15 MINS GPCQ | Physical Therapy | $397.27 |
| 2026648 | HC PT PTA AQUATIC THERAPY/EXERCISES EA 15 MINS GPCQ | Physical Therapy | $379.16 |
| 2026649 | HC PT PTA COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN GPCQ | Physical Therapy | $324.82 |
| 2026651 | HC PT PTA GAIT TRAINING THERAPY EA 15 MINS GPCQ | Physical Therapy | $345.35 |
| 2026652 | HC PT PTA MANUAL THERAPY EA 15 MINS GPCQ | Physical Therapy | $365.87 |
| 2026654 | HC PT PTA NON WND ELECT STIM GPCQ | Physical Therapy | $188.37 |
| 2026657 | HC PT PTA THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS GPCQ | Physical Therapy | $216.14 |
| 2026658 | HC PT PTA MASSAGE THERAPY EA 15 MINS GPCQ | Physical Therapy | $272.90 |
| 2026947 | HC PT HCPRO PHONE CALL 5-10MIN GP | Physical Therapy | $19.29 |
| 2026950 | HC PT HCPRO PHONE CALL 11-20MIN GP | Physical Therapy | $38.09 |
| 2026953 | HC PT HCPRO PHONE CALL 21-30MIN GP | Physical Therapy | $55.00 |
| 2022231 | HC PT RE-EVAL EST PLAN CARE GP | Physical Therapy - Evaluation or Re-evaluation | $470.93 |
| 2022232 | HC PT RE-EVAL EST PLAN CARE | Physical Therapy - Evaluation or Re-evaluation | $470.93 |
| 2025786 | HC PT EVAL MOD COMPLEX GP | Physical Therapy - Evaluation or Re-evaluation | $1,262.45 |
| 2025787 | HC PT EVAL HIGH COMPLEX GP | Physical Therapy - Evaluation or Re-evaluation | $1,893.66 |
| 2025792 | HC PT EVAL LOW COMPLEX GP | Physical Therapy - Evaluation or Re-evaluation | $841.63 |
| 2022274 | HC PT PHYSICAL MEDICINE PROCEDURE GP | Physical Therapy - Visit Charge | $135.24 |
| 2022301 | HC WORK HARDENING ADD-ON | Physical Therapy - Visit Charge | $550.02 |
| 2025840 | HC HH HHC PT MAINT EA 15 MIN | Physical Therapy - Visit Charge | $420.00 |
| 2026570 | HC HH SERV OF PT EA 15 MIN | Physical Therapy - Visit Charge | $420.00 |
| 2024676 | HC CA SCRNING PELV & BRST EXAM | Preventive Care Services | $256.84 |
| 2024677 | HC PPPS INITIAL, ANNUAL WELLNESS VISIT | Preventive Care Services | $1,480.50 |
| 2026117 | HC APP TOPICAL FLUORIDE VARNISH | Preventive Care Services | $95.40 |
| 2021943 | HC IMMUN ADMIN | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2021944 | HC IMMUN ADMIN EACH ADDL VACCINE/COMPONENT | Preventive Care Services - Vaccine Administration | $700.13 |
| 2022684 | HC ADMIN FLU VACCINE | Preventive Care Services - Vaccine Administration | $179.19 |
| 2023241 | HC ADMIN PNEUMONIA VACCINE | Preventive Care Services - Vaccine Administration | $176.63 |
| 2023759 | HC ADMIN HEPATITIS B VACCINE | Preventive Care Services - Vaccine Administration | $700.13 |
| 2025289 | HC IMMUNE ADMIN ORAL/NASAL 1 VACCINE | Preventive Care Services - Vaccine Administration | $79.56 |
| 2025290 | HC IMMUNE ADMIN ORAL/NASAL ADDL | Preventive Care Services - Vaccine Administration | $46.94 |
| 2025471 | HC IMMUN ADMIN EACH ADDL VACCINE/COMPONENT W/ COUNSELING <18 YEARS OF AGE | Preventive Care Services - Vaccine Administration | $38.40 |
| 2025806 | HC IMMUN ADMIN 1ST/ONLY COMPONENT W/ COUNSELING <18 YEARS OF AGE | Preventive Care Services - Vaccine Administration | $211.76 |
| 2027036 | HC ADM SARSCOV2 30MCG/0.3ML 1ST | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2027037 | HC ADM SARSCOV2 30MCG/0.3ML 2ND | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2027038 | HC ADM SARSCOV2 100MCG/0.5ML1ST | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2027039 | HC ADM SARSCOV2 100MCG/0.5ML2ND | Preventive Care Services - Vaccine Administration | $1,013.72 |
| 2026843 | HC EXTERNAL PT ACTIVATED DWNLD W/R&I ONLY | Professional Fees | $205.00 |
| 2026857 | HC HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/< | Professional Fees | $84.00 |
| 2026860 | HC INITIAL INPATIENT CONSULT NEW/EST PT 40 MIN | Professional Fees | $238.46 |
| 2026861 | HC INITIAL INPATIENT CONSULT NEW/EST PT 55 MIN | Professional Fees | $357.69 |
| 2026865 | HC SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/< | Professional Fees | $455.00 |
| 2026866 | HC INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS | Professional Fees | $911.00 |
| 2022129 | HC BREATHING CAPACITY TEST | Pulmonary Function | $718.46 |
| 2022130 | HC BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN | Pulmonary Function | $1,407.95 |
| 2022131 | HC BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT | Pulmonary Function | $1,365.68 |
| 2022132 | HC VITAL CAPACITY TEST | Pulmonary Function | $539.00 |
| 2022133 | HC LUNG FUNCTION TEST (MBC/MVV) | Pulmonary Function | $342.93 |
| 2022137 | HC PULMONARY STRESS TEST | Pulmonary Function | $740.20 |
| 2022138 | HC CARDIOPULM EXCER TEST MIN VENT | Pulmonary Function | $2,177.12 |
| 2022145 | HC DIFFUSING CAPACITY EX. CARBON MONOXIDE, MEMBRANE | Pulmonary Function | $665.33 |
| 2022146 | HC N-INVAS EAR/PLS OXIMTRY F/O2 SAT 1 DETER | Pulmonary Function | $346.55 |
| 2022147 | HC N-INVAS EAR/PLS OXIMTRY F/O2 SAT MLT DETERS | Pulmonary Function | $540.96 |
| 2023012 | HC CO EXPIRED GAS BY IR | Pulmonary Function | $350.18 |
| 2023116 | HC PULM FUNCT TST PLETHYSMOGRAP | Pulmonary Function | $439.53 |
| 2023117 | HC PULM FUNCTION TEST BY GAS | Pulmonary Function | $351.38 |
| 2023118 | HC AIRWY RESIST BY OSCILLOMETRY | Pulmonary Function | $324.82 |
| 2023225 | HC FLOW VOLUME LOOP | Pulmonary Function | $728.00 |
| 2024980 | HC UNLISTED PULMONARY SERVICE | Pulmonary Function | $229.39 |
| 2025208 | HC MEAS LUNG VOL THRU 2 YRS | Pulmonary Function | $1,010.63 |
| 2025209 | HC PATIENT RECORDED SPIROMETRY | Pulmonary Function | $687.92 |
| 2025210 | HC PI SPIROMETRY/30 DAYS - RECORDING | Pulmonary Function | $687.92 |
| 2025214 | HC PULMONARY COMPLIANCE | Pulmonary Function | $687.92 |
| 2025438 | HC SURFACTANT ADMIN THRU TUBE | Pulmonary Function | $714.75 |
| 2025487 | HC CONTINUOUS PULSE OX | Pulmonary Function | $2,679.44 |
| 2025939 | HC OXYGEN UPTAKE % O2 | Pulmonary Function | $860.67 |
| 2020629 | HC CONTRAST X-RAY OF BRAIN | Radiology - Diagnostic | $2,699.31 |
| 2020630 | HC RADEX MNDBL PRTL < 4 VIEWS | Radiology - Diagnostic | $347.40 |
| 2020631 | HC RADEX MNDBL COMPL MINIMUM 4 VIEWS | Radiology - Diagnostic | $677.25 |
| 2020633 | HC X-RAY EXAM OF MIDDLE EAR | Radiology - Diagnostic | $583.43 |
| 2020634 | HC X-RAY EXAM OF FACIAL BONES | Radiology - Diagnostic | $890.40 |
| 2020635 | HC X-RAY EXAM OF FACIAL BONES | Radiology - Diagnostic | $781.20 |
| 2020636 | HC X-RAY EXAM OF NASAL BONES | Radiology - Diagnostic | $577.50 |
| 2020637 | HC X-RAY EXAM OF EYE SOCKETS | Radiology - Diagnostic | $408.26 |
| 2020638 | HC X-RAY EXAM OF SINUSES | Radiology - Diagnostic | $753.90 |
| 2020639 | HC X-RAY EXAM OF SKULL | Radiology - Diagnostic | $659.30 |
| 2020640 | HC X-RAY EXAM OF SKULL | Radiology - Diagnostic | $974.40 |
| 2020642 | HC RADEX TMPRMAND JT OPN&CLSD MOUTH BI | Radiology - Diagnostic | $460.24 |
| 2020644 | HC X-RAY EXAM OF NECK | Radiology - Diagnostic | $682.50 |
| 2020680 | HC X-RAY EXAM OF RIBS | Radiology - Diagnostic | $576.88 |
| 2020687 | HC X-RAY EXAM OF RIBS/CHEST | Radiology - Diagnostic | $1,227.45 |
| 2020690 | HC X-RAY EXAM OF RIBS/CHEST | Radiology - Diagnostic | $653.26 |
| 2020691 | HC X-RAY EXAM OF RIBS | Radiology - Diagnostic | $703.67 |
| 2020693 | HC X-RAY EXAM OF BREASTBONE | Radiology - Diagnostic | $567.00 |
| 2020694 | HC X-RAY EXAM OF BREASTBONE | Radiology - Diagnostic | $504.62 |
| 2020704 | HC X-RAY EXAM ENTIRE SPI 2-3 VIEW | Radiology - Diagnostic | $1,527.79 |
| 2020705 | HC X-RAY EXAM OF SPINE | Radiology - Diagnostic | $472.92 |
| 2020706 | HC RADEX SPI CRV 2/3 VIEWS | Radiology - Diagnostic | $963.59 |
| 2020707 | HC RADEX SPI CRV MINIMUM 4 VIEWS | Radiology - Diagnostic | $1,302.11 |
| 2020708 | HC RADEX SPI CRV COMPL W/OBLQ&FLEXION&/XTN STDS | Radiology - Diagnostic | $1,627.95 |
| 2020710 | HC X-RAY EXAM OF THORACIC SPINE | Radiology - Diagnostic | $862.05 |
| 2020711 | HC X-RAY EXAM OF THORACIC SPINE | Radiology - Diagnostic | $655.49 |
| 2020712 | HC X-RAY EXAM OF THORACIC SPINE | Radiology - Diagnostic | $745.51 |
| 2020713 | HC X-RAY EXAM OF TRUNK SPINE MIN OF 2 VWS | Radiology - Diagnostic | $433.62 |
| 2020715 | HC RADEX SPI LUMBOSAC 2/3 VIEWS | Radiology - Diagnostic | $974.40 |
| 2020716 | HC RADEX SPI LUMBOSAC MINIMUM 4 VIEWS | Radiology - Diagnostic | $987.67 |
| 2020717 | HC RADEX SPI LUMBOSAC COMPL W/BENDING VIEWS | Radiology - Diagnostic | $1,253.93 |
| 2020718 | HC RADEX SPI LUMBOSAC BENDING MINIMUM 4 VIEWS | Radiology - Diagnostic | $771.59 |
| 2020740 | HC RADEX PELVIS 1/2 VIEWS | Radiology - Diagnostic | $883.05 |
| 2020741 | HC RADEX PELVIS 1/2 VIEWS 76 | Radiology - Diagnostic | $580.81 |
| 2020742 | HC RADEX PELVIS COMPL MINIMUM 3 VIEWS | Radiology - Diagnostic | $1,269.45 |
| 2020743 | HC RADEX PELVIS COMPL MINIMUM 3 VIEWS 76 | Radiology - Diagnostic | $580.81 |
| 2020754 | HC RADEX SI JTS < 3 VIEWS | Radiology - Diagnostic | $532.51 |
| 2020755 | HC RADEX SI JTS 3/MORE VIEWS | Radiology - Diagnostic | $612.38 |
| 2020756 | HC X-RAY EXAM OF TAILBONE | Radiology - Diagnostic | $554.40 |
| 2020760 | HC CONTRAST X-RAY, SPINE | Radiology - Diagnostic | $2,880.61 |
| 2020783 | HC X-RAY EXAM OF SHOULDERS | Radiology - Diagnostic | $650.42 |
| 2020831 | HC RADEX HAND 2 VIEWS | Radiology - Diagnostic | $786.08 |
| 2020903 | HC X-RAY EXAM OF KNEE, 1 OR 2 | Radiology - Diagnostic | $821.10 |
| 2020916 | HC X-RAY KNEE EXAM; BOTH KNEES STANDING AP | Radiology - Diagnostic | $867.23 |
| 2020926 | HC X-RAY EXAM OF LOWER LEG | Radiology - Diagnostic | $972.46 |
| 2020957 | HC X-RAY EXAM OF TOE(S) | Radiology - Diagnostic | $702.41 |
| 2020990 | HC XRAY EX OF AB 1 VIEW | Radiology - Diagnostic | $557.87 |
| 2021000 | HC X-RAY XM ESOPHAGUS 1CNTRST | Radiology - Diagnostic | $1,530.90 |
| 2021001 | HC X-RAY XM SWLNG FUNCJ C+ | Radiology - Diagnostic | $1,276.80 |
| 2021002 | HC X-RAY XM UPR GI TRC 1CNTRST | Radiology - Diagnostic | $662.22 |
| 2021007 | HC X-RAY XM SM INT 1CNTRST STD | Radiology - Diagnostic | $1,578.51 |
| 2021009 | HC X-RAY XM COLON 1CNTRST STD | Radiology - Diagnostic | $1,665.99 |
| 2021010 | HC X-RAY XM COLON 2CNTRST STD | Radiology - Diagnostic | $2,332.89 |
| 2021011 | HC THER ENEMA C+ RDCTJ INTUSSUSCEPTION/OBSTRCJ | Radiology - Diagnostic | $965.43 |
| 2021012 | HC CHOLANGRPH&/PCG INTRAOP RS&I | Radiology - Diagnostic | $817.78 |
| 2021016 | HC X-RAY BILE DUCT ENDOSCOPY | Radiology - Diagnostic | $912.87 |
| 2021024 | HC CONTRAST X-RAY, BLADDER | Radiology - Diagnostic | $1,756.65 |
| 2021025 | HC X-RAY, URETHRA/BLADDER | Radiology - Diagnostic | $3,404.39 |
| 2021028 | HC DILATION URTR/URT RS&I | Radiology - Diagnostic | $10,013.85 |
| 2021033 | HC AORTOGRAPY THRC SRLOGRAPY RS&I | Radiology - Diagnostic | $9,427.95 |
| 2021037 | HC X-RAY AORTA, LEG ARTERIES | Radiology - Diagnostic | $9,315.86 |
| 2021057 | HC ANGRPH SPI SLCTV RS&I | Radiology - Diagnostic | $10,385.55 |
| 2021059 | HC ARTERY X-RAYS, ARM/LEG | Radiology - Diagnostic | $10,012.80 |
| 2021068 | HC ARTERY X-RAYS, ABDOMEN | Radiology - Diagnostic | $11,928.17 |
| 2021070 | HC ARTERY X-RAYS, PELVIS | Radiology - Diagnostic | $7,179.97 |
| 2021072 | HC ANGRPH PULM UNI SLCTV RS&I | Radiology - Diagnostic | $11,639.09 |
| 2021073 | HC ANGRPH PULM BI SLCTV RS&I | Radiology - Diagnostic | $11,639.09 |
| 2021077 | HC NONVASCULAR SHUNT, X-RAY | Radiology - Diagnostic | $1,036.35 |
| 2021080 | HC CATH/EP VEIN X-RAY, ARM/LEG | Radiology - Diagnostic | $3,538.64 |
| 2021081 | HC VEIN X-RAY, ARMS/LEGS | Radiology - Diagnostic | $4,175.12 |
| 2021083 | HC VEIN X-RAY, TRUNK | Radiology - Diagnostic | $9,427.95 |
| 2021084 | HC VEIN X-RAY, CHEST | Radiology - Diagnostic | $6,627.60 |
| 2021085 | HC VNGRPH RNL UNI SLCTV RS&I | Radiology - Diagnostic | $11,639.09 |
| 2021087 | HC VEIN X-RAY, NECK | Radiology - Diagnostic | $3,874.54 |
| 2021089 | HC VNGRPH SUPRIOR SGTL SINUS RS&I | Radiology - Diagnostic | $4,029.52 |
| 2021092 | HC PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I | Radiology - Diagnostic | $9,427.95 |
| 2021093 | HC PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVAL RS&I | Radiology - Diagnostic | $4,205.25 |
| 2021094 | HC HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I | Radiology - Diagnostic | $3,874.54 |
| 2021095 | HC VENOUS SAMPLING BY CATHETER | Radiology - Diagnostic | $11,639.09 |
| 2021096 | HC TCAT THER EMBOLIZATION ANY METH RS&I | Radiology - Diagnostic | $17,915.08 |
| 2021118 | HC XRAY CONTROL CATHETER CHANGE | Radiology - Diagnostic | $2,065.37 |
| 2021119 | HC ABSCESS DRAINAGE UNDER X-RAY | Radiology - Diagnostic | $2,448.26 |
| 2021122 | HC FLUOROSCOPE EXAMINATION | Radiology - Diagnostic | $1,866.54 |
| 2021125 | HC X-RAY EXAM OF FISTULA | Radiology - Diagnostic | $1,425.90 |
| 2021126 | HC RAD XM SURG SPEC | Radiology - Diagnostic | $1,434.51 |
| 2021134 | HC RADIOGRAPHIC PROCEDURE | Radiology - Diagnostic | $1,654.80 |
| 2021169 | HC FLUOROGUIDE FOR VEIN DEVICE | Radiology - Diagnostic | $1,658.52 |
| 2021170 | HC NEEDLE LOCALIZATION BY XRAY | Radiology - Diagnostic | $2,193.81 |
| 2021171 | HC FLUOROGUIDE FOR SPINE INJECT | Radiology - Diagnostic | $1,146.00 |
| 2021178 | HC X-RAYS FOR BONE AGE | Radiology - Diagnostic | $584.49 |
| 2021179 | HC X-RAYS, BONE LENGTH STUDIES | Radiology - Diagnostic | $2,026.50 |
| 2021181 | HC X-RAYS, BONE SURVEY COMPLETE | Radiology - Diagnostic | $1,243.79 |
| 2021182 | HC X-RAYS, BONE SURVEY, INFANT | Radiology - Diagnostic | $1,355.36 |
| 2021183 | HC DXA BONE DENSITY, AXIAL | Radiology - Diagnostic | $1,176.59 |
| 2021184 | HC DXA BONE DENSITY/PERIPHERAL | Radiology - Diagnostic | $729.03 |
| 2022419 | HC CATH/EP ILIAC ART ANGIO,CARDIAC CATH | Radiology - Diagnostic | $92.98 |
| 2022718 | HC TRANS CATH FALLOP TUBE | Radiology - Diagnostic | $402.23 |
| 2022725 | HC TRANSCATHETER BIOPSY S&I | Radiology - Diagnostic | $9,701.78 |
| 2022882 | HC ANKLE WT BEAR ONLY | Radiology - Diagnostic | $715.08 |
| 2022883 | HC URETHOGRAM RETRO | Radiology - Diagnostic | $1,858.19 |
| 2022885 | HC UEXTREM INFANT MIN 2 VW | Radiology - Diagnostic | $721.35 |
| 2023085 | HC EXISTING CATH ANGIOGR FOR FOLLOW-UP | Radiology - Diagnostic | $10,731.00 |
| 2023486 | HC CLAVICLE COMPLETE | Radiology - Diagnostic | $687.19 |
| 2023487 | HC SCAPULA COMPLETE | Radiology - Diagnostic | $759.45 |
| 2023488 | HC X-RAY EXAM OF SHOULDER 1 VIEW | Radiology - Diagnostic | $583.22 |
| 2023489 | HC X-RAY EXAM OF SHOULDER 2+ VIEWS | Radiology - Diagnostic | $890.40 |
| 2023491 | HC X-RAY EXAM OF HUMERUS 2+ VIEWS | Radiology - Diagnostic | $721.35 |
| 2023492 | HC X-RAY EXAM OF ELBOW 2 VIEWS | Radiology - Diagnostic | $725.22 |
| 2023493 | HC X-RAY EXAM OF ELBOW 3+ VIEWS | Radiology - Diagnostic | $890.40 |
| 2023495 | HC X-RAY EXAM OF FOREARM 2 VIEWS | Radiology - Diagnostic | $846.30 |
| 2023496 | HC X-RAY EXAM OF WRIST 2 VIEWS | Radiology - Diagnostic | $721.35 |
| 2023497 | HC X-RAY EXAM OF WRIST 3+ VIEWS | Radiology - Diagnostic | $890.40 |
| 2023499 | HC X-RAY EXAM OF HAND 3+ VIEWS | Radiology - Diagnostic | $911.60 |
| 2023500 | HC X-RAY EXAM OF FINGER(S) 2+ VIEWS | Radiology - Diagnostic | $721.35 |
| 2023511 | HC X-RAY EXAM OF HIP 1 VIEW UNILAT | Radiology - Diagnostic | $406.99 |
| 2023516 | HC X-RAY EXAM OF KNEE 3 | Radiology - Diagnostic | $904.00 |
| 2023517 | HC X-RAY EXAM KNEE 4 OR MORE | Radiology - Diagnostic | $1,048.53 |
| 2023519 | HC X-RAY EXAM OF ANKLE 3+ VIEWS | Radiology - Diagnostic | $906.15 |
| 2023521 | HC X-RAY EXAM OF FOOT; 2 VIEWS | Radiology - Diagnostic | $730.30 |
| 2023522 | HC X-RAY EXAM OF FOOT; 3+ VIEWS | Radiology - Diagnostic | $906.15 |
| 2023523 | HC X-RAY EXAM OF HEEL 2+ VIEWS | Radiology - Diagnostic | $575.62 |
| 2023573 | HC TOMOGRAM | Radiology - Diagnostic | $627.63 |
| 2023633 | HC X-RAY XM UPR GI TRC 2CNTRST | Radiology - Diagnostic | $662.22 |
| 2023636 | HC HYSTEROSALPINGOGRAM | Radiology - Diagnostic | $1,968.75 |
| 2024309 | HC THROMBOLYTIC ART THERAPY | Radiology - Diagnostic | $5,568.28 |
| 2025010 | HC DILATE FOR STRICTURE/OBSTR | Radiology - Diagnostic | $1,210.65 |
| 2025237 | HC DXA BONE DENSITY STUDY | Radiology - Diagnostic | $1,176.59 |
| 2025240 | HC HEPATIC VENOGRAM WO HDM | Radiology - Diagnostic | $11,116.52 |
| 2025524 | HC X-RAY EXAM HIP UNI 2-3 VIEWS | Radiology - Diagnostic | $562.40 |
| 2025525 | HC X-RAY EXAM HIP UNI 4+ VIEWS | Radiology - Diagnostic | $702.74 |
| 2025528 | HC X-RAY EXAM ENTIRE SPI 1 VIEW | Radiology - Diagnostic | $948.95 |
| 2025529 | HC X-RAY EXAM ENTIRE SPI 4-5 VIEW | Radiology - Diagnostic | $1,655.86 |
| 2025530 | HC X-RAY EXAM ENTIRE SPI 6+ VIEW | Radiology - Diagnostic | $1,970.10 |
| 2025531 | HC X-RAY EXAM HIPS BI 2 VIEWS | Radiology - Diagnostic | $542.96 |
| 2025532 | HC X-RAY EXAM HIPS BI 3-4 VIEWS | Radiology - Diagnostic | $663.89 |
| 2025534 | HC X-RAY EXAM HIPS BI 5+ VIEWS | Radiology - Diagnostic | $770.74 |
| 2025535 | HC X-RAY EXAM OF FEMUR 1 | Radiology - Diagnostic | $753.12 |
| 2025536 | HC X-RAY EXAM OF FEMUR 2+ | Radiology - Diagnostic | $879.08 |
| 2025568 | HC X-RAY EXAM HIPS BI 3-4 VIEWS | Radiology - Diagnostic | $406.99 |
| 2025971 | HC X-RAY EXAM ABDOMEN 2 VIEWS | Radiology - Diagnostic | $869.77 |
| 2025972 | HC X-RAY EXAM ABDOMEN 3+ VIEWS | Radiology - Diagnostic | $956.75 |
| 2026170 | HC UNLISTED FLUORO | Radiology - Diagnostic | $218.52 |
| 2026629 | HC X-RAY SM INT F-THRU STD | Radiology - Diagnostic | $400.00 |
| 2026665 | HC XRAY CDSM EVICORE | Radiology - Diagnostic | $1.00 |
| 2026668 | HC XRAY CDSM NDSC | Radiology - Diagnostic | $1.00 |
| 2026670 | HC XRAY CDSM TEST APPROP | Radiology - Diagnostic | $1.00 |
| 2026671 | HC XRAY CDSM AIM | Radiology - Diagnostic | $1.00 |
| 2026675 | HC XRAY CDSM QUALIFIED NOS | Radiology - Diagnostic | $1.00 |
| 2021036 | HC CATH/EP AORTOGRAPY ABDL SRLOGRAPY RS&I | Radiology - Diagnostic - Arteriography | $11,264.00 |
| 2021062 | HC CATH/EP ARTERY X-RAYS, ARM/LEG | Radiology - Diagnostic - Arteriography | $7,149.61 |
| 2021064 | HC CATH/EP ARTERY X-RAYS, ARMS/LEGS | Radiology - Diagnostic - Arteriography | $10,012.80 |
| 2021069 | HC CATH/EP ARTERY X-RAYS, ABDOMEN | Radiology - Diagnostic - Arteriography | $11,360.16 |
| 2021074 | HC CATH/EP ARTERY X-RAY, EACH VESSEL | Radiology - Diagnostic - Arteriography | $4,205.25 |
| 2021106 | HC CATH/EP RETRIEVAL, BROKEN CATHETER | Radiology - Diagnostic - Arteriography | $4,587.34 |
| 2022724 | HC ANGIOGR EA ADDTL VESSEL | Radiology - Diagnostic - Arteriography | $3,440.17 |
| 2025335 | HC PULMONARY NONSELECTIVE ANGIO | Radiology - Diagnostic - Arteriography | $9,427.95 |
| 2023490 | HC SHOULDER ARTHROGRAM | Radiology - Diagnostic - Arthrography | $2,027.55 |
| 2023513 | HC HIP ARTHROGRAM | Radiology - Diagnostic - Arthrography | $1,955.07 |
| 2023518 | HC KNEE ARTHROGRAM | Radiology - Diagnostic - Arthrography | $2,027.55 |
| 2020670 | HC RADEX CHEST 1 VIEW | Radiology - Diagnostic - Chest X-Ray | $414.59 |
| 2020671 | HC RADEX CHEST 2 VIEWS | Radiology - Diagnostic - Chest X-Ray | $513.49 |
| 2020673 | HC RADEX CHEST 3 VIEWS | Radiology - Diagnostic - Chest X-Ray | $626.34 |
| 2020676 | HC RADEX CHEST 4 OR MORE VIEWS | Radiology - Diagnostic - Chest X-Ray | $719.25 |
| 2022212 | HC CHEMO NON-HORMONAL ANTI-NEOPLASTIC, SC / IM | Radiology - Therapeutic - Chemotherapy Administration - Injected | $1,214.42 |
| 2022213 | HC CHEMO HORMON ANTINEOPL SQ/IM | Radiology - Therapeutic - Chemotherapy Administration - Injected | $526.23 |
| 2022214 | HC CHEMO IV PUSH 0 -15 MINUTES, INITIAL | Radiology - Therapeutic - Chemotherapy Administration - Injected | $1,732.76 |
| 2022215 | HC CHEMO IV PUSH 0-15 MINUTES, SEQ | Radiology - Therapeutic - Chemotherapy Administration - Injected | $970.83 |
| 2022220 | HC CHEMO, IA, PUSH TECNIQUE | Radiology - Therapeutic - Chemotherapy Administration - Injected | $1,638.58 |
| 2022221 | HC CHEMO INTRA-THECAL | Radiology - Therapeutic - Chemotherapy Administration - Injected | $2,922.15 |
| 2023660 | HC CHEMOTHERAPY ADMINISTRATION INTRALESIONAL | Radiology - Therapeutic - Chemotherapy Administration - Injected | $236.67 |
| 2022216 | HC CHEMO IV INFUSION, 1ST HOUR | Radiology - Therapeutic - Chemotherapy Administration - IV | $3,129.84 |
| 2022217 | HC CHEMO IV INFUSION, ADDITIONAL HOUR | Radiology - Therapeutic - Chemotherapy Administration - IV | $656.88 |
| 2022218 | HC PROLONG CHEMO IV INFUSION REQUIRING PUMP, > 8 HOURS | Radiology - Therapeutic - Chemotherapy Administration - IV | $2,506.77 |
| 2022219 | HC CHEMO IV INFUSION, SEQ 1ST HOUR | Radiology - Therapeutic - Chemotherapy Administration - IV | $1,102.45 |
| 2023336 | HC CHEMO INTRA-PERITONEAL | Radiology - Therapeutic - Chemotherapy Administration - IV | $1,398.00 |
| 2023667 | HC CHEMO OMMAYA RESERVOIR | Radiology - Therapeutic - Chemotherapy Administration - IV | $677.80 |
| 2021185 | HC THER RAD SIMULAJ-AIDED FLD SETTING SMPL | Radiology - Therapeutic - Radiation Therapy | $3,718.05 |
| 2021186 | HC THER RAD SIMULAJ-AIDED FLD SETTING CPLX | Radiology - Therapeutic - Radiation Therapy | $6,983.55 |
| 2021187 | HC THER RAD SIMULAJ-AIDED FLD SETTING 3-DIMENSIONAL | Radiology - Therapeutic - Radiation Therapy | $14,364.00 |
| 2021188 | HC RADIATION THERAPY DOSE PLAN | Radiology - Therapeutic - Radiation Therapy | $1,983.45 |
| 2021189 | HC RADIATION THERAPY DOSE PLAN | Radiology - Therapeutic - Radiation Therapy | $935.81 |
| 2021190 | HC BRACHYTX ISODOSE COMPLEX | Radiology - Therapeutic - Radiation Therapy | $2,885.40 |
| 2021191 | HC SPECIAL RADIATION DOSIMETRY | Radiology - Therapeutic - Radiation Therapy | $1,927.80 |
| 2021192 | HC RADIATION TREATMENT AID(S) | Radiology - Therapeutic - Radiation Therapy | $1,635.90 |
| 2021193 | HC TX DEVICES - INTERMED -59 | Radiology - Therapeutic - Radiation Therapy | $869.40 |
| 2021194 | HC TX DEVICES - COMPLEX -59 | Radiology - Therapeutic - Radiation Therapy | $2,609.29 |
| 2021195 | HC CONTINUING MEDICAL PHYSICS CONSLTJ PR WK | Radiology - Therapeutic - Radiation Therapy | $1,719.90 |
| 2021196 | HC SPEC MEDICAL RADJ PHYSICS CONSLTJ | Radiology - Therapeutic - Radiation Therapy | $3,424.05 |
| 2021197 | HC SRS, MULTISOURCE | Radiology - Therapeutic - Radiation Therapy | $113,915.55 |
| 2021198 | HC SPECIAL RADIATION TREATMENT | Radiology - Therapeutic - Radiation Therapy | $4,636.80 |
| 2021199 | HC APPLY INTERSTIT RADIAT COMPL | Radiology - Therapeutic - Radiation Therapy | $4,789.05 |
| 2023315 | HC IMRT PLANNING | Radiology - Therapeutic - Radiation Therapy | $14,025.24 |
| 2023316 | HC TELETHX ISODOSE PLAN SIMPLE | Radiology - Therapeutic - Radiation Therapy | $1,802.85 |
| 2023317 | HC TELETHX ISODOSE PLAN CPLX | Radiology - Therapeutic - Radiation Therapy | $2,404.50 |
| 2023318 | HC BRACHYTX ISODOSE PLAN SIMPLE | Radiology - Therapeutic - Radiation Therapy | $1,497.30 |
| 2023319 | HC BRACHYTX ISODOSE INTERMED | Radiology - Therapeutic - Radiation Therapy | $2,249.10 |
| 2023320 | HC DESIGN MLC DEVICE FOR IMRT | Radiology - Therapeutic - Radiation Therapy | $7,195.65 |
| 2023322 | HC RADIATION TREATMENT DELIVERY, >= 1 MEV COMPLEX | Radiology - Therapeutic - Radiation Therapy | $3,160.82 |
| 2023325 | HC TREATMENT PORT VERIFICATI | Radiology - Therapeutic - Radiation Therapy | $1,065.75 |
| 2023327 | HC GUIDANCE FOR RADJ TX DLVR | Radiology - Therapeutic - Radiation Therapy | $1,556.95 |
| 2023534 | HC TX DEVICES; COMPLEX | Radiology - Therapeutic - Radiation Therapy | $4,238.85 |
| 2023596 | HC US INTERSTITIAL RE APPLIC | Radiology - Therapeutic - Radiation Therapy | $874.65 |
| 2023601 | HC RADIATION TREATMENT DELIVERY, >= 1 MEV SIMPLE | Radiology - Therapeutic - Radiation Therapy | $1,837.15 |
| 2025043 | HC SBRT DELIVERY PER FRACTION | Radiology - Therapeutic - Radiation Therapy | $107,000.00 |
| 2025087 | HC NTSTY MODUL RAD TX DLVR SMPL | Radiology - Therapeutic - Radiation Therapy | $7,166.03 |
| 2025088 | HC NTSTY MODUL RAD TX DLVR CPLX | Radiology - Therapeutic - Radiation Therapy | $7,166.03 |
| 2025124 | HC TX DEVICES; INTERMED MODIFIER XU | Radiology - Therapeutic - Radiation Therapy | $869.40 |
| 2026475 | HC TPRNL PLMT BIODEGRDABL MATRL | Radiology - Therapeutic - Radiation Therapy | $14,126.34 |
| 2026909 | HC ROBOT LIN-RADSURG FRACTX 1ST | Radiology - Therapeutic - Radiation Therapy | $107,000.00 |
| 2026910 | HC ROBOT LIN-RADSURG FRACTX 2-5 | Radiology - Therapeutic - Radiation Therapy | $107,000.00 |
| 2010002 | HC RECOVERY ROOM TO .5 HRS | Recovery Room | $607.76 |
| 2010003 | HC RECOVERY ROOM .5 - 1.5 HRS | Recovery Room | $1,853.04 |
| 2010004 | HC RECOVERY ROOM 1.5 - 3 HRS | Recovery Room | $3,388.47 |
| 2010005 | HC RECOVERY ROOM 3 - 4.5 HRS | Recovery Room | $4,978.79 |
| 2010006 | HC RECOVERY ROOM 4.5 - 6 HRS | Recovery Room | $6,422.47 |
| 2010007 | HC RECOVERY ROOM 6 - 7.5 HRS | Recovery Room | $7,875.57 |
| 2010008 | HC RECOVERY ROOM 7.5 - 9 HRS | Recovery Room | $9,315.33 |
| 2010009 | HC RECOVERY ROOM 9 - 10.5 HRS | Recovery Room | $11,721.98 |
| 2010010 | HC RECOVERY ROOM 10.5 - 12 HRS | Recovery Room | $13,193.09 |
| 2010011 | HC RECOVERY ROOM > 12 HRS | Recovery Room | $23,233.02 |
| 2010012 | HC POST PROC MONITORING TO 0.5 HR | Recovery Room | $834.36 |
| 2010013 | HC POST PROC MONITORING TO 1 HRS | Recovery Room | $1,670.31 |
| 2010014 | HC POST PROC MONITORING TO 2 HRS | Recovery Room | $3,340.62 |
| 2010015 | HC POST PROC MONITORING TO 3 HRS | Recovery Room | $5,010.94 |
| 2010016 | HC POST PROC MONITORING TO 4 HRS | Recovery Room | $6,681.26 |
| 2010017 | HC POST PROC MONITORING TO 5 HRS | Recovery Room | $8,351.56 |
| 2010018 | HC POST PROC MONITORING TO 6 HRS | Recovery Room | $10,021.86 |
| 2010019 | HC POST PROC MONITORING TO 7 HRS | Recovery Room | $11,692.19 |
| 2010020 | HC POST PROC MONITORING > 7 HRS | Recovery Room | $13,362.49 |
| 2022682 | HC RECOVERY ROOM 15 MIN OPTIME | Recovery Room | $0.00 |
| 2026795 | HC RECOVERY ROOM 15 MIN BED CHARGE BILLING | Recovery Room | $0.00 |
| 2020394 | HC CLEARANCE OF AIRWAYS | Respiratory Services | $602.54 |
| 2020496 | HC WITHDRAWAL OF ARTERIAL BLOOD | Respiratory Services | $348.97 |
| 2022003 | HC HEART/LUNG RESUSCITATION CPR | Respiratory Services | $2,211.75 |
| 2022127 | HC VENT MGMT INPAT, INIT DAY | Respiratory Services | $1,510.00 |
| 2022128 | HC VENT MGMT INPAT, SUBQ DAY | Respiratory Services | $1,510.00 |
| 2022139 | HC AIRWAY INHALATION TREATMENT | Respiratory Services | $362.25 |
| 2022140 | HC AIRWAY INHALATION TREATMENT 76 | Respiratory Services | $362.25 |
| 2022141 | HC CBT, 1ST HOUR | Respiratory Services | $396.71 |
| 2022142 | HC CBT, EACH ADDL HOUR | Respiratory Services | $126.64 |
| 2022143 | HC POS AIRWAY PRESSURE, CPAP | Respiratory Services | $603.75 |
| 2022413 | HC OTH RESP PROC, INDIV | Respiratory Services | $161.69 |
| 2022414 | HC PT OTH RESP PROC, INDIV | Respiratory Services | $161.69 |
| 2022473 | HC PEAK FLOW | Respiratory Services | $368.08 |
| 2022474 | HC RESPIRATORY THERAPY CONSULT | Respiratory Services | $155.37 |
| 2024301 | HC EVALUATE PT USE OF INHALER | Respiratory Services | $309.12 |
| 2025212 | HC AEROSOL PENTAMIDEN FOR P. CARINII | Respiratory Services | $667.75 |
| 2025213 | HC MECHANICAL CHEST WALL OSCILL | Respiratory Services | $737.78 |
| 2025219 | HC RESP MS THERAPY/15 MIN | Respiratory Services | $230.15 |
| 2025484 | HC DEMO-SMOKING CESSATION COUN 6-10 MIN | Respiratory Services | $0.00 |
| 2024451 | HC HBOT, FULL BODY CHAMBER, 30M | Respiratory Services - Hyperbaric Oxygen Therapy | $3,248.70 |
| 1011004 | HC RB PRIVATE 1B MED/SURG/GYN | Room & Board - Private (One Bed) - Medical/Surgical/GYN | $8,450.00 |
| 1011005 | HC RB PRIVATE 1B OB | Room & Board - Private (One Bed) - Obstetrics (OB) | $10,290.00 |
| 1011006 | HC RB PRIVATE 1B PEDIATRICS | Room & Board - Private (One Bed) - Pediatric | $8,000.00 |
| 1011007 | HC RB PRIVATE 1B PSYCHIATRY | Room & Board - Private (One Bed) - Psychiatric | $8,000.00 |
| 1011008 | HC RB PRIVATE 1B REHAB | Room & Board - Private (One Bed) - Rehabilitation | $6,175.26 |
| 1010005 | HC RB SEMIPRIVATE 2B MED/SURG/GYN | Room & Board - Semi-private (Two Beds) - Medical/Surgical/GYN | $8,100.00 |
| 1010008 | HC RB SEMIPRIVATE 2B OB | Room & Board - Semi-private (Two Beds) - Obstetrics (OB) | $7,725.00 |
| 1010006 | HC RB SEMIPRIVATE 2B PEDIATRICS | Room & Board - Semi-private (Two Beds) - Pediatric | $7,350.00 |
| 1010007 | HC RB SEMIPRIVATE 2B PSYCHIATRY | Room & Board - Semi-private (Two Beds) - Psychiatric | $7,625.00 |
| 1010009 | HC RB SEMIPRIVATE RB REHAB | Room & Board - Semi-private (Two Beds) - Rehabilitation | $5,800.00 |
| 1010011 | HC RB SEMIPRIVATE 4B MED/SURG/GYN | Room & Board - Three and Four Beds - Medical/Surgical/GYN | $8,300.00 |
| 1010014 | HC RB SEMIPRIVATE 4B OB | Room & Board - Three and Four Beds - Obstetrics (OB) | $9,895.12 |
| 2025843 | HC HH HHC RN E&M PLAN SVS 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026575 | HC HH HH/HOSPICE OF RN EA 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026580 | HC HH HOME INFUSION VISIT SN 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026582 | HC HH PRENATAL NEWBORN VISIT SN 15 MIN | Skilled Nursing - Visit Charge | $420.00 |
| 2026548 | HC HH NY EPS RECERTIFICATION | Special Charges - Other | $420.00 |
| 2026549 | HC HH NY EPS START OF CARE | Special Charges - Other | $420.00 |
| 2022422 | HC HOSPITAL OBSERVATION PER HR | Specialty Services - Observation Hours | $0.00 |
| 2023023 | HC NON-ED OBSERVATION PER HOUR | Specialty Services - Observation Hours | $0.00 |
| 2023347 | HC DIRECT REFER HOSPITAL OBSERV | Specialty Services - Observation Hours | $793.32 |
| 2021978 | HC TX SP LANG COMUNICAJ PCX DISORDER INDIV | Speech Therapy - Language Pathology | $615.83 |
| 2021980 | HC TX SP LANG COMUNICAJ PCX DISORDER 2/> | Speech Therapy - Language Pathology | $179.59 |
| 2021982 | HC LARYNGEAL FUNCTION STUDIES | Speech Therapy - Language Pathology | $319.99 |
| 2021983 | HC ORAL FUNCTION THERAPY GN | Speech Therapy - Language Pathology | $676.20 |
| 2021992 | HC EX FOR SPEECH DEVICE RX, 1HR GN | Speech Therapy - Language Pathology | $793.33 |
| 2021993 | HC USE OF SPEECH DEVICE SERVICE GN | Speech Therapy - Language Pathology | $966.00 |
| 2021994 | HC EVALUATE SWALLOWING FUNCTION GN | Speech Therapy - Language Pathology | $1,052.94 |
| 2021995 | HC EVALUATE SWALLOWING FUNCTION 59 | Speech Therapy - Language Pathology | $1,052.94 |
| 2021996 | HC MOTION FLUOROSCOPY/SWALLOW GN | Speech Therapy - Language Pathology | $1,393.39 |
| 2021997 | HC MOTION FLUOROSCOPY/SWALLOW | Speech Therapy - Language Pathology | $1,327.04 |
| 2022194 | HC ASSESSMENT OF APHASIA GN | Speech Therapy - Language Pathology | $874.23 |
| 2022199 | HC COGNITIVE TEST BY HC PRO GN | Speech Therapy - Language Pathology | $858.53 |
| 2022283 | HC THERAPEUTIC ACTIVITIES EA 15 MINS | Speech Therapy - Language Pathology | $363.46 |
| 2022921 | HC FACIAL NERVE FUNCTION | Speech Therapy - Language Pathology | $315.13 |
| 2025063 | HC EX FOR NONSPEECH DEVICE RX | Speech Therapy - Language Pathology | $992.57 |
| 2025065 | HC EX FOR SPEECH DEVICE RX EA ADDL 30 MIN | Speech Therapy - Language Pathology | $521.64 |
| 2025694 | HC DEVELOPMENTAL SCREEN W/SCORE GN | Speech Therapy - Language Pathology | $361.04 |
| 2026683 | HC SLP THER IVNTJ COG FUNC EA ADDL 15 MIN GN | Speech Therapy - Language Pathology | $60.80 |
| 2026684 | HC SLP THER IVNTJ COG FUNC 1ST 15 MIN GN | Speech Therapy - Language Pathology | $243.19 |
| 2026952 | HC SLP HCPRO PHONE CALL 11-20MIN GN | Speech Therapy - Language Pathology | $38.09 |
| 2026955 | HC SLP HCPRO PHONE CALL 21-30MIN GN | Speech Therapy - Language Pathology | $55.00 |
| 2021991 | HC ORAL SPEECH DEVICE EVAL GN | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $607.37 |
| 2021998 | HC ENDOSCOPY SWALLOW TST (FEES) GN | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $954.71 |
| 2024825 | HC EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER) | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $723.29 |
| 2024826 | HC EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $1,096.41 |
| 2024827 | HC EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION | Speech Therapy - Language Pathology - Evaluation or Reevaluation | $1,666.35 |
| 2024828 | HC BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE | Speech Therapy - Language Pathology - Other | $1,096.41 |
| 2026572 | HC HH SVS OF S/L PATH EA 15 MIN | Speech Therapy - Language Pathology - Visit Charge | $420.00 |
| 6020006 | LOW AIR/TURNING BED | Supply/Implant | $932.95 |
| 6020009 | PRONE THERAPY BED (ROTOPRONE) | Supply/Implant | $13,098.87 |
| 6020851 | PT KNEE WO JOINT CUSTOM L1834 | Supply/Implant | $919.00 |
| 6020869 | BARIATRIC BED STD | Supply/Implant | $1,392.23 |
| 6020956 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,515.78 |
| 6020957 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,515.78 |
| 6020958 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,515.78 |
| 6020961 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6020962 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6020963 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6020964 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6020966 | GUIDE WIRE | Supply/Implant | $6,784.00 |
| 6020971 | SUPPLY IMPLANT | Supply/Implant | $479.36 |
| 6020973 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6020977 | SUPPLY IMPLANT | Supply/Implant | $99,200.00 |
| 6020981 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $5,532.80 |
| 6020982 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,596.48 |
| 6020983 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6020984 | SUPPLY IMPLANT | Supply/Implant | $990.46 |
| 6020985 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $192.00 |
| 6020986 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6020987 | RET DEV, INSERTABLE | Supply/Implant | $3,776.00 |
| 6020988 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6020989 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6020991 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6020994 | SUPPLY IMPLANT | Supply/Implant | $1,530.88 |
| 6020995 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,308.80 |
| 6020997 | SUPPLY IMPLANT | Supply/Implant | $2,980.61 |
| 6021001 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,816.32 |
| 6021007 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $57,894.40 |
| 6021011 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $7,360.00 |
| 6021018 | SUPPLY IMPLANT | Supply/Implant | $3,164.16 |
| 6021019 | SUPPLY IMPLANT | Supply/Implant | $3,184.64 |
| 6021020 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6021021 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021022 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021023 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021024 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021025 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021026 | CATH, DRAINAGE | Supply/Implant | $1,084.67 |
| 6021027 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021029 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021030 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021031 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021032 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021033 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6021034 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021035 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021037 | VENA CAVA FILTER | Supply/Implant | $14,171.52 |
| 6021038 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,163.20 |
| 6021039 | SUPPLY IMPLANT | Supply/Implant | $1,540.22 |
| 6021040 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6021041 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6021043 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6021044 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6021049 | CATH, DRAINAGE | Supply/Implant | $1,084.80 |
| 6021050 | SUPPLY IMPLANT | Supply/Implant | $46,016.00 |
| 6021054 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,904.00 |
| 6021066 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $16,234.37 |
| 6021073 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6021075 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021076 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021078 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6021079 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6021080 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021081 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6021084 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6021086 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6021087 | GUIDE WIRE | Supply/Implant | $712.96 |
| 6021089 | GUIDE WIRE | Supply/Implant | $232.96 |
| 6021090 | INTRO/SHEATH, NON-LASER | Supply/Implant | $951.04 |
| 6021098 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021099 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021100 | INTRO/SHEATH, NON-LASER | Supply/Implant | $921.22 |
| 6021103 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021104 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6021106 | INTRO/SHEATH, NON-LASER | Supply/Implant | $793.60 |
| 6021107 | INTRO/SHEATH, NON-LASER | Supply/Implant | $831.62 |
| 6021108 | INTRO/SHEATH, NON-LASER | Supply/Implant | $831.62 |
| 6021110 | GENERAL SUPPLY | Supply/Implant | $284.03 |
| 6021111 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6021113 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,410.94 |
| 6021114 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,190.40 |
| 6021115 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,998.08 |
| 6021118 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021119 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021120 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021122 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021123 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6021127 | GUIDE WIRE | Supply/Implant | $382.34 |
| 6021129 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6021135 | SUPPLY IMPLANT | Supply/Implant | $668.16 |
| 6021136 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6021137 | SUPPLY IMPLANT | Supply/Implant | $281.73 |
| 6021141 | GUIDE WIRE | Supply/Implant | $1,490.05 |
| 6021144 | SUPPLY IMPLANT | Supply/Implant | $672.00 |
| 6021147 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6021152 | GUIDE WIRE | Supply/Implant | $132.35 |
| 6021154 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,689.60 |
| 6021155 | GUIDE WIRE | Supply/Implant | $386.69 |
| 6021156 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $19,841.92 |
| 6021157 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021158 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.64 |
| 6021159 | STERILE SUPPLY | Supply/Implant | $456.19 |
| 6021160 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6021161 | SUPPLY IMPLANT | Supply/Implant | $22,808.32 |
| 6021167 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021168 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6021169 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021170 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6021171 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6021172 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6021173 | GUIDE WIRE | Supply/Implant | $574.08 |
| 6021174 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021175 | GUIDE WIRE | Supply/Implant | $588.80 |
| 6021176 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6021177 | CATHETER, GUIDING | Supply/Implant | $278.27 |
| 6021178 | CATHETER, GUIDING | Supply/Implant | $278.27 |
| 6021180 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021181 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021183 | GUIDE WIRE | Supply/Implant | $1,600.00 |
| 6021184 | GUIDE WIRE | Supply/Implant | $620.16 |
| 6021185 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,196.10 |
| 6021186 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,956.80 |
| 6021189 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6021190 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021191 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021192 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6021193 | CATH, DRAINAGE | Supply/Implant | $1,013.12 |
| 6021198 | INTRO/SHEATH, NON-LASER | Supply/Implant | $560.51 |
| 6021199 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021200 | CATHETER, GUIDING | Supply/Implant | $7,168.00 |
| 6021202 | CATHETER, GUIDING | Supply/Implant | $11,571.20 |
| 6021203 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021205 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6021206 | SUPPLY IMPLANT | Supply/Implant | $142.34 |
| 6021207 | SUPPLY IMPLANT | Supply/Implant | $142.34 |
| 6021208 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021209 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021210 | SUPPLY IMPLANT | Supply/Implant | $142.34 |
| 6021211 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021212 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6021214 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021218 | SUPPLY IMPLANT | Supply/Implant | $1,653.76 |
| 6021219 | SUPPLY IMPLANT | Supply/Implant | $52,416.00 |
| 6021220 | SUPPLY IMPLANT | Supply/Implant | $15,296.00 |
| 6021221 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6021224 | GUIDE WIRE | Supply/Implant | $1,412.86 |
| 6021225 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6021227 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6021233 | SUPPLY IMPLANT | Supply/Implant | $311.94 |
| 6021238 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6021239 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6021240 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6021241 | GUIDE WIRE | Supply/Implant | $929.28 |
| 6021242 | GUIDE WIRE | Supply/Implant | $158.98 |
| 6021243 | INTRO/SHEATH, NON-LASER | Supply/Implant | $837.12 |
| 6021244 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,609.54 |
| 6021245 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6021247 | INTRO/SHEATH, NON-LASER | Supply/Implant | $526.08 |
| 6021248 | INTRO/SHEATH, NON-LASER | Supply/Implant | $659.97 |
| 6021251 | STERILE SUPPLY | Supply/Implant | $454.14 |
| 6021252 | GUIDE WIRE | Supply/Implant | $640.00 |
| 6021254 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $18,278.40 |
| 6021255 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021256 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6021257 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6021258 | SUPPLY IMPLANT | Supply/Implant | $509.18 |
| 6021259 | INTRO/SHEATH, NON-LASER | Supply/Implant | $677.12 |
| 6021261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021262 | SUPPLY IMPLANT | Supply/Implant | $330.37 |
| 6021264 | GUIDE WIRE | Supply/Implant | $2,995.20 |
| 6021265 | GUIDE WIRE | Supply/Implant | $6,054.40 |
| 6021266 | GUIDE WIRE | Supply/Implant | $7,155.20 |
| 6021268 | SUPPLY IMPLANT | Supply/Implant | $7,808.00 |
| 6021269 | SUPPLY IMPLANT | Supply/Implant | $288.64 |
| 6021283 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6021284 | CATHETER, GUIDING | Supply/Implant | $278.27 |
| 6021285 | SUPPLY IMPLANT | Supply/Implant | $46,016.00 |
| 6021286 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $192.00 |
| 6021288 | CATHETER, GUIDING | Supply/Implant | $208.64 |
| 6021290 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6021292 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6021296 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6021301 | CATHETER, GUIDING | Supply/Implant | $11,571.20 |
| 6021305 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021306 | CATHETER, GUIDING | Supply/Implant | $208.64 |
| 6021307 | GUIDE WIRE | Supply/Implant | $221.44 |
| 6021312 | SUPPLY IMPLANT | Supply/Implant | $509.18 |
| 6021313 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6021314 | GENERAL SUPPLY | Supply/Implant | $173.06 |
| 6021315 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6021317 | SUPPLY IMPLANT | Supply/Implant | $5,608.96 |
| 6021318 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6021319 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6021320 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6021321 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6021324 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6021325 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6021327 | GUIDE WIRE | Supply/Implant | $1,077.76 |
| 6021329 | GUIDE WIRE | Supply/Implant | $568.58 |
| 6021330 | GUIDE WIRE | Supply/Implant | $420.74 |
| 6021331 | GUIDE WIRE | Supply/Implant | $344.06 |
| 6021333 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6021337 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,088.00 |
| 6021366 | INTRO/SHEATH, NON-LASER | Supply/Implant | $657.15 |
| 6021373 | GENERAL SUPPLY | Supply/Implant | $493.06 |
| 6021374 | GENERAL SUPPLY | Supply/Implant | $479.74 |
| 6021375 | GENERAL SUPPLY | Supply/Implant | $293.12 |
| 6021388 | GENERAL SUPPLY | Supply/Implant | $132.86 |
| 6021406 | GENERAL SUPPLY | Supply/Implant | $139.14 |
| 6021410 | GENERAL SUPPLY | Supply/Implant | $173.06 |
| 6021422 | SUPPLY IMPLANT | Supply/Implant | $230.14 |
| 6021423 | STERILE SUPPLY | Supply/Implant | $363.65 |
| 6021433 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $6,515.20 |
| 6021435 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6021441 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $54,118.40 |
| 6021460 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6021461 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021462 | RET DEV, INSERTABLE | Supply/Implant | $7,253.34 |
| 6021464 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $6,630.40 |
| 6021472 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021478 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6021482 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6021485 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6021486 | SUPPLY IMPLANT | Supply/Implant | $23,936.00 |
| 6021487 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6021488 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6021496 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,680.00 |
| 6021501 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021504 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6021515 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6021521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,008.00 |
| 6021524 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6021525 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,653.79 |
| 6021528 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6021531 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6021547 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6021548 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $21,696.00 |
| 6021549 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $22,976.00 |
| 6021552 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $22,976.00 |
| 6021569 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6021571 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6021583 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6021616 | SUPPLY IMPLANT | Supply/Implant | $80,768.00 |
| 6021619 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,576.00 |
| 6021623 | INTRO/SHEATH, NON-LASER | Supply/Implant | $742.40 |
| 6021624 | INTRO/SHEATH, NON-LASER | Supply/Implant | $742.40 |
| 6021625 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $9,981.82 |
| 6021636 | INTRO/SHEATH, NON-LASER | Supply/Implant | $645.89 |
| 6021637 | INTRO/SHEATH, NON-LASER | Supply/Implant | $668.16 |
| 6021643 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $12,480.00 |
| 6021645 | CLOSURE DEV, VASC | Supply/Implant | $4,096.00 |
| 6021647 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021649 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021650 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021651 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021652 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021653 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021655 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021656 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021657 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021659 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021660 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021667 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6021672 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021673 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021674 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6021677 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021678 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021680 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6021683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021685 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021686 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6021696 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6021698 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6021699 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6021700 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6021706 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $42,112.00 |
| 6021712 | GUIDE WIRE | Supply/Implant | $147.20 |
| 6021714 | LEAD, CORONARY VENOUS | Supply/Implant | $48,640.00 |
| 6021718 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,318.40 |
| 6021731 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6021734 | GUIDE WIRE | Supply/Implant | $1,958.40 |
| 6021735 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6021745 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6021748 | CATH, DRAINAGE | Supply/Implant | $1,604.74 |
| 6021750 | GUIDE WIRE | Supply/Implant | $661.12 |
| 6021751 | GUIDE WIRE | Supply/Implant | $758.02 |
| 6021752 | GUIDE WIRE | Supply/Implant | $2,273.92 |
| 6021754 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $208.64 |
| 6021755 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6021756 | GUIDE WIRE | Supply/Implant | $903.17 |
| 6021757 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6021758 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6021759 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6021761 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,080.00 |
| 6021765 | GUIDE WIRE | Supply/Implant | $588.80 |
| 6021766 | GUIDE WIRE | Supply/Implant | $648.32 |
| 6021767 | GUIDE WIRE | Supply/Implant | $1,318.40 |
| 6021768 | GUIDE WIRE | Supply/Implant | $398.34 |
| 6021770 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021771 | SUPPLY IMPLANT | Supply/Implant | $304.38 |
| 6021772 | GUIDE WIRE | Supply/Implant | $1,779.20 |
| 6021773 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6021774 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $30,720.00 |
| 6021776 | CATHETER, GUIDING | Supply/Implant | $1,088.00 |
| 6021777 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021778 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6021781 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6021784 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021785 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021786 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6021787 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6021789 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021790 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6021794 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021795 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6021800 | GUIDE WIRE | Supply/Implant | $710.91 |
| 6021802 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021807 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021809 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6021810 | GUIDE WIRE | Supply/Implant | $140.80 |
| 6021811 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6021815 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021816 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6021818 | GUIDE WIRE | Supply/Implant | $547.20 |
| 6021820 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021821 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6021822 | GUIDE WIRE | Supply/Implant | $264.96 |
| 6021824 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6021826 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $13,312.00 |
| 6021829 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6021830 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,322.43 |
| 6021831 | SUPPLY IMPLANT | Supply/Implant | $1,497.60 |
| 6021833 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021834 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021835 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021837 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021842 | CATHETER, GUIDING | Supply/Implant | $1,779.20 |
| 6021843 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6021845 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $896.00 |
| 6021880 | CATHETER, GUIDING | Supply/Implant | $1,126.40 |
| 6021881 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6021882 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6021883 | SUPPLY IMPLANT | Supply/Implant | $328.45 |
| 6021884 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6021886 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6021887 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6021889 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6021890 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021891 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021893 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021894 | INTRO/SHEATH, NON-LASER | Supply/Implant | $179.20 |
| 6021895 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6021897 | INTRO/SHEATH, NON-LASER | Supply/Implant | $230.40 |
| 6021898 | INTRO/SHEATH, NON-LASER | Supply/Implant | $384.00 |
| 6021899 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,713.60 |
| 6021900 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6021901 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,176.00 |
| 6021903 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6021904 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6021906 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6021907 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,713.60 |
| 6021908 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $15,603.20 |
| 6021909 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,352.00 |
| 6021910 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021911 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021912 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021915 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,408.00 |
| 6021916 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6021923 | STERILE SUPPLY | Supply/Implant | $1,356.80 |
| 6021924 | STERILE SUPPLY | Supply/Implant | $1,228.80 |
| 6021927 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021928 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021929 | CATHETER, GUIDING | Supply/Implant | $7,219.20 |
| 6021930 | CATHETER, GUIDING | Supply/Implant | $2,026.75 |
| 6021933 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6021934 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6021935 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6021942 | SUPPLY IMPLANT | Supply/Implant | $1,136.00 |
| 6021945 | SUPPLY IMPLANT | Supply/Implant | $3,980.80 |
| 6021946 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6021947 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,728.00 |
| 6021948 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6021950 | CATHETER, GUIDING | Supply/Implant | $6,105.60 |
| 6021951 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $20,480.00 |
| 6021953 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6021954 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6021956 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021957 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6021958 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6021963 | GUIDE WIRE | Supply/Implant | $185.60 |
| 6021964 | GUIDE WIRE | Supply/Implant | $764.80 |
| 6021965 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021966 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021967 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021969 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021970 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021971 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021972 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021973 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6021977 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021979 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021981 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6021982 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021984 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021990 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6021998 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6022039 | STERILE SUPPLY | Supply/Implant | $914.94 |
| 6022040 | STERILE SUPPLY | Supply/Implant | $1,702.31 |
| 6022042 | SUPPLY IMPLANT | Supply/Implant | $19,129.60 |
| 6022043 | INTRO/SHEATH, NON-LASER | Supply/Implant | $128.00 |
| 6022048 | SUPPLY IMPLANT | Supply/Implant | $266.62 |
| 6022050 | SUPPLY IMPLANT | Supply/Implant | $1,412.86 |
| 6022051 | GUIDE WIRE | Supply/Implant | $1,412.86 |
| 6022052 | GUIDE WIRE | Supply/Implant | $591.36 |
| 6022053 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6022054 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6022057 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6022058 | INTRO/SHEATH, NON-LASER | Supply/Implant | $128.00 |
| 6022070 | INTRO/SHEATH, NON-LASER | Supply/Implant | $360.06 |
| 6022072 | SUPPLY IMPLANT | Supply/Implant | $1,446.40 |
| 6022073 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $1,510.40 |
| 6022075 | GUIDE WIRE | Supply/Implant | $1,253.63 |
| 6022077 | GUIDE WIRE | Supply/Implant | $352.00 |
| 6022079 | GUIDE WIRE | Supply/Implant | $233.60 |
| 6022081 | GUIDE WIRE | Supply/Implant | $1,266.18 |
| 6022083 | GUIDE WIRE | Supply/Implant | $2,571.52 |
| 6022084 | SUPPLY IMPLANT | Supply/Implant | $1,190.40 |
| 6022088 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6022089 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6022090 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,728.00 |
| 6022091 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,728.00 |
| 6022092 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6022093 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $10,880.00 |
| 6022098 | SUPPLY IMPLANT | Supply/Implant | $800.64 |
| 6022099 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $588.80 |
| 6022121 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022123 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022125 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022126 | STERILE SUPPLY | Supply/Implant | $1,497.60 |
| 6022129 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6022130 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $5,824.00 |
| 6022131 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6022132 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6022137 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6022141 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6022150 | GENERAL SUPPLY | Supply/Implant | $240.90 |
| 6022151 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6022152 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6022163 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6022164 | STERILE SUPPLY | Supply/Implant | $2,053.67 |
| 6022165 | GUIDE WIRE | Supply/Implant | $1,512.32 |
| 6022167 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6022168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6022170 | GUIDE WIRE | Supply/Implant | $351.49 |
| 6022172 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022173 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022174 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $648.32 |
| 6022176 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $19,129.60 |
| 6022177 | STERILE SUPPLY | Supply/Implant | $1,921.28 |
| 6022188 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022189 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022192 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022197 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6022198 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6022199 | VENA CAVA FILTER | Supply/Implant | $17,856.00 |
| 6022200 | VENA CAVA FILTER | Supply/Implant | $17,856.00 |
| 6022201 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6022203 | GUIDE WIRE | Supply/Implant | $526.72 |
| 6022204 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6022205 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,096.00 |
| 6022206 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6022211 | INTRO/SHEATH, NON-LASER | Supply/Implant | $128.00 |
| 6022213 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $8,128.00 |
| 6022214 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $10,496.00 |
| 6022215 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $8,128.00 |
| 6022218 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6022219 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,484.80 |
| 6022220 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,484.80 |
| 6022221 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6022222 | CATHETER, GUIDING | Supply/Implant | $2,017.28 |
| 6022223 | SUPPLY IMPLANT | Supply/Implant | $1,441.43 |
| 6022224 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6022225 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6022226 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6022227 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6022243 | GENERAL SUPPLY | Supply/Implant | $572.90 |
| 6022244 | SUPPLY IMPLANT | Supply/Implant | $648.32 |
| 6022246 | GENERAL SUPPLY | Supply/Implant | $331.90 |
| 6022250 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6022254 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,504.00 |
| 6022255 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,620.80 |
| 6022256 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $17,600.00 |
| 6022257 | STERILE SUPPLY | Supply/Implant | $3,571.20 |
| 6022261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,728.00 |
| 6022262 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6022264 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6022275 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6022276 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6022277 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6022280 | GUIDE WIRE | Supply/Implant | $1,760.00 |
| 6022281 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6022282 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6022289 | CLOSURE DEV, VASC | Supply/Implant | $3,136.00 |
| 6022294 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6022296 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6022298 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $14,976.00 |
| 6022299 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $57,536.00 |
| 6022302 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6022316 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6022317 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,728.00 |
| 6022320 | SUPPLY IMPLANT | Supply/Implant | $437.25 |
| 6022323 | GUIDE WIRE | Supply/Implant | $661.12 |
| 6022324 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6022329 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022330 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022331 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022332 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022333 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,365.76 |
| 6022334 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,365.76 |
| 6022335 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6022337 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $12,480.00 |
| 6022341 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6022342 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6022343 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6022346 | STERILE SUPPLY | Supply/Implant | $1,665.54 |
| 6022350 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6022351 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6022352 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6022353 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6022356 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6022359 | CLOSURE DEV, VASC | Supply/Implant | $3,289.60 |
| 6022361 | SUPPLY IMPLANT | Supply/Implant | $2,519.04 |
| 6022364 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,950.40 |
| 6022365 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,950.40 |
| 6022371 | CLOSURE DEV, VASC | Supply/Implant | $4,096.00 |
| 6022375 | CLOSURE DEV, VASC | Supply/Implant | $3,136.00 |
| 6022382 | COMPUTER ASSISTED SURGERY | Supply/Implant | $29,342.60 |
| 6022383 | PMKR, DUAL, RATE-RESP | Supply/Implant | $55,756.80 |
| 6022385 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6022386 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6022389 | STERILE SUPPLY | Supply/Implant | $3,968.00 |
| 6022396 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6022400 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6022401 | SUPPLY IMPLANT | Supply/Implant | $4,377.60 |
| 6022403 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6022404 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6022405 | STERILE SUPPLY | Supply/Implant | $4,377.60 |
| 6022406 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $29,440.00 |
| 6022408 | SUPPLY IMPLANT | Supply/Implant | $165.38 |
| 6022440 | STERILE SUPPLY | Supply/Implant | $855.81 |
| 6022445 | STERILE SUPPLY | Supply/Implant | $152.58 |
| 6022452 | STERILE SUPPLY | Supply/Implant | $148.86 |
| 6022483 | AIR FLUIDIZED BED | Supply/Implant | $792.52 |
| 6022494 | BARIATRIC BED OBESE | Supply/Implant | $2,034.81 |
| 6022541 | VAC RENTAL DAILY E0182 | Supply/Implant | $698.63 |
| 6022545 | PULMO/ROTATE BED | Supply/Implant | $1,516.00 |
| 6022549 | LOW AIR LOSS OVERLAY STANDARD | Supply/Implant | $310.16 |
| 6023421 | OT WH W NONTORSION W FIT | Supply/Implant | $986.00 |
| 6023529 | OT HF WO JT W FIT PREFAB | Supply/Implant | $89.00 |
| 6023619 | OT HF W JT W FIT CUSTOM | Supply/Implant | $269.00 |
| 6023721 | LOW AIR LOSS OVERLAY, OBESE | Supply/Implant | $471.23 |
| 6023744 | OT EWH RIGID W FIT CUST | Supply/Implant | $766.00 |
| 6023745 | OT WHF W JT W FIT CUSTOM | Supply/Implant | $451.00 |
| 6023849 | BARIATRIC BED, SIDE EGRESS | Supply/Implant | $963.87 |
| 6023883 | OT ELBOW W FIT CUSTOM | Supply/Implant | $287.00 |
| 6023884 | OT F WO JT W FIT CUSTOM | Supply/Implant | $212.00 |
| 6023985 | OT F PIP/DIP W JT W FIT | Supply/Implant | $51.00 |
| 6024063 | OT HF WO JT W FIT CUSTOM | Supply/Implant | $269.00 |
| 6024069 | WHFO RIGID W/O JOINTS | Supply/Implant | $1,049.43 |
| 6024089 | OT WH WO JOINTS CUSTOM | Supply/Implant | $418.00 |
| 6024116 | GENERAL SUPPLY | Supply/Implant | $258.05 |
| 6024136 | SUPPLY IMPLANT | Supply/Implant | $496.13 |
| 6024142 | GENERAL SUPPLY | Supply/Implant | $288.64 |
| 6024143 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6024144 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6024158 | GENERAL SUPPLY | Supply/Implant | $250.50 |
| 6024159 | STERILE SUPPLY | Supply/Implant | $812.67 |
| 6024161 | GENERAL SUPPLY | Supply/Implant | $476.42 |
| 6024162 | GENERAL SUPPLY | Supply/Implant | $225.79 |
| 6024166 | GENERAL SUPPLY | Supply/Implant | $131.26 |
| 6024188 | GENERAL SUPPLY | Supply/Implant | $287.49 |
| 6024196 | GENERAL SUPPLY | Supply/Implant | $656.90 |
| 6024209 | CATHETER, URETERAL | Supply/Implant | $228.22 |
| 6024221 | SUPPLY IMPLANT | Supply/Implant | $490.37 |
| 6024226 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6024230 | GENERAL SUPPLY | Supply/Implant | $144.51 |
| 6024240 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6024254 | GENERAL DRUG | Supply/Implant | $199.74 |
| 6024286 | STERILE SUPPLY | Supply/Implant | $391.55 |
| 6024294 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6024295 | SUPPLY IMPLANT | Supply/Implant | $701.44 |
| 6024297 | STERILE SUPPLY | Supply/Implant | $343.17 |
| 6024300 | GUIDE WIRE | Supply/Implant | $526.72 |
| 6024302 | STERILE SUPPLY | Supply/Implant | $511.23 |
| 6024303 | STERILE SUPPLY | Supply/Implant | $551.17 |
| 6024308 | SUPPLY IMPLANT | Supply/Implant | $2,520.32 |
| 6024310 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6024312 | SUPPLY IMPLANT | Supply/Implant | $52,416.00 |
| 6024319 | STERILE SUPPLY | Supply/Implant | $281.09 |
| 6024324 | GENERAL SUPPLY | Supply/Implant | $168.96 |
| 6024327 | SUPPLY IMPLANT | Supply/Implant | $1,530.88 |
| 6024331 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6024335 | INTRO/SHEATH, NON-LASER | Supply/Implant | $544.00 |
| 6024342 | GUIDE WIRE | Supply/Implant | $1,157.12 |
| 6024344 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,255.04 |
| 6024348 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6024349 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,619.20 |
| 6024358 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $8,320.00 |
| 6024360 | RET DEV, INSERTABLE | Supply/Implant | $8,640.00 |
| 6024361 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6024362 | GUIDE WIRE | Supply/Implant | $6,935.04 |
| 6024364 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,160.00 |
| 6024365 | RET DEV, INSERTABLE | Supply/Implant | $8,640.00 |
| 6024366 | EMBOLIZATION PROTECT SYST | Supply/Implant | $19,136.00 |
| 6024369 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,619.20 |
| 6024373 | GUIDE WIRE | Supply/Implant | $3,686.40 |
| 6024374 | CATHETER, GUIDING | Supply/Implant | $1,653.76 |
| 6024375 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $14,310.40 |
| 6024376 | CATH OCCLUSION | Supply/Implant | $14,310.40 |
| 6024386 | GUIDE WIRE | Supply/Implant | $7,980.80 |
| 6024396 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,163.20 |
| 6024397 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6024398 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6024408 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,868.80 |
| 6024415 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6024417 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6024422 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6024436 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6024439 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6024444 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6024453 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6024470 | VENA CAVA FILTER | Supply/Implant | $1,536.00 |
| 6024471 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6024472 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,653.63 |
| 6024474 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6024488 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6024490 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,352.45 |
| 6024491 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,352.45 |
| 6024504 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $640.00 |
| 6024506 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,816.32 |
| 6024518 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $21,160.32 |
| 6024520 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6024523 | SUPPLY IMPLANT | Supply/Implant | $1,305.60 |
| 6024529 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6024530 | SUPPLY IMPLANT | Supply/Implant | $729.60 |
| 6024550 | CATHETER, GUIDING | Supply/Implant | $13,824.00 |
| 6024559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,126.72 |
| 6024562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,128.00 |
| 6024566 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6024567 | GRAFT, VASCULAR | Supply/Implant | $3,942.40 |
| 6024570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $685.57 |
| 6024574 | MESH (IMPLANTABLE) | Supply/Implant | $10,973.57 |
| 6024578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6024580 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024581 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024582 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024587 | PROS, URINARY SPH, IMP | Supply/Implant | $34,280.96 |
| 6024588 | PROS, URINARY SPH, IMP | Supply/Implant | $70,786.56 |
| 6024589 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024591 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024592 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024595 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024596 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024597 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024599 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6024600 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6024601 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6024604 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6024606 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6024615 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6024616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6024617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024618 | MESH (IMPLANTABLE) | Supply/Implant | $7,375.87 |
| 6024626 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024628 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024629 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024630 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024631 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024632 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024633 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024634 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024635 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024636 | MESH (IMPLANTABLE) | Supply/Implant | $1,731.46 |
| 6024637 | MESH (IMPLANTABLE) | Supply/Implant | $6,111.74 |
| 6024638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,924.74 |
| 6024646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024649 | PORT, INDWELLING, IMP | Supply/Implant | $6,720.00 |
| 6024657 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024658 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024660 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024666 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024667 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6024669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024670 | MESH (IMPLANTABLE) | Supply/Implant | $1,019.52 |
| 6024673 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024674 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $545.92 |
| 6024685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6024692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6024700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6024702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6024703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,060.80 |
| 6024705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6024709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6024710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024722 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024725 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024726 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6024727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6024728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6024729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,686.40 |
| 6024731 | MESH (IMPLANTABLE) | Supply/Implant | $6,528.00 |
| 6024734 | MESH (IMPLANTABLE) | Supply/Implant | $9,597.95 |
| 6024735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6024741 | MESH (IMPLANTABLE) | Supply/Implant | $8,625.79 |
| 6024743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6024745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6024752 | MESH (IMPLANTABLE) | Supply/Implant | $1,731.46 |
| 6024753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6024754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6024760 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,881.60 |
| 6024761 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,881.60 |
| 6024762 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $140,553.00 |
| 6024764 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024765 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024770 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $983.04 |
| 6024788 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024789 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6024795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6024796 | GUIDE WIRE | Supply/Implant | $2,396.16 |
| 6024797 | GUIDE WIRE | Supply/Implant | $2,396.16 |
| 6024798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6024799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6024800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6024803 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $18,880.00 |
| 6024804 | LEAD, NEUROSTIMULATOR | Supply/Implant | $45,504.00 |
| 6024806 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,137.60 |
| 6024812 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6024816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6024817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6024818 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $21,120.00 |
| 6024831 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6024846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6024854 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,584.00 |
| 6024864 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024865 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024868 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024871 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6024874 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024875 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,266.30 |
| 6024880 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $31,993.60 |
| 6024881 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6024884 | LEAD, NEUROSTIMULATOR | Supply/Implant | $87,398.40 |
| 6024886 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024891 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,008.00 |
| 6024892 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6024894 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,738.30 |
| 6024895 | GUIDE WIRE | Supply/Implant | $154.75 |
| 6024896 | SUPPLY IMPLANT | Supply/Implant | $825.34 |
| 6024897 | SUPPLY IMPLANT | Supply/Implant | $4,247.04 |
| 6024898 | GUIDE WIRE | Supply/Implant | $558.82 |
| 6024899 | GUIDE WIRE | Supply/Implant | $558.85 |
| 6024900 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $72,199.68 |
| 6024901 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $74,967.04 |
| 6024902 | APLIGRAF SKIN SUB | Supply/Implant | $21,004.80 |
| 6024904 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6024907 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $255,418.90 |
| 6024914 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6024915 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6024916 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6024925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $723.97 |
| 6024927 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024928 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024936 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6024938 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6024945 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $122,640.00 |
| 6024946 | GUIDE WIRE | Supply/Implant | $344.06 |
| 6024947 | INTRO/SHEATH, NON-LASER | Supply/Implant | $542.08 |
| 6024948 | GUIDE WIRE | Supply/Implant | $560.38 |
| 6024949 | SUPPLY IMPLANT | Supply/Implant | $825.34 |
| 6024950 | SUPPLY IMPLANT | Supply/Implant | $1,335.42 |
| 6024951 | SUPPLY IMPLANT | Supply/Implant | $1,833.28 |
| 6024952 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6024954 | GUIDE WIRE | Supply/Implant | $558.85 |
| 6024955 | GUIDE WIRE | Supply/Implant | $154.75 |
| 6024958 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6024980 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $15,232.00 |
| 6024982 | GUIDE WIRE | Supply/Implant | $1,003.52 |
| 6024987 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6025005 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6025012 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025014 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6025015 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6025023 | PROS, URINARY SPH, IMP | Supply/Implant | $74,967.04 |
| 6025024 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025029 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025030 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6025033 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,279.36 |
| 6025035 | GUIDE WIRE | Supply/Implant | $198.91 |
| 6025036 | GUIDE WIRE | Supply/Implant | $144.00 |
| 6025038 | CATHETER, URETERAL | Supply/Implant | $845.82 |
| 6025040 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6025042 | INTRO/SHEATH, NON-LASER | Supply/Implant | $268.80 |
| 6025045 | GUIDE WIRE | Supply/Implant | $977.66 |
| 6025046 | INTRO/SHEATH, NON-LASER | Supply/Implant | $403.97 |
| 6025047 | GUIDE WIRE | Supply/Implant | $1,516.42 |
| 6025050 | SUPPLY IMPLANT | Supply/Implant | $2,912.51 |
| 6025051 | INTRO/SHEATH, NON-LASER | Supply/Implant | $540.93 |
| 6025053 | GUIDE WIRE | Supply/Implant | $755.20 |
| 6025054 | GENERAL DRUG | Supply/Implant | $838.02 |
| 6025056 | GUIDE WIRE | Supply/Implant | $651.39 |
| 6025057 | GUIDE WIRE | Supply/Implant | $1,305.47 |
| 6025058 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6025062 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6025063 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6025065 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6025067 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,204.67 |
| 6025068 | SUPPLY IMPLANT | Supply/Implant | $720.00 |
| 6025071 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6025075 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.38 |
| 6025077 | GUIDE WIRE | Supply/Implant | $1,424.13 |
| 6025079 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,238.72 |
| 6025080 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6025091 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6025092 | GUIDE WIRE | Supply/Implant | $183.30 |
| 6025095 | REP DEV, URINARY, W/SLING | Supply/Implant | $17,248.00 |
| 6025096 | GUIDE WIRE | Supply/Implant | $1,766.40 |
| 6025097 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6025098 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6025099 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6025100 | GUIDE WIRE | Supply/Implant | $217.60 |
| 6025101 | INTRO/SHEATH, NON-LASER | Supply/Implant | $390.40 |
| 6025103 | PORT, INDWELLING, IMP | Supply/Implant | $6,592.00 |
| 6025106 | INTRO/SHEATH, NON-LASER | Supply/Implant | $352.77 |
| 6025109 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6025110 | SUPPLY IMPLANT | Supply/Implant | $2,954.50 |
| 6025111 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6025112 | GUIDE WIRE | Supply/Implant | $2,184.96 |
| 6025113 | PORT, INDWELLING, IMP | Supply/Implant | $9,676.80 |
| 6025115 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025116 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025117 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025118 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025119 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,738.30 |
| 6025120 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025131 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025132 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025133 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,738.30 |
| 6025134 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025135 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025136 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025138 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6025139 | SYNTHETIC IMPLNT URINARY 1ML | Supply/Implant | $4,929.41 |
| 6025142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,139.20 |
| 6025143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,497.60 |
| 6025150 | GUIDE WIRE | Supply/Implant | $2,150.40 |
| 6025152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6025158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6025159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6025160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6025162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6025163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6025168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6025169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6025179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6025180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6025187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6025190 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6025191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,160.00 |
| 6025194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6025200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,958.40 |
| 6025201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6025203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6025214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $251.90 |
| 6025224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $251.90 |
| 6025225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6025227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6025237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6025238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6025239 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6025243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6025252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,160.96 |
| 6025256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6025260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6025273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,085.76 |
| 6025290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6025345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,340.80 |
| 6025363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $665.60 |
| 6025364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $622.98 |
| 6025378 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025379 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025380 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025381 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025382 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025389 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025390 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025411 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025421 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6025429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6025433 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025434 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025435 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025436 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025437 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025444 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025446 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6025464 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6025466 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6025491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,160.96 |
| 6025540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,048.00 |
| 6025541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6025542 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6025552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $534.78 |
| 6025565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $691.20 |
| 6025567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6025586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6025587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6025591 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,934.40 |
| 6025604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6025610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6025612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6025615 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,977.73 |
| 6025655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $800.00 |
| 6025656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6025709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,120.00 |
| 6025800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6025804 | GUIDE WIRE | Supply/Implant | $532.74 |
| 6025814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,190.40 |
| 6025816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,646.40 |
| 6025845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6025855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6025868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6025897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6025973 | GUIDE WIRE | Supply/Implant | $2,140.16 |
| 6025975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6025988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,171.20 |
| 6026009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $685.57 |
| 6026011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $685.57 |
| 6026013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,375.68 |
| 6026027 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $17,920.00 |
| 6026033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,340.80 |
| 6026034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,340.80 |
| 6026035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,441.60 |
| 6026036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,283.20 |
| 6026039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6026043 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6026089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,625.60 |
| 6026098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6026131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,532.80 |
| 6026132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6026143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $352.00 |
| 6026176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026178 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,150.40 |
| 6026179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,576.00 |
| 6026191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6026192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026210 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6026212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026239 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,035.20 |
| 6026246 | GUIDE WIRE | Supply/Implant | $1,881.60 |
| 6026247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026255 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6026258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,467.20 |
| 6026259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026263 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6026273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6026282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,820.74 |
| 6026288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6026304 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026305 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6026330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,820.74 |
| 6026360 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $352.00 |
| 6026370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6026371 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6026374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $537.60 |
| 6026378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,222.40 |
| 6026379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,222.40 |
| 6026380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6026393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6026396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6026397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,228.80 |
| 6026407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6026434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,324.93 |
| 6026438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6026474 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,836.80 |
| 6026475 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,836.80 |
| 6026487 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,836.80 |
| 6026504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.85 |
| 6026515 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6026525 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $140,553.00 |
| 6026559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6026562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $717.18 |
| 6026571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6026620 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $6,630.40 |
| 6026630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,838.40 |
| 6026640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6026653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6026666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6026683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6026698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026727 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6026729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6026736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026739 | GUIDE WIRE | Supply/Implant | $1,648.64 |
| 6026766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6026797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6026811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6026812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6026815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6026819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6026822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6026823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6026846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,680.00 |
| 6026853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6026863 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6026867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6026871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6026884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6026927 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $12,185.60 |
| 6026986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $163.20 |
| 6027008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6027028 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6027029 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6027030 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6027031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,516.16 |
| 6027032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6027035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,724.80 |
| 6027054 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,934.40 |
| 6027057 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6027077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,736.00 |
| 6027120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,736.00 |
| 6027121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,736.00 |
| 6027136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6027161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $624.00 |
| 6027162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $624.00 |
| 6027166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6027179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6027181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6027286 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $9,820.16 |
| 6027289 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,934.40 |
| 6027296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6027310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6027333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6027355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6027358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027415 | INFUSION PUMP, PROGRAMMABLE | Supply/Implant | $123,900.00 |
| 6027422 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027423 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $8,320.00 |
| 6027432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6027433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027438 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027441 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027444 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6027459 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,240.00 |
| 6027460 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,680.00 |
| 6027463 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027465 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6027484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,042.05 |
| 6027493 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6027496 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6027506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6027513 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,933.44 |
| 6027540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027567 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $12,160.00 |
| 6027579 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6027611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6027617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6027641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6027643 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $34,835.84 |
| 6027645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,243.52 |
| 6027649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6027650 | GUIDE WIRE | Supply/Implant | $2,931.20 |
| 6027663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,933.44 |
| 6027665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6027668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6027699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,164.80 |
| 6027702 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6027711 | CLOSURE DEV, VASC | Supply/Implant | $3,008.00 |
| 6027712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6027732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $694.78 |
| 6027737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6027747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027748 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6027751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027769 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6027770 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $8,470.40 |
| 6027799 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6027803 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6027805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $717.18 |
| 6027813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6027828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6027833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027838 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6027857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6027871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6027872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6027875 | PMKR, DUAL, RATE-RESP | Supply/Implant | $55,756.80 |
| 6027884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6027885 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6027886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,933.44 |
| 6027887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6027889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6027893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027897 | GUIDE WIRE | Supply/Implant | $1,982.08 |
| 6027898 | SUPPLY IMPLANT | Supply/Implant | $2,538.88 |
| 6027899 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,859.20 |
| 6027901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6027902 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6027908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6027909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6027926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $717.18 |
| 6027931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6027934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6027946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6027989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6028000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6028001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6028016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6028027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6028030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6028058 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6028077 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6028100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6028102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6028103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6028111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6028135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6028143 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $11,520.00 |
| 6028146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6028147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6028148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6028157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6028160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6028161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6028162 | GRAFT, VASCULAR | Supply/Implant | $35,737.60 |
| 6028177 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,008.00 |
| 6028183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6028184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6028188 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6028189 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $21,452.80 |
| 6028206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6028207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6028209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6028210 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6028211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6028212 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $28,160.00 |
| 6028213 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6028234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6028246 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $54,118.40 |
| 6028250 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6028254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6028255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6028257 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $13,801.22 |
| 6028261 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.33 |
| 6028270 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.33 |
| 6028277 | GUIDE WIRE | Supply/Implant | $1,356.42 |
| 6028282 | INTRO/SHEATH, NON-LASER | Supply/Implant | $263.55 |
| 6028283 | GUIDE WIRE | Supply/Implant | $620.16 |
| 6028284 | GUIDE WIRE | Supply/Implant | $550.40 |
| 6028299 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,940.61 |
| 6028300 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,204.67 |
| 6028301 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,940.61 |
| 6028311 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,891.84 |
| 6028312 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,806.08 |
| 6028319 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6028320 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6028322 | GUIDE WIRE | Supply/Implant | $1,334.91 |
| 6028323 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,241.60 |
| 6028330 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028331 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028336 | GUIDE WIRE | Supply/Implant | $712.96 |
| 6028342 | GUIDE WIRE | Supply/Implant | $321.28 |
| 6028344 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028348 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6028349 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6028354 | GUIDE WIRE | Supply/Implant | $432.00 |
| 6028357 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6028358 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6028368 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $960.00 |
| 6028371 | GUIDE WIRE | Supply/Implant | $2,867.20 |
| 6028374 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6028375 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6028376 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6028392 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $32,000.00 |
| 6028393 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,382.53 |
| 6028406 | SUPPLY IMPLANT | Supply/Implant | $1,507.20 |
| 6028435 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028440 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,779.20 |
| 6028445 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028447 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028455 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,276.29 |
| 6028459 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6028462 | CATHETER, GUIDING | Supply/Implant | $496.00 |
| 6028469 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028470 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,113.60 |
| 6028471 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028473 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028474 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028475 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028476 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6028479 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028480 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028481 | GUIDE WIRE | Supply/Implant | $17,670.27 |
| 6028483 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028484 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028489 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6028502 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028506 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028509 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028537 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6028570 | GUIDE WIRE | Supply/Implant | $5,721.60 |
| 6028602 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6028603 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6028607 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6028608 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6028623 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6028626 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6028632 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6028633 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6028635 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6028642 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6028646 | GUIDE WIRE | Supply/Implant | $166.40 |
| 6028650 | GUIDE WIRE | Supply/Implant | $4,044.16 |
| 6028651 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,035.20 |
| 6028656 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6028661 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6028668 | LEAD, NEUROSTIMULATOR | Supply/Implant | $1,920.00 |
| 6028670 | GUIDE WIRE | Supply/Implant | $433.92 |
| 6028683 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028684 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028685 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028692 | GUIDE WIRE | Supply/Implant | $1,422.87 |
| 6028702 | SEPTAL DEFECT IMP SYS | Supply/Implant | $9,318.40 |
| 6028704 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6028705 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028712 | INTRO/SHEATH, NON-LASER | Supply/Implant | $969.98 |
| 6028713 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,635.26 |
| 6028716 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $8,960.00 |
| 6028721 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $1,792.00 |
| 6028736 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6028737 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6028738 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6028739 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6028742 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028743 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6028747 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,195.26 |
| 6028750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $39,875.20 |
| 6028752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6028759 | SUPPLY IMPLANT | Supply/Implant | $193.66 |
| 6028763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6028764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $427.14 |
| 6028765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,329.60 |
| 6028767 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6028776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,892.80 |
| 6028778 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6028779 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6028784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6028785 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6028795 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $12,569.73 |
| 6028796 | GRAFT, VASCULAR | Supply/Implant | $3,072.00 |
| 6028804 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6028806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,659.90 |
| 6028807 | ADHESION BARRIER | Supply/Implant | $3,546.50 |
| 6028814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6028832 | SUPPLY IMPLANT | Supply/Implant | $485.50 |
| 6028833 | SUPPLY IMPLANT | Supply/Implant | $2,641.92 |
| 6028834 | SUPPLY IMPLANT | Supply/Implant | $6,982.40 |
| 6028841 | SUPPLY IMPLANT | Supply/Implant | $1,312.64 |
| 6028846 | ALLODERM SKIN SUB | Supply/Implant | $7,769.60 |
| 6028847 | GENERAL SUPPLY | Supply/Implant | $462.08 |
| 6028849 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6028851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6028852 | ALLODERM SKIN SUB | Supply/Implant | $5,888.00 |
| 6028853 | ALLODERM SKIN SUB | Supply/Implant | $9,945.60 |
| 6028858 | SUPPLY IMPLANT | Supply/Implant | $23,936.00 |
| 6028859 | SUPPLY IMPLANT | Supply/Implant | $3,143.68 |
| 6028863 | SUPPLY IMPLANT | Supply/Implant | $3,475.97 |
| 6028864 | CONN TISS, NON-HUMAN | Supply/Implant | $1,415.04 |
| 6028871 | SUPPLY IMPLANT | Supply/Implant | $1,257.18 |
| 6028872 | SUPPLY IMPLANT | Supply/Implant | $3,407.49 |
| 6028873 | SUPPLY IMPLANT | Supply/Implant | $6,832.64 |
| 6028876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,563.20 |
| 6028877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,611.20 |
| 6028879 | SUPPLY IMPLANT | Supply/Implant | $4,334.68 |
| 6028881 | SUPPLY IMPLANT | Supply/Implant | $4,395.39 |
| 6028883 | SUPPLY IMPLANT | Supply/Implant | $2,461.22 |
| 6028884 | SUPPLY IMPLANT | Supply/Implant | $1,972.39 |
| 6028885 | SUPPLY IMPLANT | Supply/Implant | $4,101.25 |
| 6028886 | SUPPLY IMPLANT | Supply/Implant | $2,124.16 |
| 6028887 | SUPPLY IMPLANT | Supply/Implant | $5,944.32 |
| 6028888 | SUPPLY IMPLANT | Supply/Implant | $2,050.56 |
| 6028889 | SUPPLY IMPLANT | Supply/Implant | $4,064.13 |
| 6028890 | SUPPLY IMPLANT | Supply/Implant | $1,165.57 |
| 6028897 | SUPPLY IMPLANT | Supply/Implant | $10,470.40 |
| 6028898 | SUPPLY IMPLANT | Supply/Implant | $1,441.54 |
| 6028900 | SUPPLY IMPLANT | Supply/Implant | $4,300.80 |
| 6028901 | SUPPLY IMPLANT | Supply/Implant | $378.75 |
| 6028906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,164.80 |
| 6028907 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,580.48 |
| 6028908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,755.20 |
| 6028911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,494.40 |
| 6028912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,539.20 |
| 6028915 | STERILE SUPPLY | Supply/Implant | $262.78 |
| 6028917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,540.80 |
| 6028919 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6028920 | STERILE SUPPLY | Supply/Implant | $3,002.88 |
| 6028921 | SUPPLY IMPLANT | Supply/Implant | $1,951.62 |
| 6028924 | MESH (IMPLANTABLE) | Supply/Implant | $28,992.00 |
| 6028925 | SUPPLY IMPLANT | Supply/Implant | $2,923.78 |
| 6028926 | SUPPLY IMPLANT | Supply/Implant | $7,983.36 |
| 6028927 | SUPPLY IMPLANT | Supply/Implant | $139.20 |
| 6028928 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6028931 | SUPPLY IMPLANT | Supply/Implant | $160.32 |
| 6028932 | SUPPLY IMPLANT | Supply/Implant | $663.81 |
| 6028940 | GENERAL SUPPLY | Supply/Implant | $14,689.02 |
| 6028945 | SUPPLY IMPLANT | Supply/Implant | $1,698.69 |
| 6028946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6028947 | ALLODERM SKIN SUB | Supply/Implant | $2,956.80 |
| 6028951 | SUPPLY IMPLANT | Supply/Implant | $1,774.08 |
| 6028952 | GENERAL SUPPLY | Supply/Implant | $132.22 |
| 6028954 | STERILE SUPPLY | Supply/Implant | $213.12 |
| 6028957 | STERILE SUPPLY | Supply/Implant | $9,228.80 |
| 6028961 | SUPPLY IMPLANT | Supply/Implant | $1,648.64 |
| 6028963 | SUPPLY IMPLANT | Supply/Implant | $31,529.79 |
| 6028966 | SUPPLY IMPLANT | Supply/Implant | $26,337.54 |
| 6028968 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6028969 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6028970 | SUPPLY IMPLANT | Supply/Implant | $1,153.54 |
| 6028972 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,407.17 |
| 6028973 | SUPPLY IMPLANT | Supply/Implant | $1,312.90 |
| 6028985 | SUPPLY IMPLANT | Supply/Implant | $6,844.67 |
| 6028987 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6028990 | SUPPLY IMPLANT | Supply/Implant | $417.54 |
| 6028993 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6028994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,274.94 |
| 6028995 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6028997 | SUPPLY IMPLANT | Supply/Implant | $9,146.37 |
| 6029006 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,035.26 |
| 6029013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6029015 | SUPPLY IMPLANT | Supply/Implant | $3,538.56 |
| 6029016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,274.94 |
| 6029019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6029022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6029023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,671.30 |
| 6029024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,150.40 |
| 6029027 | SUPPLY IMPLANT | Supply/Implant | $1,430.53 |
| 6029028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,153.73 |
| 6029030 | STERILE SUPPLY | Supply/Implant | $547.58 |
| 6029031 | SUPPLY IMPLANT | Supply/Implant | $276.10 |
| 6029032 | GENERAL SUPPLY | Supply/Implant | $404.10 |
| 6029033 | GENERAL SUPPLY | Supply/Implant | $520.32 |
| 6029035 | SUPPLY IMPLANT | Supply/Implant | $75,648.00 |
| 6029038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,671.30 |
| 6029039 | SUPPLY IMPLANT | Supply/Implant | $258.56 |
| 6029040 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029041 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029042 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029043 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6029044 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6029045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6029047 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,407.17 |
| 6029050 | SUPPLY IMPLANT | Supply/Implant | $8,256.00 |
| 6029052 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6029053 | SUPPLY IMPLANT | Supply/Implant | $4,101.25 |
| 6029054 | SUPPLY IMPLANT | Supply/Implant | $783.10 |
| 6029055 | STERILE SUPPLY | Supply/Implant | $1,813.35 |
| 6029056 | SUPPLY IMPLANT | Supply/Implant | $1,813.35 |
| 6029057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6029065 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6029066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,987.90 |
| 6029069 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6029079 | SUPPLY IMPLANT | Supply/Implant | $1,202.56 |
| 6029081 | SUPPLY IMPLANT | Supply/Implant | $743.71 |
| 6029082 | SUPPLY IMPLANT | Supply/Implant | $23,936.00 |
| 6029083 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6029085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,760.00 |
| 6029086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6029093 | SUPPLY IMPLANT | Supply/Implant | $1,092.57 |
| 6029094 | SUPPLY IMPLANT | Supply/Implant | $22,540.80 |
| 6029097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029106 | ADHESION BARRIER | Supply/Implant | $4,290.82 |
| 6029108 | SUPPLY IMPLANT | Supply/Implant | $176.00 |
| 6029111 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6029113 | SUPPLY IMPLANT | Supply/Implant | $3,110.40 |
| 6029116 | SUPPLY IMPLANT | Supply/Implant | $1,687.04 |
| 6029120 | SUPPLY IMPLANT | Supply/Implant | $2,398.57 |
| 6029121 | SUPPLY IMPLANT | Supply/Implant | $2,398.57 |
| 6029130 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6029138 | PROSTHESIS, BREAST, IMP | Supply/Implant | $7,360.00 |
| 6029140 | SUPPLY IMPLANT | Supply/Implant | $2,835.84 |
| 6029141 | SUPPLY IMPLANT | Supply/Implant | $550.66 |
| 6029143 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6029146 | SUPPLY IMPLANT | Supply/Implant | $11,712.00 |
| 6029147 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029148 | CATH, DRAINAGE | Supply/Implant | $10,057.98 |
| 6029149 | SUPPLY IMPLANT | Supply/Implant | $16,000.10 |
| 6029150 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6029151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,760.00 |
| 6029158 | SUPPLY IMPLANT | Supply/Implant | $3,153.92 |
| 6029160 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029162 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029163 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029164 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029166 | SUPPLY IMPLANT | Supply/Implant | $2,866.56 |
| 6029169 | SUPPLY IMPLANT | Supply/Implant | $1,925.12 |
| 6029170 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6029172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6029173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6029178 | ALLODERM SKIN SUB | Supply/Implant | $26,585.60 |
| 6029180 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6029183 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6029184 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6029185 | CATHETER, GUIDING | Supply/Implant | $5,440.00 |
| 6029191 | SUPPLY IMPLANT | Supply/Implant | $742.40 |
| 6029193 | SUPPLY IMPLANT | Supply/Implant | $588.80 |
| 6029195 | SUPPLY IMPLANT | Supply/Implant | $1,092.57 |
| 6029199 | MESH (IMPLANTABLE) | Supply/Implant | $5,248.00 |
| 6029200 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $9,344.00 |
| 6029207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,369.92 |
| 6029212 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029220 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6029221 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6029222 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6029223 | SUPPLY IMPLANT | Supply/Implant | $1,497.60 |
| 6029227 | CLOSURE DEV, VASC | Supply/Implant | $3,520.00 |
| 6029228 | SUPPLY IMPLANT | Supply/Implant | $48,704.00 |
| 6029231 | SUPPLY IMPLANT | Supply/Implant | $7,001.60 |
| 6029232 | SUPPLY IMPLANT | Supply/Implant | $4,211.20 |
| 6029233 | SUPPLY IMPLANT | Supply/Implant | $4,428.29 |
| 6029234 | SUPPLY IMPLANT | Supply/Implant | $1,624.32 |
| 6029235 | SUPPLY IMPLANT | Supply/Implant | $4,507.78 |
| 6029245 | INTEGRA BMWD SKIN SUB | Supply/Implant | $61,089.79 |
| 6029248 | SUPPLY IMPLANT | Supply/Implant | $582.40 |
| 6029252 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,624.00 |
| 6029254 | MESH (IMPLANTABLE) | Supply/Implant | $9,689.60 |
| 6029255 | MESH (IMPLANTABLE) | Supply/Implant | $35,089.34 |
| 6029257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6029258 | SUPPLY IMPLANT | Supply/Implant | $38,912.00 |
| 6029260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6029274 | SUPPLY IMPLANT | Supply/Implant | $13,141.76 |
| 6029276 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029284 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029285 | PROSTHETIC IMPLANT NOS | Supply/Implant | $37,964.80 |
| 6029287 | SUPPLY IMPLANT | Supply/Implant | $5,669.47 |
| 6029288 | SUPPLY IMPLANT | Supply/Implant | $766.11 |
| 6029289 | SUPPLY IMPLANT | Supply/Implant | $651.26 |
| 6029295 | PROSTHETIC IMPLANT NOS | Supply/Implant | $37,964.80 |
| 6029296 | SUPPLY IMPLANT | Supply/Implant | $4,963.97 |
| 6029297 | SUPPLY IMPLANT | Supply/Implant | $4,427.78 |
| 6029303 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $59,939.84 |
| 6029304 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029305 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029306 | SUPPLY IMPLANT | Supply/Implant | $2,461.57 |
| 6029310 | SUPPLY IMPLANT | Supply/Implant | $620.84 |
| 6029311 | SUPPLY IMPLANT | Supply/Implant | $907.67 |
| 6029312 | SUPPLY IMPLANT | Supply/Implant | $611.84 |
| 6029313 | SUPPLY IMPLANT | Supply/Implant | $907.67 |
| 6029314 | SUPPLY IMPLANT | Supply/Implant | $1,181.22 |
| 6029315 | SUPPLY IMPLANT | Supply/Implant | $1,740.71 |
| 6029316 | SUPPLY IMPLANT | Supply/Implant | $2,208.90 |
| 6029317 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6029319 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,070.59 |
| 6029323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6029324 | GRAFT, VASCULAR | Supply/Implant | $16,153.60 |
| 6029327 | STERILE SUPPLY | Supply/Implant | $15,086.08 |
| 6029330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6029331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.80 |
| 6029333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029335 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6029342 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $3,697.92 |
| 6029343 | SUPPLY IMPLANT | Supply/Implant | $3,698.05 |
| 6029344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6029354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,139.20 |
| 6029355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029362 | SUPPLY IMPLANT | Supply/Implant | $6,179.58 |
| 6029366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6029369 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6029371 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6029372 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6029373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6029374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6029378 | MESH (IMPLANTABLE) | Supply/Implant | $5,670.40 |
| 6029379 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6029380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,966.72 |
| 6029385 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,152.00 |
| 6029387 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6029389 | INTRO/SHEATH, NON-LASER | Supply/Implant | $668.16 |
| 6029390 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6029393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,315.20 |
| 6029396 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,547.20 |
| 6029403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6029410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6029413 | MESH (IMPLANTABLE) | Supply/Implant | $6,310.40 |
| 6029415 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $52,915.20 |
| 6029418 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6029422 | GENERAL SUPPLY | Supply/Implant | $358.27 |
| 6029424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6029426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6029430 | SUPPLY IMPLANT | Supply/Implant | $14,720.00 |
| 6029434 | SUPPLY IMPLANT | Supply/Implant | $3,975.94 |
| 6029436 | SUPPLY IMPLANT | Supply/Implant | $1,308.16 |
| 6029439 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6029444 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6029446 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $31,744.00 |
| 6029447 | SUPPLY IMPLANT | Supply/Implant | $3,975.94 |
| 6029448 | SUPPLY IMPLANT | Supply/Implant | $3,911.04 |
| 6029457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,572.80 |
| 6029460 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $91,468.80 |
| 6029464 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029466 | SUPPLY IMPLANT | Supply/Implant | $4,000.64 |
| 6029468 | INTRO/SHEATH, NON-LASER | Supply/Implant | $476.93 |
| 6029472 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029473 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029474 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $6,336.00 |
| 6029476 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6029477 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6029478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,660.42 |
| 6029484 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6029485 | GUIDE WIRE | Supply/Implant | $1,088.00 |
| 6029487 | SUPPLY IMPLANT | Supply/Implant | $5,470.72 |
| 6029488 | EMBOLIZATION PROTECT SYST | Supply/Implant | $23,680.00 |
| 6029494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,945.60 |
| 6029496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6029498 | INTRO/SHEATH, NON-LASER | Supply/Implant | $268.80 |
| 6029517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6029521 | LEAD, NEUROSTIMULATOR | Supply/Implant | $33,024.00 |
| 6029527 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $34,560.00 |
| 6029567 | SUPPLY IMPLANT | Supply/Implant | $490.42 |
| 6029580 | GENERAL SUPPLY | Supply/Implant | $1,353.60 |
| 6029582 | GENERAL SUPPLY | Supply/Implant | $1,039.74 |
| 6029583 | GENERAL SUPPLY | Supply/Implant | $1,307.14 |
| 6029584 | GENERAL SUPPLY | Supply/Implant | $1,795.58 |
| 6029585 | STERILE SUPPLY | Supply/Implant | $1,860.10 |
| 6029588 | STERILE SUPPLY | Supply/Implant | $535.04 |
| 6029592 | SUPPLY IMPLANT | Supply/Implant | $3,279.36 |
| 6029593 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6029594 | SUPPLY IMPLANT | Supply/Implant | $1,666.56 |
| 6029595 | SUPPLY IMPLANT | Supply/Implant | $1,666.56 |
| 6029597 | INTRO/SHEATH, NON-LASER | Supply/Implant | $559.10 |
| 6029623 | GENERAL SUPPLY | Supply/Implant | $220.42 |
| 6029627 | STERILE SUPPLY | Supply/Implant | $260.10 |
| 6029631 | GENERAL SUPPLY | Supply/Implant | $873.34 |
| 6029632 | GENERAL SUPPLY | Supply/Implant | $2,795.39 |
| 6029633 | GENERAL SUPPLY | Supply/Implant | $1,027.71 |
| 6029634 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6029635 | SUPPLY IMPLANT | Supply/Implant | $2,343.94 |
| 6029637 | SUPPLY IMPLANT | Supply/Implant | $145.15 |
| 6029638 | SUPPLY IMPLANT | Supply/Implant | $343.94 |
| 6029640 | GENERAL SUPPLY | Supply/Implant | $2,009.86 |
| 6029641 | GENERAL SUPPLY | Supply/Implant | $991.23 |
| 6029642 | GENERAL SUPPLY | Supply/Implant | $2,353.92 |
| 6029643 | GENERAL SUPPLY | Supply/Implant | $1,085.82 |
| 6029645 | STERILE SUPPLY | Supply/Implant | $1,989.63 |
| 6029648 | GENERAL SUPPLY | Supply/Implant | $2,379.01 |
| 6029649 | GENERAL SUPPLY | Supply/Implant | $834.18 |
| 6029650 | STERILE SUPPLY | Supply/Implant | $1,413.25 |
| 6029651 | GENERAL SUPPLY | Supply/Implant | $1,687.55 |
| 6029652 | GENERAL SUPPLY | Supply/Implant | $2,022.27 |
| 6029653 | GENERAL SUPPLY | Supply/Implant | $1,386.50 |
| 6029654 | STERILE SUPPLY | Supply/Implant | $786.18 |
| 6029655 | GENERAL SUPPLY | Supply/Implant | $603.90 |
| 6029656 | GENERAL SUPPLY | Supply/Implant | $507.65 |
| 6029657 | GENERAL SUPPLY | Supply/Implant | $838.27 |
| 6029658 | CATHETER, URETERAL | Supply/Implant | $1,350.02 |
| 6029659 | CATHETER, URETERAL | Supply/Implant | $967.68 |
| 6029664 | GENERAL SUPPLY | Supply/Implant | $1,447.55 |
| 6029670 | SUPPLY IMPLANT | Supply/Implant | $197.89 |
| 6029671 | STERILE SUPPLY | Supply/Implant | $934.40 |
| 6029672 | SUPPLY IMPLANT | Supply/Implant | $971.65 |
| 6029676 | GENERAL SUPPLY | Supply/Implant | $2,094.66 |
| 6029677 | SUPPLY IMPLANT | Supply/Implant | $1,095.33 |
| 6029678 | GENERAL SUPPLY | Supply/Implant | $429.76 |
| 6029679 | SUPPLY IMPLANT | Supply/Implant | $2,744.79 |
| 6029681 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,225.60 |
| 6029682 | STERILE SUPPLY | Supply/Implant | $285.70 |
| 6029689 | SUPPLY IMPLANT | Supply/Implant | $226.00 |
| 6029696 | GENERAL DRUG | Supply/Implant | $270.59 |
| 6029711 | STERILE SUPPLY | Supply/Implant | $169.22 |
| 6029715 | GENERAL SUPPLY | Supply/Implant | $727.42 |
| 6029716 | GENERAL SUPPLY | Supply/Implant | $706.18 |
| 6029721 | STERILE SUPPLY | Supply/Implant | $195.07 |
| 6029738 | GENERAL SUPPLY | Supply/Implant | $282.75 |
| 6029741 | CATHETER, URETERAL | Supply/Implant | $195.84 |
| 6029750 | GENERAL SUPPLY | Supply/Implant | $480.77 |
| 6029765 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6029766 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $721.02 |
| 6029776 | STERILE SUPPLY | Supply/Implant | $155.14 |
| 6029779 | STERILE SUPPLY | Supply/Implant | $177.38 |
| 6029787 | STERILE SUPPLY | Supply/Implant | $163.33 |
| 6029789 | STERILE SUPPLY | Supply/Implant | $166.78 |
| 6029790 | STERILE SUPPLY | Supply/Implant | $180.52 |
| 6029796 | STERILE SUPPLY | Supply/Implant | $181.41 |
| 6029797 | STERILE SUPPLY | Supply/Implant | $197.76 |
| 6029798 | STERILE SUPPLY | Supply/Implant | $198.78 |
| 6029831 | STERILE SUPPLY | Supply/Implant | $249.86 |
| 6029846 | STERILE SUPPLY | Supply/Implant | $192.83 |
| 6029847 | STERILE SUPPLY | Supply/Implant | $238.03 |
| 6029853 | STERILE SUPPLY | Supply/Implant | $317.44 |
| 6029854 | STERILE SUPPLY | Supply/Implant | $228.48 |
| 6029857 | STERILE SUPPLY | Supply/Implant | $129.15 |
| 6029876 | STERILE SUPPLY | Supply/Implant | $135.94 |
| 6029877 | STERILE SUPPLY | Supply/Implant | $234.50 |
| 6029878 | STERILE SUPPLY | Supply/Implant | $183.30 |
| 6029884 | STERILE SUPPLY | Supply/Implant | $150.30 |
| 6029887 | STERILE SUPPLY | Supply/Implant | $396.66 |
| 6029895 | STERILE SUPPLY | Supply/Implant | $162.21 |
| 6029898 | STERILE SUPPLY | Supply/Implant | $331.14 |
| 6029899 | STERILE SUPPLY | Supply/Implant | $338.83 |
| 6029900 | STERILE SUPPLY | Supply/Implant | $259.56 |
| 6029904 | STERILE SUPPLY | Supply/Implant | $307.20 |
| 6029905 | STERILE SUPPLY | Supply/Implant | $300.80 |
| 6029906 | STERILE SUPPLY | Supply/Implant | $332.44 |
| 6029907 | STERILE SUPPLY | Supply/Implant | $307.20 |
| 6029908 | STERILE SUPPLY | Supply/Implant | $2,959.36 |
| 6029910 | STERILE SUPPLY | Supply/Implant | $155.14 |
| 6029929 | STERILE SUPPLY | Supply/Implant | $216.79 |
| 6029932 | STERILE SUPPLY | Supply/Implant | $228.48 |
| 6029933 | STERILE SUPPLY | Supply/Implant | $247.04 |
| 6029935 | STERILE SUPPLY | Supply/Implant | $129.47 |
| 6029936 | STERILE SUPPLY | Supply/Implant | $770.28 |
| 6029937 | STERILE SUPPLY | Supply/Implant | $193.51 |
| 6029938 | STERILE SUPPLY | Supply/Implant | $812.84 |
| 6029939 | STERILE SUPPLY | Supply/Implant | $810.65 |
| 6029940 | STERILE SUPPLY | Supply/Implant | $203.19 |
| 6029941 | STERILE SUPPLY | Supply/Implant | $887.80 |
| 6029942 | STERILE SUPPLY | Supply/Implant | $919.85 |
| 6029943 | STERILE SUPPLY | Supply/Implant | $919.72 |
| 6029944 | STERILE SUPPLY | Supply/Implant | $727.81 |
| 6029945 | STERILE SUPPLY | Supply/Implant | $374.27 |
| 6029952 | SUPPLY IMPLANT | Supply/Implant | $1,902.94 |
| 6029954 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6029960 | STERILE SUPPLY | Supply/Implant | $204.80 |
| 6029962 | STERILE SUPPLY | Supply/Implant | $198.66 |
| 6029963 | STERILE SUPPLY | Supply/Implant | $290.02 |
| 6029975 | STERILE SUPPLY | Supply/Implant | $264.65 |
| 6029981 | SUPPLY IMPLANT | Supply/Implant | $204.16 |
| 6029982 | SUPPLY IMPLANT | Supply/Implant | $219.90 |
| 6029983 | SUPPLY IMPLANT | Supply/Implant | $290.75 |
| 6029984 | SUPPLY IMPLANT | Supply/Implant | $290.82 |
| 6029986 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,419.20 |
| 6029987 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,419.20 |
| 6029989 | GENERAL SUPPLY | Supply/Implant | $243.84 |
| 6029992 | SUPPLY IMPLANT | Supply/Implant | $137.34 |
| 6030006 | SUPPLY IMPLANT | Supply/Implant | $1,459.07 |
| 6030008 | STERILE SUPPLY | Supply/Implant | $149.12 |
| 6030009 | SUPPLY IMPLANT | Supply/Implant | $2,863.85 |
| 6030014 | SUPPLY IMPLANT | Supply/Implant | $309.76 |
| 6030015 | SUPPLY IMPLANT | Supply/Implant | $974.72 |
| 6030016 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6030018 | SUPPLY IMPLANT | Supply/Implant | $232.41 |
| 6030019 | CATHETER, URETERAL | Supply/Implant | $237.18 |
| 6030022 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6030023 | CATHETER, URETERAL | Supply/Implant | $258.20 |
| 6030024 | SUPPLY IMPLANT | Supply/Implant | $241.28 |
| 6030029 | CATHETER, URETERAL | Supply/Implant | $239.36 |
| 6030030 | SUPPLY IMPLANT | Supply/Implant | $11,129.60 |
| 6030031 | CATHETER, URETERAL | Supply/Implant | $146.82 |
| 6030032 | CATHETER, URETERAL | Supply/Implant | $146.82 |
| 6030034 | CATHETER, URETERAL | Supply/Implant | $228.22 |
| 6030035 | CATHETER, URETERAL | Supply/Implant | $228.22 |
| 6030036 | SUPPLY IMPLANT | Supply/Implant | $146.18 |
| 6030037 | SUPPLY IMPLANT | Supply/Implant | $188.03 |
| 6030038 | SUPPLY IMPLANT | Supply/Implant | $188.03 |
| 6030039 | SUPPLY IMPLANT | Supply/Implant | $159.62 |
| 6030042 | CATHETER, URETERAL | Supply/Implant | $391.68 |
| 6030043 | SUPPLY IMPLANT | Supply/Implant | $391.68 |
| 6030044 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6030045 | CATHETER, URETERAL | Supply/Implant | $294.91 |
| 6030046 | CATHETER, URETERAL | Supply/Implant | $282.75 |
| 6030048 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6030049 | CATH, DRAINAGE | Supply/Implant | $291.33 |
| 6030050 | CATHETER, URETERAL | Supply/Implant | $152.32 |
| 6030067 | LOCM 100-199MG/ML IODINE,1ML | Supply/Implant | $517.50 |
| 6030082 | SUPPLY IMPLANT | Supply/Implant | $440.65 |
| 6030083 | GENERAL SUPPLY | Supply/Implant | $2,844.29 |
| 6030104 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6030105 | GENERAL SUPPLY | Supply/Implant | $231.68 |
| 6030108 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6030115 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6030116 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6030119 | SUPPLY IMPLANT | Supply/Implant | $605.16 |
| 6030121 | SUPPLY IMPLANT | Supply/Implant | $1,833.34 |
| 6030122 | SUPPLY IMPLANT | Supply/Implant | $489.89 |
| 6030123 | GENERAL SUPPLY | Supply/Implant | $678.40 |
| 6030125 | GENERAL SUPPLY | Supply/Implant | $186.88 |
| 6030126 | SUPPLY IMPLANT | Supply/Implant | $3,001.22 |
| 6030137 | SUPPLY IMPLANT | Supply/Implant | $378.62 |
| 6030143 | GENERAL SUPPLY | Supply/Implant | $141.82 |
| 6030153 | SUPPLY IMPLANT | Supply/Implant | $298.24 |
| 6030159 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6030160 | GENERAL SUPPLY | Supply/Implant | $829.39 |
| 6030161 | GENERAL SUPPLY | Supply/Implant | $700.86 |
| 6030164 | SUPPLY IMPLANT | Supply/Implant | $133.38 |
| 6030169 | CATHETER, URETERAL | Supply/Implant | $319.36 |
| 6030170 | SUPPLY IMPLANT | Supply/Implant | $160.38 |
| 6030174 | SUPPLY IMPLANT | Supply/Implant | $723.97 |
| 6030176 | SUPPLY IMPLANT | Supply/Implant | $249.22 |
| 6030178 | SUPPLY IMPLANT | Supply/Implant | $511.36 |
| 6030179 | GENERAL SUPPLY | Supply/Implant | $177.60 |
| 6030180 | CATHETER, URETERAL | Supply/Implant | $181.76 |
| 6030185 | STERILE SUPPLY | Supply/Implant | $140.42 |
| 6030194 | SUPPLY IMPLANT | Supply/Implant | $852.74 |
| 6030195 | STERILE SUPPLY | Supply/Implant | $540.16 |
| 6030196 | STERILE SUPPLY | Supply/Implant | $1,228.29 |
| 6030197 | STERILE SUPPLY | Supply/Implant | $1,066.11 |
| 6030199 | SUPPLY IMPLANT | Supply/Implant | $1,553.72 |
| 6030204 | STERILE SUPPLY | Supply/Implant | $1,413.89 |
| 6030205 | STERILE SUPPLY | Supply/Implant | $748.42 |
| 6030207 | STERILE SUPPLY | Supply/Implant | $3,504.90 |
| 6030210 | STERILE SUPPLY | Supply/Implant | $170.98 |
| 6030211 | GENERAL SUPPLY | Supply/Implant | $152.58 |
| 6030216 | SUPPLY IMPLANT | Supply/Implant | $652.80 |
| 6030217 | SUPPLY IMPLANT | Supply/Implant | $359.04 |
| 6030218 | SUPPLY IMPLANT | Supply/Implant | $563.20 |
| 6030219 | SUPPLY IMPLANT | Supply/Implant | $330.24 |
| 6030220 | SUPPLY IMPLANT | Supply/Implant | $321.15 |
| 6030223 | GENERAL SUPPLY | Supply/Implant | $225.98 |
| 6030232 | STERILE SUPPLY | Supply/Implant | $234.11 |
| 6030233 | STERILE SUPPLY | Supply/Implant | $179.20 |
| 6030251 | SUPPLY IMPLANT | Supply/Implant | $789.50 |
| 6030253 | GENERAL SUPPLY | Supply/Implant | $252.29 |
| 6030255 | SUPPLY IMPLANT | Supply/Implant | $666.62 |
| 6030256 | SUPPLY IMPLANT | Supply/Implant | $338.69 |
| 6030260 | SUPPLY IMPLANT | Supply/Implant | $633.98 |
| 6030262 | SUPPLY IMPLANT | Supply/Implant | $556.80 |
| 6030263 | SUPPLY IMPLANT | Supply/Implant | $282.75 |
| 6030264 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6030270 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6030271 | SUPPLY IMPLANT | Supply/Implant | $376.32 |
| 6030272 | SUPPLY IMPLANT | Supply/Implant | $376.32 |
| 6030274 | SUPPLY IMPLANT | Supply/Implant | $1,217.28 |
| 6030276 | SUPPLY IMPLANT | Supply/Implant | $1,304.06 |
| 6030282 | SUPPLY IMPLANT | Supply/Implant | $484.22 |
| 6030282 | SUPPLY IMPLANT | Supply/Implant | $547.66 |
| 6030283 | CATHETER, URETERAL | Supply/Implant | $177.05 |
| 6030293 | SUPPLY IMPLANT | Supply/Implant | $830.85 |
| 6030294 | GENERAL SUPPLY | Supply/Implant | $211.20 |
| 6030298 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6030301 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6030306 | GENERAL SUPPLY | Supply/Implant | $134.53 |
| 6030312 | STERILE SUPPLY | Supply/Implant | $416.03 |
| 6030313 | SUPPLY IMPLANT | Supply/Implant | $775.68 |
| 6030317 | GENERAL SUPPLY | Supply/Implant | $180.99 |
| 6030321 | SUPPLY IMPLANT | Supply/Implant | $2,549.09 |
| 6030323 | SUPPLY IMPLANT | Supply/Implant | $2,662.14 |
| 6030328 | STERILE SUPPLY | Supply/Implant | $496.00 |
| 6030333 | SUPPLY IMPLANT | Supply/Implant | $633.98 |
| 6030334 | SUPPLY IMPLANT | Supply/Implant | $2,605.82 |
| 6030338 | SUPPLY IMPLANT | Supply/Implant | $2,290.23 |
| 6030339 | SUPPLY IMPLANT | Supply/Implant | $2,754.18 |
| 6030340 | STERILE SUPPLY | Supply/Implant | $244.06 |
| 6030343 | STERILE SUPPLY | Supply/Implant | $129.09 |
| 6030347 | STERILE SUPPLY | Supply/Implant | $1,587.84 |
| 6030348 | STERILE SUPPLY | Supply/Implant | $1,606.78 |
| 6030349 | STERILE SUPPLY | Supply/Implant | $1,987.97 |
| 6030350 | STERILE SUPPLY | Supply/Implant | $855.42 |
| 6030351 | STERILE SUPPLY | Supply/Implant | $1,151.74 |
| 6030352 | STERILE SUPPLY | Supply/Implant | $1,231.62 |
| 6030354 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030355 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030356 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030357 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6030359 | SUPPLY IMPLANT | Supply/Implant | $1,304.06 |
| 6030362 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6030364 | SUPPLY IMPLANT | Supply/Implant | $569.09 |
| 6030365 | STERILE SUPPLY | Supply/Implant | $1,349.89 |
| 6030368 | SUPPLY IMPLANT | Supply/Implant | $825.34 |
| 6030370 | STERILE SUPPLY | Supply/Implant | $222.08 |
| 6030372 | SUPPLY IMPLANT | Supply/Implant | $290.82 |
| 6030373 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6030374 | SUPPLY IMPLANT | Supply/Implant | $3,820.80 |
| 6030376 | GENERAL SUPPLY | Supply/Implant | $228.48 |
| 6030377 | SUPPLY IMPLANT | Supply/Implant | $273.64 |
| 6030379 | STERILE SUPPLY | Supply/Implant | $246.40 |
| 6030381 | STERILE SUPPLY | Supply/Implant | $165.70 |
| 6030383 | SUPPLY IMPLANT | Supply/Implant | $566.14 |
| 6030388 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6030390 | SUPPLY IMPLANT | Supply/Implant | $259.84 |
| 6030391 | SUPPLY IMPLANT | Supply/Implant | $152.32 |
| 6030395 | SUPPLY IMPLANT | Supply/Implant | $511.63 |
| 6030397 | SUPPLY IMPLANT | Supply/Implant | $211.46 |
| 6030400 | STERILE SUPPLY | Supply/Implant | $136.83 |
| 6030402 | GENERAL SUPPLY | Supply/Implant | $275.20 |
| 6030403 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6030408 | SUPPLY IMPLANT | Supply/Implant | $1,149.31 |
| 6030410 | SUPPLY IMPLANT | Supply/Implant | $507.52 |
| 6030414 | SUPPLY IMPLANT | Supply/Implant | $476.29 |
| 6030415 | GENERAL SUPPLY | Supply/Implant | $247.42 |
| 6030416 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6030418 | SUPPLY IMPLANT | Supply/Implant | $2,228.60 |
| 6030420 | STERILE SUPPLY | Supply/Implant | $157.82 |
| 6030421 | STERILE SUPPLY | Supply/Implant | $249.86 |
| 6030422 | STERILE SUPPLY | Supply/Implant | $2,134.40 |
| 6030423 | STERILE SUPPLY | Supply/Implant | $472.32 |
| 6030427 | STERILE SUPPLY | Supply/Implant | $1,407.74 |
| 6030430 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6030437 | STERILE SUPPLY | Supply/Implant | $290.05 |
| 6030439 | SUPPLY IMPLANT | Supply/Implant | $1,167.36 |
| 6030442 | STERILE SUPPLY | Supply/Implant | $2,104.19 |
| 6030445 | GENERAL SUPPLY | Supply/Implant | $876.80 |
| 6030446 | STERILE SUPPLY | Supply/Implant | $1,260.67 |
| 6030447 | GENERAL SUPPLY | Supply/Implant | $323.75 |
| 6030448 | STERILE SUPPLY | Supply/Implant | $1,428.65 |
| 6030450 | CATHETER, URETERAL | Supply/Implant | $137.73 |
| 6030452 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6030454 | SUPPLY IMPLANT | Supply/Implant | $2,965.63 |
| 6030457 | SUPPLY IMPLANT | Supply/Implant | $2,577.66 |
| 6030458 | SUPPLY IMPLANT | Supply/Implant | $228.48 |
| 6030462 | SUPPLY IMPLANT | Supply/Implant | $1,576.45 |
| 6030465 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $176.60 |
| 6030466 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6030468 | INTRO/SHEATH, NON-LASER | Supply/Implant | $304.64 |
| 6030469 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030470 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030472 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6030481 | SUPPLY IMPLANT | Supply/Implant | $4,772.01 |
| 6030483 | GENERAL SUPPLY | Supply/Implant | $257.86 |
| 6030488 | GENERAL SUPPLY | Supply/Implant | $135.17 |
| 6030490 | SUPPLY IMPLANT | Supply/Implant | $209.79 |
| 6030492 | INTRO/SHEATH, NON-LASER | Supply/Implant | $870.40 |
| 6030493 | SUPPLY IMPLANT | Supply/Implant | $412.03 |
| 6030495 | STERILE SUPPLY | Supply/Implant | $1,005.02 |
| 6030497 | CATHETER, URETERAL | Supply/Implant | $252.16 |
| 6030502 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6030504 | SUPPLY IMPLANT | Supply/Implant | $9,830.40 |
| 6030505 | SUPPLY IMPLANT | Supply/Implant | $797.70 |
| 6030507 | RET DEV, INSERTABLE | Supply/Implant | $5,056.00 |
| 6030508 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030509 | SUPPLY IMPLANT | Supply/Implant | $736.13 |
| 6030516 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6030517 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030518 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030519 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030526 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6030529 | SUPPLY IMPLANT | Supply/Implant | $2,739.20 |
| 6030533 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6030535 | STERILE SUPPLY | Supply/Implant | $130.56 |
| 6030536 | SUPPLY IMPLANT | Supply/Implant | $1,389.44 |
| 6030538 | SUPPLY IMPLANT | Supply/Implant | $214.66 |
| 6030539 | STERILE SUPPLY | Supply/Implant | $130.56 |
| 6030541 | STERILE SUPPLY | Supply/Implant | $232.83 |
| 6030542 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6030543 | SUPPLY IMPLANT | Supply/Implant | $1,131.14 |
| 6030548 | SUPPLY IMPLANT | Supply/Implant | $649.92 |
| 6030551 | SUPPLY IMPLANT | Supply/Implant | $146.94 |
| 6030552 | SUPPLY IMPLANT | Supply/Implant | $5,090.69 |
| 6030556 | STERILE SUPPLY | Supply/Implant | $1,273.09 |
| 6030557 | STERILE SUPPLY | Supply/Implant | $705.66 |
| 6030561 | SUPPLY IMPLANT | Supply/Implant | $1,952.06 |
| 6030562 | GENERAL SUPPLY | Supply/Implant | $727.81 |
| 6030564 | STERILE SUPPLY | Supply/Implant | $887.80 |
| 6030571 | SUPPLY IMPLANT | Supply/Implant | $3,238.02 |
| 6030572 | SUPPLY IMPLANT | Supply/Implant | $2,368.68 |
| 6030575 | STERILE SUPPLY | Supply/Implant | $358.40 |
| 6030576 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030578 | SUPPLY IMPLANT | Supply/Implant | $686.46 |
| 6030582 | SUPPLY IMPLANT | Supply/Implant | $833.28 |
| 6030583 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6030584 | SUPPLY IMPLANT | Supply/Implant | $174.72 |
| 6030585 | STERILE SUPPLY | Supply/Implant | $170.62 |
| 6030586 | SUPPLY IMPLANT | Supply/Implant | $682.62 |
| 6030587 | SUPPLY IMPLANT | Supply/Implant | $619.52 |
| 6030590 | SUPPLY IMPLANT | Supply/Implant | $1,517.82 |
| 6030592 | SUPPLY IMPLANT | Supply/Implant | $334.72 |
| 6030593 | SUPPLY IMPLANT | Supply/Implant | $302.08 |
| 6030598 | SUPPLY IMPLANT | Supply/Implant | $974.46 |
| 6030600 | STERILE SUPPLY | Supply/Implant | $364.16 |
| 6030602 | SUPPLY IMPLANT | Supply/Implant | $283.39 |
| 6030604 | GENERAL SUPPLY | Supply/Implant | $129.79 |
| 6030608 | GENERAL SUPPLY | Supply/Implant | $219.90 |
| 6030613 | SUPPLY IMPLANT | Supply/Implant | $5,249.66 |
| 6030615 | SUPPLY IMPLANT | Supply/Implant | $5,249.66 |
| 6030617 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030618 | SUPPLY IMPLANT | Supply/Implant | $316.80 |
| 6030619 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6030620 | GENERAL SUPPLY | Supply/Implant | $476.03 |
| 6030622 | SUPPLY IMPLANT | Supply/Implant | $2,916.10 |
| 6030624 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030626 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030627 | SUPPLY IMPLANT | Supply/Implant | $598.14 |
| 6030634 | SUPPLY IMPLANT | Supply/Implant | $2,522.34 |
| 6030637 | GENERAL SUPPLY | Supply/Implant | $801.66 |
| 6030639 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6030640 | SUPPLY IMPLANT | Supply/Implant | $2,922.11 |
| 6030643 | SUPPLY IMPLANT | Supply/Implant | $1,081.09 |
| 6030652 | SUPPLY IMPLANT | Supply/Implant | $241.41 |
| 6030653 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $189.95 |
| 6030656 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6030658 | SUPPLY IMPLANT | Supply/Implant | $737.41 |
| 6030661 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6030663 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,989.06 |
| 6030664 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6030665 | SUPPLY IMPLANT | Supply/Implant | $1,903.87 |
| 6030667 | STERILE SUPPLY | Supply/Implant | $1,079.33 |
| 6030668 | STERILE SUPPLY | Supply/Implant | $308.99 |
| 6030669 | SUPPLY IMPLANT | Supply/Implant | $444.42 |
| 6030681 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030682 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030683 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6030684 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030686 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030687 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030688 | SUPPLY IMPLANT | Supply/Implant | $1,012.48 |
| 6030690 | STERILE SUPPLY | Supply/Implant | $288.90 |
| 6030691 | GENERAL SUPPLY | Supply/Implant | $360.06 |
| 6030692 | SUPPLY IMPLANT | Supply/Implant | $2,316.80 |
| 6030693 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6030695 | SUPPLY IMPLANT | Supply/Implant | $5,126.66 |
| 6030701 | STERILE SUPPLY | Supply/Implant | $584.58 |
| 6030703 | CATHETER, GUIDING | Supply/Implant | $1,648.38 |
| 6030707 | SUPPLY IMPLANT | Supply/Implant | $8,585.47 |
| 6030709 | SUPPLY IMPLANT | Supply/Implant | $747.78 |
| 6030711 | GENERAL SUPPLY | Supply/Implant | $373.12 |
| 6030713 | SUPPLY IMPLANT | Supply/Implant | $1,881.60 |
| 6030714 | SUPPLY IMPLANT | Supply/Implant | $1,089.15 |
| 6030715 | SUPPLY IMPLANT | Supply/Implant | $2,283.01 |
| 6030716 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6030718 | SUPPLY IMPLANT | Supply/Implant | $1,243.52 |
| 6030721 | SUPPLY IMPLANT | Supply/Implant | $961.54 |
| 6030722 | SUPPLY IMPLANT | Supply/Implant | $4,560.00 |
| 6030724 | SUPPLY IMPLANT | Supply/Implant | $995.33 |
| 6030725 | STERILE SUPPLY | Supply/Implant | $382.59 |
| 6030730 | STERILE SUPPLY | Supply/Implant | $207.74 |
| 6030733 | SUPPLY IMPLANT | Supply/Implant | $316.88 |
| 6030734 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6030738 | SUPPLY IMPLANT | Supply/Implant | $199.30 |
| 6030739 | SUPPLY IMPLANT | Supply/Implant | $4,851.84 |
| 6030740 | SUPPLY IMPLANT | Supply/Implant | $1,404.54 |
| 6030742 | GENERAL SUPPLY | Supply/Implant | $308.99 |
| 6030746 | STERILE SUPPLY | Supply/Implant | $380.01 |
| 6030747 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6030748 | STERILE SUPPLY | Supply/Implant | $453.95 |
| 6030749 | GENERAL SUPPLY | Supply/Implant | $211.20 |
| 6030750 | SUPPLY IMPLANT | Supply/Implant | $1,434.37 |
| 6030751 | SUPPLY IMPLANT | Supply/Implant | $1,434.37 |
| 6030752 | SUPPLY IMPLANT | Supply/Implant | $361.34 |
| 6030752 | SUPPLY IMPLANT | Supply/Implant | $461.57 |
| 6030755 | STERILE SUPPLY | Supply/Implant | $158.21 |
| 6030756 | STERILE SUPPLY | Supply/Implant | $157.44 |
| 6030757 | GENERAL SUPPLY | Supply/Implant | $155.14 |
| 6030758 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6030759 | STERILE SUPPLY | Supply/Implant | $140.65 |
| 6030762 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6030763 | CATHETER, URETERAL | Supply/Implant | $162.15 |
| 6030764 | GENERAL SUPPLY | Supply/Implant | $711.68 |
| 6030766 | SUPPLY IMPLANT | Supply/Implant | $195.56 |
| 6030769 | STERILE SUPPLY | Supply/Implant | $482.82 |
| 6030772 | STERILE SUPPLY | Supply/Implant | $165.93 |
| 6030775 | GENERAL SUPPLY | Supply/Implant | $619.01 |
| 6030777 | SUPPLY IMPLANT | Supply/Implant | $393.60 |
| 6030778 | SUPPLY IMPLANT | Supply/Implant | $1,767.59 |
| 6030783 | STERILE SUPPLY | Supply/Implant | $262.66 |
| 6030784 | STERILE SUPPLY | Supply/Implant | $250.88 |
| 6030787 | SUPPLY IMPLANT | Supply/Implant | $160.90 |
| 6030792 | SUPPLY IMPLANT | Supply/Implant | $212.74 |
| 6030795 | SUPPLY IMPLANT | Supply/Implant | $1,079.96 |
| 6030802 | SUPPLY IMPLANT | Supply/Implant | $224.90 |
| 6030803 | SUPPLY IMPLANT | Supply/Implant | $154.62 |
| 6030804 | GENERAL SUPPLY | Supply/Implant | $751.87 |
| 6030805 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6030807 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,279.36 |
| 6030818 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6030820 | SUPPLY IMPLANT | Supply/Implant | $5,241.60 |
| 6030822 | SUPPLY IMPLANT | Supply/Implant | $799.62 |
| 6030832 | SUPPLY IMPLANT | Supply/Implant | $1,355.01 |
| 6030836 | SUPPLY IMPLANT | Supply/Implant | $1,434.37 |
| 6030839 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6030840 | STERILE SUPPLY | Supply/Implant | $229.95 |
| 6030857 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6030860 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6030861 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6030862 | GENERAL SUPPLY | Supply/Implant | $1,301.25 |
| 6030863 | STERILE SUPPLY | Supply/Implant | $681.34 |
| 6030872 | SUPPLY IMPLANT | Supply/Implant | $273.97 |
| 6030873 | SUPPLY IMPLANT | Supply/Implant | $273.97 |
| 6030874 | SUPPLY IMPLANT | Supply/Implant | $5,902.08 |
| 6030877 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6030878 | SUPPLY IMPLANT | Supply/Implant | $547.58 |
| 6030879 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6030883 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6030884 | SUPPLY IMPLANT | Supply/Implant | $541.31 |
| 6030900 | SUPPLY IMPLANT | Supply/Implant | $3,298.43 |
| 6030908 | GENERAL SUPPLY | Supply/Implant | $2,816.00 |
| 6030910 | SUPPLY IMPLANT | Supply/Implant | $3,047.63 |
| 6030913 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6030916 | SUPPLY IMPLANT | Supply/Implant | $258.56 |
| 6030918 | STERILE SUPPLY | Supply/Implant | $170.50 |
| 6030919 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $265.09 |
| 6030922 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $353.66 |
| 6030923 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $314.62 |
| 6030932 | GENERAL SUPPLY | Supply/Implant | $2,880.00 |
| 6030933 | SUPPLY IMPLANT | Supply/Implant | $258.56 |
| 6030935 | STERILE SUPPLY | Supply/Implant | $244.99 |
| 6030940 | GENERAL SUPPLY | Supply/Implant | $375.17 |
| 6030942 | CATHETER, URETERAL | Supply/Implant | $185.60 |
| 6030943 | CATHETER, URETERAL | Supply/Implant | $185.60 |
| 6030948 | SUPPLY IMPLANT | Supply/Implant | $9,369.60 |
| 6030949 | SUPPLY IMPLANT | Supply/Implant | $1,122.82 |
| 6030968 | STERILE SUPPLY | Supply/Implant | $5,132.16 |
| 6030970 | GENERAL SUPPLY | Supply/Implant | $608.26 |
| 6030973 | STERILE SUPPLY | Supply/Implant | $252.80 |
| 6030975 | SUPPLY IMPLANT | Supply/Implant | $4,098.05 |
| 6030976 | SUPPLY IMPLANT | Supply/Implant | $4,025.31 |
| 6030981 | STERILE SUPPLY | Supply/Implant | $248.06 |
| 6030985 | STERILE SUPPLY | Supply/Implant | $4,418.94 |
| 6030987 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6030992 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6030999 | INTRO/SHEATH, NON-LASER | Supply/Implant | $591.36 |
| 6031009 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6031011 | GENERAL SUPPLY | Supply/Implant | $152.55 |
| 6031015 | SUPPLY IMPLANT | Supply/Implant | $145.79 |
| 6031016 | SUPPLY IMPLANT | Supply/Implant | $169.22 |
| 6031018 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6031023 | SUPPLY IMPLANT | Supply/Implant | $1,033.34 |
| 6031024 | SUPPLY IMPLANT | Supply/Implant | $283.39 |
| 6031025 | CATHETER, URETERAL | Supply/Implant | $129.41 |
| 6031030 | SUPPLY IMPLANT | Supply/Implant | $374.14 |
| 6031031 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031032 | ADHESION BARRIER | Supply/Implant | $9,991.68 |
| 6031034 | GENERAL SUPPLY | Supply/Implant | $729.60 |
| 6031039 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031040 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031041 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031042 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031043 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6031052 | SUPPLY IMPLANT | Supply/Implant | $6,170.11 |
| 6031062 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6031065 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6031070 | SUPPLY IMPLANT | Supply/Implant | $841.93 |
| 6031080 | SUPPLY IMPLANT | Supply/Implant | $7,456.00 |
| 6031082 | SUPPLY IMPLANT | Supply/Implant | $977.73 |
| 6031086 | STERILE SUPPLY | Supply/Implant | $574.67 |
| 6031087 | SUPPLY IMPLANT | Supply/Implant | $642.56 |
| 6031088 | SUPPLY IMPLANT | Supply/Implant | $1,058.23 |
| 6031089 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031093 | SUPPLY IMPLANT | Supply/Implant | $316.80 |
| 6031096 | SUPPLY IMPLANT | Supply/Implant | $619.52 |
| 6031098 | SUPPLY IMPLANT | Supply/Implant | $3,820.80 |
| 6031108 | GUIDE WIRE | Supply/Implant | $3,387.78 |
| 6031112 | STERILE SUPPLY | Supply/Implant | $656.19 |
| 6031114 | SUPPLY IMPLANT | Supply/Implant | $2,789.18 |
| 6031117 | STERILE SUPPLY | Supply/Implant | $214.34 |
| 6031118 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6031119 | GENERAL SUPPLY | Supply/Implant | $620.80 |
| 6031123 | STERILE SUPPLY | Supply/Implant | $422.40 |
| 6031126 | SUPPLY IMPLANT | Supply/Implant | $367.87 |
| 6031127 | SUPPLY IMPLANT | Supply/Implant | $166.57 |
| 6031128 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6031130 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6031132 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031135 | GENERAL SUPPLY | Supply/Implant | $1,024.00 |
| 6031136 | SUPPLY IMPLANT | Supply/Implant | $3,257.86 |
| 6031141 | SUPPLY IMPLANT | Supply/Implant | $572.03 |
| 6031143 | SUPPLY IMPLANT | Supply/Implant | $956.01 |
| 6031144 | SUPPLY IMPLANT | Supply/Implant | $1,839.10 |
| 6031149 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6031150 | SUPPLY IMPLANT | Supply/Implant | $5,738.66 |
| 6031155 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6031159 | STERILE SUPPLY | Supply/Implant | $134.14 |
| 6031168 | STERILE SUPPLY | Supply/Implant | $734.72 |
| 6031171 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6031172 | SUPPLY IMPLANT | Supply/Implant | $917.38 |
| 6031173 | SUPPLY IMPLANT | Supply/Implant | $128.00 |
| 6031175 | STERILE SUPPLY | Supply/Implant | $1,676.80 |
| 6031181 | STERILE SUPPLY | Supply/Implant | $156.54 |
| 6031184 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6031185 | STERILE SUPPLY | Supply/Implant | $972.42 |
| 6031190 | SUPPLY IMPLANT | Supply/Implant | $1,635.84 |
| 6031192 | SUPPLY IMPLANT | Supply/Implant | $1,653.06 |
| 6031195 | SUPPLY IMPLANT | Supply/Implant | $3,644.48 |
| 6031196 | SUPPLY IMPLANT | Supply/Implant | $2,655.36 |
| 6031198 | STERILE SUPPLY | Supply/Implant | $204.16 |
| 6031201 | SUPPLY IMPLANT | Supply/Implant | $1,202.05 |
| 6031205 | SUPPLY IMPLANT | Supply/Implant | $3,993.60 |
| 6031206 | SUPPLY IMPLANT | Supply/Implant | $4,070.40 |
| 6031207 | GENERAL SUPPLY | Supply/Implant | $217.97 |
| 6031208 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6031209 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6031210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6031211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6031212 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6031215 | SUPPLY IMPLANT | Supply/Implant | $904.96 |
| 6031219 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6031225 | SUPPLY IMPLANT | Supply/Implant | $4,565.34 |
| 6031227 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6031228 | SUPPLY IMPLANT | Supply/Implant | $353.15 |
| 6031231 | STERILE SUPPLY | Supply/Implant | $357.12 |
| 6031234 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6031235 | GENERAL SUPPLY | Supply/Implant | $360.96 |
| 6031236 | GENERAL SUPPLY | Supply/Implant | $499.20 |
| 6031238 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $182.02 |
| 6031244 | GENERAL SUPPLY | Supply/Implant | $187.39 |
| 6031249 | STERILE SUPPLY | Supply/Implant | $273.97 |
| 6031251 | STERILE SUPPLY | Supply/Implant | $430.08 |
| 6031252 | SUPPLY IMPLANT | Supply/Implant | $50,585.60 |
| 6031253 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6031259 | STERILE SUPPLY | Supply/Implant | $150.18 |
| 6031263 | SUPPLY IMPLANT | Supply/Implant | $336.00 |
| 6031267 | GENERAL SUPPLY | Supply/Implant | $279.68 |
| 6031269 | SUPPLY IMPLANT | Supply/Implant | $7,677.06 |
| 6031272 | SUPPLY IMPLANT | Supply/Implant | $568.63 |
| 6031273 | SUPPLY IMPLANT | Supply/Implant | $568.63 |
| 6031274 | SUPPLY IMPLANT | Supply/Implant | $619.01 |
| 6031276 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,894.40 |
| 6031278 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,894.40 |
| 6031280 | SUPPLY IMPLANT | Supply/Implant | $1,753.60 |
| 6031283 | STERILE SUPPLY | Supply/Implant | $343.94 |
| 6031284 | LEAD, NEUROSTIMULATOR | Supply/Implant | $87,398.40 |
| 6031288 | SUPPLY IMPLANT | Supply/Implant | $1,434.11 |
| 6031289 | SUPPLY IMPLANT | Supply/Implant | $2,380.80 |
| 6031290 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6031291 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6031292 | STERILE SUPPLY | Supply/Implant | $984.52 |
| 6031297 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6031300 | STERILE SUPPLY | Supply/Implant | $193.15 |
| 6031302 | GENERAL SUPPLY | Supply/Implant | $1,164.80 |
| 6031303 | SUPPLY IMPLANT | Supply/Implant | $1,587.20 |
| 6031305 | SUPPLY IMPLANT | Supply/Implant | $445.18 |
| 6031307 | SUPPLY IMPLANT | Supply/Implant | $4,318.34 |
| 6031310 | STERILE SUPPLY | Supply/Implant | $172.29 |
| 6031312 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6031318 | STERILE SUPPLY | Supply/Implant | $756.61 |
| 6031320 | STERILE SUPPLY | Supply/Implant | $976.90 |
| 6031321 | SUPPLY IMPLANT | Supply/Implant | $2,736.64 |
| 6031322 | SUPPLY IMPLANT | Supply/Implant | $6,715.90 |
| 6031325 | SUPPLY IMPLANT | Supply/Implant | $3,233.82 |
| 6031339 | SUPPLY IMPLANT | Supply/Implant | $938.62 |
| 6031344 | GENERAL SUPPLY | Supply/Implant | $364.80 |
| 6031348 | SUPPLY IMPLANT | Supply/Implant | $1,196.93 |
| 6031351 | SUPPLY IMPLANT | Supply/Implant | $1,931.01 |
| 6031353 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6031354 | SUPPLY IMPLANT | Supply/Implant | $5,735.42 |
| 6031355 | SUPPLY IMPLANT | Supply/Implant | $649.98 |
| 6031358 | SUPPLY IMPLANT | Supply/Implant | $863.74 |
| 6031359 | SUPPLY IMPLANT | Supply/Implant | $710.14 |
| 6031360 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6031361 | SUPPLY IMPLANT | Supply/Implant | $1,587.20 |
| 6031368 | GENERAL SUPPLY | Supply/Implant | $1,344.00 |
| 6031372 | SUPPLY IMPLANT | Supply/Implant | $668.42 |
| 6031373 | SUPPLY IMPLANT | Supply/Implant | $1,178.75 |
| 6031376 | SUPPLY IMPLANT | Supply/Implant | $1,405.57 |
| 6031382 | SUPPLY IMPLANT | Supply/Implant | $297.60 |
| 6031385 | SUPPLY IMPLANT | Supply/Implant | $338.39 |
| 6031387 | STERILE SUPPLY | Supply/Implant | $281.60 |
| 6031388 | GENERAL SUPPLY | Supply/Implant | $564.22 |
| 6031391 | SUPPLY IMPLANT | Supply/Implant | $146.48 |
| 6031391 | SUPPLY IMPLANT | Supply/Implant | $149.58 |
| 6031393 | STERILE SUPPLY | Supply/Implant | $456.06 |
| 6031396 | SUPPLY IMPLANT | Supply/Implant | $188.42 |
| 6031398 | SUPPLY IMPLANT | Supply/Implant | $1,375.00 |
| 6031399 | STERILE SUPPLY | Supply/Implant | $214.66 |
| 6031401 | SUPPLY IMPLANT | Supply/Implant | $336.13 |
| 6031402 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6031409 | SUPPLY IMPLANT | Supply/Implant | $809.86 |
| 6031414 | SUPPLY IMPLANT | Supply/Implant | $135.81 |
| 6031415 | SUPPLY IMPLANT | Supply/Implant | $4,642.56 |
| 6031417 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,881.54 |
| 6031418 | STERILE SUPPLY | Supply/Implant | $493.95 |
| 6031419 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6031421 | SUPPLY IMPLANT | Supply/Implant | $302.08 |
| 6031422 | SUPPLY IMPLANT | Supply/Implant | $719.87 |
| 6031424 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6031426 | SUPPLY IMPLANT | Supply/Implant | $2,590.08 |
| 6031429 | STERILE SUPPLY | Supply/Implant | $303.36 |
| 6031433 | STERILE SUPPLY | Supply/Implant | $1,408.00 |
| 6031437 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6031438 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6031441 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6031442 | STERILE SUPPLY | Supply/Implant | $1,943.42 |
| 6031443 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $29,440.00 |
| 6031444 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $34,560.00 |
| 6031445 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6031446 | STERILE SUPPLY | Supply/Implant | $691.20 |
| 6031452 | SUPPLY IMPLANT | Supply/Implant | $5,165.44 |
| 6031453 | SUPPLY IMPLANT | Supply/Implant | $5,165.44 |
| 6031454 | SUPPLY IMPLANT | Supply/Implant | $2,378.11 |
| 6031456 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $6,813.76 |
| 6031463 | SUPPLY IMPLANT | Supply/Implant | $1,653.50 |
| 6031467 | SUPPLY IMPLANT | Supply/Implant | $1,095.33 |
| 6031468 | SUPPLY IMPLANT | Supply/Implant | $584.17 |
| 6031471 | SUPPLY IMPLANT | Supply/Implant | $4,984.96 |
| 6031482 | SUPPLY IMPLANT | Supply/Implant | $11,175.91 |
| 6031483 | SUPPLY IMPLANT | Supply/Implant | $10,476.06 |
| 6031494 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6031497 | STERILE SUPPLY | Supply/Implant | $293.25 |
| 6031500 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6031506 | STERILE SUPPLY | Supply/Implant | $550.40 |
| 6031510 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6031511 | SUPPLY IMPLANT | Supply/Implant | $5,067.01 |
| 6031512 | STERILE SUPPLY | Supply/Implant | $145.15 |
| 6031513 | GENERAL DRUG | Supply/Implant | $893.44 |
| 6031515 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,350.40 |
| 6031520 | STERILE SUPPLY | Supply/Implant | $761.34 |
| 6031524 | STERILE SUPPLY | Supply/Implant | $257.15 |
| 6031531 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6031536 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6031539 | SUPPLY IMPLANT | Supply/Implant | $606.67 |
| 6031545 | STERILE SUPPLY | Supply/Implant | $627.84 |
| 6031550 | CATHETER, URETERAL | Supply/Implant | $240.00 |
| 6031558 | SUPPLY IMPLANT | Supply/Implant | $158.46 |
| 6031559 | SUPPLY IMPLANT | Supply/Implant | $158.46 |
| 6031560 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6031566 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6031568 | CATHETER, URETERAL | Supply/Implant | $137.73 |
| 6031572 | SUPPLY IMPLANT | Supply/Implant | $1,551.36 |
| 6031573 | SUPPLY IMPLANT | Supply/Implant | $1,551.36 |
| 6031575 | GENERAL SUPPLY | Supply/Implant | $183.42 |
| 6031576 | SUPPLY IMPLANT | Supply/Implant | $2,019.58 |
| 6031580 | SUPPLY IMPLANT | Supply/Implant | $595.58 |
| 6031588 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6031592 | SUPPLY IMPLANT | Supply/Implant | $4,328.19 |
| 6031593 | SUPPLY IMPLANT | Supply/Implant | $4,328.19 |
| 6031601 | SUPPLY IMPLANT | Supply/Implant | $11,888.68 |
| 6031602 | SUPPLY IMPLANT | Supply/Implant | $267.65 |
| 6031605 | SUPPLY IMPLANT | Supply/Implant | $1,957.76 |
| 6031606 | MESH (IMPLANTABLE) | Supply/Implant | $2,086.40 |
| 6031608 | STERILE SUPPLY | Supply/Implant | $312.54 |
| 6031609 | GENERAL SUPPLY | Supply/Implant | $137.34 |
| 6031610 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6031613 | SUPPLY IMPLANT | Supply/Implant | $1,142.78 |
| 6031620 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6031622 | SUPPLY IMPLANT | Supply/Implant | $384.03 |
| 6031624 | STERILE SUPPLY | Supply/Implant | $530.66 |
| 6031627 | STERILE SUPPLY | Supply/Implant | $219.39 |
| 6031628 | SUPPLY IMPLANT | Supply/Implant | $2,252.80 |
| 6031630 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6031631 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6031639 | GENERAL SUPPLY | Supply/Implant | $524.80 |
| 6031641 | SUPPLY IMPLANT | Supply/Implant | $405.38 |
| 6031644 | STERILE SUPPLY | Supply/Implant | $537.60 |
| 6031647 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6031652 | SUPPLY IMPLANT | Supply/Implant | $954.24 |
| 6031654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6031655 | SUPPLY IMPLANT | Supply/Implant | $5,165.44 |
| 6031663 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6031666 | PROS, URINARY SPH, IMP | Supply/Implant | $74,967.04 |
| 6031668 | STERILE SUPPLY | Supply/Implant | $198.91 |
| 6031669 | MESH (IMPLANTABLE) | Supply/Implant | $4,809.09 |
| 6031670 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6031671 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6031672 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6031676 | GENERAL SUPPLY | Supply/Implant | $1,834.88 |
| 6031677 | SUPPLY IMPLANT | Supply/Implant | $322.94 |
| 6031678 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6031680 | STERILE SUPPLY | Supply/Implant | $284.67 |
| 6031685 | SUPPLY IMPLANT | Supply/Implant | $782.08 |
| 6031686 | STERILE SUPPLY | Supply/Implant | $883.20 |
| 6031691 | CATHETER, URETERAL | Supply/Implant | $308.19 |
| 6031692 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6031696 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6031697 | SUPPLY IMPLANT | Supply/Implant | $2,799.74 |
| 6031701 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6031703 | STERILE SUPPLY | Supply/Implant | $259.56 |
| 6031706 | STERILE SUPPLY | Supply/Implant | $5,789.44 |
| 6031707 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6031711 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6031712 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6031713 | SUPPLY IMPLANT | Supply/Implant | $322.56 |
| 6031722 | SUPPLY IMPLANT | Supply/Implant | $441.98 |
| 6031724 | SUPPLY IMPLANT | Supply/Implant | $2,199.17 |
| 6031725 | SUPPLY IMPLANT | Supply/Implant | $2,844.16 |
| 6031726 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6031728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6031729 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6031730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6031737 | SUPPLY IMPLANT | Supply/Implant | $2,188.54 |
| 6031738 | SUPPLY IMPLANT | Supply/Implant | $2,124.80 |
| 6031739 | SUPPLY IMPLANT | Supply/Implant | $2,503.94 |
| 6031742 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,136.00 |
| 6031753 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6031759 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6031762 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,520.00 |
| 6031768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6031769 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6031770 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6031772 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6031775 | SUPPLY IMPLANT | Supply/Implant | $11,992.19 |
| 6031776 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6031779 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6031780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,915.20 |
| 6031787 | SUPPLY IMPLANT | Supply/Implant | $6,921.60 |
| 6031795 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6031797 | SUPPLY IMPLANT | Supply/Implant | $323.20 |
| 6031803 | SUPPLY IMPLANT | Supply/Implant | $2,992.79 |
| 6031805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $947.20 |
| 6031807 | SUPPLY IMPLANT | Supply/Implant | $313.60 |
| 6031808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6031809 | SUPPLY IMPLANT | Supply/Implant | $3,697.02 |
| 6031810 | SUPPLY IMPLANT | Supply/Implant | $314.24 |
| 6031811 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6031812 | SUPPLY IMPLANT | Supply/Implant | $245.76 |
| 6031813 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6031814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6031815 | SUPPLY IMPLANT | Supply/Implant | $67,840.00 |
| 6031816 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6031817 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6031820 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6031821 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6031822 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6031826 | SUPPLY IMPLANT | Supply/Implant | $7,028.74 |
| 6031829 | SUPPLY IMPLANT | Supply/Implant | $672.13 |
| 6031841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6031844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,563.20 |
| 6031845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,732.80 |
| 6031848 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6031849 | SUPPLY IMPLANT | Supply/Implant | $1,042.05 |
| 6031852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6031853 | SUPPLY IMPLANT | Supply/Implant | $28,655.49 |
| 6031858 | SUPPLY IMPLANT | Supply/Implant | $940.80 |
| 6031859 | SUPPLY IMPLANT | Supply/Implant | $590.59 |
| 6031862 | SUPPLY IMPLANT | Supply/Implant | $20,106.75 |
| 6031866 | GENERAL SUPPLY | Supply/Implant | $468.35 |
| 6031867 | SUPPLY IMPLANT | Supply/Implant | $13,104.90 |
| 6031868 | SUPPLY IMPLANT | Supply/Implant | $14,090.37 |
| 6031877 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6031878 | STERILE SUPPLY | Supply/Implant | $206.98 |
| 6031879 | GENERAL SUPPLY | Supply/Implant | $277.63 |
| 6031880 | SUPPLY IMPLANT | Supply/Implant | $270.08 |
| 6031882 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6031886 | SUPPLY IMPLANT | Supply/Implant | $226.05 |
| 6031888 | SUPPLY IMPLANT | Supply/Implant | $1,256.81 |
| 6031890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6031891 | SUPPLY IMPLANT | Supply/Implant | $632.70 |
| 6031897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6031899 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,169.60 |
| 6031900 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,520.00 |
| 6031901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,664.00 |
| 6031905 | STERILE SUPPLY | Supply/Implant | $1,671.68 |
| 6031907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6031909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,993.60 |
| 6031913 | GUIDE WIRE | Supply/Implant | $1,331.20 |
| 6031916 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6031920 | SUPPLY IMPLANT | Supply/Implant | $317.44 |
| 6031921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6031922 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6031926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6031927 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6031931 | SUPPLY IMPLANT | Supply/Implant | $317.44 |
| 6031932 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6031935 | SUPPLY IMPLANT | Supply/Implant | $591.26 |
| 6031936 | SUPPLY IMPLANT | Supply/Implant | $591.26 |
| 6031937 | SUPPLY IMPLANT | Supply/Implant | $548.48 |
| 6031939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,643.14 |
| 6031940 | SUPPLY IMPLANT | Supply/Implant | $570.88 |
| 6031942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6031944 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6031945 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6031949 | SUPPLY IMPLANT | Supply/Implant | $13,184.00 |
| 6031958 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6031960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6031968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6031970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6031971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6031978 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6031981 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,977.60 |
| 6031986 | SUPPLY IMPLANT | Supply/Implant | $362.88 |
| 6031988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6031989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6031992 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $627.20 |
| 6031993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,785.60 |
| 6031994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $632.32 |
| 6032002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6032003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6032004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6032006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6032018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6032020 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6032024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6032025 | SUPPLY IMPLANT | Supply/Implant | $524.54 |
| 6032026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6032027 | SUPPLY IMPLANT | Supply/Implant | $4,544.00 |
| 6032029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,614.40 |
| 6032032 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6032033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,977.60 |
| 6032035 | SUPPLY IMPLANT | Supply/Implant | $11,233.02 |
| 6032041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,682.37 |
| 6032043 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032046 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6032048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6032050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032058 | SUPPLY IMPLANT | Supply/Implant | $19,111.55 |
| 6032059 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6032060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6032068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6032069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6032073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,932.80 |
| 6032074 | SUPPLY IMPLANT | Supply/Implant | $1,932.80 |
| 6032076 | STERILE SUPPLY | Supply/Implant | $518.40 |
| 6032077 | STERILE SUPPLY | Supply/Implant | $518.40 |
| 6032078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6032086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $825.60 |
| 6032091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6032092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6032112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032118 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6032120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,105.92 |
| 6032124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,454.08 |
| 6032125 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032126 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6032130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032135 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6032138 | STERILE SUPPLY | Supply/Implant | $213.12 |
| 6032143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,012.48 |
| 6032145 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6032152 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6032162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6032165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,561.60 |
| 6032167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,878.40 |
| 6032168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6032171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032172 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6032173 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6032174 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6032175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6032184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,925.50 |
| 6032185 | STERILE SUPPLY | Supply/Implant | $486.40 |
| 6032189 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6032195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,105.92 |
| 6032197 | STERILE SUPPLY | Supply/Implant | $15,360.00 |
| 6032203 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6032208 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6032212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,150.40 |
| 6032219 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6032220 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6032224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,028.80 |
| 6032227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6032228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6032229 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6032240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6032242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6032245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,499.84 |
| 6032246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6032250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6032253 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6032254 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6032258 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6032259 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,280.00 |
| 6032260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,924.74 |
| 6032261 | GUIDE WIRE | Supply/Implant | $669.57 |
| 6032266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $517.12 |
| 6032267 | SUPPLY IMPLANT | Supply/Implant | $779.60 |
| 6032268 | SUPPLY IMPLANT | Supply/Implant | $852.56 |
| 6032271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032272 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6032283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,377.60 |
| 6032284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6032285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032288 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6032289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6032293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032299 | SUPPLY IMPLANT | Supply/Implant | $8,534.40 |
| 6032300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,984.64 |
| 6032310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6032311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032312 | GENERAL SUPPLY | Supply/Implant | $3,686.40 |
| 6032313 | GENERAL SUPPLY | Supply/Implant | $3,955.20 |
| 6032319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032329 | SUPPLY IMPLANT | Supply/Implant | $5,977.60 |
| 6032334 | SUPPLY IMPLANT | Supply/Implant | $3,697.02 |
| 6032343 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6032344 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6032345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6032346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032347 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6032348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032350 | STERILE SUPPLY | Supply/Implant | $529.92 |
| 6032353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,089.60 |
| 6032354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6032357 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6032365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6032369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6032382 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6032384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6032389 | SUPPLY IMPLANT | Supply/Implant | $52,838.40 |
| 6032397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6032402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6032406 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6032407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6032408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,030.40 |
| 6032410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6032412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6032414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6032415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6032416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6032417 | SUPPLY IMPLANT | Supply/Implant | $4,218.88 |
| 6032418 | GUIDE WIRE | Supply/Implant | $407.81 |
| 6032419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6032425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6032426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6032427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6032429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6032430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6032431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6032432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,089.60 |
| 6032433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6032435 | GENERAL SUPPLY | Supply/Implant | $148.48 |
| 6032438 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $762.62 |
| 6032439 | GENERAL SUPPLY | Supply/Implant | $275.46 |
| 6032442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6032454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6032461 | SUPPLY IMPLANT | Supply/Implant | $2,214.40 |
| 6032466 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6032468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6032470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6032478 | GENERAL SUPPLY | Supply/Implant | $130.56 |
| 6032480 | SUPPLY IMPLANT | Supply/Implant | $373.63 |
| 6032484 | GENERAL SUPPLY | Supply/Implant | $151.68 |
| 6032496 | STERILE SUPPLY | Supply/Implant | $172.03 |
| 6032500 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,043.20 |
| 6032501 | GENERAL SUPPLY | Supply/Implant | $138.24 |
| 6032512 | GENERAL SUPPLY | Supply/Implant | $819.20 |
| 6032515 | SUPPLY IMPLANT | Supply/Implant | $533.12 |
| 6032518 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6032522 | SUPPLY IMPLANT | Supply/Implant | $633.98 |
| 6032523 | SUPPLY IMPLANT | Supply/Implant | $150.53 |
| 6032524 | SUPPLY IMPLANT | Supply/Implant | $146.18 |
| 6032525 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6032529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,643.14 |
| 6032541 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $190.59 |
| 6032544 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6032549 | STERILE SUPPLY | Supply/Implant | $210.94 |
| 6032554 | SUPPLY IMPLANT | Supply/Implant | $2,232.83 |
| 6032556 | STERILE SUPPLY | Supply/Implant | $217.47 |
| 6032561 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6032563 | STERILE SUPPLY | Supply/Implant | $962.30 |
| 6032568 | SUPPLY IMPLANT | Supply/Implant | $1,931.01 |
| 6032569 | STERILE SUPPLY | Supply/Implant | $252.42 |
| 6032571 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6032572 | STERILE SUPPLY | Supply/Implant | $148.48 |
| 6032574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $315.01 |
| 6032579 | STERILE SUPPLY | Supply/Implant | $824.06 |
| 6032582 | STERILE SUPPLY | Supply/Implant | $499.07 |
| 6032583 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6032587 | SUPPLY IMPLANT | Supply/Implant | $2,151.68 |
| 6032592 | STERILE SUPPLY | Supply/Implant | $203.19 |
| 6032593 | GENERAL SUPPLY | Supply/Implant | $254.34 |
| 6032596 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6032597 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6032598 | STERILE SUPPLY | Supply/Implant | $199.26 |
| 6032600 | STERILE SUPPLY | Supply/Implant | $130.05 |
| 6032603 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6032604 | STERILE SUPPLY | Supply/Implant | $380.16 |
| 6032608 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6032611 | SUPPLY IMPLANT | Supply/Implant | $489.09 |
| 6032616 | SUPPLY IMPLANT | Supply/Implant | $6,921.60 |
| 6032617 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6032620 | SUPPLY IMPLANT | Supply/Implant | $836.48 |
| 6032624 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6032626 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6032633 | SUPPLY IMPLANT | Supply/Implant | $440.83 |
| 6032635 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6032636 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6032641 | SUPPLY IMPLANT | Supply/Implant | $1,795.20 |
| 6032644 | GUIDE WIRE | Supply/Implant | $2,841.60 |
| 6032646 | SUPPLY IMPLANT | Supply/Implant | $1,161.60 |
| 6032647 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6032652 | SUPPLY IMPLANT | Supply/Implant | $165.76 |
| 6032658 | STERILE SUPPLY | Supply/Implant | $636.80 |
| 6032659 | STERILE SUPPLY | Supply/Implant | $414.98 |
| 6032661 | SUPPLY IMPLANT | Supply/Implant | $1,363.58 |
| 6032662 | SUPPLY IMPLANT | Supply/Implant | $1,074.69 |
| 6032665 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6032667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6032669 | STERILE SUPPLY | Supply/Implant | $221.25 |
| 6032675 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6032676 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032677 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032678 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032679 | STERILE SUPPLY | Supply/Implant | $330.75 |
| 6032680 | SUPPLY IMPLANT | Supply/Implant | $1,074.69 |
| 6032683 | GUIDE WIRE | Supply/Implant | $1,267.20 |
| 6032688 | SUPPLY IMPLANT | Supply/Implant | $4,825.60 |
| 6032690 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6032692 | SUPPLY IMPLANT | Supply/Implant | $1,886.72 |
| 6032693 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6032695 | STERILE SUPPLY | Supply/Implant | $297.42 |
| 6032696 | SUPPLY IMPLANT | Supply/Implant | $445.18 |
| 6032697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032699 | SUPPLY IMPLANT | Supply/Implant | $633.47 |
| 6032704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6032706 | STERILE SUPPLY | Supply/Implant | $215.81 |
| 6032707 | STERILE SUPPLY | Supply/Implant | $224.00 |
| 6032713 | SUPPLY IMPLANT | Supply/Implant | $713.60 |
| 6032717 | SUPPLY IMPLANT | Supply/Implant | $391.68 |
| 6032719 | STERILE SUPPLY | Supply/Implant | $4,088.90 |
| 6032720 | SUPPLY IMPLANT | Supply/Implant | $5,437.44 |
| 6032721 | SUPPLY IMPLANT | Supply/Implant | $426.75 |
| 6032722 | STERILE SUPPLY | Supply/Implant | $1,774.08 |
| 6032726 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6032729 | SUPPLY IMPLANT | Supply/Implant | $6,514.43 |
| 6032733 | STERILE SUPPLY | Supply/Implant | $200.32 |
| 6032737 | STERILE SUPPLY | Supply/Implant | $195.84 |
| 6032743 | SUPPLY IMPLANT | Supply/Implant | $815.81 |
| 6032744 | SUPPLY IMPLANT | Supply/Implant | $524.54 |
| 6032745 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6032753 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6032754 | SUPPLY IMPLANT | Supply/Implant | $1,167.36 |
| 6032761 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6032763 | SUPPLY IMPLANT | Supply/Implant | $1,237.34 |
| 6032764 | SUPPLY IMPLANT | Supply/Implant | $1,105.92 |
| 6032766 | SUPPLY IMPLANT | Supply/Implant | $2,188.80 |
| 6032767 | STERILE SUPPLY | Supply/Implant | $435.20 |
| 6032770 | STERILE SUPPLY | Supply/Implant | $3,915.52 |
| 6032772 | SUPPLY IMPLANT | Supply/Implant | $398.08 |
| 6032775 | STERILE SUPPLY | Supply/Implant | $514.18 |
| 6032776 | STERILE SUPPLY | Supply/Implant | $830.98 |
| 6032778 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6032780 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6032781 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6032783 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6032790 | STERILE SUPPLY | Supply/Implant | $274.94 |
| 6032798 | SUPPLY IMPLANT | Supply/Implant | $5,312.00 |
| 6032813 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6032814 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6032815 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6032816 | GENERAL SUPPLY | Supply/Implant | $137.60 |
| 6032817 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6032822 | STERILE SUPPLY | Supply/Implant | $1,026.56 |
| 6032824 | STERILE SUPPLY | Supply/Implant | $415.49 |
| 6032825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6032826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,825.60 |
| 6032828 | GUIDE WIRE | Supply/Implant | $947.20 |
| 6032829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,073.60 |
| 6032832 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6032836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,225.60 |
| 6032838 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $675.33 |
| 6032839 | GENERAL SUPPLY | Supply/Implant | $355.71 |
| 6032840 | GENERAL SUPPLY | Supply/Implant | $346.62 |
| 6032843 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6032849 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6032853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,399.04 |
| 6032854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6032861 | SUPPLY IMPLANT | Supply/Implant | $175.62 |
| 6032863 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6032873 | STERILE SUPPLY | Supply/Implant | $1,023.36 |
| 6032895 | STERILE SUPPLY | Supply/Implant | $216.97 |
| 6032903 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $672.38 |
| 6032904 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $683.26 |
| 6032905 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $233.60 |
| 6032909 | SUPPLY IMPLANT | Supply/Implant | $1,186.56 |
| 6032910 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6032911 | SUPPLY IMPLANT | Supply/Implant | $737.79 |
| 6032912 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6032916 | STERILE SUPPLY | Supply/Implant | $1,144.32 |
| 6032918 | SUPPLY IMPLANT | Supply/Implant | $4,185.60 |
| 6032924 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $270.08 |
| 6032925 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $270.08 |
| 6032932 | STERILE SUPPLY | Supply/Implant | $428.99 |
| 6032934 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $670.85 |
| 6032939 | SUPPLY IMPLANT | Supply/Implant | $6,537.60 |
| 6032941 | SUPPLY IMPLANT | Supply/Implant | $1,128.70 |
| 6032942 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6032944 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6032950 | STERILE SUPPLY | Supply/Implant | $1,732.01 |
| 6032951 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6032953 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6032956 | STERILE SUPPLY | Supply/Implant | $429.76 |
| 6032975 | STERILE SUPPLY | Supply/Implant | $476.66 |
| 6032976 | STERILE SUPPLY | Supply/Implant | $452.86 |
| 6032981 | SUPPLY IMPLANT | Supply/Implant | $291.33 |
| 6032982 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6033008 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6033009 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6033010 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6033011 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6033014 | GENERAL SUPPLY | Supply/Implant | $574.85 |
| 6033015 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6033016 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6033021 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6033023 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6033025 | STERILE SUPPLY | Supply/Implant | $147.20 |
| 6033026 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6033027 | SUPPLY IMPLANT | Supply/Implant | $437.76 |
| 6033031 | STERILE SUPPLY | Supply/Implant | $276.35 |
| 6033032 | STERILE SUPPLY | Supply/Implant | $301.16 |
| 6033033 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6033043 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6033053 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6033055 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,132.80 |
| 6033056 | SUPPLY IMPLANT | Supply/Implant | $1,082.75 |
| 6033063 | STERILE SUPPLY | Supply/Implant | $852.56 |
| 6033067 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6033070 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6033073 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6033089 | SUPPLY IMPLANT | Supply/Implant | $3,338.88 |
| 6033097 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6033103 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6033105 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6033106 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6033107 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6033108 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6033109 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6033112 | SUPPLY IMPLANT | Supply/Implant | $230.40 |
| 6033113 | SUPPLY IMPLANT | Supply/Implant | $5,080.19 |
| 6033116 | GENERAL SUPPLY | Supply/Implant | $515.71 |
| 6033118 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6033133 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6033138 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6033139 | GUIDE WIRE | Supply/Implant | $512.00 |
| 6033140 | GUIDE WIRE | Supply/Implant | $512.00 |
| 6033146 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6033157 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6033163 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6033164 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6033181 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6033185 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6033188 | GRAFT, VASCULAR | Supply/Implant | $11,061.12 |
| 6033189 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033214 | SUPPLY IMPLANT | Supply/Implant | $2,181.12 |
| 6033215 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,772.48 |
| 6033232 | SUPPLY IMPLANT | Supply/Implant | $12,172.80 |
| 6033237 | SUPPLY IMPLANT | Supply/Implant | $14,374.40 |
| 6033240 | SUPPLY IMPLANT | Supply/Implant | $4,736.00 |
| 6033241 | SUPPLY IMPLANT | Supply/Implant | $4,736.00 |
| 6033247 | SUPPLY IMPLANT | Supply/Implant | $11,303.04 |
| 6033248 | GRAFT, VASCULAR | Supply/Implant | $11,303.04 |
| 6033249 | GRAFT, VASCULAR | Supply/Implant | $11,303.04 |
| 6033250 | GRAFT, VASCULAR | Supply/Implant | $11,057.79 |
| 6033251 | GRAFT, VASCULAR | Supply/Implant | $8,079.36 |
| 6033252 | GRAFT, VASCULAR | Supply/Implant | $9,009.15 |
| 6033255 | GRAFT, VASCULAR | Supply/Implant | $8,646.02 |
| 6033256 | GRAFT, VASCULAR | Supply/Implant | $8,983.68 |
| 6033264 | SUPPLY IMPLANT | Supply/Implant | $8,669.06 |
| 6033266 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033267 | GRAFT, VASCULAR | Supply/Implant | $6,361.60 |
| 6033271 | GRAFT, VASCULAR | Supply/Implant | $21,580.80 |
| 6033273 | GRAFT, VASCULAR | Supply/Implant | $5,286.40 |
| 6033281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6033282 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $38,182.40 |
| 6033283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,430.40 |
| 6033301 | SUPPLY IMPLANT | Supply/Implant | $7,232.00 |
| 6033302 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6033303 | SUPPLY IMPLANT | Supply/Implant | $3,975.04 |
| 6033304 | SUPPLY IMPLANT | Supply/Implant | $6,048.64 |
| 6033306 | SUPPLY IMPLANT | Supply/Implant | $8,396.80 |
| 6033307 | SUPPLY IMPLANT | Supply/Implant | $12,979.20 |
| 6033308 | SUPPLY IMPLANT | Supply/Implant | $1,356.67 |
| 6033309 | SUPPLY IMPLANT | Supply/Implant | $15,991.94 |
| 6033312 | SUPPLY IMPLANT | Supply/Implant | $4,338.56 |
| 6033314 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6033315 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6033320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6033329 | GRAFT, VASCULAR | Supply/Implant | $20,851.20 |
| 6033330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033332 | GRAFT, VASCULAR | Supply/Implant | $17,766.40 |
| 6033334 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6033335 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033357 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $427.14 |
| 6033372 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,464.00 |
| 6033374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6033386 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6033392 | SUPPLY IMPLANT | Supply/Implant | $522.50 |
| 6033393 | SUPPLY IMPLANT | Supply/Implant | $37,854.59 |
| 6033407 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,959.55 |
| 6033408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,959.55 |
| 6033412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,394.05 |
| 6033430 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033431 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033432 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6033436 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6033437 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6033438 | SUPPLY IMPLANT | Supply/Implant | $1,316.99 |
| 6033448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6033450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6033452 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6033453 | ALLODERM SKIN SUB | Supply/Implant | $2,956.80 |
| 6033454 | GRAFT, VASCULAR | Supply/Implant | $2,136.96 |
| 6033457 | SUPPLY IMPLANT | Supply/Implant | $3,829.34 |
| 6033464 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $17,827.84 |
| 6033468 | SUPPLY IMPLANT | Supply/Implant | $2,377.47 |
| 6033469 | SUPPLY IMPLANT | Supply/Implant | $4,764.29 |
| 6033470 | SUPPLY IMPLANT | Supply/Implant | $1,638.02 |
| 6033472 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033473 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033474 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033475 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6033491 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033492 | SUPPLY IMPLANT | Supply/Implant | $56,960.00 |
| 6033493 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033495 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033496 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033497 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033498 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033499 | SUPPLY IMPLANT | Supply/Implant | $53,760.00 |
| 6033508 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6033512 | SUPPLY IMPLANT | Supply/Implant | $3,597.70 |
| 6033513 | SUPPLY IMPLANT | Supply/Implant | $2,461.22 |
| 6033514 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $17,827.84 |
| 6033525 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033526 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033527 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033528 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033529 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033530 | SUPPLY IMPLANT | Supply/Implant | $17,868.80 |
| 6033531 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6033536 | SUPPLY IMPLANT | Supply/Implant | $17,864.70 |
| 6033547 | SUPPLY IMPLANT | Supply/Implant | $10,897.92 |
| 6033548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6033551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $898.56 |
| 6033552 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6033563 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6033577 | SUPPLY IMPLANT | Supply/Implant | $3,829.38 |
| 6033578 | SUPPLY IMPLANT | Supply/Implant | $3,829.38 |
| 6033579 | SUPPLY IMPLANT | Supply/Implant | $3,829.38 |
| 6033582 | SUPPLY IMPLANT | Supply/Implant | $6,553.60 |
| 6033586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $124,225.50 |
| 6033601 | SUPPLY IMPLANT | Supply/Implant | $1,770.11 |
| 6033603 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6033604 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6033605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6033606 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6033607 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6033611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6033612 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033613 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033614 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033615 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033616 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6033617 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6033619 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6033620 | SUPPLY IMPLANT | Supply/Implant | $47,020.80 |
| 6033621 | SUPPLY IMPLANT | Supply/Implant | $47,020.80 |
| 6033639 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6033643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,176.70 |
| 6033644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,311.10 |
| 6033646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,020.80 |
| 6033652 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6033657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,750.40 |
| 6033658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,755.20 |
| 6033659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,851.20 |
| 6033660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,555.20 |
| 6033662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,158.40 |
| 6033669 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6033672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6033674 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6033678 | GUIDE WIRE | Supply/Implant | $2,931.20 |
| 6033681 | SUPPLY IMPLANT | Supply/Implant | $3,619.07 |
| 6033688 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,770.30 |
| 6033689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,610.43 |
| 6033690 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,822.59 |
| 6033693 | SUPPLY IMPLANT | Supply/Implant | $2,108.93 |
| 6033702 | SUPPLY IMPLANT | Supply/Implant | $7,180.80 |
| 6033703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6033704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6033706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,090.37 |
| 6033707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,964.48 |
| 6033708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,390.34 |
| 6033710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,381.70 |
| 6033712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,031.04 |
| 6033714 | SUPPLY IMPLANT | Supply/Implant | $5,427.20 |
| 6033716 | SUPPLY IMPLANT | Supply/Implant | $11,635.20 |
| 6033735 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6033736 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,341.44 |
| 6033738 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,407.17 |
| 6033743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,364.42 |
| 6033745 | SUPPLY IMPLANT | Supply/Implant | $5,319.55 |
| 6033746 | SUPPLY IMPLANT | Supply/Implant | $40,320.00 |
| 6033751 | GRAFT, VASCULAR | Supply/Implant | $4,428.80 |
| 6033752 | SUPPLY IMPLANT | Supply/Implant | $883.20 |
| 6033764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6033765 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,395.26 |
| 6033766 | SUPPLY IMPLANT | Supply/Implant | $18,395.26 |
| 6033779 | GRAFT, VASCULAR | Supply/Implant | $6,361.60 |
| 6033780 | SUPPLY IMPLANT | Supply/Implant | $5,280.77 |
| 6033782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,920.00 |
| 6033793 | INTRO/SHEATH, NON-LASER | Supply/Implant | $658.69 |
| 6033794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,411.01 |
| 6033796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $102,728.96 |
| 6033797 | STERILE SUPPLY | Supply/Implant | $2,981.12 |
| 6033803 | SUPPLY IMPLANT | Supply/Implant | $5,280.77 |
| 6033812 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $561.02 |
| 6033814 | SUPPLY IMPLANT | Supply/Implant | $3,417.60 |
| 6033816 | SUPPLY IMPLANT | Supply/Implant | $5,977.60 |
| 6033818 | SUPPLY IMPLANT | Supply/Implant | $12,518.40 |
| 6033820 | SUPPLY IMPLANT | Supply/Implant | $9,674.24 |
| 6033830 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6033831 | SUPPLY IMPLANT | Supply/Implant | $18,299.39 |
| 6033835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,223.62 |
| 6033837 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6033848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,592.00 |
| 6033853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,265.98 |
| 6033876 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,689.60 |
| 6033877 | INTERSPINOUS IMPLANT | Supply/Implant | $15,360.00 |
| 6033878 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6033890 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6033892 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6033896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,207.62 |
| 6033897 | SUPPLY IMPLANT | Supply/Implant | $3,648.00 |
| 6033898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,207.62 |
| 6033899 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6033900 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6033901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,633.47 |
| 6033903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,255.17 |
| 6033904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,555.01 |
| 6033905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6033906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,420.61 |
| 6033907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,392.83 |
| 6033908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,311.10 |
| 6033909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,070.59 |
| 6033910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,972.35 |
| 6033911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,342.14 |
| 6033921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,352.90 |
| 6033923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,393.60 |
| 6033933 | SUPPLY IMPLANT | Supply/Implant | $10,448.51 |
| 6033942 | SUPPLY IMPLANT | Supply/Implant | $1,042.05 |
| 6033944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,631.17 |
| 6033956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,081.41 |
| 6033958 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6033959 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,689.60 |
| 6033967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,132.48 |
| 6033993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6033998 | SUPPLY IMPLANT | Supply/Implant | $741.50 |
| 6034007 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6034010 | SUPPLY IMPLANT | Supply/Implant | $564.90 |
| 6034011 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6034013 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6034018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6034023 | SUPPLY IMPLANT | Supply/Implant | $1,464.32 |
| 6034031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6034032 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034033 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034035 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6034036 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $970.37 |
| 6034037 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $970.37 |
| 6034049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6034055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,689.60 |
| 6034056 | SUPPLY IMPLANT | Supply/Implant | $2,982.40 |
| 6034059 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6034061 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,312.90 |
| 6034062 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6034078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034090 | INFUSION PUMP, PROGRAMMABLE | Supply/Implant | $123,900.00 |
| 6034096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,394.05 |
| 6034113 | SUPPLY IMPLANT | Supply/Implant | $8,668.80 |
| 6034115 | SUPPLY IMPLANT | Supply/Implant | $1,186.56 |
| 6034133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6034135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6034140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6034141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6034143 | SUPPLY IMPLANT | Supply/Implant | $7,238.40 |
| 6034153 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,683.65 |
| 6034155 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6034163 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6034166 | SUPPLY IMPLANT | Supply/Implant | $1,603.20 |
| 6034167 | SUPPLY IMPLANT | Supply/Implant | $3,360.00 |
| 6034168 | SUPPLY IMPLANT | Supply/Implant | $3,974.40 |
| 6034182 | SUPPLY IMPLANT | Supply/Implant | $14,025.60 |
| 6034186 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6034192 | SUPPLY IMPLANT | Supply/Implant | $176.00 |
| 6034193 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6034194 | SUPPLY IMPLANT | Supply/Implant | $2,398.59 |
| 6034197 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034205 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6034207 | SUPPLY IMPLANT | Supply/Implant | $7,420.80 |
| 6034210 | SUPPLY IMPLANT | Supply/Implant | $7,001.60 |
| 6034211 | SUPPLY IMPLANT | Supply/Implant | $5,646.98 |
| 6034215 | SUPPLY IMPLANT | Supply/Implant | $5,396.48 |
| 6034225 | SUPPLY IMPLANT | Supply/Implant | $17,274.88 |
| 6034227 | SUPPLY IMPLANT | Supply/Implant | $17,274.88 |
| 6034228 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6034247 | SUPPLY IMPLANT | Supply/Implant | $31,294.08 |
| 6034258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6034264 | SUPPLY IMPLANT | Supply/Implant | $69,966.34 |
| 6034265 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6034268 | SUPPLY IMPLANT | Supply/Implant | $965.89 |
| 6034271 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6034277 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034278 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034287 | SUPPLY IMPLANT | Supply/Implant | $2,038.53 |
| 6034288 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6034291 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034292 | SUPPLY IMPLANT | Supply/Implant | $2,296.19 |
| 6034293 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6034307 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034308 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034309 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6034317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6034318 | MESH (IMPLANTABLE) | Supply/Implant | $54,835.20 |
| 6034320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034324 | SUPPLY IMPLANT | Supply/Implant | $2,421.95 |
| 6034336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034352 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6034363 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6034364 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6034366 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,508.54 |
| 6034368 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6034373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6034377 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,859.20 |
| 6034395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,184.00 |
| 6034416 | SUPPLY IMPLANT | Supply/Implant | $8,691.20 |
| 6034417 | SUPPLY IMPLANT | Supply/Implant | $5,593.47 |
| 6034418 | SUPPLY IMPLANT | Supply/Implant | $3,829.34 |
| 6034426 | SUPPLY IMPLANT | Supply/Implant | $1,352.45 |
| 6034429 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6034431 | SUPPLY IMPLANT | Supply/Implant | $6,809.60 |
| 6034440 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,495.23 |
| 6034443 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6034444 | SUPPLY IMPLANT | Supply/Implant | $6,131.20 |
| 6034447 | SUPPLY IMPLANT | Supply/Implant | $25,169.92 |
| 6034448 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6034452 | SUPPLY IMPLANT | Supply/Implant | $3,829.34 |
| 6034454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034459 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6034460 | SUPPLY IMPLANT | Supply/Implant | $19,878.40 |
| 6034462 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034463 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034473 | SUPPLY IMPLANT | Supply/Implant | $14,899.71 |
| 6034476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,413.18 |
| 6034478 | SUPPLY IMPLANT | Supply/Implant | $3,110.40 |
| 6034483 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034488 | SUPPLY IMPLANT | Supply/Implant | $11,712.00 |
| 6034489 | SUPPLY IMPLANT | Supply/Implant | $10,009.60 |
| 6034497 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034501 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,058.24 |
| 6034507 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6034508 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6034517 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034518 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034527 | MESH (IMPLANTABLE) | Supply/Implant | $9,561.60 |
| 6034528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6034533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,228.22 |
| 6034538 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034540 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034542 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034544 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034545 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034547 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034548 | SUPPLY IMPLANT | Supply/Implant | $1,074.69 |
| 6034551 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034552 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6034561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6034566 | SUPPLY IMPLANT | Supply/Implant | $9,076.48 |
| 6034568 | SUPPLY IMPLANT | Supply/Implant | $1,250.24 |
| 6034572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6034574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6034575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034576 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034577 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034578 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034580 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034581 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,693.06 |
| 6034595 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034596 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034597 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034598 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034599 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6034604 | SUPPLY IMPLANT | Supply/Implant | $1,860.22 |
| 6034605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034606 | SUPPLY IMPLANT | Supply/Implant | $1,568.90 |
| 6034607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034611 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034612 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,069.82 |
| 6034615 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.98 |
| 6034621 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034625 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034626 | SUPPLY IMPLANT | Supply/Implant | $25,169.92 |
| 6034627 | SUPPLY IMPLANT | Supply/Implant | $19,948.31 |
| 6034628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6034630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034635 | SUPPLY IMPLANT | Supply/Implant | $5,255.55 |
| 6034636 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034637 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034642 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034643 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034649 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034657 | SUPPLY IMPLANT | Supply/Implant | $2,350.08 |
| 6034658 | SUPPLY IMPLANT | Supply/Implant | $4,218.88 |
| 6034661 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,693.06 |
| 6034662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034664 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6034665 | SUPPLY IMPLANT | Supply/Implant | $49,746.05 |
| 6034666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $37,259.52 |
| 6034668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034670 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6034673 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034676 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034681 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034683 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034685 | SUPPLY IMPLANT | Supply/Implant | $3,968.00 |
| 6034690 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034691 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034692 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034694 | SUPPLY IMPLANT | Supply/Implant | $68,480.00 |
| 6034696 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6034704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6034706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6034708 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034710 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6034712 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034722 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6034723 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6034728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6034729 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6034730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6034742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6034758 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6034759 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6034760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034766 | SUPPLY IMPLANT | Supply/Implant | $112,576.00 |
| 6034768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6034778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,137.66 |
| 6034779 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6034787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,574.40 |
| 6034797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6034798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034799 | SUPPLY IMPLANT | Supply/Implant | $2,774.40 |
| 6034802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034806 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6034814 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6034815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,966.72 |
| 6034817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6034822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,375.68 |
| 6034826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,053.31 |
| 6034829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,192.96 |
| 6034830 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6034840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6034851 | SUPPLY IMPLANT | Supply/Implant | $6,148.99 |
| 6034852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $840.45 |
| 6034854 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6034856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6034860 | SUPPLY IMPLANT | Supply/Implant | $10,321.92 |
| 6034863 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034864 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6034868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,188.22 |
| 6034869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,085.95 |
| 6034885 | SUPPLY IMPLANT | Supply/Implant | $318.72 |
| 6034893 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,433.60 |
| 6034894 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6034897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6034898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6034912 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6034919 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6034921 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6034922 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6034925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,266.30 |
| 6034934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6034935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6034937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,187.33 |
| 6034939 | SUPPLY IMPLANT | Supply/Implant | $668.03 |
| 6034940 | SUPPLY IMPLANT | Supply/Implant | $1,181.22 |
| 6034941 | SUPPLY IMPLANT | Supply/Implant | $1,740.71 |
| 6034942 | SUPPLY IMPLANT | Supply/Implant | $535.08 |
| 6034943 | SUPPLY IMPLANT | Supply/Implant | $535.08 |
| 6034944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,117.76 |
| 6034949 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,008.00 |
| 6034954 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,808.00 |
| 6034955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6034957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6034962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6034964 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6034965 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6034966 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6034967 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6034977 | SUPPLY IMPLANT | Supply/Implant | $768.64 |
| 6034984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6034991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6034992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,226.43 |
| 6034996 | SUPPLY IMPLANT | Supply/Implant | $1,698.69 |
| 6034997 | SUPPLY IMPLANT | Supply/Implant | $1,123.71 |
| 6034998 | SUPPLY IMPLANT | Supply/Implant | $193.13 |
| 6034999 | SUPPLY IMPLANT | Supply/Implant | $1,086.46 |
| 6035000 | SUPPLY IMPLANT | Supply/Implant | $1,123.71 |
| 6035001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,401.22 |
| 6035007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,401.22 |
| 6035009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,053.31 |
| 6035019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $605.18 |
| 6035030 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6035044 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035047 | SUPPLY IMPLANT | Supply/Implant | $21,056.00 |
| 6035053 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035054 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035055 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035056 | SUPPLY IMPLANT | Supply/Implant | $51,712.00 |
| 6035059 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $73,776.00 |
| 6035066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,292.99 |
| 6035078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6035087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6035089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6035094 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6035103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6035112 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6035113 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035114 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6035118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6035120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6035135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $883.20 |
| 6035151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6035152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,952.00 |
| 6035153 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6035154 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6035158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,460.80 |
| 6035159 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6035165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6035179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,353.92 |
| 6035187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6035188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6035191 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6035202 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6035207 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,984.64 |
| 6035217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6035219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6035222 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6035223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6035231 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,729.66 |
| 6035240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6035244 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,808.64 |
| 6035248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6035253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6035260 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6035285 | INTRO/SHEATH, NON-LASER | Supply/Implant | $742.40 |
| 6035289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6035293 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $35,840.00 |
| 6035302 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035311 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,453.44 |
| 6035317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6035320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,035.57 |
| 6035323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,546.50 |
| 6035324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6035326 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,776.00 |
| 6035337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6035345 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6035346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,914.37 |
| 6035347 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035348 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035349 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035350 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035351 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6035353 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $10,368.00 |
| 6035354 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $9,600.00 |
| 6035367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6035368 | SUPPLY IMPLANT | Supply/Implant | $43,187.71 |
| 6035369 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6035378 | SUPPLY IMPLANT | Supply/Implant | $252,500.00 |
| 6035379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,477.70 |
| 6035381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6035394 | SUPPLY IMPLANT | Supply/Implant | $48,872.70 |
| 6035395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6035396 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6035403 | SUPPLY IMPLANT | Supply/Implant | $225.28 |
| 6035431 | SUPPLY IMPLANT | Supply/Implant | $1,885.06 |
| 6035442 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6035447 | SUPPLY IMPLANT | Supply/Implant | $4,966.40 |
| 6035461 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $439.04 |
| 6035472 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035496 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $36,352.00 |
| 6035500 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6035528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,572.80 |
| 6035529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6035530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6035531 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6035532 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6035535 | SUPPLY IMPLANT | Supply/Implant | $147,000.00 |
| 6035537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,414.72 |
| 6035541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6035548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035551 | SUPPLY IMPLANT | Supply/Implant | $105,843.20 |
| 6035567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,414.72 |
| 6035569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.81 |
| 6035570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.81 |
| 6035571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.81 |
| 6035573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,165.50 |
| 6035576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6035577 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6035585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6035586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6035589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6035597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6035627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6035632 | SUPPLY IMPLANT | Supply/Implant | $652.80 |
| 6035633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6035639 | SUPPLY IMPLANT | Supply/Implant | $3,494.40 |
| 6035641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6035642 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,535.94 |
| 6035647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6035670 | GRAFT, VASCULAR | Supply/Implant | $35,737.60 |
| 6035671 | GRAFT, VASCULAR | Supply/Implant | $23,244.80 |
| 6035672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6035677 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6035678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6035702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6035705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035722 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035733 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6035734 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6035735 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6035744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6035752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,139.20 |
| 6035760 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6035773 | SUPPLY IMPLANT | Supply/Implant | $13,632.00 |
| 6035777 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $66,560.00 |
| 6035779 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $66,560.00 |
| 6035782 | MESH (IMPLANTABLE) | Supply/Implant | $13,580.80 |
| 6035799 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6035801 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6035812 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6035820 | SUPPLY IMPLANT | Supply/Implant | $5,593.47 |
| 6035839 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6035840 | GUIDE WIRE | Supply/Implant | $1,478.40 |
| 6035846 | SUPPLY IMPLANT | Supply/Implant | $24,701.57 |
| 6035862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6035863 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6035865 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6035867 | GRAFT, VASCULAR | Supply/Implant | $10,265.60 |
| 6035869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6035874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6035875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6035878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035880 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6035886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,052.80 |
| 6035887 | SUPPLY IMPLANT | Supply/Implant | $3,254.40 |
| 6035894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6035896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6035897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035899 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6035901 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6035904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6035906 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6035909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6035911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6035912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6035914 | CATH, DRAINAGE | Supply/Implant | $1,042.69 |
| 6035925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6035927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6035944 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6035947 | SUPPLY IMPLANT | Supply/Implant | $2,755.20 |
| 6035952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6035967 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6035972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,266.30 |
| 6035974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.29 |
| 6035975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6035976 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6035977 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6035978 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6036001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $739.58 |
| 6036003 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6036006 | SUPPLY IMPLANT | Supply/Implant | $11,712.00 |
| 6036014 | SUPPLY IMPLANT | Supply/Implant | $9,676.80 |
| 6036016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6036023 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6036029 | SUPPLY IMPLANT | Supply/Implant | $16,947.20 |
| 6036050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6036057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6036058 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6036067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6036075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6036096 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6036096 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036100 | STERILE SUPPLY | Supply/Implant | $212.48 |
| 6036101 | STERILE SUPPLY | Supply/Implant | $727.81 |
| 6036103 | STERILE SUPPLY | Supply/Implant | $430.55 |
| 6036104 | STERILE SUPPLY | Supply/Implant | $144.90 |
| 6036106 | STERILE SUPPLY | Supply/Implant | $160.13 |
| 6036110 | SUPPLY IMPLANT | Supply/Implant | $429.18 |
| 6036112 | SUPPLY IMPLANT | Supply/Implant | $366.59 |
| 6036114 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6036115 | SUPPLY IMPLANT | Supply/Implant | $366.59 |
| 6036116 | SUPPLY IMPLANT | Supply/Implant | $366.59 |
| 6036117 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036118 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036119 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036120 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036126 | CATHETER, GUIDING | Supply/Implant | $326.02 |
| 6036127 | STERILE SUPPLY | Supply/Implant | $1,636.86 |
| 6036128 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036129 | SUPPLY IMPLANT | Supply/Implant | $374.02 |
| 6036130 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6036131 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6036138 | SUPPLY IMPLANT | Supply/Implant | $343.94 |
| 6036140 | CATH, DRAINAGE | Supply/Implant | $913.92 |
| 6036141 | CATH, DRAINAGE | Supply/Implant | $967.68 |
| 6036143 | CATHETER, URETERAL | Supply/Implant | $239.36 |
| 6036144 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6036146 | CATH, DRAINAGE | Supply/Implant | $177.92 |
| 6036147 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6036148 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6036151 | STERILE SUPPLY | Supply/Implant | $157.25 |
| 6036152 | GENERAL SUPPLY | Supply/Implant | $191.36 |
| 6036158 | STERILE SUPPLY | Supply/Implant | $1,151.36 |
| 6036159 | STERILE SUPPLY | Supply/Implant | $1,142.53 |
| 6036163 | CATH, DRAINAGE | Supply/Implant | $291.33 |
| 6036164 | CATH, DRAINAGE | Supply/Implant | $325.63 |
| 6036168 | SUPPLY IMPLANT | Supply/Implant | $219.90 |
| 6036173 | SUPPLY IMPLANT | Supply/Implant | $524.93 |
| 6036174 | SUPPLY IMPLANT | Supply/Implant | $524.93 |
| 6036175 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036176 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6036177 | SUPPLY IMPLANT | Supply/Implant | $402.43 |
| 6036178 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036179 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6036183 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036184 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6036186 | SUPPLY IMPLANT | Supply/Implant | $1,854.85 |
| 6036187 | GENERAL SUPPLY | Supply/Implant | $160.90 |
| 6036188 | SUPPLY IMPLANT | Supply/Implant | $247.42 |
| 6036189 | SUPPLY IMPLANT | Supply/Implant | $247.30 |
| 6036190 | SUPPLY IMPLANT | Supply/Implant | $202.75 |
| 6036191 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6036192 | CATH, DRAINAGE | Supply/Implant | $153.60 |
| 6036193 | CATH, DRAINAGE | Supply/Implant | $153.60 |
| 6036194 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $2,419.20 |
| 6036200 | SUPPLY IMPLANT | Supply/Implant | $7,872.51 |
| 6036202 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6036205 | CATH, DRAINAGE | Supply/Implant | $177.10 |
| 6036206 | CATH, DRAINAGE | Supply/Implant | $179.71 |
| 6036211 | SUPPLY IMPLANT | Supply/Implant | $583.17 |
| 6036212 | STERILE SUPPLY | Supply/Implant | $298.24 |
| 6036221 | SUPPLY IMPLANT | Supply/Implant | $459.52 |
| 6036228 | STERILE SUPPLY | Supply/Implant | $273.79 |
| 6036229 | STERILE SUPPLY | Supply/Implant | $281.96 |
| 6036230 | STERILE SUPPLY | Supply/Implant | $293.34 |
| 6036239 | SUPPLY IMPLANT | Supply/Implant | $137.98 |
| 6036242 | SUPPLY IMPLANT | Supply/Implant | $1,257.73 |
| 6036244 | CATHETER, URETERAL | Supply/Implant | $244.86 |
| 6036245 | CATHETER, URETERAL | Supply/Implant | $244.86 |
| 6036251 | SUPPLY IMPLANT | Supply/Implant | $204.16 |
| 6036252 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6036257 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6036258 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6036260 | STERILE SUPPLY | Supply/Implant | $1,360.26 |
| 6036268 | SUPPLY IMPLANT | Supply/Implant | $657.02 |
| 6036269 | SUPPLY IMPLANT | Supply/Implant | $132.22 |
| 6036272 | STERILE SUPPLY | Supply/Implant | $452.16 |
| 6036279 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6036289 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6036293 | SUPPLY IMPLANT | Supply/Implant | $2,965.63 |
| 6036296 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $247.30 |
| 6036298 | SUPPLY IMPLANT | Supply/Implant | $281.86 |
| 6036301 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6036302 | GENERAL SUPPLY | Supply/Implant | $277.34 |
| 6036311 | SUPPLY IMPLANT | Supply/Implant | $1,228.16 |
| 6036314 | SUPPLY IMPLANT | Supply/Implant | $768.64 |
| 6036318 | STERILE SUPPLY | Supply/Implant | $4,966.55 |
| 6036320 | SUPPLY IMPLANT | Supply/Implant | $10,876.52 |
| 6036321 | SUPPLY IMPLANT | Supply/Implant | $24,931.97 |
| 6036330 | SUPPLY IMPLANT | Supply/Implant | $197.63 |
| 6036337 | SUPPLY IMPLANT | Supply/Implant | $794.75 |
| 6036338 | SUPPLY IMPLANT | Supply/Implant | $2,201.73 |
| 6036339 | SUPPLY IMPLANT | Supply/Implant | $272.26 |
| 6036341 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6036344 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6036347 | STERILE SUPPLY | Supply/Implant | $4,861.93 |
| 6036349 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6036350 | STERILE SUPPLY | Supply/Implant | $4,032.00 |
| 6036351 | SUPPLY IMPLANT | Supply/Implant | $571.53 |
| 6036352 | STERILE SUPPLY | Supply/Implant | $2,965.63 |
| 6036357 | SUPPLY IMPLANT | Supply/Implant | $3,233.79 |
| 6036362 | SUPPLY IMPLANT | Supply/Implant | $167.68 |
| 6036364 | SUPPLY IMPLANT | Supply/Implant | $793.83 |
| 6036370 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6036371 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6036372 | CATHETER, URETERAL | Supply/Implant | $170.98 |
| 6036374 | SUPPLY IMPLANT | Supply/Implant | $2,992.00 |
| 6036375 | SUPPLY IMPLANT | Supply/Implant | $1,679.36 |
| 6036376 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6036377 | INTRO/SHEATH, NON-LASER | Supply/Implant | $425.09 |
| 6036378 | STERILE SUPPLY | Supply/Implant | $159.90 |
| 6036380 | SUPPLY IMPLANT | Supply/Implant | $1,329.28 |
| 6036381 | SUPPLY IMPLANT | Supply/Implant | $2,333.18 |
| 6036384 | SUPPLY IMPLANT | Supply/Implant | $1,200.64 |
| 6036385 | SUPPLY IMPLANT | Supply/Implant | $1,680.90 |
| 6036386 | SUPPLY IMPLANT | Supply/Implant | $1,455.49 |
| 6036392 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6036394 | STERILE SUPPLY | Supply/Implant | $1,062.78 |
| 6036395 | SUPPLY IMPLANT | Supply/Implant | $3,057.28 |
| 6036396 | SUPPLY IMPLANT | Supply/Implant | $375.68 |
| 6036406 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6036407 | CATH OCCLUSION | Supply/Implant | $2,631.42 |
| 6036412 | SUPPLY IMPLANT | Supply/Implant | $598.40 |
| 6036414 | CATH, DRAINAGE | Supply/Implant | $449.92 |
| 6036415 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6036418 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $197.76 |
| 6036419 | SUPPLY IMPLANT | Supply/Implant | $2,015.62 |
| 6036422 | STERILE SUPPLY | Supply/Implant | $2,321.28 |
| 6036423 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6036431 | STERILE SUPPLY | Supply/Implant | $412.03 |
| 6036432 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6036433 | SUPPLY IMPLANT | Supply/Implant | $2,483.71 |
| 6036434 | SUPPLY IMPLANT | Supply/Implant | $1,294.98 |
| 6036439 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6036440 | TISSUE LOCALIZATION EXCISION | Supply/Implant | $23,987.20 |
| 6036447 | GUIDE WIRE | Supply/Implant | $1,336.32 |
| 6036453 | STERILE SUPPLY | Supply/Implant | $1,299.20 |
| 6036454 | INTRO/SHEATH, NON-LASER | Supply/Implant | $496.77 |
| 6036457 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6036459 | SUPPLY IMPLANT | Supply/Implant | $808.58 |
| 6036461 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6036462 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6036467 | SUPPLY IMPLANT | Supply/Implant | $1,294.98 |
| 6036468 | SUPPLY IMPLANT | Supply/Implant | $1,587.75 |
| 6036474 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6036477 | SUPPLY IMPLANT | Supply/Implant | $3,041.28 |
| 6036480 | STERILE SUPPLY | Supply/Implant | $2,713.60 |
| 6036483 | SUPPLY IMPLANT | Supply/Implant | $1,569.41 |
| 6036484 | GENERAL SUPPLY | Supply/Implant | $142.08 |
| 6036485 | GENERAL SUPPLY | Supply/Implant | $1,024.51 |
| 6036492 | SUPPLY IMPLANT | Supply/Implant | $1,663.74 |
| 6036495 | SUPPLY IMPLANT | Supply/Implant | $1,535.10 |
| 6036496 | SUPPLY IMPLANT | Supply/Implant | $1,130.88 |
| 6036501 | SUPPLY IMPLANT | Supply/Implant | $2,437.12 |
| 6036505 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6036508 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6036509 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6036513 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6036515 | SUPPLY IMPLANT | Supply/Implant | $234.66 |
| 6036524 | SUPPLY IMPLANT | Supply/Implant | $634.88 |
| 6036528 | SUPPLY IMPLANT | Supply/Implant | $659.20 |
| 6036529 | STERILE SUPPLY | Supply/Implant | $487.09 |
| 6036535 | SUPPLY IMPLANT | Supply/Implant | $1,320.96 |
| 6036538 | SUPPLY IMPLANT | Supply/Implant | $1,234.94 |
| 6036542 | STERILE SUPPLY | Supply/Implant | $2,475.64 |
| 6036543 | STERILE SUPPLY | Supply/Implant | $238.03 |
| 6036546 | SUPPLY IMPLANT | Supply/Implant | $6,787.20 |
| 6036548 | SUPPLY IMPLANT | Supply/Implant | $590.59 |
| 6036549 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6036550 | SUPPLY IMPLANT | Supply/Implant | $2,908.80 |
| 6036551 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6036553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,536.77 |
| 6036555 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6036556 | SUPPLY IMPLANT | Supply/Implant | $1,466.50 |
| 6036559 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6036560 | SUPPLY IMPLANT | Supply/Implant | $2,294.40 |
| 6036561 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6036567 | SUPPLY IMPLANT | Supply/Implant | $1,893.89 |
| 6036568 | SUPPLY IMPLANT | Supply/Implant | $1,468.03 |
| 6036572 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6036573 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6036575 | SUPPLY IMPLANT | Supply/Implant | $1,692.16 |
| 6036577 | CATH OCCLUSION | Supply/Implant | $5,142.40 |
| 6036579 | SUPPLY IMPLANT | Supply/Implant | $213.25 |
| 6036590 | SUPPLY IMPLANT | Supply/Implant | $133.45 |
| 6036591 | SUPPLY IMPLANT | Supply/Implant | $224.90 |
| 6036593 | SUPPLY IMPLANT | Supply/Implant | $426.75 |
| 6036612 | SUPPLY IMPLANT | Supply/Implant | $731.78 |
| 6036614 | SUPPLY IMPLANT | Supply/Implant | $32,416.90 |
| 6036623 | SUPPLY IMPLANT | Supply/Implant | $2,396.16 |
| 6036625 | STERILE SUPPLY | Supply/Implant | $449.79 |
| 6036628 | SUPPLY IMPLANT | Supply/Implant | $8,439.42 |
| 6036630 | SUPPLY IMPLANT | Supply/Implant | $1,395.84 |
| 6036631 | SUPPLY IMPLANT | Supply/Implant | $951.04 |
| 6036632 | SUPPLY IMPLANT | Supply/Implant | $11,270.66 |
| 6036635 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6036639 | SUPPLY IMPLANT | Supply/Implant | $708.35 |
| 6036641 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6036643 | GUIDE WIRE | Supply/Implant | $1,024.00 |
| 6036649 | STERILE SUPPLY | Supply/Implant | $134.14 |
| 6036651 | STERILE SUPPLY | Supply/Implant | $400.51 |
| 6036657 | SUPPLY IMPLANT | Supply/Implant | $8,988.42 |
| 6036658 | SUPPLY IMPLANT | Supply/Implant | $1,473.66 |
| 6036660 | SUPPLY IMPLANT | Supply/Implant | $5,043.20 |
| 6036661 | SUPPLY IMPLANT | Supply/Implant | $4,550.02 |
| 6036662 | CATH, DRAINAGE | Supply/Implant | $5,396.48 |
| 6036663 | GENERAL SUPPLY | Supply/Implant | $302.08 |
| 6036664 | SUPPLY IMPLANT | Supply/Implant | $143.71 |
| 6036667 | CATH, SUPRAPUBIC/CYSTOSCOPIC | Supply/Implant | $3,454.98 |
| 6036668 | STERILE SUPPLY | Supply/Implant | $2,150.40 |
| 6036674 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6036675 | STERILE SUPPLY | Supply/Implant | $290.64 |
| 6036677 | SUPPLY IMPLANT | Supply/Implant | $4,876.80 |
| 6036679 | SUPPLY IMPLANT | Supply/Implant | $658.82 |
| 6036680 | SUPPLY IMPLANT | Supply/Implant | $8,988.42 |
| 6036681 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6036681 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6036682 | SUPPLY IMPLANT | Supply/Implant | $533.62 |
| 6036683 | SUPPLY IMPLANT | Supply/Implant | $1,142.78 |
| 6036685 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036686 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6036687 | SUPPLY IMPLANT | Supply/Implant | $46,592.00 |
| 6036688 | SUPPLY IMPLANT | Supply/Implant | $5,148.45 |
| 6036689 | STERILE SUPPLY | Supply/Implant | $3,628.29 |
| 6036694 | SUPPLY IMPLANT | Supply/Implant | $3,094.02 |
| 6036697 | SUPPLY IMPLANT | Supply/Implant | $731.01 |
| 6036698 | SUPPLY IMPLANT | Supply/Implant | $3,842.05 |
| 6036705 | SUPPLY IMPLANT | Supply/Implant | $929.28 |
| 6036709 | STERILE SUPPLY | Supply/Implant | $6,461.44 |
| 6036710 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,223.68 |
| 6036717 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,696.00 |
| 6036723 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6036729 | SUPPLY IMPLANT | Supply/Implant | $2,187.87 |
| 6036731 | SUPPLY IMPLANT | Supply/Implant | $14,899.71 |
| 6036732 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036733 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6036734 | SUPPLY IMPLANT | Supply/Implant | $5,438.46 |
| 6036738 | SUPPLY IMPLANT | Supply/Implant | $1,653.76 |
| 6036741 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6036742 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6036744 | SUPPLY IMPLANT | Supply/Implant | $3,417.73 |
| 6036745 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036746 | STERILE SUPPLY | Supply/Implant | $133.76 |
| 6036747 | SUPPLY IMPLANT | Supply/Implant | $3,983.36 |
| 6036753 | SUPPLY IMPLANT | Supply/Implant | $1,186.39 |
| 6036754 | SUPPLY IMPLANT | Supply/Implant | $1,169.41 |
| 6036755 | SUPPLY IMPLANT | Supply/Implant | $545.54 |
| 6036756 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,420.80 |
| 6036757 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,420.80 |
| 6036758 | SUPPLY IMPLANT | Supply/Implant | $993.28 |
| 6036781 | SUPPLY IMPLANT | Supply/Implant | $863.74 |
| 6036782 | SUPPLY IMPLANT | Supply/Implant | $668.42 |
| 6036785 | RET DEV, INSERTABLE | Supply/Implant | $457.59 |
| 6036786 | SUPPLY IMPLANT | Supply/Implant | $605.57 |
| 6036787 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6036790 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6036791 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6036792 | SUPPLY IMPLANT | Supply/Implant | $15,948.80 |
| 6036793 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6036799 | SUPPLY IMPLANT | Supply/Implant | $768.64 |
| 6036803 | SUPPLY IMPLANT | Supply/Implant | $2,664.19 |
| 6036806 | SUPPLY IMPLANT | Supply/Implant | $1,320.70 |
| 6036807 | SUPPLY IMPLANT | Supply/Implant | $1,178.75 |
| 6036808 | SUPPLY IMPLANT | Supply/Implant | $1,208.96 |
| 6036809 | SUPPLY IMPLANT | Supply/Implant | $4,863.62 |
| 6036811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6036814 | SUPPLY IMPLANT | Supply/Implant | $2,321.28 |
| 6036815 | SUPPLY IMPLANT | Supply/Implant | $1,294.98 |
| 6036818 | SUPPLY IMPLANT | Supply/Implant | $7,246.46 |
| 6036819 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,800.81 |
| 6036825 | SUPPLY IMPLANT | Supply/Implant | $11,328.00 |
| 6036826 | SUPPLY IMPLANT | Supply/Implant | $1,156.57 |
| 6036829 | SUPPLY IMPLANT | Supply/Implant | $6,774.02 |
| 6036835 | SUPPLY IMPLANT | Supply/Implant | $772.48 |
| 6036836 | SUPPLY IMPLANT | Supply/Implant | $772.48 |
| 6036842 | SUPPLY IMPLANT | Supply/Implant | $13,058.18 |
| 6036844 | SUPPLY IMPLANT | Supply/Implant | $3,430.40 |
| 6036846 | INTRO/SHEATH, NON-LASER | Supply/Implant | $633.60 |
| 6036848 | SUPPLY IMPLANT | Supply/Implant | $1,648.64 |
| 6036856 | SUPPLY IMPLANT | Supply/Implant | $2,979.84 |
| 6036858 | SUPPLY IMPLANT | Supply/Implant | $201.60 |
| 6036859 | STERILE SUPPLY | Supply/Implant | $4,233.60 |
| 6036860 | GENERAL SUPPLY | Supply/Implant | $703.36 |
| 6036861 | SUPPLY IMPLANT | Supply/Implant | $668.42 |
| 6036863 | SUPPLY IMPLANT | Supply/Implant | $3,764.10 |
| 6036864 | SUPPLY IMPLANT | Supply/Implant | $3,764.10 |
| 6036868 | STERILE SUPPLY | Supply/Implant | $3,328.00 |
| 6036875 | STERILE SUPPLY | Supply/Implant | $3,835.90 |
| 6036881 | SUPPLY IMPLANT | Supply/Implant | $475.84 |
| 6036882 | SUPPLY IMPLANT | Supply/Implant | $660.61 |
| 6036885 | SUPPLY IMPLANT | Supply/Implant | $1,887.36 |
| 6036886 | SUPPLY IMPLANT | Supply/Implant | $1,192.96 |
| 6036889 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6036893 | SUPPLY IMPLANT | Supply/Implant | $38,169.60 |
| 6036894 | GRAFT, VASCULAR | Supply/Implant | $23,244.80 |
| 6036902 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6036909 | SUPPLY IMPLANT | Supply/Implant | $2,658.56 |
| 6036914 | SUPPLY IMPLANT | Supply/Implant | $21,478.40 |
| 6036917 | GUIDE WIRE | Supply/Implant | $1,024.00 |
| 6036918 | STERILE SUPPLY | Supply/Implant | $140.16 |
| 6036919 | SUPPLY IMPLANT | Supply/Implant | $6,131.20 |
| 6036920 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6036922 | SUPPLY IMPLANT | Supply/Implant | $280.45 |
| 6036925 | STERILE SUPPLY | Supply/Implant | $309.50 |
| 6036926 | GENERAL SUPPLY | Supply/Implant | $153.86 |
| 6036930 | SUPPLY IMPLANT | Supply/Implant | $874.24 |
| 6036931 | SUPPLY IMPLANT | Supply/Implant | $2,086.40 |
| 6036937 | SUPPLY IMPLANT | Supply/Implant | $15,847.55 |
| 6036939 | STERILE SUPPLY | Supply/Implant | $2,816.00 |
| 6036940 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6036945 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,536.77 |
| 6036947 | SUPPLY IMPLANT | Supply/Implant | $66,560.00 |
| 6036950 | SUPPLY IMPLANT | Supply/Implant | $2,697.60 |
| 6036953 | SUPPLY IMPLANT | Supply/Implant | $3,041.28 |
| 6036954 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6036955 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6036960 | STERILE SUPPLY | Supply/Implant | $568.00 |
| 6036964 | SUPPLY IMPLANT | Supply/Implant | $3,004.33 |
| 6036965 | SUPPLY IMPLANT | Supply/Implant | $4,921.47 |
| 6036969 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,520.00 |
| 6036970 | SUPPLY IMPLANT | Supply/Implant | $234.50 |
| 6036971 | SUPPLY IMPLANT | Supply/Implant | $234.50 |
| 6036972 | SUPPLY IMPLANT | Supply/Implant | $234.50 |
| 6036974 | SUPPLY IMPLANT | Supply/Implant | $531.24 |
| 6036975 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6036981 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6036982 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6036983 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6036987 | SUPPLY IMPLANT | Supply/Implant | $2,231.30 |
| 6036988 | SUPPLY IMPLANT | Supply/Implant | $2,512.13 |
| 6036989 | SUPPLY IMPLANT | Supply/Implant | $1,587.75 |
| 6036993 | GRAFT, VASCULAR | Supply/Implant | $38,169.60 |
| 6036994 | SUPPLY IMPLANT | Supply/Implant | $1,561.34 |
| 6036996 | STERILE SUPPLY | Supply/Implant | $524.80 |
| 6037001 | SUPPLY IMPLANT | Supply/Implant | $5,376.00 |
| 6037003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6037009 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $789.38 |
| 6037011 | SUPPLY IMPLANT | Supply/Implant | $6,322.18 |
| 6037013 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6037016 | SUPPLY IMPLANT | Supply/Implant | $3,251.20 |
| 6037023 | SUPPLY IMPLANT | Supply/Implant | $17,523.20 |
| 6037027 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6037030 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6037035 | SUPPLY IMPLANT | Supply/Implant | $6,054.40 |
| 6037038 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037043 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037045 | RET DEV, INSERTABLE | Supply/Implant | $7,253.34 |
| 6037046 | SUPPLY IMPLANT | Supply/Implant | $739.33 |
| 6037056 | RET DEV, INSERTABLE | Supply/Implant | $4,352.00 |
| 6037058 | STERILE SUPPLY | Supply/Implant | $1,166.34 |
| 6037059 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037060 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037062 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037063 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6037065 | SUPPLY IMPLANT | Supply/Implant | $234.66 |
| 6037066 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6037067 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6037068 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6037069 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037070 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037071 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037072 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037073 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037074 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6037077 | GRAFT, VASCULAR | Supply/Implant | $2,176.00 |
| 6037078 | GRAFT, VASCULAR | Supply/Implant | $3,187.20 |
| 6037081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6037092 | STERILE SUPPLY | Supply/Implant | $174.21 |
| 6037100 | STERILE SUPPLY | Supply/Implant | $151.24 |
| 6037101 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6037102 | STERILE SUPPLY | Supply/Implant | $156.42 |
| 6037103 | STERILE SUPPLY | Supply/Implant | $190.46 |
| 6037106 | SUPPLY IMPLANT | Supply/Implant | $660.48 |
| 6037114 | SUPPLY IMPLANT | Supply/Implant | $604.16 |
| 6037116 | STERILE SUPPLY | Supply/Implant | $396.26 |
| 6037118 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6037119 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6037121 | SUPPLY IMPLANT | Supply/Implant | $251.49 |
| 6037124 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6037125 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6037127 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6037128 | SUPPLY IMPLANT | Supply/Implant | $501.89 |
| 6037130 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6037131 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6037132 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6037133 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6037134 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6037135 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6037136 | SUPPLY IMPLANT | Supply/Implant | $402.56 |
| 6037139 | SUPPLY IMPLANT | Supply/Implant | $570.24 |
| 6037153 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6037155 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6037160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $184.32 |
| 6037165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037171 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6037176 | SUPPLY IMPLANT | Supply/Implant | $402.94 |
| 6037183 | SUPPLY IMPLANT | Supply/Implant | $2,296.96 |
| 6037184 | SUPPLY IMPLANT | Supply/Implant | $2,296.96 |
| 6037185 | SUPPLY IMPLANT | Supply/Implant | $2,296.96 |
| 6037186 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,859.01 |
| 6037188 | STERILE SUPPLY | Supply/Implant | $1,223.77 |
| 6037189 | STERILE SUPPLY | Supply/Implant | $187.90 |
| 6037201 | SUPPLY IMPLANT | Supply/Implant | $8,230.40 |
| 6037202 | GENERAL SUPPLY | Supply/Implant | $224.64 |
| 6037203 | CATHETER, GUIDING | Supply/Implant | $7,680.00 |
| 6037205 | GENERAL SUPPLY | Supply/Implant | $477.44 |
| 6037206 | GENERAL SUPPLY | Supply/Implant | $524.16 |
| 6037207 | SUPPLY IMPLANT | Supply/Implant | $10,432.00 |
| 6037208 | SUPPLY IMPLANT | Supply/Implant | $391.46 |
| 6037209 | GENERAL SUPPLY | Supply/Implant | $304.64 |
| 6037211 | SUPPLY IMPLANT | Supply/Implant | $5,148.45 |
| 6037216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $156.93 |
| 6037218 | SUPPLY IMPLANT | Supply/Implant | $1,866.11 |
| 6037222 | SUPPLY IMPLANT | Supply/Implant | $2,340.10 |
| 6037226 | SUPPLY IMPLANT | Supply/Implant | $2,531.46 |
| 6037235 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,228.80 |
| 6037245 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,854.40 |
| 6037256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,291.20 |
| 6037262 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,961.28 |
| 6037265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6037289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6037298 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037310 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037318 | SUPPLY IMPLANT | Supply/Implant | $9,967.10 |
| 6037319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6037321 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6037323 | SUPPLY IMPLANT | Supply/Implant | $712.96 |
| 6037329 | GENERAL SUPPLY | Supply/Implant | $14,689.02 |
| 6037336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6037343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6037348 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,271.36 |
| 6037353 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,060.80 |
| 6037354 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,060.80 |
| 6037361 | GENERAL SUPPLY | Supply/Implant | $10,198.02 |
| 6037363 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6037365 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037366 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6037367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6037368 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037369 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037373 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037375 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037376 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037378 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037380 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037382 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037388 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6037389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,450.24 |
| 6037406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6037407 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6037416 | GENERAL SUPPLY | Supply/Implant | $9,918.59 |
| 6037417 | GENERAL SUPPLY | Supply/Implant | $9,918.59 |
| 6037425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6037426 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6037429 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6037440 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $105,350.40 |
| 6037442 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,867.20 |
| 6037444 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,867.20 |
| 6037448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6037450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,444.80 |
| 6037454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037460 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037461 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037463 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037466 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037468 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037469 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037470 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037471 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6037473 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6037475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,137.60 |
| 6037476 | SUPPLY IMPLANT | Supply/Implant | $5,152.00 |
| 6037477 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,793.02 |
| 6037479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6037485 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6037506 | SUPPLY IMPLANT | Supply/Implant | $4,579.20 |
| 6037508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,592.00 |
| 6037550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $777.60 |
| 6037554 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6037559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6037578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6037580 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,267.20 |
| 6037596 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6037607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6037611 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6037626 | SUPPLY IMPLANT | Supply/Implant | $8,944.00 |
| 6037643 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037648 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,536.32 |
| 6037657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6037697 | SUPPLY IMPLANT | Supply/Implant | $2,531.46 |
| 6037698 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,291.65 |
| 6037719 | SUPPLY IMPLANT | Supply/Implant | $11,520.38 |
| 6037720 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037725 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,134.40 |
| 6037727 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6037730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6037743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,984.70 |
| 6037744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6037748 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6037762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6037767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037769 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037770 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037792 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037793 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6037795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6037804 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6037807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6037808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6037809 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6037810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6037811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037812 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6037813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6037816 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,913.66 |
| 6037817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,691.20 |
| 6037818 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037819 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,640.70 |
| 6037822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,342.72 |
| 6037823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6037828 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6037833 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6037835 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6037837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6037838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6037839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037850 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6037853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037854 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,553.86 |
| 6037855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6037856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6037865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6037866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037869 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037870 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,360.00 |
| 6037871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6037872 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6037873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037877 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6037879 | SUPPLY IMPLANT | Supply/Implant | $10,240.13 |
| 6037880 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037881 | SUPPLY IMPLANT | Supply/Implant | $10,240.13 |
| 6037882 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6037883 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6037890 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,342.72 |
| 6037891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,419.20 |
| 6037893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6037894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6037897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6037904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6037905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6037907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6037909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6037914 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6037916 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,644.29 |
| 6037922 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037923 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6037924 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6037925 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6037926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6037931 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6037932 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6037933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6037935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,697.60 |
| 6037936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6037938 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6037942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6037949 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,129.60 |
| 6037951 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6037955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6037964 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037965 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6037966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,542.40 |
| 6037967 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,200.00 |
| 6037968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6037969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6037973 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6037974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6037978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6037980 | GENERAL SUPPLY | Supply/Implant | $10,732.80 |
| 6037981 | SUPPLY IMPLANT | Supply/Implant | $19,187.33 |
| 6037983 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,360.00 |
| 6037985 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6037989 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,473.09 |
| 6037991 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6037995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6037997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6038006 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6038014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,820.74 |
| 6038018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6038027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6038031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6038033 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,838.34 |
| 6038034 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,955.20 |
| 6038037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6038038 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038058 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038060 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6038061 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038068 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6038076 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $116,992.00 |
| 6038078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6038085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,184.13 |
| 6038096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6038106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6038107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6038118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038123 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,580.80 |
| 6038129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038132 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,126.72 |
| 6038141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038142 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6038147 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6038148 | INTERSPINOUS IMPLANT | Supply/Implant | $60,678.40 |
| 6038152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6038157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,977.60 |
| 6038159 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038162 | SUPPLY IMPLANT | Supply/Implant | $1,815.42 |
| 6038166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,687.36 |
| 6038171 | SUPPLY IMPLANT | Supply/Implant | $23,511.68 |
| 6038181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6038182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6038183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,112.00 |
| 6038186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6038188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038189 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6038190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,979.20 |
| 6038191 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6038193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038197 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,993.60 |
| 6038207 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6038221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6038226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6038228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6038229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,556.80 |
| 6038230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6038237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6038240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6038246 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6038256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6038257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6038269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,608.00 |
| 6038270 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038274 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6038282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,267.20 |
| 6038298 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6038299 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6038301 | INTERSPINOUS IMPLANT | Supply/Implant | $79,385.60 |
| 6038303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6038308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6038309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,896.00 |
| 6038320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038326 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6038330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,267.20 |
| 6038331 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,829.31 |
| 6038333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,896.00 |
| 6038336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6038337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038348 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6038356 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,496.00 |
| 6038360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6038362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,747.90 |
| 6038368 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6038373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,384.00 |
| 6038378 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6038384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,742.27 |
| 6038415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038416 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038417 | SUPPLY IMPLANT | Supply/Implant | $550.02 |
| 6038418 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6038426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6038434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6038435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6038436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6038440 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6038443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,686.40 |
| 6038447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6038449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6038451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038452 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,192.64 |
| 6038461 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,463.30 |
| 6038464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,384.00 |
| 6038465 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6038467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,686.40 |
| 6038468 | GUIDE WIRE | Supply/Implant | $2,880.00 |
| 6038470 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,747.90 |
| 6038473 | SUPPLY IMPLANT | Supply/Implant | $10,464.00 |
| 6038481 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6038483 | INTERSPINOUS IMPLANT | Supply/Implant | $60,678.40 |
| 6038489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,448.00 |
| 6038493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,224.00 |
| 6038496 | GUIDE WIRE | Supply/Implant | $2,944.00 |
| 6038497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,448.00 |
| 6038502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6038505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038507 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,077.38 |
| 6038508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6038509 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038511 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,618.62 |
| 6038525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038527 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6038528 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038533 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,793.02 |
| 6038534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6038535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,259.20 |
| 6038536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,705.60 |
| 6038543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,448.00 |
| 6038546 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038547 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038553 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038556 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6038557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6038573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,223.81 |
| 6038575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6038579 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6038585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6038586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6038591 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6038592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6038599 | GUIDE WIRE | Supply/Implant | $1,584.00 |
| 6038605 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6038613 | SUPPLY IMPLANT | Supply/Implant | $13,946.88 |
| 6038620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6038624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6038632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6038634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6038635 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,223.81 |
| 6038641 | INTERSPINOUS IMPLANT | Supply/Implant | $25,159.68 |
| 6038647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038652 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6038653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038654 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6038670 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,472.96 |
| 6038673 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038675 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6038678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,797.38 |
| 6038700 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,463.30 |
| 6038703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038716 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038719 | INTERSPINOUS IMPLANT | Supply/Implant | $75,648.00 |
| 6038733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6038735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6038744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038748 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6038749 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6038750 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6038753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038754 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038756 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6038760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6038763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6038770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,606.40 |
| 6038771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6038773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038776 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038777 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,049.47 |
| 6038803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6038819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038821 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6038822 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6038829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6038836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6038838 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6038841 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6038842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6038850 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038851 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6038855 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038858 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,895.62 |
| 6038869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6038884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,473.09 |
| 6038888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6038889 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6038894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,138.82 |
| 6038897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6038901 | SUPPLY IMPLANT | Supply/Implant | $373.63 |
| 6038908 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6038909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6038916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6038917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,758.40 |
| 6038922 | SUPPLY IMPLANT | Supply/Implant | $329.09 |
| 6038923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,516.80 |
| 6038926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6038930 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6038934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6038940 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,702.40 |
| 6038942 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,735.62 |
| 6038943 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6038947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,339.52 |
| 6038951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6038952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,976.00 |
| 6038961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6038973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6038974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6038975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6038977 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,328.00 |
| 6038979 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6038985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6038988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,640.70 |
| 6038993 | SUPPLY IMPLANT | Supply/Implant | $1,971.20 |
| 6038995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,746.24 |
| 6038996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6039000 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6039008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,392.00 |
| 6039009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6039012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6039018 | SUPPLY IMPLANT | Supply/Implant | $8,192.00 |
| 6039021 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,787.07 |
| 6039023 | SUPPLY IMPLANT | Supply/Implant | $4,881.28 |
| 6039030 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6039045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,256.06 |
| 6039046 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,261.12 |
| 6039055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,477.70 |
| 6039063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6039064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6039100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039115 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6039120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6039129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039132 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,960.00 |
| 6039146 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6039164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6039166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6039190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6039193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039207 | SUPPLY IMPLANT | Supply/Implant | $993.28 |
| 6039211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,347.20 |
| 6039219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6039227 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039232 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6039242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6039247 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,241.60 |
| 6039249 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6039253 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6039254 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6039255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,912.00 |
| 6039258 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039259 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039264 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,262.27 |
| 6039281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6039284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,553.60 |
| 6039290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039297 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6039300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039303 | SUPPLY IMPLANT | Supply/Implant | $34,240.00 |
| 6039308 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6039309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,939.20 |
| 6039316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,676.80 |
| 6039323 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6039331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039358 | GENERAL SUPPLY | Supply/Implant | $2,607.74 |
| 6039359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6039368 | SUPPLY IMPLANT | Supply/Implant | $619.14 |
| 6039371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039381 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039382 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6039387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,814.40 |
| 6039391 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,544.06 |
| 6039404 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039405 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6039410 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6039413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6039415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6039422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6039423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,952.00 |
| 6039426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,477.70 |
| 6039430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,548.80 |
| 6039436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039441 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039444 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6039453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6039456 | SUPPLY IMPLANT | Supply/Implant | $23,488.00 |
| 6039467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6039468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6039473 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6039501 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039503 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039504 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039506 | SUPPLY IMPLANT | Supply/Implant | $10,895.23 |
| 6039507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6039512 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6039521 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6039522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6039524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6039526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6039531 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6039532 | SUPPLY IMPLANT | Supply/Implant | $18,304.00 |
| 6039533 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039534 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6039541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039551 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6039552 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6039589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6039590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,262.27 |
| 6039591 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039606 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6039623 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6039641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6039644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039649 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6039651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6039653 | SUPPLY IMPLANT | Supply/Implant | $1,141.89 |
| 6039659 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,203.52 |
| 6039661 | SUPPLY IMPLANT | Supply/Implant | $4,803.20 |
| 6039686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039687 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,088.00 |
| 6039689 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $14,118.40 |
| 6039702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6039705 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,752.00 |
| 6039706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,944.00 |
| 6039707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,944.00 |
| 6039712 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6039713 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6039716 | SUPPLY IMPLANT | Supply/Implant | $43,520.00 |
| 6039732 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6039750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6039751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,766.40 |
| 6039753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6039760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,588.80 |
| 6039770 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6039773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,544.00 |
| 6039782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6039783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6039784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6039785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,735.62 |
| 6039796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,760.00 |
| 6039798 | SUPPLY IMPLANT | Supply/Implant | $6,461.44 |
| 6039803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6039807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6039808 | SUPPLY IMPLANT | Supply/Implant | $806.40 |
| 6039809 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6039836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039840 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6039846 | SUPPLY IMPLANT | Supply/Implant | $7,936.00 |
| 6039847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6039853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,262.27 |
| 6039858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6039859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6039866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6039867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,003.20 |
| 6039871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,392.00 |
| 6039872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6039873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6039875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6039876 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,032.00 |
| 6039885 | SUPPLY IMPLANT | Supply/Implant | $7,430.40 |
| 6039887 | SUPPLY IMPLANT | Supply/Implant | $36,595.20 |
| 6039891 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6039898 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039900 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039902 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6039905 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,866.88 |
| 6039906 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6039907 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039908 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6039909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6039910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6039913 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6039914 | STERILE SUPPLY | Supply/Implant | $5,760.00 |
| 6039918 | SUPPLY IMPLANT | Supply/Implant | $9,987.71 |
| 6039936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6039948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6039960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $116,992.00 |
| 6039961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039963 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6039981 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6039982 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6039984 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6039985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6039999 | GENERAL SUPPLY | Supply/Implant | $278.02 |
| 6040002 | SUPPLY IMPLANT | Supply/Implant | $3,914.02 |
| 6040005 | SUPPLY IMPLANT | Supply/Implant | $1,411.20 |
| 6040006 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6040011 | SUPPLY IMPLANT | Supply/Implant | $2,333.18 |
| 6040015 | SUPPLY IMPLANT | Supply/Implant | $1,243.52 |
| 6040022 | STERILE SUPPLY | Supply/Implant | $1,480.58 |
| 6040026 | SUPPLY IMPLANT | Supply/Implant | $1,415.04 |
| 6040036 | SUPPLY IMPLANT | Supply/Implant | $172.80 |
| 6040042 | GUIDE WIRE | Supply/Implant | $2,931.20 |
| 6040043 | SUPPLY IMPLANT | Supply/Implant | $2,640.00 |
| 6040044 | SUPPLY IMPLANT | Supply/Implant | $1,903.87 |
| 6040047 | SUPPLY IMPLANT | Supply/Implant | $2,015.62 |
| 6040055 | STERILE SUPPLY | Supply/Implant | $7,257.60 |
| 6040060 | SUPPLY IMPLANT | Supply/Implant | $11,123.97 |
| 6040061 | SUPPLY IMPLANT | Supply/Implant | $1,682.56 |
| 6040062 | SUPPLY IMPLANT | Supply/Implant | $682.38 |
| 6040065 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040066 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6040067 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040071 | SUPPLY IMPLANT | Supply/Implant | $10,009.60 |
| 6040072 | SUPPLY IMPLANT | Supply/Implant | $17,619.07 |
| 6040073 | SUPPLY IMPLANT | Supply/Implant | $3,016.45 |
| 6040080 | SUPPLY IMPLANT | Supply/Implant | $1,741.48 |
| 6040098 | SUPPLY IMPLANT | Supply/Implant | $4,410.15 |
| 6040099 | STERILE SUPPLY | Supply/Implant | $595.32 |
| 6040101 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6040105 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6040107 | STERILE SUPPLY | Supply/Implant | $243.71 |
| 6040108 | STERILE SUPPLY | Supply/Implant | $1,635.33 |
| 6040109 | GENERAL SUPPLY | Supply/Implant | $397.82 |
| 6040111 | SUPPLY IMPLANT | Supply/Implant | $862.85 |
| 6040119 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6040121 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6040127 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6040128 | SUPPLY IMPLANT | Supply/Implant | $210.37 |
| 6040130 | STERILE SUPPLY | Supply/Implant | $739.07 |
| 6040131 | SUPPLY IMPLANT | Supply/Implant | $195.56 |
| 6040134 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6040135 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6040136 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6040137 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6040139 | SUPPLY IMPLANT | Supply/Implant | $514.18 |
| 6040142 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6040145 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040146 | SUPPLY IMPLANT | Supply/Implant | $1,197.70 |
| 6040163 | CATHETER, URETERAL | Supply/Implant | $142.72 |
| 6040165 | GENERAL SUPPLY | Supply/Implant | $141.18 |
| 6040166 | SUPPLY IMPLANT | Supply/Implant | $2,640.00 |
| 6040167 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6040169 | STERILE SUPPLY | Supply/Implant | $253.31 |
| 6040178 | SUPPLY IMPLANT | Supply/Implant | $2,687.00 |
| 6040179 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6040180 | STERILE SUPPLY | Supply/Implant | $438.66 |
| 6040181 | STERILE SUPPLY | Supply/Implant | $512.13 |
| 6040191 | SUPPLY IMPLANT | Supply/Implant | $2,204.33 |
| 6040195 | STERILE SUPPLY | Supply/Implant | $370.56 |
| 6040196 | STERILE SUPPLY | Supply/Implant | $276.35 |
| 6040198 | SUPPLY IMPLANT | Supply/Implant | $3,497.73 |
| 6040200 | GENERAL SUPPLY | Supply/Implant | $206.21 |
| 6040201 | GENERAL SUPPLY | Supply/Implant | $376.06 |
| 6040202 | GENERAL SUPPLY | Supply/Implant | $138.24 |
| 6040206 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040207 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6040210 | SUPPLY IMPLANT | Supply/Implant | $1,041.54 |
| 6040213 | STERILE SUPPLY | Supply/Implant | $643.58 |
| 6040216 | SUPPLY IMPLANT | Supply/Implant | $10,176.00 |
| 6040217 | SUPPLY IMPLANT | Supply/Implant | $15,936.00 |
| 6040221 | SUPPLY IMPLANT | Supply/Implant | $2,437.76 |
| 6040222 | STERILE SUPPLY | Supply/Implant | $1,700.86 |
| 6040223 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6040224 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6040233 | SUPPLY IMPLANT | Supply/Implant | $3,705.60 |
| 6040238 | SUPPLY IMPLANT | Supply/Implant | $931.84 |
| 6040239 | SUPPLY IMPLANT | Supply/Implant | $45,209.60 |
| 6040243 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6040244 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6040245 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6040253 | SUPPLY IMPLANT | Supply/Implant | $5,247.10 |
| 6040255 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6040256 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6040260 | SUPPLY IMPLANT | Supply/Implant | $977.92 |
| 6040267 | SUPPLY IMPLANT | Supply/Implant | $741.50 |
| 6040268 | SUPPLY IMPLANT | Supply/Implant | $3,338.88 |
| 6040270 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6040276 | STERILE SUPPLY | Supply/Implant | $522.24 |
| 6040277 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6040278 | SUPPLY IMPLANT | Supply/Implant | $3,338.88 |
| 6040279 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6040309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $281.47 |
| 6040341 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6040390 | GRAFT, VASCULAR | Supply/Implant | $5,286.40 |
| 6040433 | GRAFT, VASCULAR | Supply/Implant | $8,646.02 |
| 6040457 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6040478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,460.80 |
| 6040504 | SUPPLY IMPLANT | Supply/Implant | $53,644.80 |
| 6040506 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6040546 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $11,543.04 |
| 6040549 | SUPPLY IMPLANT | Supply/Implant | $4,264.45 |
| 6040623 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6040679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6040680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,450.24 |
| 6040718 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6040734 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,722.75 |
| 6040802 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6040847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6040857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $82,240.00 |
| 6040898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6040899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,036.80 |
| 6040902 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6040903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6041026 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $4,160.00 |
| 6041096 | SUPPLY IMPLANT | Supply/Implant | $41,484.80 |
| 6041143 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,832.00 |
| 6041177 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,120.00 |
| 6041188 | SUPPLY IMPLANT | Supply/Implant | $5,606.40 |
| 6041197 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6041217 | SUPPLY IMPLANT | Supply/Implant | $15,704.67 |
| 6041224 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6041232 | SUPPLY IMPLANT | Supply/Implant | $870.40 |
| 6041235 | SUPPLY IMPLANT | Supply/Implant | $9,210.62 |
| 6041247 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,832.00 |
| 6041253 | SUPPLY IMPLANT | Supply/Implant | $160.38 |
| 6041264 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $66,577.28 |
| 6041272 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041273 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041275 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041307 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6041316 | SUPPLY IMPLANT | Supply/Implant | $13,056.00 |
| 6041323 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,707.20 |
| 6041345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,292.80 |
| 6041356 | SUPPLY IMPLANT | Supply/Implant | $2,962.56 |
| 6041360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,828.16 |
| 6041412 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6041422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,707.20 |
| 6041428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $124,225.50 |
| 6041444 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041483 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6041484 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6041488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6041497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041498 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041517 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6041518 | VENA CAVA FILTER | Supply/Implant | $13,619.07 |
| 6041520 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041524 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6041536 | SUPPLY IMPLANT | Supply/Implant | $17,446.40 |
| 6041540 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6041541 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6041544 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6041561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,380.80 |
| 6041612 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6041614 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6041729 | SUPPLY IMPLANT | Supply/Implant | $4,313.60 |
| 6041739 | GENERAL SUPPLY | Supply/Implant | $2,243.46 |
| 6041784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,593.60 |
| 6041844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,888.00 |
| 6041866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,910.40 |
| 6041869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,537.60 |
| 6041897 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,510.40 |
| 6041902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,236.03 |
| 6041916 | SUPPLY IMPLANT | Supply/Implant | $8,944.00 |
| 6041927 | SUPPLY IMPLANT | Supply/Implant | $5,280.77 |
| 6041947 | SUPPLY IMPLANT | Supply/Implant | $9,497.60 |
| 6041975 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,580.48 |
| 6041986 | SUPPLY IMPLANT | Supply/Implant | $10,073.60 |
| 6042005 | PROSTHETIC IMPLANT NOS | Supply/Implant | $22,540.80 |
| 6042051 | SUPPLY IMPLANT | Supply/Implant | $3,432.70 |
| 6042055 | INTERSPINOUS IMPLANT | Supply/Implant | $58,240.00 |
| 6042063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6042085 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6042085 | SUPPLY IMPLANT | Supply/Implant | $191.62 |
| 6042099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,052.80 |
| 6042108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $947.20 |
| 6042110 | SUPPLY IMPLANT | Supply/Implant | $15,595.52 |
| 6042120 | SUPPLY IMPLANT | Supply/Implant | $685.57 |
| 6042136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,613.70 |
| 6042161 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6042248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,603.20 |
| 6042252 | SUPPLY IMPLANT | Supply/Implant | $973.44 |
| 6042265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6042289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,555.01 |
| 6042348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,476.67 |
| 6042361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $734.98 |
| 6042367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,437.12 |
| 6042385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,487.81 |
| 6042388 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6042399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,633.47 |
| 6042414 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6042415 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6042483 | SUPPLY IMPLANT | Supply/Implant | $973.44 |
| 6042499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,870.40 |
| 6042512 | SUPPLY IMPLANT | Supply/Implant | $5,116.80 |
| 6042611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,181.12 |
| 6042627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6042653 | GUIDE WIRE | Supply/Implant | $2,995.20 |
| 6042681 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6042764 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6042780 | SUPPLY IMPLANT | Supply/Implant | $2,274.30 |
| 6042858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,676.80 |
| 6042873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6042874 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6042918 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,580.48 |
| 6042941 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6042963 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6043010 | GENERAL SUPPLY | Supply/Implant | $526.34 |
| 6043031 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6043034 | SUPPLY IMPLANT | Supply/Implant | $326.40 |
| 6043045 | SUPPLY IMPLANT | Supply/Implant | $1,352.45 |
| 6043085 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6043148 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6043257 | SUPPLY IMPLANT | Supply/Implant | $323.20 |
| 6043285 | SUPPLY IMPLANT | Supply/Implant | $231.17 |
| 6043287 | SUPPLY IMPLANT | Supply/Implant | $231.17 |
| 6043300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6043323 | SUPPLY IMPLANT | Supply/Implant | $6,988.80 |
| 6043358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,984.70 |
| 6043366 | SUPPLY IMPLANT | Supply/Implant | $1,352.45 |
| 6043387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6043409 | GRAFT, VASCULAR | Supply/Implant | $31,294.08 |
| 6043513 | SUPPLY IMPLANT | Supply/Implant | $324.61 |
| 6043531 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,012.99 |
| 6043576 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $23,667.20 |
| 6043661 | SUPPLY IMPLANT | Supply/Implant | $668.80 |
| 6043674 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6043686 | SUPPLY IMPLANT | Supply/Implant | $4,000.64 |
| 6043689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,704.00 |
| 6043690 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6043704 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6043760 | SUPPLY IMPLANT | Supply/Implant | $23,828.48 |
| 6043770 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6043832 | ALLODERM SKIN SUB | Supply/Implant | $37,465.60 |
| 6043865 | GRAFT, VASCULAR | Supply/Implant | $2,315.26 |
| 6043925 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,296.00 |
| 6043938 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6043947 | SUPPLY IMPLANT | Supply/Implant | $62,933.76 |
| 6043951 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6043954 | SUPPLY IMPLANT | Supply/Implant | $30,087.68 |
| 6043971 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6043979 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,774.40 |
| 6043992 | SUPPLY IMPLANT | Supply/Implant | $1,663.49 |
| 6044000 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6044086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6044087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6044092 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6044096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,481.34 |
| 6044111 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6044117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6044125 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6044133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6044163 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6044167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6044168 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6044180 | SUPPLY IMPLANT | Supply/Implant | $19,403.52 |
| 6044188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,828.48 |
| 6044203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,407.49 |
| 6044237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $784.51 |
| 6044256 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6044269 | SUPPLY IMPLANT | Supply/Implant | $2,754.56 |
| 6044280 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6044294 | SUPPLY IMPLANT | Supply/Implant | $541.27 |
| 6044299 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,588.80 |
| 6044315 | GENERAL SUPPLY | Supply/Implant | $180.48 |
| 6044320 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6044331 | GENERAL SUPPLY | Supply/Implant | $288.26 |
| 6044342 | GENERAL SUPPLY | Supply/Implant | $154.50 |
| 6044345 | GENERAL SUPPLY | Supply/Implant | $419.58 |
| 6044351 | GENERAL SUPPLY | Supply/Implant | $957.80 |
| 6044353 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $798.46 |
| 6044367 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6044374 | GENERAL SUPPLY | Supply/Implant | $327.04 |
| 6044384 | GENERAL SUPPLY | Supply/Implant | $214.14 |
| 6044401 | GENERAL SUPPLY | Supply/Implant | $133.12 |
| 6044403 | STERILE SUPPLY | Supply/Implant | $181.80 |
| 6044407 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6044410 | GENERAL SUPPLY | Supply/Implant | $377.60 |
| 6044418 | SUPPLY IMPLANT | Supply/Implant | $3,123.20 |
| 6044419 | SUPPLY IMPLANT | Supply/Implant | $3,030.14 |
| 6044420 | SUPPLY IMPLANT | Supply/Implant | $3,030.14 |
| 6044429 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6044437 | CATHETER, URETERAL | Supply/Implant | $209.02 |
| 6044438 | CATH, DRAINAGE | Supply/Implant | $291.33 |
| 6044439 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6044440 | CATH, DRAINAGE | Supply/Implant | $325.63 |
| 6044441 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6044442 | SUPPLY IMPLANT | Supply/Implant | $328.45 |
| 6044459 | SUPPLY IMPLANT | Supply/Implant | $219.90 |
| 6044475 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6044510 | SUPPLY IMPLANT | Supply/Implant | $1,679.87 |
| 6044534 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6044535 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6044547 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6044557 | GENERAL SUPPLY | Supply/Implant | $149.76 |
| 6044558 | SUPPLY IMPLANT | Supply/Implant | $178.94 |
| 6044559 | GENERAL SUPPLY | Supply/Implant | $171.65 |
| 6044571 | SUPPLY IMPLANT | Supply/Implant | $1,438.08 |
| 6044615 | STERILE SUPPLY | Supply/Implant | $515.84 |
| 6044616 | STERILE SUPPLY | Supply/Implant | $476.16 |
| 6044633 | GENERAL SUPPLY | Supply/Implant | $185.86 |
| 6044634 | GENERAL SUPPLY | Supply/Implant | $132.48 |
| 6044635 | GENERAL SUPPLY | Supply/Implant | $223.74 |
| 6044647 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $314.24 |
| 6044653 | SUPPLY IMPLANT | Supply/Implant | $2,965.63 |
| 6044672 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,786.18 |
| 6044700 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $2,368.00 |
| 6044720 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6044726 | SUPPLY IMPLANT | Supply/Implant | $457.09 |
| 6044728 | SUPPLY IMPLANT | Supply/Implant | $457.09 |
| 6044730 | SUPPLY IMPLANT | Supply/Implant | $524.29 |
| 6044734 | SUPPLY IMPLANT | Supply/Implant | $566.27 |
| 6044743 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6044813 | SUPPLY IMPLANT | Supply/Implant | $3,415.17 |
| 6044823 | GENERAL SUPPLY | Supply/Implant | $303.49 |
| 6044857 | SUPPLY IMPLANT | Supply/Implant | $211.58 |
| 6044863 | CATHETER, URETERAL | Supply/Implant | $135.55 |
| 6044902 | CATH, DRAINAGE | Supply/Implant | $449.92 |
| 6044903 | SUPPLY IMPLANT | Supply/Implant | $492.93 |
| 6044911 | GENERAL SUPPLY | Supply/Implant | $271.36 |
| 6044912 | SUPPLY IMPLANT | Supply/Implant | $1,505.28 |
| 6044919 | SUPPLY IMPLANT | Supply/Implant | $6,785.66 |
| 6044921 | SUPPLY IMPLANT | Supply/Implant | $917.63 |
| 6044925 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,126.58 |
| 6044945 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6044947 | SUPPLY IMPLANT | Supply/Implant | $3,199.36 |
| 6044995 | CATHETER, URETERAL | Supply/Implant | $231.42 |
| 6045000 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6045004 | TRANS ANGIOPLASTY CATH | Supply/Implant | $12,160.00 |
| 6045027 | STERILE SUPPLY | Supply/Implant | $245.16 |
| 6045028 | STERILE SUPPLY | Supply/Implant | $152.18 |
| 6045050 | SUPPLY IMPLANT | Supply/Implant | $5,542.40 |
| 6045051 | SUPPLY IMPLANT | Supply/Implant | $6,825.60 |
| 6045059 | GENERAL SUPPLY | Supply/Implant | $178.82 |
| 6045068 | STERILE SUPPLY | Supply/Implant | $311.62 |
| 6045094 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6045096 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6045103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6045108 | GENERAL SUPPLY | Supply/Implant | $254.34 |
| 6045117 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6045121 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6045122 | SUPPLY IMPLANT | Supply/Implant | $1,276.80 |
| 6045125 | SUPPLY IMPLANT | Supply/Implant | $1,862.40 |
| 6045134 | SUPPLY IMPLANT | Supply/Implant | $209.54 |
| 6045149 | SUPPLY IMPLANT | Supply/Implant | $1,852.80 |
| 6045177 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6045178 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6045179 | STERILE SUPPLY | Supply/Implant | $3,027.46 |
| 6045182 | SUPPLY IMPLANT | Supply/Implant | $4,134.40 |
| 6045186 | STERILE SUPPLY | Supply/Implant | $5,824.00 |
| 6045212 | CATHETER, GUIDING | Supply/Implant | $275.20 |
| 6045213 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,453.06 |
| 6045227 | SUPPLY IMPLANT | Supply/Implant | $1,244.29 |
| 6045243 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6045246 | SUPPLY IMPLANT | Supply/Implant | $3,600.00 |
| 6045247 | SUPPLY IMPLANT | Supply/Implant | $3,891.20 |
| 6045257 | SUPPLY IMPLANT | Supply/Implant | $4,172.80 |
| 6045269 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,523.20 |
| 6045271 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $38,336.00 |
| 6045275 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6045331 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6045333 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6045505 | SUPPLY IMPLANT | Supply/Implant | $973.44 |
| 6045534 | GENERAL SUPPLY | Supply/Implant | $547.84 |
| 6045553 | CATHETER, GUIDING | Supply/Implant | $275.20 |
| 6045557 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $588.80 |
| 6045587 | STERILE SUPPLY | Supply/Implant | $1,862.14 |
| 6045598 | RET DEV, INSERTABLE | Supply/Implant | $8,960.00 |
| 6045635 | SUPPLY IMPLANT | Supply/Implant | $10,176.00 |
| 6045665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $473.60 |
| 6045666 | SUPPLY IMPLANT | Supply/Implant | $2,585.09 |
| 6045671 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6045672 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,084.80 |
| 6045678 | CATH, DRAINAGE | Supply/Implant | $962.43 |
| 6045680 | GENERAL SUPPLY | Supply/Implant | $363.52 |
| 6045721 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6045725 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6045726 | SUPPLY IMPLANT | Supply/Implant | $460.16 |
| 6045727 | SUPPLY IMPLANT | Supply/Implant | $3,842.05 |
| 6045763 | SUPPLY IMPLANT | Supply/Implant | $175.87 |
| 6045767 | GENERAL SUPPLY | Supply/Implant | $599.04 |
| 6045769 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6045770 | SUPPLY IMPLANT | Supply/Implant | $1,264.64 |
| 6045777 | SUPPLY IMPLANT | Supply/Implant | $362.88 |
| 6045779 | SUPPLY IMPLANT | Supply/Implant | $3,226.34 |
| 6045799 | INTRO/SHEATH, NON-LASER | Supply/Implant | $591.36 |
| 6045800 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6045811 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6045817 | SUPPLY IMPLANT | Supply/Implant | $1,078.27 |
| 6045818 | SUPPLY IMPLANT | Supply/Implant | $3,315.39 |
| 6045822 | SUPPLY IMPLANT | Supply/Implant | $523.49 |
| 6045837 | GENERAL SUPPLY | Supply/Implant | $342.78 |
| 6045843 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6045852 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6045859 | SUPPLY IMPLANT | Supply/Implant | $437.63 |
| 6045863 | SUPPLY IMPLANT | Supply/Implant | $3,315.39 |
| 6045865 | GENERAL SUPPLY | Supply/Implant | $131.58 |
| 6045870 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6045878 | SUPPLY IMPLANT | Supply/Implant | $3,040.00 |
| 6045882 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6045884 | SUPPLY IMPLANT | Supply/Implant | $875.52 |
| 6045897 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,024.90 |
| 6045899 | STERILE SUPPLY | Supply/Implant | $145.02 |
| 6045923 | SUPPLY IMPLANT | Supply/Implant | $406.43 |
| 6045928 | GENERAL SUPPLY | Supply/Implant | $154.37 |
| 6045929 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6045942 | SUPPLY IMPLANT | Supply/Implant | $551.30 |
| 6045944 | CATHETER, GUIDING | Supply/Implant | $4,467.20 |
| 6045947 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6045957 | SUPPLY IMPLANT | Supply/Implant | $1,238.53 |
| 6045958 | SUPPLY IMPLANT | Supply/Implant | $2,802.56 |
| 6045964 | STERILE SUPPLY | Supply/Implant | $906.37 |
| 6045966 | STERILE SUPPLY | Supply/Implant | $914.56 |
| 6045974 | STERILE SUPPLY | Supply/Implant | $214.40 |
| 6045975 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6045976 | GENERAL SUPPLY | Supply/Implant | $172.19 |
| 6045978 | SUPPLY IMPLANT | Supply/Implant | $427.78 |
| 6045985 | STERILE SUPPLY | Supply/Implant | $513.79 |
| 6045999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6046016 | SUPPLY IMPLANT | Supply/Implant | $653.31 |
| 6046017 | STERILE SUPPLY | Supply/Implant | $1,113.60 |
| 6046021 | SUPPLY IMPLANT | Supply/Implant | $406.43 |
| 6046026 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6046034 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6046039 | GENERAL SUPPLY | Supply/Implant | $263.68 |
| 6046039 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6046041 | SUPPLY IMPLANT | Supply/Implant | $8,925.31 |
| 6046049 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6046050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,345.60 |
| 6046054 | STERILE SUPPLY | Supply/Implant | $494.46 |
| 6046055 | MISC SUP/ACC IMP VAD | Supply/Implant | $704.00 |
| 6046065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,640.70 |
| 6046066 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6046082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6046101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6046133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,594.37 |
| 6046137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6046148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6046149 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6046150 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6046153 | SUPPLY IMPLANT | Supply/Implant | $25,110.53 |
| 6046159 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6046188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6046198 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,032.58 |
| 6046234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6046236 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6046244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,425.60 |
| 6046268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6046272 | SUPPLY IMPLANT | Supply/Implant | $122,367.00 |
| 6046281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,407.49 |
| 6046289 | SUPPLY IMPLANT | Supply/Implant | $2,992.64 |
| 6046294 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,360.00 |
| 6046297 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,509.57 |
| 6046324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6046335 | SUPPLY IMPLANT | Supply/Implant | $4,146.56 |
| 6046359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6046386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6046394 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6046405 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6046411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6046412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6046423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6046434 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6046453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $55,632.00 |
| 6046467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6046477 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6046478 | SUPPLY IMPLANT | Supply/Implant | $14,566.40 |
| 6046488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,336.00 |
| 6046489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,336.00 |
| 6046491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6046492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6046494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,336.00 |
| 6046495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,336.00 |
| 6046506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046518 | SUPPLY IMPLANT | Supply/Implant | $853.50 |
| 6046522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6046559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6046593 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6046614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6046644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6046657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6046658 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6046666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6046672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6046680 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $37,760.00 |
| 6046712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6046728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6046733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6046752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6046753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6046772 | GUIDE WIRE | Supply/Implant | $604.16 |
| 6046780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6046792 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,876.35 |
| 6046798 | SUPPLY IMPLANT | Supply/Implant | $884.35 |
| 6046799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,888.00 |
| 6046808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6046823 | GENERAL SUPPLY | Supply/Implant | $10,946.56 |
| 6046826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6046837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6046843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6046877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6046900 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,157.12 |
| 6046904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6046905 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6046906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,398.40 |
| 6046914 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,686.40 |
| 6046916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,949.12 |
| 6046933 | GUIDE WIRE | Supply/Implant | $2,944.00 |
| 6046940 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6046948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,517.76 |
| 6046957 | SUPPLY IMPLANT | Supply/Implant | $13,286.40 |
| 6046958 | SUPPLY IMPLANT | Supply/Implant | $10,939.65 |
| 6046981 | SUPPLY IMPLANT | Supply/Implant | $3,763.20 |
| 6046982 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,294.08 |
| 6046983 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6046988 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6047000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.80 |
| 6047001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6047011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6047018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,556.80 |
| 6047031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6047048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,687.36 |
| 6047050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $440.32 |
| 6047069 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6047075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,580.80 |
| 6047093 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6047130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6047147 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6047151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6047167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6047172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6047178 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6047198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6047199 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6047219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6047221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047228 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,716.80 |
| 6047238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,544.06 |
| 6047241 | SUPPLY IMPLANT | Supply/Implant | $2,754.56 |
| 6047243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6047246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6047251 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6047252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6047253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,072.77 |
| 6047260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6047267 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6047277 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6047282 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6047285 | GUIDE WIRE | Supply/Implant | $524.80 |
| 6047286 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6047300 | SUPPLY IMPLANT | Supply/Implant | $1,080.27 |
| 6047301 | STERILE SUPPLY | Supply/Implant | $7,553.28 |
| 6047303 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6047315 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6047316 | SUPPLY IMPLANT | Supply/Implant | $17,452.29 |
| 6047319 | SUPPLY IMPLANT | Supply/Implant | $2,467.20 |
| 6047334 | GUIDE WIRE | Supply/Implant | $366.46 |
| 6047338 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6047342 | SUPPLY IMPLANT | Supply/Implant | $2,416.64 |
| 6047343 | SUPPLY IMPLANT | Supply/Implant | $3,705.60 |
| 6047353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6047362 | GUIDE WIRE | Supply/Implant | $2,611.20 |
| 6047371 | SUPPLY IMPLANT | Supply/Implant | $2,163.84 |
| 6047376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,318.40 |
| 6047425 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6047426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,793.92 |
| 6047436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6047437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6047448 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6047449 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6047450 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6047452 | STERILE SUPPLY | Supply/Implant | $1,066.75 |
| 6047457 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6047462 | SUPPLY IMPLANT | Supply/Implant | $160.90 |
| 6047480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6047481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6047483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6047517 | STERILE SUPPLY | Supply/Implant | $1,433.60 |
| 6047519 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6047532 | STERILE SUPPLY | Supply/Implant | $210.30 |
| 6047533 | STERILE SUPPLY | Supply/Implant | $1,094.40 |
| 6047540 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,766.40 |
| 6047557 | GRAFT, VASCULAR | Supply/Implant | $79,360.00 |
| 6047564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6047600 | GUIDE WIRE | Supply/Implant | $1,126.27 |
| 6047601 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6047614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,065.02 |
| 6047627 | GENERAL SUPPLY | Supply/Implant | $399.10 |
| 6047641 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6047663 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $8,960.00 |
| 6047666 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6047671 | SUPPLY IMPLANT | Supply/Implant | $1,594.24 |
| 6047672 | SUPPLY IMPLANT | Supply/Implant | $660.61 |
| 6047690 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6047691 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6047692 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6047701 | GENERAL SUPPLY | Supply/Implant | $6,696.32 |
| 6047714 | STERILE SUPPLY | Supply/Implant | $497.61 |
| 6047726 | SUPPLY IMPLANT | Supply/Implant | $3,090.18 |
| 6047733 | STERILE SUPPLY | Supply/Implant | $237.31 |
| 6047736 | SUPPLY IMPLANT | Supply/Implant | $171.14 |
| 6047759 | GENERAL SUPPLY | Supply/Implant | $6,336.00 |
| 6047760 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6047778 | SUPPLY IMPLANT | Supply/Implant | $2,639.03 |
| 6047784 | SUPPLY IMPLANT | Supply/Implant | $300.80 |
| 6047789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6047804 | SUPPLY IMPLANT | Supply/Implant | $10,672.00 |
| 6047811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,394.05 |
| 6047820 | SUPPLY IMPLANT | Supply/Implant | $544.00 |
| 6047824 | SUPPLY IMPLANT | Supply/Implant | $12,172.80 |
| 6047826 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6047827 | CATHETER, GUIDING | Supply/Implant | $1,984.00 |
| 6047828 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6047829 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6047830 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6047834 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6047855 | STERILE SUPPLY | Supply/Implant | $223.87 |
| 6047861 | SUPPLY IMPLANT | Supply/Implant | $2,287.49 |
| 6047870 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,926.40 |
| 6047917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6047958 | GENERAL SUPPLY | Supply/Implant | $1,526.40 |
| 6047962 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6047963 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6047964 | SUPPLY IMPLANT | Supply/Implant | $5,462.40 |
| 6047965 | SUPPLY IMPLANT | Supply/Implant | $5,462.40 |
| 6047977 | SUPPLY IMPLANT | Supply/Implant | $1,161.60 |
| 6047996 | STERILE SUPPLY | Supply/Implant | $760.32 |
| 6048000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,118.21 |
| 6048041 | STERILE SUPPLY | Supply/Implant | $137.22 |
| 6048047 | SUPPLY IMPLANT | Supply/Implant | $231.83 |
| 6048051 | GENERAL SUPPLY | Supply/Implant | $433.66 |
| 6048070 | STERILE SUPPLY | Supply/Implant | $880.26 |
| 6048083 | GENERAL SUPPLY | Supply/Implant | $514.43 |
| 6048112 | GENERAL SUPPLY | Supply/Implant | $150.22 |
| 6048128 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6048138 | STERILE SUPPLY | Supply/Implant | $166.78 |
| 6048143 | STERILE SUPPLY | Supply/Implant | $200.06 |
| 6048143 | STERILE SUPPLY | Supply/Implant | $203.78 |
| 6048151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,534.40 |
| 6048152 | INTEGRA BMWD SKIN SUB | Supply/Implant | $100,317.31 |
| 6048156 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6048167 | GUIDE WIRE | Supply/Implant | $2,534.40 |
| 6048183 | STERILE SUPPLY | Supply/Implant | $183.04 |
| 6048205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,185.60 |
| 6048213 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6048233 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,199.42 |
| 6048245 | GENERAL SUPPLY | Supply/Implant | $306.18 |
| 6048286 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,045.12 |
| 6048289 | CATHETER, GUIDING | Supply/Implant | $8,755.20 |
| 6048294 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6048301 | STERILE SUPPLY | Supply/Implant | $140.42 |
| 6048303 | SUPPLY IMPLANT | Supply/Implant | $5,067.01 |
| 6048305 | SUPPLY IMPLANT | Supply/Implant | $782.08 |
| 6048314 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $343.42 |
| 6048316 | GENERAL SUPPLY | Supply/Implant | $190.46 |
| 6048317 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6048318 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6048319 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6048387 | STERILE SUPPLY | Supply/Implant | $147.60 |
| 6048388 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,298.37 |
| 6048407 | SUPPLY IMPLANT | Supply/Implant | $275.97 |
| 6048414 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6048467 | STERILE SUPPLY | Supply/Implant | $4,377.60 |
| 6048475 | GUIDE WIRE | Supply/Implant | $8,755.20 |
| 6048478 | SUPPLY IMPLANT | Supply/Implant | $307.33 |
| 6048492 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6048497 | STERILE SUPPLY | Supply/Implant | $4,800.00 |
| 6048520 | GENERAL SUPPLY | Supply/Implant | $161.28 |
| 6048521 | GENERAL SUPPLY | Supply/Implant | $161.28 |
| 6048522 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6048523 | GENERAL SUPPLY | Supply/Implant | $153.60 |
| 6048525 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $153.60 |
| 6048529 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6048548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6048554 | SUPPLY IMPLANT | Supply/Implant | $27,522.69 |
| 6048559 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6048560 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6048561 | GENERAL SUPPLY | Supply/Implant | $234.66 |
| 6048569 | SUPPLY IMPLANT | Supply/Implant | $1,848.96 |
| 6048595 | GUIDE WIRE | Supply/Implant | $1,024.00 |
| 6048596 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6048597 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6048615 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,520.00 |
| 6048624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6048640 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $27,522.69 |
| 6048641 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6048643 | SUPPLY IMPLANT | Supply/Implant | $4,838.40 |
| 6048674 | SUPPLY IMPLANT | Supply/Implant | $2,879.36 |
| 6048676 | SUPPLY IMPLANT | Supply/Implant | $487.30 |
| 6048694 | SUPPLY IMPLANT | Supply/Implant | $3,427.20 |
| 6048697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6048724 | STERILE SUPPLY | Supply/Implant | $690.05 |
| 6048734 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6048742 | SUPPLY IMPLANT | Supply/Implant | $13,760.00 |
| 6048759 | SUPPLY IMPLANT | Supply/Implant | $273.97 |
| 6048767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6048777 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6048780 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6048791 | SUPPLY IMPLANT | Supply/Implant | $260.20 |
| 6048795 | SUPPLY IMPLANT | Supply/Implant | $1,930.24 |
| 6048811 | STERILE SUPPLY | Supply/Implant | $162.82 |
| 6048821 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6048823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,784.32 |
| 6048824 | STERILE SUPPLY | Supply/Implant | $264.77 |
| 6048894 | VENA CAVA FILTER | Supply/Implant | $1,536.00 |
| 6048898 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6048903 | INTRO/SHEATH, NON-LASER | Supply/Implant | $506.24 |
| 6048928 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6048929 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6048931 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6048934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $49,470.98 |
| 6048978 | SUPPLY IMPLANT | Supply/Implant | $6,338.56 |
| 6048979 | SUPPLY IMPLANT | Supply/Implant | $5,468.16 |
| 6048980 | SUPPLY IMPLANT | Supply/Implant | $5,376.00 |
| 6048981 | SUPPLY IMPLANT | Supply/Implant | $6,215.68 |
| 6048992 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,395.26 |
| 6049008 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6049009 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6049040 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6049067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,369.92 |
| 6049071 | GENERAL SUPPLY | Supply/Implant | $6,387.20 |
| 6049111 | STERILE SUPPLY | Supply/Implant | $1,594.88 |
| 6049158 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6049159 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6049160 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6049178 | SUPPLY IMPLANT | Supply/Implant | $2,313.60 |
| 6049231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $840.45 |
| 6049249 | GUIDE WIRE | Supply/Implant | $135.42 |
| 6049266 | STERILE SUPPLY | Supply/Implant | $231.85 |
| 6049275 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6049293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6049332 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6049340 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $1,088.00 |
| 6049357 | STERILE SUPPLY | Supply/Implant | $448.32 |
| 6049358 | GENERAL SUPPLY | Supply/Implant | $1,218.05 |
| 6049359 | GENERAL SUPPLY | Supply/Implant | $981.50 |
| 6049422 | SUPPLY IMPLANT | Supply/Implant | $3,635.20 |
| 6049464 | SUPPLY IMPLANT | Supply/Implant | $672.26 |
| 6049477 | GENERAL SUPPLY | Supply/Implant | $147.33 |
| 6049501 | SUPPLY IMPLANT | Supply/Implant | $19,826.05 |
| 6049508 | GENERAL SUPPLY | Supply/Implant | $330.69 |
| 6049526 | SUPPLY IMPLANT | Supply/Implant | $2,935.81 |
| 6049557 | STERILE SUPPLY | Supply/Implant | $304.88 |
| 6049590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6049605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,636.99 |
| 6049655 | SUPPLY IMPLANT | Supply/Implant | $1,055.49 |
| 6049726 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6049727 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6049738 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,944.00 |
| 6049770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6049795 | SUPPLY IMPLANT | Supply/Implant | $2,015.62 |
| 6049802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6049862 | GENERAL SUPPLY | Supply/Implant | $409.15 |
| 6049872 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049873 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049874 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049875 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049876 | GENERAL SUPPLY | Supply/Implant | $191.87 |
| 6049891 | GENERAL SUPPLY | Supply/Implant | $221.18 |
| 6049892 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6049893 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6049894 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6049895 | GENERAL SUPPLY | Supply/Implant | $217.09 |
| 6049896 | GENERAL SUPPLY | Supply/Implant | $217.09 |
| 6049949 | STERILE SUPPLY | Supply/Implant | $8,704.00 |
| 6050023 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6050024 | GENERAL SUPPLY | Supply/Implant | $374.66 |
| 6050056 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6050083 | GENERAL SUPPLY | Supply/Implant | $314.11 |
| 6050139 | GENERAL SUPPLY | Supply/Implant | $652.80 |
| 6050170 | STERILE SUPPLY | Supply/Implant | $174.81 |
| 6050225 | STERILE SUPPLY | Supply/Implant | $1,629.70 |
| 6050249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6050250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6050271 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6050272 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6050287 | CATH, DRAINAGE | Supply/Implant | $1,021.44 |
| 6050315 | STERILE SUPPLY | Supply/Implant | $273.15 |
| 6050333 | STERILE SUPPLY | Supply/Implant | $511.36 |
| 6050353 | GENERAL SUPPLY | Supply/Implant | $883.20 |
| 6050354 | SUPPLY IMPLANT | Supply/Implant | $1,591.30 |
| 6050419 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,920.00 |
| 6050432 | GENERAL SUPPLY | Supply/Implant | $732.93 |
| 6050490 | SUPPLY IMPLANT | Supply/Implant | $534.27 |
| 6050491 | SUPPLY IMPLANT | Supply/Implant | $605.57 |
| 6050501 | SUPPLY IMPLANT | Supply/Implant | $2,050.30 |
| 6050502 | SUPPLY IMPLANT | Supply/Implant | $2,050.30 |
| 6050504 | SUPPLY IMPLANT | Supply/Implant | $1,114.24 |
| 6050505 | SUPPLY IMPLANT | Supply/Implant | $1,114.24 |
| 6050506 | SUPPLY IMPLANT | Supply/Implant | $1,114.24 |
| 6050551 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6050552 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6050553 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6050554 | SUPPLY IMPLANT | Supply/Implant | $534.27 |
| 6050563 | GENERAL SUPPLY | Supply/Implant | $12,921.60 |
| 6050564 | GENERAL SUPPLY | Supply/Implant | $23,936.00 |
| 6050565 | GENERAL SUPPLY | Supply/Implant | $12,921.60 |
| 6050603 | GENERAL SUPPLY | Supply/Implant | $148.79 |
| 6050621 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6050665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6050673 | SUPPLY IMPLANT | Supply/Implant | $4,257.59 |
| 6050688 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6050702 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6050703 | STERILE SUPPLY | Supply/Implant | $1,585.15 |
| 6050824 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6050828 | GENERAL SUPPLY | Supply/Implant | $273.02 |
| 6050847 | GENERAL SUPPLY | Supply/Implant | $3,360.00 |
| 6050881 | SUPPLY IMPLANT | Supply/Implant | $184.32 |
| 6050883 | SUPPLY IMPLANT | Supply/Implant | $184.32 |
| 6050920 | STERILE SUPPLY | Supply/Implant | $839.81 |
| 6050921 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $1,575.94 |
| 6050922 | STERILE SUPPLY | Supply/Implant | $270.72 |
| 6050923 | SUPPLY IMPLANT | Supply/Implant | $8,768.00 |
| 6050976 | GENERAL SUPPLY | Supply/Implant | $4,198.40 |
| 6051012 | GENERAL SUPPLY | Supply/Implant | $336.00 |
| 6051058 | STERILE SUPPLY | Supply/Implant | $187.90 |
| 6051072 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6051073 | SUPPLY IMPLANT | Supply/Implant | $4,684.54 |
| 6051075 | STERILE SUPPLY | Supply/Implant | $1,202.05 |
| 6051083 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6051084 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6051103 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6051165 | STERILE SUPPLY | Supply/Implant | $555.07 |
| 6051166 | SUPPLY IMPLANT | Supply/Implant | $469.25 |
| 6051172 | SUPPLY IMPLANT | Supply/Implant | $5,286.40 |
| 6051173 | GENERAL SUPPLY | Supply/Implant | $5,286.40 |
| 6051199 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6051200 | OSSICULAR IMPLANT | Supply/Implant | $4,963.97 |
| 6051282 | SUPPLY IMPLANT | Supply/Implant | $342.78 |
| 6051299 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,395.20 |
| 6051341 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6051342 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6051357 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6051373 | WOUND FILLER GEL/PASTE /OZ | Supply/Implant | $596.48 |
| 6051403 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6051433 | STERILE SUPPLY | Supply/Implant | $1,818.62 |
| 6051434 | STERILE SUPPLY | Supply/Implant | $1,341.82 |
| 6051437 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6051438 | SUPPLY IMPLANT | Supply/Implant | $143.87 |
| 6051439 | INTRO/SHEATH, NON-LASER | Supply/Implant | $136.03 |
| 6051447 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $3,210.24 |
| 6051494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $784.51 |
| 6051495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.85 |
| 6051496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,633.47 |
| 6051499 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6051507 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6051523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6051524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6051553 | STERILE SUPPLY | Supply/Implant | $1,600.51 |
| 6051557 | STERILE SUPPLY | Supply/Implant | $441.60 |
| 6051566 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6051590 | GRAFT, VASCULAR | Supply/Implant | $36,812.80 |
| 6051604 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6051660 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6051666 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6051681 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6051705 | STERILE SUPPLY | Supply/Implant | $1,094.40 |
| 6051711 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6051716 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6051736 | SUPPLY IMPLANT | Supply/Implant | $357.89 |
| 6051739 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6051749 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6051773 | SUPPLY IMPLANT | Supply/Implant | $16,192.00 |
| 6051774 | SUPPLY IMPLANT | Supply/Implant | $5,652.48 |
| 6051779 | SUPPLY IMPLANT | Supply/Implant | $246.78 |
| 6051781 | SUPPLY IMPLANT | Supply/Implant | $1,086.46 |
| 6051782 | SUPPLY IMPLANT | Supply/Implant | $1,207.21 |
| 6051792 | SUPPLY IMPLANT | Supply/Implant | $192.26 |
| 6051794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6051797 | SUPPLY IMPLANT | Supply/Implant | $529.28 |
| 6051798 | SUPPLY IMPLANT | Supply/Implant | $475.84 |
| 6051817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6051818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6051820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6051913 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,718.40 |
| 6051951 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6051989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6051991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,826.62 |
| 6051993 | SUPPLY IMPLANT | Supply/Implant | $4,852.35 |
| 6052050 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6052051 | GENERAL SUPPLY | Supply/Implant | $285.95 |
| 6052058 | SUPPLY IMPLANT | Supply/Implant | $713.60 |
| 6052091 | SUPPLY IMPLANT | Supply/Implant | $210.05 |
| 6052099 | STERILE SUPPLY | Supply/Implant | $1,127.04 |
| 6052101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $632.32 |
| 6052113 | GENERAL SUPPLY | Supply/Implant | $181.89 |
| 6052135 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6052173 | SUPPLY IMPLANT | Supply/Implant | $199.17 |
| 6052174 | SUPPLY IMPLANT | Supply/Implant | $333.18 |
| 6052209 | GENERAL SUPPLY | Supply/Implant | $974.59 |
| 6052231 | GRAFT, VASCULAR | Supply/Implant | $23,244.80 |
| 6052234 | SUPPLY IMPLANT | Supply/Implant | $1,719.17 |
| 6052242 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6052259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,062.59 |
| 6052272 | CATHETER, GUIDING | Supply/Implant | $14,080.00 |
| 6052280 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6052313 | SUPPLY IMPLANT | Supply/Implant | $3,342.21 |
| 6052357 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6052375 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6052389 | SUPPLY IMPLANT | Supply/Implant | $24,384.00 |
| 6052395 | SUPPLY IMPLANT | Supply/Implant | $7,088.00 |
| 6052401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $750.85 |
| 6052413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,830.78 |
| 6052415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6052418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6052434 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $33,851.78 |
| 6052466 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6052476 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6052477 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6052482 | SUPPLY IMPLANT | Supply/Implant | $140.16 |
| 6052483 | SUPPLY IMPLANT | Supply/Implant | $140.16 |
| 6052488 | STERILE SUPPLY | Supply/Implant | $915.20 |
| 6052505 | STERILE SUPPLY | Supply/Implant | $165.43 |
| 6052531 | STERILE SUPPLY | Supply/Implant | $3,028.48 |
| 6052555 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6052556 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6052557 | SUPPLY IMPLANT | Supply/Implant | $131.07 |
| 6052570 | CATHETER, GUIDING | Supply/Implant | $9,344.00 |
| 6052573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,498.62 |
| 6052648 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.64 |
| 6052656 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6052658 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6052659 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6052660 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6052663 | GUIDE WIRE | Supply/Implant | $4,787.20 |
| 6052664 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6052665 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6052666 | GUIDE WIRE | Supply/Implant | $2,035.20 |
| 6052680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6052683 | SEPTAL DEFECT IMP SYS | Supply/Implant | $80,768.00 |
| 6052705 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6052737 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6052741 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6052784 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052788 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052790 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052796 | SUPPLY IMPLANT | Supply/Implant | $2,711.42 |
| 6052797 | SUPPLY IMPLANT | Supply/Implant | $2,711.42 |
| 6052805 | SUPPLY IMPLANT | Supply/Implant | $2,583.17 |
| 6052822 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6052826 | GENERAL SUPPLY | Supply/Implant | $1,512.19 |
| 6052830 | GENERAL SUPPLY | Supply/Implant | $294.66 |
| 6052845 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6052896 | GENERAL SUPPLY | Supply/Implant | $1,385.60 |
| 6052950 | PROSTHESIS, BREAST, IMP | Supply/Implant | $5,632.00 |
| 6052952 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6052974 | MESH (IMPLANTABLE) | Supply/Implant | $86,937.60 |
| 6052988 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6052989 | GENERAL SUPPLY | Supply/Implant | $547.84 |
| 6052998 | GENERAL SUPPLY | Supply/Implant | $296.32 |
| 6053002 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $13,760.00 |
| 6053006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6053015 | GUIDE WIRE | Supply/Implant | $3,712.00 |
| 6053039 | SUPPLY IMPLANT | Supply/Implant | $3,379.20 |
| 6053041 | SUPPLY IMPLANT | Supply/Implant | $2,252.80 |
| 6053056 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,960.00 |
| 6053094 | GENERAL SUPPLY | Supply/Implant | $1,924.35 |
| 6053095 | SUPPLY IMPLANT | Supply/Implant | $2,293.76 |
| 6053103 | GUIDE WIRE | Supply/Implant | $2,240.00 |
| 6053106 | SUPPLY IMPLANT | Supply/Implant | $364.80 |
| 6053111 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6053126 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6053131 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6053134 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6053137 | SUPPLY IMPLANT | Supply/Implant | $3,459.43 |
| 6053180 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6053183 | STERILE SUPPLY | Supply/Implant | $1,152.00 |
| 6053200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,937.92 |
| 6053208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6053229 | SUPPLY IMPLANT | Supply/Implant | $2,580.48 |
| 6053254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,981.89 |
| 6053261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053267 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6053272 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6053274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6053277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,747.20 |
| 6053281 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6053343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,905.60 |
| 6053354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6053355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6053373 | STERILE SUPPLY | Supply/Implant | $5,068.80 |
| 6053393 | SUPPLY IMPLANT | Supply/Implant | $1,080.32 |
| 6053398 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6053409 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6053413 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6053417 | CATHETER, URETERAL | Supply/Implant | $266.62 |
| 6053422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6053423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,072.77 |
| 6053424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,463.87 |
| 6053430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6053464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6053469 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6053470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,558.40 |
| 6053481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6053482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6053490 | STERILE SUPPLY | Supply/Implant | $142.98 |
| 6053491 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $588.80 |
| 6053524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,463.87 |
| 6053548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,393.60 |
| 6053588 | SUPPLY IMPLANT | Supply/Implant | $2,134.40 |
| 6053600 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6053608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6053664 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6053665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,913.66 |
| 6053705 | GENERAL SUPPLY | Supply/Implant | $360.96 |
| 6053706 | GENERAL SUPPLY | Supply/Implant | $474.62 |
| 6053707 | STERILE SUPPLY | Supply/Implant | $158.21 |
| 6053744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,509.12 |
| 6053746 | SUPPLY IMPLANT | Supply/Implant | $7,027.20 |
| 6053752 | SUPPLY IMPLANT | Supply/Implant | $48,869.63 |
| 6053756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6053757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6053770 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6053771 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6053788 | GENERAL SUPPLY | Supply/Implant | $28,160.00 |
| 6053810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,348.80 |
| 6053817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,072.77 |
| 6053818 | GUIDE WIRE | Supply/Implant | $1,238.40 |
| 6053823 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6053836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6053837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6053840 | GENERAL SUPPLY | Supply/Implant | $160.17 |
| 6053842 | SUPPLY IMPLANT | Supply/Implant | $266.50 |
| 6053844 | SUPPLY IMPLANT | Supply/Implant | $3,320.32 |
| 6053880 | WHFO,NO JOINT, PREFABRICATED | Supply/Implant | $281.60 |
| 6053908 | SUPPLY IMPLANT | Supply/Implant | $1,081.22 |
| 6053911 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6053921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6053941 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6053947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6053950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,878.40 |
| 6053951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,696.70 |
| 6053952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6053960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,220.42 |
| 6053965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6054024 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $34,835.84 |
| 6054031 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6054032 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6054033 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6054047 | SUPPLY IMPLANT | Supply/Implant | $3,421.44 |
| 6054064 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,751.17 |
| 6054083 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6054088 | STERILE SUPPLY | Supply/Implant | $5,013.50 |
| 6054114 | GUIDE WIRE | Supply/Implant | $7,155.20 |
| 6054126 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6054127 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6054128 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6054145 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6054153 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6054154 | SUPPLY IMPLANT | Supply/Implant | $6,054.40 |
| 6054159 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6054160 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6054169 | CATHETER, GUIDING | Supply/Implant | $1,632.00 |
| 6054186 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6054192 | GENERAL SUPPLY | Supply/Implant | $7,324.80 |
| 6054197 | STERILE SUPPLY | Supply/Implant | $5,843.20 |
| 6054199 | STERILE SUPPLY | Supply/Implant | $4,608.00 |
| 6054200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,398.40 |
| 6054207 | SUPPLY IMPLANT | Supply/Implant | $3,139.20 |
| 6054208 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6054209 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,624.00 |
| 6054210 | SUPPLY IMPLANT | Supply/Implant | $42,560.00 |
| 6054211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,062.59 |
| 6054218 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $90,457.60 |
| 6054253 | SUPPLY IMPLANT | Supply/Implant | $3,571.20 |
| 6054264 | SUPPLY IMPLANT | Supply/Implant | $34,568.45 |
| 6054293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6054300 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6054328 | SUPPLY IMPLANT | Supply/Implant | $823.68 |
| 6054335 | SUPPLY IMPLANT | Supply/Implant | $945.41 |
| 6054339 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6054351 | SUPPLY IMPLANT | Supply/Implant | $2,130.69 |
| 6054353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,304.00 |
| 6054364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,259.20 |
| 6054365 | SUPPLY IMPLANT | Supply/Implant | $340.74 |
| 6054368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6054376 | SUPPLY IMPLANT | Supply/Implant | $458.11 |
| 6054380 | SUPPLY IMPLANT | Supply/Implant | $1,088.26 |
| 6054383 | SUPPLY IMPLANT | Supply/Implant | $160.77 |
| 6054407 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6054421 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6054423 | SUPPLY IMPLANT | Supply/Implant | $3,315.71 |
| 6054430 | SUPPLY IMPLANT | Supply/Implant | $446.98 |
| 6054432 | SUPPLY IMPLANT | Supply/Implant | $453.76 |
| 6054439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,411.39 |
| 6054442 | STERILE SUPPLY | Supply/Implant | $1,660.80 |
| 6054472 | STERILE SUPPLY | Supply/Implant | $3,264.00 |
| 6054477 | SUPPLY IMPLANT | Supply/Implant | $3,030.14 |
| 6054492 | STERILE SUPPLY | Supply/Implant | $1,536.00 |
| 6054520 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6054522 | SUPPLY IMPLANT | Supply/Implant | $329.47 |
| 6054534 | GENERAL SUPPLY | Supply/Implant | $188.75 |
| 6054543 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054544 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054546 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054547 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054548 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054549 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054550 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6054563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6054606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6054608 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6054638 | SUPPLY IMPLANT | Supply/Implant | $402.43 |
| 6054645 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,587.20 |
| 6054681 | GENERAL SUPPLY | Supply/Implant | $666.37 |
| 6054682 | GENERAL SUPPLY | Supply/Implant | $785.54 |
| 6054709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,697.60 |
| 6054711 | CATHETER, GUIDING | Supply/Implant | $1,935.36 |
| 6054775 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6054794 | SUPPLY IMPLANT | Supply/Implant | $1,971.20 |
| 6054813 | GENERAL SUPPLY | Supply/Implant | $203.52 |
| 6054845 | STERILE SUPPLY | Supply/Implant | $450.56 |
| 6054850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,124.80 |
| 6054889 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,000.00 |
| 6054925 | STERILE SUPPLY | Supply/Implant | $3,315.20 |
| 6054946 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6055036 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6055037 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6055073 | GENERAL SUPPLY | Supply/Implant | $12,221.95 |
| 6055074 | GENERAL SUPPLY | Supply/Implant | $11,640.70 |
| 6055075 | STERILE SUPPLY | Supply/Implant | $13,210.24 |
| 6055076 | GENERAL SUPPLY | Supply/Implant | $12,338.69 |
| 6055117 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $309.50 |
| 6055123 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $309.50 |
| 6055162 | GENERAL SUPPLY | Supply/Implant | $1,073.79 |
| 6055167 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6055174 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6055175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $727.04 |
| 6055217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,304.00 |
| 6055293 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,072.00 |
| 6055330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055337 | SUPPLY IMPLANT | Supply/Implant | $4,515.84 |
| 6055340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6055385 | GUIDE WIRE | Supply/Implant | $2,134.40 |
| 6055389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6055392 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6055435 | SUPPLY IMPLANT | Supply/Implant | $52,416.00 |
| 6055455 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $560.00 |
| 6055489 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6055496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6055514 | GENERAL SUPPLY | Supply/Implant | $646.66 |
| 6055532 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6055535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6055540 | SUPPLY IMPLANT | Supply/Implant | $13,120.00 |
| 6055543 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,663.74 |
| 6055544 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,664.00 |
| 6055548 | GENERAL SUPPLY | Supply/Implant | $1,209.60 |
| 6055562 | SUPPLY IMPLANT | Supply/Implant | $4,963.97 |
| 6055568 | CATH, DRAINAGE | Supply/Implant | $935.68 |
| 6055619 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6055620 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6055638 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6055639 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,381.38 |
| 6055640 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $37,381.38 |
| 6055688 | CATH, DRAINAGE | Supply/Implant | $1,042.69 |
| 6055777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6055825 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6055862 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6055890 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6055895 | SUPPLY IMPLANT | Supply/Implant | $46,016.00 |
| 6055911 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,552.00 |
| 6055917 | CATH, DRAINAGE | Supply/Implant | $2,204.16 |
| 6056017 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,859.01 |
| 6056050 | GENERAL SUPPLY | Supply/Implant | $221.06 |
| 6056055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,117.76 |
| 6056064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,280.00 |
| 6056071 | GENERAL SUPPLY | Supply/Implant | $366.08 |
| 6056073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6056082 | GENERAL SUPPLY | Supply/Implant | $2,573.31 |
| 6056118 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6056120 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6056149 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056150 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056151 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056156 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $3,769.60 |
| 6056158 | SUPPLY IMPLANT | Supply/Implant | $526.34 |
| 6056160 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6056162 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6056217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,060.80 |
| 6056231 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6056285 | SUPPLY IMPLANT | Supply/Implant | $1,703.55 |
| 6056287 | STERILE SUPPLY | Supply/Implant | $4,470.02 |
| 6056295 | SUPPLY IMPLANT | Supply/Implant | $3,257.47 |
| 6056296 | GENERAL SUPPLY | Supply/Implant | $1,550.46 |
| 6056307 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $273,609.00 |
| 6056310 | STERILE SUPPLY | Supply/Implant | $635.40 |
| 6056327 | GENERAL SUPPLY | Supply/Implant | $358.66 |
| 6056354 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6056364 | GENERAL SUPPLY | Supply/Implant | $942.98 |
| 6056368 | GENERAL SUPPLY | Supply/Implant | $131.20 |
| 6056378 | GENERAL SUPPLY | Supply/Implant | $952.32 |
| 6056379 | SUPPLY IMPLANT | Supply/Implant | $143.62 |
| 6056450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6056453 | SUPPLY IMPLANT | Supply/Implant | $381.82 |
| 6056459 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6056460 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6056461 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6056507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6056520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6056537 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6056547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.29 |
| 6056554 | SUPPLY IMPLANT | Supply/Implant | $3,764.10 |
| 6056568 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6056571 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6056573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6056576 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6056616 | SUPPLY IMPLANT | Supply/Implant | $12,224.00 |
| 6056617 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,509.12 |
| 6056619 | GENERAL DRUG | Supply/Implant | $263.68 |
| 6056636 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6056659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,179.20 |
| 6056665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6056667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6056691 | CATHETER, GUIDING | Supply/Implant | $5,158.40 |
| 6056692 | CATHETER, GUIDING | Supply/Implant | $5,158.40 |
| 6056694 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6056695 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6056696 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6056723 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6056741 | SUPPLY IMPLANT | Supply/Implant | $10,432.00 |
| 6056760 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6056771 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6056790 | SUPPLY IMPLANT | Supply/Implant | $5,624.32 |
| 6056791 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6056792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,099.20 |
| 6056799 | SUPPLY IMPLANT | Supply/Implant | $1,760.00 |
| 6056812 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6056814 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6056815 | GENERAL SUPPLY | Supply/Implant | $472.32 |
| 6056816 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6056834 | STERILE SUPPLY | Supply/Implant | $133.25 |
| 6056907 | SUPPLY IMPLANT | Supply/Implant | $959.36 |
| 6056912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6056943 | INTRO/SHEATH, NON-LASER | Supply/Implant | $560.00 |
| 6056944 | INTRO/SHEATH, NON-LASER | Supply/Implant | $560.00 |
| 6056945 | GENERAL SUPPLY | Supply/Implant | $128.38 |
| 6056949 | SUPPLY IMPLANT | Supply/Implant | $5,702.02 |
| 6056961 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6056975 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $13,555.20 |
| 6056976 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $13,555.20 |
| 6057031 | SUPPLY IMPLANT | Supply/Implant | $3,025.66 |
| 6057044 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6057055 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6057061 | STERILE SUPPLY | Supply/Implant | $2,099.97 |
| 6057067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6057079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6057086 | SUPPLY IMPLANT | Supply/Implant | $509.18 |
| 6057103 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6057112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6057113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6057132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6057139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,114.24 |
| 6057144 | SUPPLY IMPLANT | Supply/Implant | $1,484.42 |
| 6057151 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6057152 | SUPPLY IMPLANT | Supply/Implant | $4,121.60 |
| 6057154 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6057155 | SUPPLY IMPLANT | Supply/Implant | $634.50 |
| 6057156 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6057158 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6057161 | SUPPLY IMPLANT | Supply/Implant | $4,318.34 |
| 6057166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6057168 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6057171 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6057181 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6057189 | SUPPLY IMPLANT | Supply/Implant | $669.44 |
| 6057190 | SUPPLY IMPLANT | Supply/Implant | $422.40 |
| 6057191 | SUPPLY IMPLANT | Supply/Implant | $422.40 |
| 6057207 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057209 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057222 | GENERAL SUPPLY | Supply/Implant | $329.73 |
| 6057227 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057229 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057230 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057231 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057232 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057233 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6057262 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057283 | SUPPLY IMPLANT | Supply/Implant | $13,060.10 |
| 6057286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6057287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6057289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,825.60 |
| 6057296 | DEXTRANOMER/HYALURONIC ACID 1 ML | Supply/Implant | $24,312.96 |
| 6057298 | SUPPLY IMPLANT | Supply/Implant | $3,010.62 |
| 6057306 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6057309 | GENERAL SUPPLY | Supply/Implant | $855.04 |
| 6057312 | RET DEV, INSERTABLE | Supply/Implant | $4,096.00 |
| 6057313 | CATHETER, GUIDING | Supply/Implant | $202.24 |
| 6057316 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,748.10 |
| 6057318 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6057319 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,404.93 |
| 6057321 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $32,000.00 |
| 6057338 | RET DEV, INSERTABLE | Supply/Implant | $7,253.34 |
| 6057358 | ALLODERM SKIN SUB | Supply/Implant | $123,891.20 |
| 6057368 | SUPPLY IMPLANT | Supply/Implant | $2,539.52 |
| 6057370 | SUPPLY IMPLANT | Supply/Implant | $3,061.76 |
| 6057371 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6057373 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $1,941.38 |
| 6057379 | GUIDE WIRE | Supply/Implant | $715.14 |
| 6057382 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6057390 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,003.58 |
| 6057391 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,914.75 |
| 6057392 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,204.67 |
| 6057393 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,062.59 |
| 6057402 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,113.60 |
| 6057403 | SUPPLY IMPLANT | Supply/Implant | $3,980.80 |
| 6057407 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6057409 | INTRO/SHEATH, NON-LASER | Supply/Implant | $985.60 |
| 6057410 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6057430 | SUPPLY IMPLANT | Supply/Implant | $19,129.60 |
| 6057431 | SUPPLY IMPLANT | Supply/Implant | $19,129.60 |
| 6057437 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,520.38 |
| 6057441 | GUIDE WIRE | Supply/Implant | $247.04 |
| 6057443 | SUPPLY IMPLANT | Supply/Implant | $1,446.40 |
| 6057448 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $8,896.00 |
| 6057463 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,808.00 |
| 6057468 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,928.00 |
| 6057469 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6057489 | ALLODERM SKIN SUB | Supply/Implant | $123,891.20 |
| 6057521 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6057526 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6057527 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6057533 | GUIDE WIRE | Supply/Implant | $2,005.18 |
| 6057534 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6057535 | GUIDE WIRE | Supply/Implant | $4,369.92 |
| 6057536 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,043.97 |
| 6057539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,640.00 |
| 6057550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6057567 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6057568 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6057583 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,424.00 |
| 6057600 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,352.45 |
| 6057614 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6057616 | SUPPLY IMPLANT | Supply/Implant | $108,517.50 |
| 6057618 | SUPPLY IMPLANT | Supply/Implant | $3,955.20 |
| 6057623 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6057624 | SUPPLY IMPLANT | Supply/Implant | $2,240.51 |
| 6057626 | SUPPLY IMPLANT | Supply/Implant | $526.34 |
| 6057628 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6057629 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6057630 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6057631 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6057640 | GENERAL SUPPLY | Supply/Implant | $4,296.70 |
| 6057642 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6057657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.26 |
| 6057658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.26 |
| 6057659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $713.60 |
| 6057664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,715.20 |
| 6057665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6057671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,872.70 |
| 6057673 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6057678 | SUPPLY IMPLANT | Supply/Implant | $3,212.80 |
| 6057680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6057681 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6057689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,188.80 |
| 6057690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6057691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6057701 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6057704 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6057705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $736.90 |
| 6057706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6057707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6057710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,520.00 |
| 6057718 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6057719 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,886.40 |
| 6057734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6057735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,993.60 |
| 6057741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6057743 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6057761 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6057787 | GENERAL SUPPLY | Supply/Implant | $3,955.20 |
| 6057794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,501.89 |
| 6057795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,501.89 |
| 6057801 | SUPPLY IMPLANT | Supply/Implant | $2,451.71 |
| 6057802 | SUPPLY IMPLANT | Supply/Implant | $2,948.10 |
| 6057803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6057814 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6057818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $736.90 |
| 6057823 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6057846 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,328.00 |
| 6057848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6057850 | GENERAL SUPPLY | Supply/Implant | $2,547.46 |
| 6057857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6057859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,198.46 |
| 6057860 | SUPPLY IMPLANT | Supply/Implant | $8,322.05 |
| 6057861 | GUIDE WIRE | Supply/Implant | $502.66 |
| 6057894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6057901 | SUPPLY IMPLANT | Supply/Implant | $3,375.10 |
| 6057902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6057903 | APLIGRAF SKIN SUB | Supply/Implant | $22,989.70 |
| 6057913 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,838.40 |
| 6057915 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,199.42 |
| 6057918 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,344.00 |
| 6057920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6057922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6057940 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,581.57 |
| 6057942 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6057944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $119,795.20 |
| 6057949 | MESH (IMPLANTABLE) | Supply/Implant | $12,089.47 |
| 6057950 | VENA CAVA FILTER | Supply/Implant | $14,438.40 |
| 6057954 | SEPTAL DEFECT IMP SYS | Supply/Implant | $10,649.60 |
| 6057956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6057966 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6057971 | SUPPLY IMPLANT | Supply/Implant | $1,031.55 |
| 6057975 | SUPPLY IMPLANT | Supply/Implant | $80,768.00 |
| 6057976 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6057978 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6057980 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6057982 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6057988 | SUPPLY IMPLANT | Supply/Implant | $368.64 |
| 6058000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6058008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,328.00 |
| 6058011 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6058012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6058031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,344.32 |
| 6058039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,344.32 |
| 6058040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,344.32 |
| 6058051 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6058053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $162.56 |
| 6058069 | SUPPLY IMPLANT | Supply/Implant | $3,474.05 |
| 6058073 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6058074 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6058077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $455.04 |
| 6058105 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,715.01 |
| 6058110 | SUPPLY IMPLANT | Supply/Implant | $1,356.80 |
| 6058114 | STERILE SUPPLY | Supply/Implant | $729.60 |
| 6058158 | GUIDE WIRE | Supply/Implant | $1,510.40 |
| 6058159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,459.20 |
| 6058178 | STERILE SUPPLY | Supply/Implant | $882.05 |
| 6058184 | GUIDE WIRE | Supply/Implant | $588.80 |
| 6058197 | SUPPLY IMPLANT | Supply/Implant | $2,469.25 |
| 6058198 | STERILE SUPPLY | Supply/Implant | $140.42 |
| 6058206 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,200.00 |
| 6058209 | GENERAL SUPPLY | Supply/Implant | $450.69 |
| 6058211 | GENERAL SUPPLY | Supply/Implant | $246.02 |
| 6058224 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058225 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058227 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058228 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058229 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6058248 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,763.90 |
| 6058263 | SUPPLY IMPLANT | Supply/Implant | $199.10 |
| 6058264 | STERILE SUPPLY | Supply/Implant | $527.87 |
| 6058266 | GUIDE WIRE | Supply/Implant | $1,920.00 |
| 6058267 | SUPPLY IMPLANT | Supply/Implant | $489.09 |
| 6058278 | STERILE SUPPLY | Supply/Implant | $839.94 |
| 6058279 | STERILE SUPPLY | Supply/Implant | $839.94 |
| 6058283 | GENERAL SUPPLY | Supply/Implant | $477.82 |
| 6058287 | SUPPLY IMPLANT | Supply/Implant | $596.35 |
| 6058288 | SUPPLY IMPLANT | Supply/Implant | $441.98 |
| 6058296 | STERILE SUPPLY | Supply/Implant | $285.70 |
| 6058297 | STERILE SUPPLY | Supply/Implant | $347.78 |
| 6058298 | STERILE SUPPLY | Supply/Implant | $434.82 |
| 6058301 | GENERAL SUPPLY | Supply/Implant | $1,678.98 |
| 6058323 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058324 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058325 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058326 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058329 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058330 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058331 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058335 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058336 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058338 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058339 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058342 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058343 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058345 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058346 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058348 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058349 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058350 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058352 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058353 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058354 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058355 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058356 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058358 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058359 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058362 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6058366 | STERILE SUPPLY | Supply/Implant | $686.59 |
| 6058367 | STERILE SUPPLY | Supply/Implant | $375.94 |
| 6058369 | PORT, INDWELLING, IMP | Supply/Implant | $9,792.00 |
| 6058386 | SUPPLY IMPLANT | Supply/Implant | $2,223.85 |
| 6058407 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6058421 | SUPPLY IMPLANT | Supply/Implant | $2,407.49 |
| 6058432 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058433 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058434 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058435 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058444 | STERILE SUPPLY | Supply/Implant | $1,131.78 |
| 6058461 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6058462 | GENERAL SUPPLY | Supply/Implant | $1,062.40 |
| 6058471 | STERILE SUPPLY | Supply/Implant | $1,387.39 |
| 6058482 | STERILE SUPPLY | Supply/Implant | $4,636.80 |
| 6058483 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6058484 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6058488 | SUPPLY IMPLANT | Supply/Implant | $9,113.34 |
| 6058492 | STERILE SUPPLY | Supply/Implant | $576.77 |
| 6058495 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6058497 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6058513 | SUPPLY IMPLANT | Supply/Implant | $4,511.36 |
| 6058519 | GENERAL SUPPLY | Supply/Implant | $244.99 |
| 6058526 | GENERAL SUPPLY | Supply/Implant | $333.18 |
| 6058529 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058530 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058531 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058540 | CATHETER, GUIDING | Supply/Implant | $8,947.20 |
| 6058542 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6058543 | GENERAL SUPPLY | Supply/Implant | $267.65 |
| 6058550 | SUPPLY IMPLANT | Supply/Implant | $662.66 |
| 6058555 | SUPPLY IMPLANT | Supply/Implant | $136.96 |
| 6058556 | STERILE SUPPLY | Supply/Implant | $1,604.99 |
| 6058560 | STERILE SUPPLY | Supply/Implant | $484.48 |
| 6058572 | SUPPLY IMPLANT | Supply/Implant | $3,705.60 |
| 6058594 | SUPPLY IMPLANT | Supply/Implant | $1,276.42 |
| 6058596 | STERILE SUPPLY | Supply/Implant | $303.55 |
| 6058597 | SUPPLY IMPLANT | Supply/Implant | $368.90 |
| 6058598 | SUPPLY IMPLANT | Supply/Implant | $387.33 |
| 6058599 | SUPPLY IMPLANT | Supply/Implant | $368.90 |
| 6058603 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6058605 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6058610 | SUPPLY IMPLANT | Supply/Implant | $2,344.96 |
| 6058612 | SUPPLY IMPLANT | Supply/Implant | $1,751.04 |
| 6058615 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6058638 | SUPPLY IMPLANT | Supply/Implant | $10,570.88 |
| 6058639 | SUPPLY IMPLANT | Supply/Implant | $10,570.88 |
| 6058640 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6058643 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6058644 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,126.58 |
| 6058646 | SUPPLY IMPLANT | Supply/Implant | $1,164.80 |
| 6058647 | GUIDE WIRE | Supply/Implant | $2,134.40 |
| 6058650 | SUPPLY IMPLANT | Supply/Implant | $544.26 |
| 6058652 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6058659 | SUPPLY IMPLANT | Supply/Implant | $157.18 |
| 6058661 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $63,936.00 |
| 6058668 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6058671 | SUPPLY IMPLANT | Supply/Implant | $1,450.88 |
| 6058752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,355.20 |
| 6058865 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,568.77 |
| 6058866 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6058867 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6058868 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6058875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,036.80 |
| 6059014 | SUPPLY IMPLANT | Supply/Implant | $9,518.85 |
| 6059202 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6059210 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6059261 | GENERAL SUPPLY | Supply/Implant | $3,139.07 |
| 6059326 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6059328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6059337 | GENERAL SUPPLY | Supply/Implant | $5,888.00 |
| 6059338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,263.36 |
| 6059339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6059341 | GUIDE WIRE | Supply/Implant | $2,571.52 |
| 6059346 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,632.00 |
| 6059503 | SUPPLY IMPLANT | Supply/Implant | $458.37 |
| 6059675 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6059676 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6059788 | SUPPLY IMPLANT | Supply/Implant | $1,561.60 |
| 6059798 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6059815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,118.08 |
| 6059821 | SUPPLY IMPLANT | Supply/Implant | $1,341.82 |
| 6059822 | SUPPLY IMPLANT | Supply/Implant | $958.46 |
| 6059870 | SUPPLY IMPLANT | Supply/Implant | $1,140.48 |
| 6059874 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6059875 | GRAFT, VASCULAR | Supply/Implant | $7,078.40 |
| 6059932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6059934 | SUPPLY IMPLANT | Supply/Implant | $7,156.99 |
| 6059992 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6060007 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,400.00 |
| 6060009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6060037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,998.40 |
| 6060039 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,268.80 |
| 6060041 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,268.80 |
| 6060071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,321.60 |
| 6060104 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6060108 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6060111 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6060120 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6060121 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6060143 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6060146 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6060153 | CATHETER, GUIDING | Supply/Implant | $8,768.00 |
| 6060157 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6060158 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6060161 | NEUROMATRIX NERVE CUFF, CM | Supply/Implant | $23,109.12 |
| 6060182 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6060184 | SUPPLY IMPLANT | Supply/Implant | $16,128.00 |
| 6060198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6060210 | STERILE SUPPLY | Supply/Implant | $4,736.00 |
| 6060218 | SUPPLY IMPLANT | Supply/Implant | $20,480.00 |
| 6060219 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6060228 | SUPPLY IMPLANT | Supply/Implant | $1,843.20 |
| 6060229 | SUPPLY IMPLANT | Supply/Implant | $8,184.58 |
| 6060231 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $122,535.00 |
| 6060233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $862.85 |
| 6060235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,537.60 |
| 6060255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6060256 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6060257 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060258 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6060261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,131.71 |
| 6060263 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6060317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6060318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,411.97 |
| 6060322 | SUPPLY IMPLANT | Supply/Implant | $62,933.76 |
| 6060353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,495.68 |
| 6060375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $629.76 |
| 6060384 | SUPPLY IMPLANT | Supply/Implant | $1,004.80 |
| 6060395 | GUIDE WIRE | Supply/Implant | $640.00 |
| 6060423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,304.00 |
| 6060427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,909.50 |
| 6060437 | SUPPLY IMPLANT | Supply/Implant | $852.56 |
| 6060444 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6060445 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6060448 | SUPPLY IMPLANT | Supply/Implant | $6,003.20 |
| 6060449 | SUPPLY IMPLANT | Supply/Implant | $10,048.00 |
| 6060450 | SUPPLY IMPLANT | Supply/Implant | $6,622.72 |
| 6060451 | SUPPLY IMPLANT | Supply/Implant | $4,055.04 |
| 6060461 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,290.24 |
| 6060463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,129.60 |
| 6060466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,300.80 |
| 6060495 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6060504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6060507 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6060521 | SUPPLY IMPLANT | Supply/Implant | $26,501.12 |
| 6060524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6060538 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6060542 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,993.60 |
| 6060543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6060546 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6060547 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6060557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,984.00 |
| 6060569 | SUPPLY IMPLANT | Supply/Implant | $11,840.00 |
| 6060570 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,433.60 |
| 6060571 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,472.00 |
| 6060576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,280.00 |
| 6060579 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6060590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6060603 | GRAFT, VASCULAR | Supply/Implant | $21,263.23 |
| 6060604 | GRAFT, VASCULAR | Supply/Implant | $5,184.00 |
| 6060605 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6060608 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060609 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060610 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060611 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6060613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,048.00 |
| 6060628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6060635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6060646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,076.48 |
| 6060652 | SUPPLY IMPLANT | Supply/Implant | $1,427.97 |
| 6060659 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6060663 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6060696 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,306.24 |
| 6060699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060700 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6060706 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6060708 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6060709 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6060713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6060730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,535.94 |
| 6060739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6060740 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6060742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,643.14 |
| 6060746 | SUPPLY IMPLANT | Supply/Implant | $9,981.06 |
| 6060748 | PROSTHESIS, BREAST, IMP | Supply/Implant | $7,680.00 |
| 6060755 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6060757 | STERILE SUPPLY | Supply/Implant | $7,270.40 |
| 6060802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $793.60 |
| 6060814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,553.60 |
| 6060819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,032.00 |
| 6060822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6060823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,142.34 |
| 6060825 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6060852 | SUPPLY IMPLANT | Supply/Implant | $643.71 |
| 6060863 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6060868 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060871 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060884 | VENA CAVA FILTER | Supply/Implant | $11,840.00 |
| 6060889 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060890 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060891 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060892 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6060898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,539.20 |
| 6060899 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $32,000.00 |
| 6060914 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060916 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060917 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060919 | SUPPLY IMPLANT | Supply/Implant | $131,250.00 |
| 6060930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6060933 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6060935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6060954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6060956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,392.00 |
| 6060962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,307.20 |
| 6060969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6061009 | SUPPLY IMPLANT | Supply/Implant | $2,088.96 |
| 6061017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6061018 | SUPPLY IMPLANT | Supply/Implant | $475.78 |
| 6061025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,437.38 |
| 6061034 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6061035 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6061036 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6061039 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6061040 | SUPPLY IMPLANT | Supply/Implant | $19,968.00 |
| 6061041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6061042 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6061043 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6061052 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.16 |
| 6061055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6061056 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,255.68 |
| 6061058 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,050.69 |
| 6061072 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6061073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6061078 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6061089 | SUPPLY IMPLANT | Supply/Implant | $19,430.40 |
| 6061096 | SUPPLY IMPLANT | Supply/Implant | $135,649.50 |
| 6061106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,353.60 |
| 6061108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,675.20 |
| 6061112 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6061130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6061132 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,185.60 |
| 6061137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,864.00 |
| 6061138 | GENERAL SUPPLY | Supply/Implant | $2,119.42 |
| 6061142 | SUPPLY IMPLANT | Supply/Implant | $2,577.66 |
| 6061151 | SUPPLY IMPLANT | Supply/Implant | $9,088.00 |
| 6061164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,203.52 |
| 6061165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6061173 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,872.13 |
| 6061176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6061181 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,892.80 |
| 6061183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6061190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6061193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6061196 | REP DEV, URINARY, W/SLING | Supply/Implant | $16,496.64 |
| 6061200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6061201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6061212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6061216 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,863.36 |
| 6061217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,288.00 |
| 6061219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6061224 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6061242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6061243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6061250 | SUPPLY IMPLANT | Supply/Implant | $17,024.00 |
| 6061256 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6061293 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,305.60 |
| 6061313 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6061338 | STERILE SUPPLY | Supply/Implant | $214.27 |
| 6061347 | SUPPLY IMPLANT | Supply/Implant | $492.03 |
| 6061372 | SUPPLY IMPLANT | Supply/Implant | $4,339.20 |
| 6061382 | SUPPLY IMPLANT | Supply/Implant | $1,165.06 |
| 6061419 | RET DEV, INSERTABLE | Supply/Implant | $384.61 |
| 6061420 | GENERAL SUPPLY | Supply/Implant | $614.40 |
| 6061431 | SUPPLY IMPLANT | Supply/Implant | $211.46 |
| 6061438 | SUPPLY IMPLANT | Supply/Implant | $2,342.40 |
| 6061442 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6061443 | CATHETER, GUIDING | Supply/Implant | $2,086.40 |
| 6061444 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6061446 | CATHETER, GUIDING | Supply/Implant | $832.00 |
| 6061449 | CATHETER, GUIDING | Supply/Implant | $465.92 |
| 6061450 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6061451 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6061452 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6061453 | INTRO/SHEATH, NON-LASER | Supply/Implant | $278.27 |
| 6061454 | GUIDE WIRE | Supply/Implant | $620.16 |
| 6061466 | SUPPLY IMPLANT | Supply/Implant | $2,201.73 |
| 6061468 | SUPPLY IMPLANT | Supply/Implant | $2,201.73 |
| 6061499 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,965.63 |
| 6061501 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,786.18 |
| 6061502 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,786.18 |
| 6061560 | SUPPLY IMPLANT | Supply/Implant | $585.34 |
| 6061561 | SUPPLY IMPLANT | Supply/Implant | $582.14 |
| 6061562 | SUPPLY IMPLANT | Supply/Implant | $506.24 |
| 6061583 | STERILE SUPPLY | Supply/Implant | $438.53 |
| 6061589 | SUPPLY IMPLANT | Supply/Implant | $534.27 |
| 6061590 | SUPPLY IMPLANT | Supply/Implant | $2,195.46 |
| 6061592 | SUPPLY IMPLANT | Supply/Implant | $4,487.87 |
| 6061596 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6061633 | SUPPLY IMPLANT | Supply/Implant | $2,580.48 |
| 6061639 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6061640 | SUPPLY IMPLANT | Supply/Implant | $323.20 |
| 6061685 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6061693 | SUPPLY IMPLANT | Supply/Implant | $658.33 |
| 6061704 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6061712 | SUPPLY IMPLANT | Supply/Implant | $5,363.20 |
| 6061717 | GUIDE WIRE | Supply/Implant | $712.96 |
| 6061718 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6061726 | CATH, DRAINAGE | Supply/Implant | $873.98 |
| 6061751 | SUPPLY IMPLANT | Supply/Implant | $4,467.20 |
| 6061756 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6061757 | STERILE SUPPLY | Supply/Implant | $230.05 |
| 6061775 | GENERAL SUPPLY | Supply/Implant | $140.58 |
| 6061784 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,881.60 |
| 6061795 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6061822 | SUPPLY IMPLANT | Supply/Implant | $371.33 |
| 6061933 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6061937 | SUPPLY IMPLANT | Supply/Implant | $440.70 |
| 6061942 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6061955 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6061958 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6061964 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6061965 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6061970 | CATH, DRAINAGE | Supply/Implant | $1,182.72 |
| 6061977 | GENERAL SUPPLY | Supply/Implant | $243.20 |
| 6061978 | GENERAL SUPPLY | Supply/Implant | $245.76 |
| 6061979 | GENERAL SUPPLY | Supply/Implant | $204.42 |
| 6061985 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6061992 | STERILE SUPPLY | Supply/Implant | $2,176.00 |
| 6062000 | STERILE SUPPLY | Supply/Implant | $978.59 |
| 6062013 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6062017 | STERILE SUPPLY | Supply/Implant | $304.90 |
| 6062023 | SUPPLY IMPLANT | Supply/Implant | $20,160.00 |
| 6062029 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,483.78 |
| 6062056 | SUPPLY IMPLANT | Supply/Implant | $309.76 |
| 6062063 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6062068 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6062070 | SUPPLY IMPLANT | Supply/Implant | $4,352.00 |
| 6062073 | STERILE SUPPLY | Supply/Implant | $7,828.48 |
| 6062076 | STERILE SUPPLY | Supply/Implant | $723.46 |
| 6062087 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6062105 | SUPPLY IMPLANT | Supply/Implant | $489.09 |
| 6062106 | STERILE SUPPLY | Supply/Implant | $164.61 |
| 6062120 | SUPPLY IMPLANT | Supply/Implant | $6,148.74 |
| 6062126 | STERILE SUPPLY | Supply/Implant | $3,314.43 |
| 6062127 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6062138 | STERILE SUPPLY | Supply/Implant | $156.80 |
| 6062141 | STERILE SUPPLY | Supply/Implant | $2,204.16 |
| 6062147 | GUIDE WIRE | Supply/Implant | $3,136.00 |
| 6062148 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6062149 | CATHETER, GUIDING | Supply/Implant | $1,152.00 |
| 6062151 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6062180 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6062200 | SUPPLY IMPLANT | Supply/Implant | $588.29 |
| 6062207 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6062210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,676.80 |
| 6062214 | SUPPLY IMPLANT | Supply/Implant | $590.59 |
| 6062219 | SUPPLY IMPLANT | Supply/Implant | $742.40 |
| 6062222 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6062223 | SUPPLY IMPLANT | Supply/Implant | $1,647.49 |
| 6062227 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6062233 | STERILE SUPPLY | Supply/Implant | $3,008.00 |
| 6062248 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6062259 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6062261 | GENERAL SUPPLY | Supply/Implant | $772.86 |
| 6062281 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6062302 | SUPPLY IMPLANT | Supply/Implant | $8,576.00 |
| 6062316 | GENERAL SUPPLY | Supply/Implant | $17,480.06 |
| 6062343 | GENERAL SUPPLY | Supply/Implant | $476.16 |
| 6062344 | GENERAL SUPPLY | Supply/Implant | $476.16 |
| 6062362 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6062363 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6062395 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6062403 | GENERAL SUPPLY | Supply/Implant | $1,864.96 |
| 6062406 | STERILE SUPPLY | Supply/Implant | $613.89 |
| 6062425 | STERILE SUPPLY | Supply/Implant | $275.84 |
| 6062465 | STERILE SUPPLY | Supply/Implant | $915.58 |
| 6062468 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6062472 | STERILE SUPPLY | Supply/Implant | $765.31 |
| 6062482 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062484 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062487 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062488 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062489 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062490 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062492 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062493 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062494 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062495 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062500 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062501 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6062502 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062511 | STERILE SUPPLY | Supply/Implant | $159.10 |
| 6062512 | STERILE SUPPLY | Supply/Implant | $210.05 |
| 6062520 | SUPPLY IMPLANT | Supply/Implant | $381.82 |
| 6062521 | SUPPLY IMPLANT | Supply/Implant | $318.34 |
| 6062523 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6062524 | SUPPLY IMPLANT | Supply/Implant | $619.14 |
| 6062525 | SUPPLY IMPLANT | Supply/Implant | $272.00 |
| 6062533 | STERILE SUPPLY | Supply/Implant | $4,443.01 |
| 6062537 | RET DEV, INSERTABLE | Supply/Implant | $281.60 |
| 6062556 | SUPPLY IMPLANT | Supply/Implant | $2,431.74 |
| 6062565 | STERILE SUPPLY | Supply/Implant | $2,496.00 |
| 6062568 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062569 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062570 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062571 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062574 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062575 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062576 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6062589 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6062606 | GENERAL SUPPLY | Supply/Implant | $1,564.80 |
| 6062608 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6062622 | SUPPLY IMPLANT | Supply/Implant | $138.50 |
| 6062657 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062667 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $268.80 |
| 6062669 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6062670 | GENERAL SUPPLY | Supply/Implant | $698.75 |
| 6062671 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6062680 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6062681 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6062695 | CATHETER, GUIDING | Supply/Implant | $14,310.40 |
| 6062700 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,088.00 |
| 6062701 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,088.00 |
| 6062722 | STERILE SUPPLY | Supply/Implant | $411.01 |
| 6062728 | SUPPLY IMPLANT | Supply/Implant | $598.40 |
| 6062729 | GUIDE WIRE | Supply/Implant | $5,312.00 |
| 6062733 | GENERAL SUPPLY | Supply/Implant | $2,889.47 |
| 6062735 | SUPPLY IMPLANT | Supply/Implant | $218.24 |
| 6062746 | SUPPLY IMPLANT | Supply/Implant | $1,100.80 |
| 6062756 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6062757 | SUPPLY IMPLANT | Supply/Implant | $524.80 |
| 6062759 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6062760 | SUPPLY IMPLANT | Supply/Implant | $143.62 |
| 6062771 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6062778 | SUPPLY IMPLANT | Supply/Implant | $2,841.06 |
| 6062780 | SUPPLY IMPLANT | Supply/Implant | $5,831.68 |
| 6062798 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6062799 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6062801 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6062805 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6062809 | CATH, DRAINAGE | Supply/Implant | $5,589.38 |
| 6062833 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6062851 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6062875 | GENERAL SUPPLY | Supply/Implant | $840.96 |
| 6062876 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6062886 | STERILE SUPPLY | Supply/Implant | $486.78 |
| 6062890 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6062895 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6062897 | SUPPLY IMPLANT | Supply/Implant | $2,730.11 |
| 6062898 | STERILE SUPPLY | Supply/Implant | $287.62 |
| 6062899 | STERILE SUPPLY | Supply/Implant | $258.98 |
| 6062916 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6063308 | SUPPLY IMPLANT | Supply/Implant | $4,264.45 |
| 6063353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.96 |
| 6063358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,221.70 |
| 6063379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6063606 | SUPPLY IMPLANT | Supply/Implant | $4,928.77 |
| 6063611 | SUPPLY IMPLANT | Supply/Implant | $4,928.77 |
| 6063689 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,550.40 |
| 6063699 | MESH (IMPLANTABLE) | Supply/Implant | $18,434.56 |
| 6063700 | MESH (IMPLANTABLE) | Supply/Implant | $12,439.17 |
| 6063888 | MESH (IMPLANTABLE) | Supply/Implant | $18,434.56 |
| 6063903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,981.12 |
| 6063904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,846.46 |
| 6063905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,149.06 |
| 6063920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,671.30 |
| 6063953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,619.84 |
| 6063954 | MESH (IMPLANTABLE) | Supply/Implant | $1,019.52 |
| 6064017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6064074 | SUPPLY IMPLANT | Supply/Implant | $759.81 |
| 6064084 | SUPPLY IMPLANT | Supply/Implant | $1,760.00 |
| 6064090 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6064135 | SUPPLY IMPLANT | Supply/Implant | $717.18 |
| 6064145 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6064152 | GENERAL SUPPLY | Supply/Implant | $883.20 |
| 6064175 | GENERAL SUPPLY | Supply/Implant | $6,784.00 |
| 6064186 | STERILE SUPPLY | Supply/Implant | $316.80 |
| 6064213 | ALLODERM SKIN SUB | Supply/Implant | $10,355.20 |
| 6064276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064285 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,858.18 |
| 6064342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,561.60 |
| 6064351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $268.80 |
| 6064370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,998.40 |
| 6064423 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6064448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6064474 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6064478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,065.60 |
| 6064479 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6064481 | SUPPLY IMPLANT | Supply/Implant | $889.22 |
| 6064484 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6064491 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064494 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064495 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064496 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064497 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064498 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064499 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064500 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064501 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064502 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064503 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,432.00 |
| 6064504 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064505 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064506 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064507 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064508 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064509 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,432.00 |
| 6064510 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064511 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064513 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064515 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064516 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6064517 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6064537 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6064539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6064540 | SUPPLY IMPLANT | Supply/Implant | $6,461.44 |
| 6064550 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064555 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064559 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6064574 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6064576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6064577 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064578 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064580 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064581 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064584 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064585 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6064606 | GUIDE WIRE | Supply/Implant | $1,648.64 |
| 6064608 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6064624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,817.22 |
| 6064632 | SUPPLY IMPLANT | Supply/Implant | $1,275.99 |
| 6064637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,353.60 |
| 6064672 | SUPPLY IMPLANT | Supply/Implant | $3,638.78 |
| 6064684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6064709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,849.28 |
| 6064711 | SUPPLY IMPLANT | Supply/Implant | $18,391.68 |
| 6064746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6064751 | SUPPLY IMPLANT | Supply/Implant | $965.89 |
| 6064755 | GENERAL SUPPLY | Supply/Implant | $7,067.14 |
| 6064784 | INTEGRA BMWD SKIN SUB | Supply/Implant | $78,272.00 |
| 6064798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6064806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064809 | SUPPLY IMPLANT | Supply/Implant | $7,906.18 |
| 6064825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6064869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,203.52 |
| 6064908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,544.00 |
| 6064909 | CONN TISS, NON-HUMAN | Supply/Implant | $7,644.16 |
| 6064910 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6064917 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6064940 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6064941 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6064942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6064947 | SUPPLY IMPLANT | Supply/Implant | $12,228.48 |
| 6064951 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,120.00 |
| 6064956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $516.99 |
| 6064981 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6064986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,449.34 |
| 6064987 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,663.74 |
| 6064988 | SUPPLY IMPLANT | Supply/Implant | $25,663.74 |
| 6064994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6064997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6064999 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6065001 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,242.37 |
| 6065010 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,328.00 |
| 6065011 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6065013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6065015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6065017 | SUPPLY IMPLANT | Supply/Implant | $13,754.88 |
| 6065038 | SUPPLY IMPLANT | Supply/Implant | $2,344.96 |
| 6065044 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6065057 | SUPPLY IMPLANT | Supply/Implant | $7,334.40 |
| 6065065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.20 |
| 6065067 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,376.00 |
| 6065075 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6065078 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6065086 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,400.00 |
| 6065087 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,400.00 |
| 6065095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6065096 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $15,603.20 |
| 6065104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.18 |
| 6065110 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6065115 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6065117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6065120 | STERILE SUPPLY | Supply/Implant | $263.68 |
| 6065121 | STERILE SUPPLY | Supply/Implant | $270.41 |
| 6065127 | SUPPLY IMPLANT | Supply/Implant | $15,565.44 |
| 6065133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6065135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,006.40 |
| 6065184 | SUPPLY IMPLANT | Supply/Implant | $14,630.40 |
| 6065191 | STERILE SUPPLY | Supply/Implant | $230.05 |
| 6065192 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6065198 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6065199 | SUPPLY IMPLANT | Supply/Implant | $6,262.40 |
| 6065206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6065254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,425.60 |
| 6065261 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6065264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6065265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6065272 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6065279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6065284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,758.40 |
| 6065288 | SUPPLY IMPLANT | Supply/Implant | $12,697.60 |
| 6065289 | SUPPLY IMPLANT | Supply/Implant | $25,574.40 |
| 6065290 | SUPPLY IMPLANT | Supply/Implant | $41,574.40 |
| 6065293 | CONN TISS, NON-HUMAN | Supply/Implant | $2,635.01 |
| 6065294 | CONN TISS, NON-HUMAN | Supply/Implant | $2,635.01 |
| 6065306 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,880.00 |
| 6065307 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,880.00 |
| 6065308 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $10,880.00 |
| 6065312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6065317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6065318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6065320 | PORT, INDWELLING, IMP | Supply/Implant | $6,262.40 |
| 6065331 | SUPPLY IMPLANT | Supply/Implant | $228.61 |
| 6065352 | SUPPLY IMPLANT | Supply/Implant | $759.68 |
| 6065353 | SUPPLY IMPLANT | Supply/Implant | $547.33 |
| 6065360 | GENERAL SUPPLY | Supply/Implant | $200.96 |
| 6065394 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6065398 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6065414 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6065420 | GENERAL SUPPLY | Supply/Implant | $10,996.99 |
| 6065429 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6065436 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6065437 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6065441 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6065464 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6065467 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6065468 | SUPPLY IMPLANT | Supply/Implant | $10,570.88 |
| 6065469 | SUPPLY IMPLANT | Supply/Implant | $1,203.20 |
| 6065479 | INTEGRA BMWD SKIN SUB | Supply/Implant | $35,035.90 |
| 6065499 | SUPPLY IMPLANT | Supply/Implant | $1,403.65 |
| 6065508 | IMPL EXT ACCESS CATH | Supply/Implant | $9,708.42 |
| 6065523 | GENERAL SUPPLY | Supply/Implant | $592.90 |
| 6065524 | GENERAL SUPPLY | Supply/Implant | $663.42 |
| 6065526 | GENERAL SUPPLY | Supply/Implant | $2,137.60 |
| 6065531 | SUPPLY IMPLANT | Supply/Implant | $2,245.82 |
| 6065532 | SUPPLY IMPLANT | Supply/Implant | $3,139.58 |
| 6065533 | SUPPLY IMPLANT | Supply/Implant | $3,316.48 |
| 6065534 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6065541 | STERILE SUPPLY | Supply/Implant | $1,094.53 |
| 6065542 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6065543 | STERILE SUPPLY | Supply/Implant | $746.62 |
| 6065544 | SUPPLY IMPLANT | Supply/Implant | $181.45 |
| 6065546 | SUPPLY IMPLANT | Supply/Implant | $584.96 |
| 6065551 | SUPPLY IMPLANT | Supply/Implant | $3,330.43 |
| 6065552 | SUPPLY IMPLANT | Supply/Implant | $2,256.51 |
| 6065556 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065557 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065558 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065559 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065560 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065561 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065562 | STERILE SUPPLY | Supply/Implant | $633.86 |
| 6065563 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $7,680.00 |
| 6065580 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6065596 | SUPPLY IMPLANT | Supply/Implant | $2,620.67 |
| 6065597 | SUPPLY IMPLANT | Supply/Implant | $3,685.63 |
| 6065598 | SUPPLY IMPLANT | Supply/Implant | $2,739.29 |
| 6065599 | SUPPLY IMPLANT | Supply/Implant | $3,859.16 |
| 6065606 | SUPPLY IMPLANT | Supply/Implant | $3,902.89 |
| 6065607 | SUPPLY IMPLANT | Supply/Implant | $4,025.31 |
| 6065613 | SUPPLY IMPLANT | Supply/Implant | $5,056.00 |
| 6065615 | SUPPLY IMPLANT | Supply/Implant | $5,056.00 |
| 6065616 | SUPPLY IMPLANT | Supply/Implant | $5,056.00 |
| 6065618 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,120.64 |
| 6065622 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6065640 | SUPPLY IMPLANT | Supply/Implant | $1,744.77 |
| 6065645 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6065647 | GENERAL SUPPLY | Supply/Implant | $301.79 |
| 6065648 | GENERAL SUPPLY | Supply/Implant | $305.02 |
| 6065649 | CATHETER, URETERAL | Supply/Implant | $316.88 |
| 6065650 | STERILE SUPPLY | Supply/Implant | $316.93 |
| 6065653 | SUPPLY IMPLANT | Supply/Implant | $1,366.78 |
| 6065670 | SUPPLY IMPLANT | Supply/Implant | $575.87 |
| 6065673 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6065674 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6065690 | SUPPLY IMPLANT | Supply/Implant | $6,747.52 |
| 6065718 | STERILE SUPPLY | Supply/Implant | $152.06 |
| 6065720 | STERILE SUPPLY | Supply/Implant | $1,250.24 |
| 6065721 | STERILE SUPPLY | Supply/Implant | $212.94 |
| 6065734 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6065736 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6065741 | SUPPLY IMPLANT | Supply/Implant | $2,092.80 |
| 6065744 | SUPPLY IMPLANT | Supply/Implant | $6,785.66 |
| 6065747 | SUPPLY IMPLANT | Supply/Implant | $6,008.58 |
| 6065751 | SUPPLY IMPLANT | Supply/Implant | $8,978.30 |
| 6065757 | CATHETER, GUIDING | Supply/Implant | $465.92 |
| 6065758 | SUPPLY IMPLANT | Supply/Implant | $246.40 |
| 6065760 | STERILE SUPPLY | Supply/Implant | $231.94 |
| 6065765 | STERILE SUPPLY | Supply/Implant | $5,362.56 |
| 6065768 | SUPPLY IMPLANT | Supply/Implant | $2,870.27 |
| 6065776 | STERILE SUPPLY | Supply/Implant | $170.11 |
| 6065777 | STERILE SUPPLY | Supply/Implant | $164.74 |
| 6065780 | STERILE SUPPLY | Supply/Implant | $1,468.16 |
| 6065781 | SUPPLY IMPLANT | Supply/Implant | $185.47 |
| 6065783 | STERILE SUPPLY | Supply/Implant | $220.56 |
| 6065787 | SUPPLY IMPLANT | Supply/Implant | $1,406.46 |
| 6065788 | STERILE SUPPLY | Supply/Implant | $219.39 |
| 6065789 | STERILE SUPPLY | Supply/Implant | $219.26 |
| 6065811 | STERILE SUPPLY | Supply/Implant | $147.33 |
| 6065812 | STERILE SUPPLY | Supply/Implant | $202.79 |
| 6065813 | STERILE SUPPLY | Supply/Implant | $232.33 |
| 6065816 | STERILE SUPPLY | Supply/Implant | $197.64 |
| 6065828 | SUPPLY IMPLANT | Supply/Implant | $529.56 |
| 6065829 | GENERAL SUPPLY | Supply/Implant | $678.91 |
| 6065836 | SUPPLY IMPLANT | Supply/Implant | $152.70 |
| 6065837 | SUPPLY IMPLANT | Supply/Implant | $129.92 |
| 6065838 | STERILE SUPPLY | Supply/Implant | $245.63 |
| 6065840 | GENERAL SUPPLY | Supply/Implant | $174.36 |
| 6065841 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6065847 | STERILE SUPPLY | Supply/Implant | $245.63 |
| 6065861 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6065879 | SUPPLY IMPLANT | Supply/Implant | $695.17 |
| 6065885 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6065886 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6065887 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6065896 | SUPPLY IMPLANT | Supply/Implant | $1,432.19 |
| 6065900 | GENERAL SUPPLY | Supply/Implant | $27,456.00 |
| 6065906 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6065921 | SUPPLY IMPLANT | Supply/Implant | $216.96 |
| 6065927 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6065931 | SUPPLY IMPLANT | Supply/Implant | $13,211.48 |
| 6065932 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6065934 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6065935 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6065936 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6065953 | STERILE SUPPLY | Supply/Implant | $1,094.53 |
| 6065977 | SUPPLY IMPLANT | Supply/Implant | $241.41 |
| 6065978 | GENERAL SUPPLY | Supply/Implant | $928.51 |
| 6065996 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $435.20 |
| 6066009 | STERILE SUPPLY | Supply/Implant | $790.05 |
| 6066018 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $793.60 |
| 6066020 | STERILE SUPPLY | Supply/Implant | $1,055.87 |
| 6066021 | STERILE SUPPLY | Supply/Implant | $532.35 |
| 6066026 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6066027 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6066031 | SUPPLY IMPLANT | Supply/Implant | $302.72 |
| 6066070 | SUPPLY IMPLANT | Supply/Implant | $8,522.24 |
| 6066071 | SUPPLY IMPLANT | Supply/Implant | $5,061.12 |
| 6066072 | STERILE SUPPLY | Supply/Implant | $7,667.20 |
| 6066073 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6066074 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6066076 | SUPPLY IMPLANT | Supply/Implant | $1,839.10 |
| 6066081 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6066086 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,360.00 |
| 6066089 | GENERAL SUPPLY | Supply/Implant | $595.20 |
| 6066104 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066105 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066106 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066107 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6066148 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6066151 | SUPPLY IMPLANT | Supply/Implant | $288.96 |
| 6066160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,098.24 |
| 6066163 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6066168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $736.90 |
| 6066169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6066170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6066187 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6066195 | SUPPLY IMPLANT | Supply/Implant | $19,276.80 |
| 6066196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6066197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6066207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6066208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6066220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6066224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6066225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6066227 | SUPPLY IMPLANT | Supply/Implant | $2,713.60 |
| 6066235 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6066236 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6066237 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,630.40 |
| 6066241 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6066244 | SUPPLY IMPLANT | Supply/Implant | $659.20 |
| 6066247 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066248 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6066260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,423.23 |
| 6066261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,689.54 |
| 6066262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,423.23 |
| 6066271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,492.48 |
| 6066275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,123.20 |
| 6066294 | SUPPLY IMPLANT | Supply/Implant | $3,729.02 |
| 6066295 | SUPPLY IMPLANT | Supply/Implant | $4,987.01 |
| 6066296 | SUPPLY IMPLANT | Supply/Implant | $4,552.70 |
| 6066301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,493.50 |
| 6066310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6066311 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6066341 | SUPPLY IMPLANT | Supply/Implant | $3,680.00 |
| 6066351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,048.00 |
| 6066358 | SUPPLY IMPLANT | Supply/Implant | $195.84 |
| 6066362 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066363 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6066372 | SUPPLY IMPLANT | Supply/Implant | $12,531.20 |
| 6066417 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6066418 | GENERAL SUPPLY | Supply/Implant | $998.40 |
| 6066420 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6066421 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6066430 | SUPPLY IMPLANT | Supply/Implant | $8,697.60 |
| 6066436 | INTRO/SHEATH, NON-LASER | Supply/Implant | $777.86 |
| 6066440 | SUPPLY IMPLANT | Supply/Implant | $3,199.74 |
| 6066441 | SUPPLY IMPLANT | Supply/Implant | $5,158.91 |
| 6066445 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066459 | SUPPLY IMPLANT | Supply/Implant | $1,661.44 |
| 6066462 | STERILE SUPPLY | Supply/Implant | $4,397.06 |
| 6066464 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6066465 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6066466 | GUIDE WIRE | Supply/Implant | $8,531.20 |
| 6066473 | STERILE SUPPLY | Supply/Implant | $2,050.05 |
| 6066478 | SUPPLY IMPLANT | Supply/Implant | $3,059.20 |
| 6066485 | SUPPLY IMPLANT | Supply/Implant | $4,536.06 |
| 6066495 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6066499 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6066501 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6066504 | SUPPLY IMPLANT | Supply/Implant | $7,244.80 |
| 6066518 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,600.00 |
| 6066544 | GENERAL SUPPLY | Supply/Implant | $130.05 |
| 6066545 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6066546 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6066547 | SUPPLY IMPLANT | Supply/Implant | $6,262.40 |
| 6066566 | STERILE SUPPLY | Supply/Implant | $334.34 |
| 6066574 | SUPPLY IMPLANT | Supply/Implant | $1,175.55 |
| 6066576 | SUPPLY IMPLANT | Supply/Implant | $1,175.55 |
| 6066580 | STERILE SUPPLY | Supply/Implant | $1,514.37 |
| 6066582 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6066600 | STERILE SUPPLY | Supply/Implant | $514.56 |
| 6066610 | STERILE SUPPLY | Supply/Implant | $6,336.00 |
| 6066611 | STERILE SUPPLY | Supply/Implant | $3,776.00 |
| 6066615 | STERILE SUPPLY | Supply/Implant | $6,888.96 |
| 6066616 | SUPPLY IMPLANT | Supply/Implant | $9,853.44 |
| 6066617 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6066618 | SUPPLY IMPLANT | Supply/Implant | $998.40 |
| 6066619 | GENERAL SUPPLY | Supply/Implant | $998.40 |
| 6066633 | STERILE SUPPLY | Supply/Implant | $336.00 |
| 6066640 | SUPPLY IMPLANT | Supply/Implant | $30,720.00 |
| 6066660 | GENERAL SUPPLY | Supply/Implant | $558.21 |
| 6066668 | SUPPLY IMPLANT | Supply/Implant | $3,818.88 |
| 6066669 | SUPPLY IMPLANT | Supply/Implant | $3,729.02 |
| 6066670 | STERILE SUPPLY | Supply/Implant | $5,166.72 |
| 6066674 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066675 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066678 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066679 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066680 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6066690 | SUPPLY IMPLANT | Supply/Implant | $387.33 |
| 6066692 | GUIDE WIRE | Supply/Implant | $423.68 |
| 6066693 | GUIDE WIRE | Supply/Implant | $568.32 |
| 6066694 | GUIDE WIRE | Supply/Implant | $423.68 |
| 6066697 | SUPPLY IMPLANT | Supply/Implant | $5,438.46 |
| 6066699 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,827.20 |
| 6066704 | SUPPLY IMPLANT | Supply/Implant | $5,728.00 |
| 6066712 | SUPPLY IMPLANT | Supply/Implant | $6,381.82 |
| 6066714 | STERILE SUPPLY | Supply/Implant | $5,634.94 |
| 6066715 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $435.20 |
| 6066738 | LITH-ION BATT ELEC/PNEUM VAD | Supply/Implant | $8,000.00 |
| 6066739 | BAT CLPS ELEC/COMBO VAD REP | Supply/Implant | $7,040.00 |
| 6066741 | CHARGER ELEC/COMBO VAD REP | Supply/Implant | $92,160.00 |
| 6066777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,124.80 |
| 6066863 | SUPPLY IMPLANT | Supply/Implant | $30,087.68 |
| 6066864 | CONN TISS, NON-HUMAN | Supply/Implant | $4,587.52 |
| 6066865 | MESH (IMPLANTABLE) | Supply/Implant | $6,291.46 |
| 6066866 | CONN TISS, NON-HUMAN | Supply/Implant | $13,957.50 |
| 6066873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,160.00 |
| 6066892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6066896 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6066915 | SUPPLY IMPLANT | Supply/Implant | $1,464.32 |
| 6066918 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6066922 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6066929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6066952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,689.54 |
| 6066961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $806.91 |
| 6066968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6066977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6066978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6066980 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,211.20 |
| 6066982 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6067039 | CONN TISS, NON-HUMAN | Supply/Implant | $4,664.83 |
| 6067060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6067063 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6067066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,927.55 |
| 6067069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,390.08 |
| 6067073 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6067074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,976.00 |
| 6067076 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6067105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $780.80 |
| 6067113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6067117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6067122 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,272.00 |
| 6067133 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6067158 | SUPPLY IMPLANT | Supply/Implant | $30,087.68 |
| 6067161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6067163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6067166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6067169 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6067171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6067181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6067182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6067188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $829.31 |
| 6067192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6067226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,913.66 |
| 6067233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,847.30 |
| 6067234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,847.30 |
| 6067247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6067249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6067250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6067252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,837.44 |
| 6067269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6067283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6067284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6067288 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6067297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,502.40 |
| 6067299 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6067331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6067360 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6067362 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6067363 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $45,568.00 |
| 6067364 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $51,417.60 |
| 6067365 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6067366 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6067368 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $51,417.60 |
| 6067370 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,651.20 |
| 6067371 | SUPPLY IMPLANT | Supply/Implant | $46,144.00 |
| 6067372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $51,417.60 |
| 6067374 | SUPPLY IMPLANT | Supply/Implant | $42,944.00 |
| 6067375 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $46,144.00 |
| 6067380 | GENERAL SUPPLY | Supply/Implant | $421.89 |
| 6067388 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6067390 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6067391 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6067393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6067394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6067397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,094.40 |
| 6067409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6067410 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6067426 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6067437 | SUPPLY IMPLANT | Supply/Implant | $439.17 |
| 6067442 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067443 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067447 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067449 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067450 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067452 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067467 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067472 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067473 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067475 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067478 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067480 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6067507 | STERILE SUPPLY | Supply/Implant | $184.69 |
| 6067513 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6067514 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6067538 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $37,760.00 |
| 6067552 | GENERAL SUPPLY | Supply/Implant | $386.56 |
| 6067582 | SUPPLY IMPLANT | Supply/Implant | $8,522.24 |
| 6067611 | GENERAL SUPPLY | Supply/Implant | $277.89 |
| 6067616 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6067622 | STERILE SUPPLY | Supply/Implant | $312.42 |
| 6067629 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067630 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067631 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067632 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067633 | SUPPLY IMPLANT | Supply/Implant | $4,096.00 |
| 6067635 | SUPPLY IMPLANT | Supply/Implant | $6,706.56 |
| 6067636 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067637 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6067638 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6067639 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067640 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067641 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067642 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067649 | SUPPLY IMPLANT | Supply/Implant | $20,278.91 |
| 6067650 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067651 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067652 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067654 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067655 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067656 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067658 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067660 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6067664 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,632.00 |
| 6067668 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,146.88 |
| 6067674 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6067676 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6067677 | SUPPLY IMPLANT | Supply/Implant | $1,417.60 |
| 6067678 | STERILE SUPPLY | Supply/Implant | $263.42 |
| 6067679 | SUPPLY IMPLANT | Supply/Implant | $1,418.37 |
| 6067680 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6067682 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6067707 | GENERAL SUPPLY | Supply/Implant | $247.55 |
| 6067710 | STERILE SUPPLY | Supply/Implant | $452.99 |
| 6067712 | SUPPLY IMPLANT | Supply/Implant | $16,576.00 |
| 6067715 | SUPPLY IMPLANT | Supply/Implant | $3,020.80 |
| 6067724 | SUPPLY IMPLANT | Supply/Implant | $1,884.16 |
| 6067730 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $10,368.00 |
| 6067740 | RET DEV, INSERTABLE | Supply/Implant | $13,478.40 |
| 6067760 | STERILE SUPPLY | Supply/Implant | $1,356.80 |
| 6067761 | STERILE SUPPLY | Supply/Implant | $273.09 |
| 6067766 | SUPPLY IMPLANT | Supply/Implant | $314.88 |
| 6067812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6067823 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6067824 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,844.80 |
| 6067904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,693.06 |
| 6067910 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6067918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6067929 | SUPPLY IMPLANT | Supply/Implant | $88,960.00 |
| 6067985 | AMNIOTIC MEMBRANE | Supply/Implant | $7,616.00 |
| 6068000 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6068017 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6068030 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6068032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,008.00 |
| 6068057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,777.60 |
| 6068076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6068078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6068084 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6068085 | INTRO/SHEATH, NON-LASER | Supply/Implant | $760.32 |
| 6068086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6068087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6068088 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6068091 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6068092 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,457.34 |
| 6068097 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6068100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6068101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6068102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6068111 | POWER MODULE COMBO VAD REP | Supply/Implant | $132,300.00 |
| 6068115 | SUPPLY IMPLANT | Supply/Implant | $12,228.48 |
| 6068125 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6068134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,461.44 |
| 6068142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6068146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,756.16 |
| 6068147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,419.84 |
| 6068181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6068196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,422.08 |
| 6068203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,422.08 |
| 6068205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,422.08 |
| 6068268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6068269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6068273 | SUPPLY IMPLANT | Supply/Implant | $441.70 |
| 6068275 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6068277 | SUPPLY IMPLANT | Supply/Implant | $438.53 |
| 6068287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $67,200.00 |
| 6068289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6068323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068343 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068348 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6068355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,174.40 |
| 6068382 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,171.20 |
| 6068385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,512.00 |
| 6068413 | CATHETER, GUIDING | Supply/Implant | $8,614.40 |
| 6068423 | GUIDE WIRE | Supply/Implant | $334.72 |
| 6068424 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6068430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6068435 | STERILE SUPPLY | Supply/Implant | $264.58 |
| 6068437 | SUPPLY IMPLANT | Supply/Implant | $2,519.04 |
| 6068439 | STERILE SUPPLY | Supply/Implant | $314.25 |
| 6068442 | SUPPLY IMPLANT | Supply/Implant | $1,986.56 |
| 6068443 | SUPPLY IMPLANT | Supply/Implant | $1,884.16 |
| 6068448 | STERILE SUPPLY | Supply/Implant | $652.80 |
| 6068454 | SUPPLY IMPLANT | Supply/Implant | $4,556.80 |
| 6068458 | STERILE SUPPLY | Supply/Implant | $9,088.51 |
| 6068462 | SUPPLY IMPLANT | Supply/Implant | $458.24 |
| 6068485 | SUPPLY IMPLANT | Supply/Implant | $138.62 |
| 6068491 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6068499 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6068500 | STERILE SUPPLY | Supply/Implant | $285.57 |
| 6068501 | SUPPLY IMPLANT | Supply/Implant | $8,522.24 |
| 6068502 | STERILE SUPPLY | Supply/Implant | $225.88 |
| 6068506 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6068511 | STERILE SUPPLY | Supply/Implant | $12,736.00 |
| 6068514 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6068520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,833.60 |
| 6068526 | STERILE SUPPLY | Supply/Implant | $13,145.60 |
| 6068530 | SUPPLY IMPLANT | Supply/Implant | $6,067.20 |
| 6068531 | SUPPLY IMPLANT | Supply/Implant | $6,278.40 |
| 6068534 | SUPPLY IMPLANT | Supply/Implant | $11,596.80 |
| 6068540 | SHWR COV ELECT/COMBO VAD REP | Supply/Implant | $2,880.00 |
| 6068552 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6068558 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6068601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6068611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6068613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6068626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,123.20 |
| 6068639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,596.80 |
| 6068668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,272.00 |
| 6068674 | SUPPLY IMPLANT | Supply/Implant | $23,526.40 |
| 6068678 | SUPPLY IMPLANT | Supply/Implant | $6,388.48 |
| 6070055 | SUPPLY IMPLANT | Supply/Implant | $120,750.00 |
| 6070068 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,457.34 |
| 6070069 | GENERAL SUPPLY | Supply/Implant | $233.09 |
| 6070078 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6070079 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6070086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6070088 | SUPPLY IMPLANT | Supply/Implant | $2,593.28 |
| 6070089 | SUPPLY IMPLANT | Supply/Implant | $1,383.81 |
| 6070090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6070093 | SUPPLY IMPLANT | Supply/Implant | $2,665.60 |
| 6070094 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6070095 | GENERAL SUPPLY | Supply/Implant | $441.70 |
| 6070109 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6070110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6070114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6070122 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6070123 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,564.80 |
| 6070128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6070129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6070131 | GRAFT, VASCULAR | Supply/Implant | $31,294.08 |
| 6070132 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6070133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6070142 | GENERAL SUPPLY | Supply/Implant | $2,424.19 |
| 6070143 | GENERAL SUPPLY | Supply/Implant | $2,157.18 |
| 6070161 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6070162 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6070175 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6070180 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6070181 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6070183 | GUIDE WIRE | Supply/Implant | $412.80 |
| 6070184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,247.49 |
| 6070185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6070190 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,502.40 |
| 6070194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6070197 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6070212 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070222 | GUIDE WIRE | Supply/Implant | $436.74 |
| 6070236 | STERILE SUPPLY | Supply/Implant | $2,368.00 |
| 6070244 | CONN TISS, NON-HUMAN | Supply/Implant | $19,738.62 |
| 6070248 | CONN TISS, NON-HUMAN | Supply/Implant | $26,985.73 |
| 6070257 | STERILE SUPPLY | Supply/Implant | $307.20 |
| 6070263 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070271 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070281 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070285 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070295 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070311 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6070313 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6070315 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070317 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6070334 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $37,760.00 |
| 6070337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6070339 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,560.00 |
| 6070340 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6070341 | SUPPLY IMPLANT | Supply/Implant | $130.82 |
| 6070344 | SUPPLY IMPLANT | Supply/Implant | $5,273.47 |
| 6070345 | SUPPLY IMPLANT | Supply/Implant | $5,017.34 |
| 6070351 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6070360 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6070363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,988.80 |
| 6070376 | SUPPLY IMPLANT | Supply/Implant | $5,294.59 |
| 6070382 | SUPPLY IMPLANT | Supply/Implant | $4,705.66 |
| 6070412 | STERILE SUPPLY | Supply/Implant | $352.00 |
| 6070413 | STERILE SUPPLY | Supply/Implant | $318.94 |
| 6070425 | SUPPLY IMPLANT | Supply/Implant | $466.18 |
| 6070428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6070430 | SUPPLY IMPLANT | Supply/Implant | $70,976.00 |
| 6070438 | SUPPLY IMPLANT | Supply/Implant | $381.57 |
| 6070439 | SUPPLY IMPLANT | Supply/Implant | $2,521.60 |
| 6070441 | GENERAL SUPPLY | Supply/Implant | $389.12 |
| 6070448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6070451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070460 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $122,880.00 |
| 6070462 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6070468 | SUPPLY IMPLANT | Supply/Implant | $1,120.64 |
| 6070469 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6070470 | STERILE SUPPLY | Supply/Implant | $1,545.09 |
| 6070483 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6070488 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6070504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6070510 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6070535 | SUPPLY IMPLANT | Supply/Implant | $28,060.16 |
| 6070548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6070551 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070553 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070554 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070555 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070557 | SUPPLY IMPLANT | Supply/Implant | $2,445.57 |
| 6070560 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070561 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070581 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6070582 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6070583 | SUPPLY IMPLANT | Supply/Implant | $230.91 |
| 6070586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,929.41 |
| 6070591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,130.69 |
| 6070592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,130.69 |
| 6070593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,130.69 |
| 6070605 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $4,416.00 |
| 6070612 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $4,416.00 |
| 6070618 | SUPPLY IMPLANT | Supply/Implant | $19,276.80 |
| 6070623 | PWR MODULE PT CABLE LVAD RPL | Supply/Implant | $16,000.00 |
| 6070624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6070653 | SUPPLY IMPLANT | Supply/Implant | $18,624.00 |
| 6070657 | SUPPLY IMPLANT | Supply/Implant | $18,624.00 |
| 6070660 | SUPPLY IMPLANT | Supply/Implant | $17,630.72 |
| 6070666 | INTEGRA MATRIX SKIN SUB | Supply/Implant | $65,854.46 |
| 6070667 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6070672 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $82,675.20 |
| 6070673 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6070682 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $724.22 |
| 6070685 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070689 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6070696 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6070697 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,408.00 |
| 6070706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6070716 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6070718 | SUPPLY IMPLANT | Supply/Implant | $356.35 |
| 6070720 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6070728 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6070732 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6070736 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,586.37 |
| 6070739 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,784.58 |
| 6070758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,712.00 |
| 6070762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070767 | GENERAL SUPPLY | Supply/Implant | $477.34 |
| 6070769 | GUIDE WIRE | Supply/Implant | $793.60 |
| 6070781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6070782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6070783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6070787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6070809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.20 |
| 6070814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6070817 | PORT, INDWELLING, IMP | Supply/Implant | $9,907.20 |
| 6070818 | PORT, INDWELLING, IMP | Supply/Implant | $9,907.20 |
| 6070821 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6070822 | SUPPLY IMPLANT | Supply/Implant | $7,961.60 |
| 6070824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,070.40 |
| 6070835 | GUIDE WIRE | Supply/Implant | $3,238.40 |
| 6070836 | GUIDE WIRE | Supply/Implant | $3,532.80 |
| 6070837 | GUIDE WIRE | Supply/Implant | $3,238.40 |
| 6070838 | SUPPLY IMPLANT | Supply/Implant | $34,240.00 |
| 6070839 | SUPPLY IMPLANT | Supply/Implant | $34,240.00 |
| 6070840 | CATHETER, GUIDING | Supply/Implant | $9,331.20 |
| 6070841 | CATHETER, GUIDING | Supply/Implant | $9,331.20 |
| 6070844 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070848 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070849 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070850 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070851 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070852 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070855 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070857 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6070858 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070859 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070860 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070861 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070862 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070863 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070864 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070865 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070866 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070867 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070868 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070869 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070874 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070875 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6070890 | SUPPLY IMPLANT | Supply/Implant | $487.30 |
| 6070895 | INTEGRA MATRIX SKIN SUB | Supply/Implant | $62,973.57 |
| 6070896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,048.00 |
| 6070901 | SUPPLY IMPLANT | Supply/Implant | $18,304.00 |
| 6070942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6070944 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6070978 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6070979 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6070980 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6070989 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6070990 | SUPPLY IMPLANT | Supply/Implant | $7,961.60 |
| 6071001 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $576.00 |
| 6071002 | SUPPLY IMPLANT | Supply/Implant | $870.40 |
| 6071003 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6071019 | GUIDE WIRE | Supply/Implant | $6,054.40 |
| 6071021 | GUIDE WIRE | Supply/Implant | $6,880.00 |
| 6071022 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,080.00 |
| 6071030 | GENERAL SUPPLY | Supply/Implant | $285.44 |
| 6071034 | CLOSURE DEV, VASC | Supply/Implant | $2,432.00 |
| 6071035 | CLOSURE DEV, VASC | Supply/Implant | $2,432.00 |
| 6071036 | CLOSURE DEV, VASC | Supply/Implant | $2,432.00 |
| 6071037 | SUPPLY IMPLANT | Supply/Implant | $3,280.18 |
| 6071042 | SUPPLY IMPLANT | Supply/Implant | $2,078.72 |
| 6071045 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6071046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,520.00 |
| 6071049 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6071050 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6071053 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6071056 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6071067 | SUPPLY IMPLANT | Supply/Implant | $293.89 |
| 6071074 | SUPPLY IMPLANT | Supply/Implant | $205.70 |
| 6071079 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6071080 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6071082 | SUPPLY IMPLANT | Supply/Implant | $288.00 |
| 6071113 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6071122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6071123 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071124 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071125 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071126 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6071138 | SUPPLY IMPLANT | Supply/Implant | $4,684.80 |
| 6071143 | STERILE SUPPLY | Supply/Implant | $21,596.16 |
| 6071161 | SUPPLY IMPLANT | Supply/Implant | $2,492.80 |
| 6071166 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071168 | SUPPLY IMPLANT | Supply/Implant | $8,460.80 |
| 6071175 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $31,993.60 |
| 6071176 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $127,692.80 |
| 6071186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $60,895.36 |
| 6071187 | SUPPLY IMPLANT | Supply/Implant | $8,870.40 |
| 6071189 | GENERAL SUPPLY | Supply/Implant | $465.92 |
| 6071197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6071198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6071202 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6071206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,025.73 |
| 6071209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,592.00 |
| 6071219 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,247.49 |
| 6071220 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6071228 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6071230 | SUPPLY IMPLANT | Supply/Implant | $16,569.65 |
| 6071233 | SUPPLY IMPLANT | Supply/Implant | $65,534.98 |
| 6071235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,050.24 |
| 6071242 | RET DEV, INSERTABLE | Supply/Implant | $8,678.40 |
| 6071250 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071251 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,619.20 |
| 6071252 | SUPPLY IMPLANT | Supply/Implant | $4,363.65 |
| 6071253 | SUPPLY IMPLANT | Supply/Implant | $3,274.59 |
| 6071254 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6071256 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6071277 | STERILE SUPPLY | Supply/Implant | $294.40 |
| 6071280 | STERILE SUPPLY | Supply/Implant | $170.24 |
| 6071281 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6071310 | SUPPLY IMPLANT | Supply/Implant | $4,427.26 |
| 6071311 | STERILE SUPPLY | Supply/Implant | $193.02 |
| 6071322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6071371 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071372 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071373 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071374 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071375 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071376 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071377 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071378 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6071394 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6071398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,680.00 |
| 6071408 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071409 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071410 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071411 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071412 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6071414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6071416 | SUPPLY IMPLANT | Supply/Implant | $1,202.05 |
| 6071417 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071419 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071420 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071422 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071423 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071424 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071425 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071426 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,202.05 |
| 6071427 | SUPPLY IMPLANT | Supply/Implant | $1,617.66 |
| 6071428 | SUPPLY IMPLANT | Supply/Implant | $1,617.66 |
| 6071430 | SUPPLY IMPLANT | Supply/Implant | $2,582.53 |
| 6071435 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6071438 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6071439 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6071451 | SUPPLY IMPLANT | Supply/Implant | $306.69 |
| 6071453 | CATHETER, GUIDING | Supply/Implant | $9,331.20 |
| 6071458 | GENERAL SUPPLY | Supply/Implant | $154.91 |
| 6071459 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,457.34 |
| 6071462 | CATHETER, GUIDING | Supply/Implant | $838.91 |
| 6071467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,662.40 |
| 6071472 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6071473 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6071479 | SUPPLY IMPLANT | Supply/Implant | $2,526.72 |
| 6071480 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6071481 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6071482 | SUPPLY IMPLANT | Supply/Implant | $13,171.20 |
| 6071486 | SUPPLY IMPLANT | Supply/Implant | $31,294.08 |
| 6071489 | SUPPLY IMPLANT | Supply/Implant | $1,720.32 |
| 6071494 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6071501 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6071502 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6071504 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071505 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071506 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071507 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6071508 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6071509 | SUPPLY IMPLANT | Supply/Implant | $5,235.20 |
| 6071512 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,109.18 |
| 6071522 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,164.80 |
| 6071526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,357.76 |
| 6071535 | GUIDE WIRE | Supply/Implant | $8,641.28 |
| 6071539 | CATHETER, GUIDING | Supply/Implant | $20,467.20 |
| 6071540 | CATHETER, GUIDING | Supply/Implant | $16,000.00 |
| 6071542 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6071564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6071565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,187.84 |
| 6071569 | CATHETER, GUIDING | Supply/Implant | $6,336.00 |
| 6071570 | CATHETER, GUIDING | Supply/Implant | $6,336.00 |
| 6071571 | CATHETER, GUIDING | Supply/Implant | $6,272.00 |
| 6071572 | CATHETER, GUIDING | Supply/Implant | $6,272.00 |
| 6071573 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $42,176.00 |
| 6071584 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6071588 | GUIDE WIRE | Supply/Implant | $3,712.00 |
| 6071592 | SUPPLY IMPLANT | Supply/Implant | $7,091.20 |
| 6071594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,235.20 |
| 6071595 | SUPPLY IMPLANT | Supply/Implant | $7,923.20 |
| 6071596 | SUPPLY IMPLANT | Supply/Implant | $7,808.00 |
| 6071597 | SUPPLY IMPLANT | Supply/Implant | $7,539.20 |
| 6071598 | SUPPLY IMPLANT | Supply/Implant | $6,950.40 |
| 6071599 | SUPPLY IMPLANT | Supply/Implant | $5,606.40 |
| 6071602 | PROS, URINARY SPH, IMP | Supply/Implant | $71,257.60 |
| 6071603 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6071607 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6071614 | GENERAL SUPPLY | Supply/Implant | $974.34 |
| 6071615 | STERILE SUPPLY | Supply/Implant | $902.78 |
| 6071616 | GENERAL SUPPLY | Supply/Implant | $979.33 |
| 6071619 | SUPPLY IMPLANT | Supply/Implant | $1,579.52 |
| 6071621 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071622 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071623 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071624 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6071660 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6071664 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6071665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071666 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6071671 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $205,030.00 |
| 6071674 | SUPPLY IMPLANT | Supply/Implant | $4,508.42 |
| 6071687 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6071694 | STERILE SUPPLY | Supply/Implant | $260.86 |
| 6071698 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6071700 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6071701 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6071702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6071703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,636.80 |
| 6071707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6071708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,080.00 |
| 6071709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071710 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,840.00 |
| 6071711 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6071712 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6071713 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,120.00 |
| 6071717 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071718 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,840.00 |
| 6071719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,369.60 |
| 6071727 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $78,848.00 |
| 6071734 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,247.23 |
| 6071751 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6071761 | SUPPLY IMPLANT | Supply/Implant | $1,202.30 |
| 6071763 | SUPPLY IMPLANT | Supply/Implant | $2,086.40 |
| 6071764 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6071765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,909.50 |
| 6071770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6071778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6071790 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $140.80 |
| 6071804 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,793.02 |
| 6071805 | CATHETER, URETERAL | Supply/Implant | $244.86 |
| 6071807 | CATHETER, URETERAL | Supply/Implant | $395.14 |
| 6071812 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071813 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,384.00 |
| 6071816 | SUPPLY IMPLANT | Supply/Implant | $216.70 |
| 6071824 | SUPPLY IMPLANT | Supply/Implant | $4,697.60 |
| 6071825 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6071832 | SUPPLY IMPLANT | Supply/Implant | $55,795.20 |
| 6071841 | SUPPLY IMPLANT | Supply/Implant | $1,423.36 |
| 6071842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6071845 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6071848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6071852 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6071853 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6071854 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6071855 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6071859 | SUPPLY IMPLANT | Supply/Implant | $1,748.48 |
| 6071860 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6071861 | SUPPLY IMPLANT | Supply/Implant | $1,573.50 |
| 6071864 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6071884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6071887 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6071891 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6071893 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6071904 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071905 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,864.00 |
| 6071906 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071907 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,160.00 |
| 6071923 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $42,176.00 |
| 6071927 | SUPPLY IMPLANT | Supply/Implant | $209.79 |
| 6071931 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6071932 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6071939 | SUPPLY IMPLANT | Supply/Implant | $119,962.50 |
| 6071940 | SUPPLY IMPLANT | Supply/Implant | $4,289.02 |
| 6071946 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6071948 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,295.49 |
| 6071949 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,320.96 |
| 6071961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6071962 | SUPPLY IMPLANT | Supply/Implant | $118,053.39 |
| 6071963 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6071969 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6071970 | SUPPLY IMPLANT | Supply/Implant | $645.89 |
| 6071979 | STERILE SUPPLY | Supply/Implant | $12,736.00 |
| 6071981 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6071995 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6071996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.70 |
| 6071997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.70 |
| 6072000 | SUPPLY IMPLANT | Supply/Implant | $2,451.71 |
| 6072001 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6072003 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6072006 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,792.00 |
| 6072007 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,892.80 |
| 6072008 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6072009 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6072012 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $42,112.00 |
| 6072027 | STERILE SUPPLY | Supply/Implant | $2,426.75 |
| 6072029 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6072036 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6072039 | SUPPLY IMPLANT | Supply/Implant | $1,113.60 |
| 6072040 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6072046 | SUPPLY IMPLANT | Supply/Implant | $418.69 |
| 6072047 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6072071 | PORT, INDWELLING, IMP | Supply/Implant | $6,720.00 |
| 6072077 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,408.00 |
| 6072084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,566.08 |
| 6072086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,397.50 |
| 6072092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,988.80 |
| 6072099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,566.08 |
| 6072102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6072103 | SUPPLY IMPLANT | Supply/Implant | $573.44 |
| 6072121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,428.80 |
| 6072123 | SUPPLY IMPLANT | Supply/Implant | $120,532.48 |
| 6072126 | GENERAL SUPPLY | Supply/Implant | $330.75 |
| 6072129 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6072130 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6072131 | STERILE SUPPLY | Supply/Implant | $519.68 |
| 6072142 | NEURAWRAP NERVE PROTECTOR,CM | Supply/Implant | $25,123.20 |
| 6072148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072170 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6072172 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6072173 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6072181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6072184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,912.38 |
| 6072193 | SUPPLY IMPLANT | Supply/Implant | $7,730.56 |
| 6072195 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072196 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072197 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072198 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072199 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072200 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072201 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072202 | GENERAL SUPPLY | Supply/Implant | $181.38 |
| 6072204 | GENERAL SUPPLY | Supply/Implant | $1,314.05 |
| 6072209 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072212 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6072215 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6072219 | SUPPLY IMPLANT | Supply/Implant | $1,325.44 |
| 6072220 | SUPPLY IMPLANT | Supply/Implant | $1,192.90 |
| 6072260 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $108,267.01 |
| 6072274 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6072276 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6072277 | GENERAL SUPPLY | Supply/Implant | $658.69 |
| 6072279 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $116,992.00 |
| 6072283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6072302 | CORNEAL TISSUE PROCESSING | Supply/Implant | $48,640.00 |
| 6072307 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.20 |
| 6072314 | GENERAL SUPPLY | Supply/Implant | $296.45 |
| 6072323 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072333 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072336 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072365 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072366 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,712.00 |
| 6072377 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6072378 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6072379 | SUPPLY IMPLANT | Supply/Implant | $883.20 |
| 6072381 | SUPPLY IMPLANT | Supply/Implant | $10,142.34 |
| 6072382 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,406.66 |
| 6072383 | SUPPLY IMPLANT | Supply/Implant | $1,862.53 |
| 6072384 | SUPPLY IMPLANT | Supply/Implant | $958.21 |
| 6072387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,299.20 |
| 6072390 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6072391 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6072393 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6072397 | GENERAL SUPPLY | Supply/Implant | $1,425.66 |
| 6072398 | GENERAL SUPPLY | Supply/Implant | $2,162.10 |
| 6072403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,703.42 |
| 6072405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6072407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6072412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6072424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6072431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,863.36 |
| 6072432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6072433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $638.72 |
| 6072435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,979.52 |
| 6072438 | GENERAL SUPPLY | Supply/Implant | $2,948.10 |
| 6072440 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6072442 | SUPPLY IMPLANT | Supply/Implant | $140,955.89 |
| 6072444 | CATH OCCLUSION | Supply/Implant | $17,920.00 |
| 6072446 | GUIDE WIRE | Supply/Implant | $2,188.80 |
| 6072448 | GENERAL SUPPLY | Supply/Implant | $336.90 |
| 6072450 | SUPPLY IMPLANT | Supply/Implant | $2,268.25 |
| 6072451 | SUPPLY IMPLANT | Supply/Implant | $9,379.33 |
| 6072456 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072457 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072458 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072459 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072460 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072461 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072469 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072470 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072471 | SUPPLY IMPLANT | Supply/Implant | $6,648.32 |
| 6072472 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072473 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072474 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6072481 | STERILE SUPPLY | Supply/Implant | $1,728.38 |
| 6072494 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6072498 | GENERAL SUPPLY | Supply/Implant | $293.12 |
| 6072499 | GENERAL SUPPLY | Supply/Implant | $267.52 |
| 6072510 | CATHETER, GUIDING | Supply/Implant | $512.00 |
| 6072511 | CATHETER, GUIDING | Supply/Implant | $1,408.00 |
| 6072512 | CATHETER, GUIDING | Supply/Implant | $307.20 |
| 6072535 | INTRO/SHEATH, NON-LASER | Supply/Implant | $947.20 |
| 6072536 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6072537 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6072544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,067.20 |
| 6072546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,969.73 |
| 6072547 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $660.74 |
| 6072548 | SUPPLY IMPLANT | Supply/Implant | $604.80 |
| 6072554 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6072568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,038.50 |
| 6072569 | SUPPLY IMPLANT | Supply/Implant | $7,728.00 |
| 6072572 | GRAFT, VASCULAR | Supply/Implant | $39,499.26 |
| 6072576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,958.40 |
| 6072577 | SUPPLY IMPLANT | Supply/Implant | $5,958.40 |
| 6072580 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6072583 | GENERAL SUPPLY | Supply/Implant | $257.54 |
| 6072585 | GRAFT, VASCULAR | Supply/Implant | $39,499.26 |
| 6072590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6072591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6072598 | SUPPLY IMPLANT | Supply/Implant | $10,854.40 |
| 6072606 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,137.28 |
| 6072616 | SUPPLY IMPLANT | Supply/Implant | $306.82 |
| 6072617 | SUPPLY IMPLANT | Supply/Implant | $246.02 |
| 6072618 | SUPPLY IMPLANT | Supply/Implant | $246.02 |
| 6072636 | SUPPLY IMPLANT | Supply/Implant | $1,152.26 |
| 6072637 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6072638 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6072639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6072640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,150.72 |
| 6072642 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6072648 | GENERAL SUPPLY | Supply/Implant | $645.12 |
| 6072649 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6072651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6072653 | SUPPLY IMPLANT | Supply/Implant | $1,270.14 |
| 6072655 | SUPPLY IMPLANT | Supply/Implant | $1,209.60 |
| 6072656 | SUPPLY IMPLANT | Supply/Implant | $1,270.14 |
| 6072657 | SUPPLY IMPLANT | Supply/Implant | $589.57 |
| 6072658 | SUPPLY IMPLANT | Supply/Implant | $649.98 |
| 6072659 | SUPPLY IMPLANT | Supply/Implant | $589.57 |
| 6072661 | SUPPLY IMPLANT | Supply/Implant | $2,947.84 |
| 6072662 | SUPPLY IMPLANT | Supply/Implant | $1,434.11 |
| 6072669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6072675 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,706.69 |
| 6072684 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6072688 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,408.13 |
| 6072689 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,408.13 |
| 6072696 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,450.43 |
| 6072697 | SUPPLY IMPLANT | Supply/Implant | $1,012.74 |
| 6072699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6072700 | INTRO/SHEATH, NON-LASER | Supply/Implant | $307.20 |
| 6072701 | ALLODERM SKIN SUB | Supply/Implant | $3,660.80 |
| 6072702 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6072704 | STERILE SUPPLY | Supply/Implant | $499.20 |
| 6072715 | LEAD, CORONARY VENOUS | Supply/Implant | $120,640.00 |
| 6072716 | LEAD, CORONARY VENOUS | Supply/Implant | $120,640.00 |
| 6072719 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6072732 | SUPPLY IMPLANT | Supply/Implant | $1,184.00 |
| 6072733 | SUPPLY IMPLANT | Supply/Implant | $1,184.00 |
| 6072734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6072748 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,267.20 |
| 6072750 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6072754 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6072755 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6072757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6072760 | STERILE SUPPLY | Supply/Implant | $332.80 |
| 6072767 | MESH (IMPLANTABLE) | Supply/Implant | $8,010.50 |
| 6072770 | SUPPLY IMPLANT | Supply/Implant | $598.53 |
| 6072776 | SUPPLY IMPLANT | Supply/Implant | $5,504.00 |
| 6072815 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6072827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,136.00 |
| 6072828 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6072838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,209.60 |
| 6072840 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6072844 | STERILE SUPPLY | Supply/Implant | $488.32 |
| 6072846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6072848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6072856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,352.00 |
| 6072860 | GENERAL SUPPLY | Supply/Implant | $271.36 |
| 6072869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6072872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6072873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6072876 | SUPPLY IMPLANT | Supply/Implant | $4,648.96 |
| 6072878 | SUPPLY IMPLANT | Supply/Implant | $2,997.89 |
| 6072886 | SUPPLY IMPLANT | Supply/Implant | $3,297.79 |
| 6072891 | SUPPLY IMPLANT | Supply/Implant | $2,539.52 |
| 6072901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,881.60 |
| 6072915 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,328.00 |
| 6072917 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6072929 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $119,680.00 |
| 6072937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,884.03 |
| 6072946 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $14,470.40 |
| 6072947 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $184,432.50 |
| 6072948 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $116,249.60 |
| 6072949 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $116,249.60 |
| 6072975 | SUPPLY IMPLANT | Supply/Implant | $223.36 |
| 6072979 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $8,268.80 |
| 6072999 | SUPPLY IMPLANT | Supply/Implant | $606.72 |
| 6073009 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6073012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6073017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6073023 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6073026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6073027 | CATHETER, GUIDING | Supply/Implant | $2,112.00 |
| 6073028 | SUPPLY IMPLANT | Supply/Implant | $3,267.07 |
| 6073032 | SUPPLY IMPLANT | Supply/Implant | $883.33 |
| 6073036 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $3,551.74 |
| 6073055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6073083 | GENERAL SUPPLY | Supply/Implant | $419.97 |
| 6073120 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6073122 | SUPPLY IMPLANT | Supply/Implant | $59,776.00 |
| 6073123 | SUPPLY IMPLANT | Supply/Implant | $7,689.60 |
| 6073124 | SUPPLY IMPLANT | Supply/Implant | $7,689.60 |
| 6073125 | SUPPLY IMPLANT | Supply/Implant | $7,555.20 |
| 6073126 | SUPPLY IMPLANT | Supply/Implant | $7,555.20 |
| 6073129 | INTERSPINOUS IMPLANT | Supply/Implant | $37,888.00 |
| 6073133 | INTERSPINOUS IMPLANT | Supply/Implant | $60,806.40 |
| 6073152 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6073153 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6073174 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,897.60 |
| 6073175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6073176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6073178 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6073179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6073182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,772.16 |
| 6073184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073187 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6073190 | GENERAL SUPPLY | Supply/Implant | $672.00 |
| 6073210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,929.41 |
| 6073211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6073230 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $1,886.85 |
| 6073231 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $1,806.08 |
| 6073232 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,806.08 |
| 6073237 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,806.08 |
| 6073239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,840.00 |
| 6073240 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6073245 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6073246 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6073263 | GENERAL SUPPLY | Supply/Implant | $600.06 |
| 6073278 | IMPLT NEUROSTIM ELCTR EACH | Supply/Implant | $30,592.00 |
| 6073286 | GENERAL SUPPLY | Supply/Implant | $253.31 |
| 6073307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,369.60 |
| 6073309 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6073311 | CATH, DRAINAGE | Supply/Implant | $2,944.00 |
| 6073317 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073320 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073321 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073328 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6073346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6073349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,088.96 |
| 6073350 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6073352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6073356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,318.72 |
| 6073357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,318.72 |
| 6073358 | CATHETER, GUIDING | Supply/Implant | $2,206.85 |
| 6073359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6073372 | GENERAL SUPPLY | Supply/Implant | $316.03 |
| 6073398 | SUPPLY IMPLANT | Supply/Implant | $87,360.00 |
| 6073404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $318.72 |
| 6073408 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6073421 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $25,523.20 |
| 6073429 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,867.01 |
| 6073436 | GENERAL SUPPLY | Supply/Implant | $288.51 |
| 6073442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,814.40 |
| 6073443 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6073450 | SUPPLY IMPLANT | Supply/Implant | $6,649.60 |
| 6073465 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6073474 | GENERAL SUPPLY | Supply/Implant | $395.78 |
| 6073475 | STERILE SUPPLY | Supply/Implant | $8,481.79 |
| 6073485 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6073490 | MESH (IMPLANTABLE) | Supply/Implant | $71,616.00 |
| 6073491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6073497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6073498 | SUPPLY IMPLANT | Supply/Implant | $23,203.84 |
| 6073504 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,664.00 |
| 6073505 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6073506 | GENERAL SUPPLY | Supply/Implant | $216.96 |
| 6073510 | SUPPLY IMPLANT | Supply/Implant | $1,556.48 |
| 6073513 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073514 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073517 | SUPPLY IMPLANT | Supply/Implant | $2,011.48 |
| 6073518 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073522 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073523 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073526 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073527 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073530 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073531 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073537 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073539 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073541 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073542 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,048.00 |
| 6073543 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073544 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073546 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073547 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073548 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073549 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073550 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073551 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073552 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073554 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073556 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073558 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073559 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073560 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6073563 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6073565 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,480.00 |
| 6073569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6073580 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $94,707.20 |
| 6073582 | RET DEV, INSERTABLE | Supply/Implant | $94,707.20 |
| 6073583 | RET DEV, INSERTABLE | Supply/Implant | $94,707.20 |
| 6073591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6073592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6073604 | SUPPLY IMPLANT | Supply/Implant | $2,221.44 |
| 6073605 | SUPPLY IMPLANT | Supply/Implant | $3,826.43 |
| 6073609 | SUPPLY IMPLANT | Supply/Implant | $15,552.00 |
| 6073630 | INTRO/SHEATH, NON-LASER | Supply/Implant | $10,585.60 |
| 6073632 | INTRO/SHEATH, NON-LASER | Supply/Implant | $10,585.60 |
| 6073638 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073639 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073641 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073642 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073643 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073644 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073647 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073648 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073650 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073651 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073652 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073653 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073654 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073656 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,040.00 |
| 6073658 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073662 | SUPPLY IMPLANT | Supply/Implant | $257,550.00 |
| 6073670 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073671 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073672 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073673 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6073680 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6073690 | SUPPLY IMPLANT | Supply/Implant | $1,021.44 |
| 6073694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,920.06 |
| 6073703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,804.48 |
| 6073709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6073716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073724 | SUPPLY IMPLANT | Supply/Implant | $23,500.80 |
| 6073725 | SUPPLY IMPLANT | Supply/Implant | $66,585.60 |
| 6073741 | SUPPLY IMPLANT | Supply/Implant | $2,734.08 |
| 6073743 | SUPPLY IMPLANT | Supply/Implant | $2,836.48 |
| 6073744 | SUPPLY IMPLANT | Supply/Implant | $931.84 |
| 6073752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6073756 | STERILE SUPPLY | Supply/Implant | $246.53 |
| 6073757 | STERILE SUPPLY | Supply/Implant | $199.17 |
| 6073759 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,348.80 |
| 6073766 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6073768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6073772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,742.40 |
| 6073774 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6073782 | SUPPLY IMPLANT | Supply/Implant | $148.74 |
| 6073783 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6073794 | GRAFT, VASCULAR | Supply/Implant | $87,360.00 |
| 6073795 | GRAFT, VASCULAR | Supply/Implant | $42,560.00 |
| 6073811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6073813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6073814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6073824 | INTRO/SHEATH, NON-LASER | Supply/Implant | $556.80 |
| 6073847 | CATHETER, GUIDING | Supply/Implant | $2,772.48 |
| 6073861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073865 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,720.00 |
| 6073876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $854.40 |
| 6073879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,065.60 |
| 6073881 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $63,936.00 |
| 6073884 | SUPPLY IMPLANT | Supply/Implant | $1,054.72 |
| 6073906 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6073907 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6073911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,121.22 |
| 6073913 | SUPPLY IMPLANT | Supply/Implant | $575.87 |
| 6073921 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6073935 | SUPPLY IMPLANT | Supply/Implant | $1,182.72 |
| 6073940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6073973 | SUPPLY IMPLANT | Supply/Implant | $495.10 |
| 6073990 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6073991 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6073992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6073999 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6074002 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6074007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,736.00 |
| 6074008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,651.20 |
| 6074012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6074013 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6074014 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6074017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6074020 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074024 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6074025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6074026 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6074029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6074030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,736.00 |
| 6074032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,467.20 |
| 6074034 | GENERAL SUPPLY | Supply/Implant | $5,712.00 |
| 6074047 | SUPPLY IMPLANT | Supply/Implant | $2,910.72 |
| 6074052 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6074054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074064 | SUPPLY IMPLANT | Supply/Implant | $3,302.40 |
| 6074080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6074081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,668.54 |
| 6074102 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6074104 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,471.74 |
| 6074106 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,480.19 |
| 6074107 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6074108 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6074113 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6074118 | SUPPLY IMPLANT | Supply/Implant | $1,182.72 |
| 6074120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,651.20 |
| 6074129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074131 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6074133 | SUPPLY IMPLANT | Supply/Implant | $3,827.20 |
| 6074134 | SUPPLY IMPLANT | Supply/Implant | $645.89 |
| 6074136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6074145 | LEAD, NEUROSTIMULATOR | Supply/Implant | $100,480.00 |
| 6074150 | GENERAL SUPPLY | Supply/Implant | $1,399.17 |
| 6074151 | GENERAL SUPPLY | Supply/Implant | $1,372.42 |
| 6074157 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6074158 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6074159 | STERILE SUPPLY | Supply/Implant | $601.34 |
| 6074160 | STERILE SUPPLY | Supply/Implant | $835.58 |
| 6074161 | STERILE SUPPLY | Supply/Implant | $360.19 |
| 6074166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6074167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6074169 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074171 | STERILE SUPPLY | Supply/Implant | $467.42 |
| 6074172 | INTERSPINOUS IMPLANT | Supply/Implant | $48,114.56 |
| 6074173 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6074186 | SUPPLY IMPLANT | Supply/Implant | $216.45 |
| 6074188 | SUPPLY IMPLANT | Supply/Implant | $149.12 |
| 6074189 | STERILE SUPPLY | Supply/Implant | $301.31 |
| 6074190 | STERILE SUPPLY | Supply/Implant | $301.31 |
| 6074194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6074195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6074202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $386.30 |
| 6074214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6074217 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6074225 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074234 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $52,467.20 |
| 6074235 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $52,467.20 |
| 6074240 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074242 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074249 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074250 | SUPPLY IMPLANT | Supply/Implant | $26,307.07 |
| 6074252 | MISC SUP/ACC IMP VAD | Supply/Implant | $139.14 |
| 6074255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074256 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074258 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074262 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074263 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074264 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6074267 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074268 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074269 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074270 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074271 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074276 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,945.60 |
| 6074277 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074278 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074279 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074281 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6074284 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074285 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074286 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074287 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074289 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6074293 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074294 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074295 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,764.80 |
| 6074298 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6074300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074304 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6074322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074327 | GENERAL SUPPLY | Supply/Implant | $461.70 |
| 6074328 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6074333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074335 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,817.60 |
| 6074336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6074337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6074338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,146.88 |
| 6074341 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $63,254.40 |
| 6074350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6074356 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6074357 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6074359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,802.88 |
| 6074361 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6074362 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6074363 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6074371 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6074375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6074378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074381 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6074386 | GUIDE WIRE | Supply/Implant | $7,508.86 |
| 6074387 | GUIDE WIRE | Supply/Implant | $7,508.86 |
| 6074390 | GENERAL SUPPLY | Supply/Implant | $1,039.74 |
| 6074397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6074398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6074404 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074405 | SUPPLY IMPLANT | Supply/Implant | $6,412.29 |
| 6074406 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074407 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074408 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074409 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074410 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6074411 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074412 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074414 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074415 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074416 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6074428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6074429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6074430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6074464 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6074465 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6074466 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6074469 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6074472 | GENERAL SUPPLY | Supply/Implant | $7,616.00 |
| 6074473 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6074487 | ALLODERM SKIN SUB | Supply/Implant | $2,956.80 |
| 6074490 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $14,018.69 |
| 6074491 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,576.45 |
| 6074499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,124.80 |
| 6074505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6074509 | SUPPLY IMPLANT | Supply/Implant | $5,990.40 |
| 6074522 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,566.08 |
| 6074533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074534 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6074535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6074536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074538 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074542 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6074543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6074544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $896.00 |
| 6074545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,790.40 |
| 6074546 | RET DEV, INSERTABLE | Supply/Implant | $1,407.05 |
| 6074550 | CORNEAL TISSUE PROCESSING | Supply/Implant | $51,200.00 |
| 6074551 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $10,579.20 |
| 6074552 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $10,579.20 |
| 6074563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074577 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6074580 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6074585 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6074587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,790.40 |
| 6074588 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $32,000.00 |
| 6074592 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074593 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074594 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074595 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074596 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074597 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074598 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074603 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074604 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6074606 | GUIDE WIRE | Supply/Implant | $332.80 |
| 6074608 | GUIDE WIRE | Supply/Implant | $268.80 |
| 6074610 | GUIDE WIRE | Supply/Implant | $419.61 |
| 6074611 | SUPPLY IMPLANT | Supply/Implant | $3,357.70 |
| 6074615 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6074617 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6074638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6074639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6074640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6074647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6074648 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6074653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,017.22 |
| 6074665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,534.98 |
| 6074681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6074683 | GUIDE WIRE | Supply/Implant | $601.60 |
| 6074740 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,960.00 |
| 6074749 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6074761 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $119,680.00 |
| 6074764 | GRAFT, VASCULAR | Supply/Implant | $119,680.00 |
| 6074766 | GENERAL SUPPLY | Supply/Implant | $1,628.03 |
| 6074770 | SUPPLY IMPLANT | Supply/Implant | $108,736.00 |
| 6074774 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $119,680.00 |
| 6074779 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $704.00 |
| 6074780 | GRAFT, VASCULAR | Supply/Implant | $119,680.00 |
| 6074782 | GRAFT, VASCULAR | Supply/Implant | $108,736.00 |
| 6074786 | GRAFT, VASCULAR | Supply/Implant | $108,736.00 |
| 6074788 | GRAFT, VASCULAR | Supply/Implant | $115,500.00 |
| 6074791 | SUPPLY IMPLANT | Supply/Implant | $15,595.52 |
| 6074796 | GRAFT, VASCULAR | Supply/Implant | $44,736.00 |
| 6074810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,872.13 |
| 6074814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074817 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6074822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074836 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6074845 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074846 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074847 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074848 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6074863 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074864 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074865 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074867 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074868 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074870 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074871 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6074877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6074878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6074879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,548.80 |
| 6074887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6074890 | SUPPLY IMPLANT | Supply/Implant | $548.35 |
| 6074892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6074893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6074894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $652.80 |
| 6074895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6074899 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6074903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6074912 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,872.13 |
| 6074916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074919 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,587.84 |
| 6074921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,187.20 |
| 6074922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6074928 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6074929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074934 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6074942 | SUPPLY IMPLANT | Supply/Implant | $6,345.22 |
| 6074962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,566.53 |
| 6074963 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $36,480.00 |
| 6074964 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $36,480.00 |
| 6074965 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $36,480.00 |
| 6074966 | SUPPLY IMPLANT | Supply/Implant | $368.64 |
| 6074973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6074975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6074980 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6074981 | GUIDE WIRE | Supply/Implant | $1,740.80 |
| 6074982 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $3,200.00 |
| 6074983 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6074988 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6074990 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,328.00 |
| 6074994 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,328.00 |
| 6074997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,006.40 |
| 6075007 | LEAD, CORONARY VENOUS | Supply/Implant | $35,840.00 |
| 6075012 | GRAFT, VASCULAR | Supply/Implant | $63,680.00 |
| 6075013 | SUPPLY IMPLANT | Supply/Implant | $59,520.00 |
| 6075014 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6075018 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6075019 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6075020 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6075021 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6075029 | GRAFT, VASCULAR | Supply/Implant | $61,440.00 |
| 6075041 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6075042 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075043 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075044 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075045 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075046 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075048 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075049 | CATHETER, GUIDING | Supply/Implant | $1,664.00 |
| 6075054 | STERILE SUPPLY | Supply/Implant | $1,375.87 |
| 6075063 | GRAFT, VASCULAR | Supply/Implant | $60,496.00 |
| 6075064 | GRAFT, VASCULAR | Supply/Implant | $58,976.00 |
| 6075067 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,776.00 |
| 6075070 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075080 | GENERAL SUPPLY | Supply/Implant | $142.85 |
| 6075081 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,312.00 |
| 6075082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075085 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6075086 | SUPPLY IMPLANT | Supply/Implant | $30,720.00 |
| 6075093 | STERILE SUPPLY | Supply/Implant | $318.85 |
| 6075103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6075107 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $271,690.00 |
| 6075108 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $28,160.00 |
| 6075111 | CATHETER, GUIDING | Supply/Implant | $1,779.20 |
| 6075121 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,036.80 |
| 6075137 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6075139 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $1,186.56 |
| 6075157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6075164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,395.52 |
| 6075168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075174 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,305.60 |
| 6075186 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075187 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075188 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075189 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075190 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075191 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075192 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6075194 | CATHETER, GUIDING | Supply/Implant | $448.00 |
| 6075199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6075201 | STERILE SUPPLY | Supply/Implant | $177.28 |
| 6075224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075225 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6075229 | GENERAL SUPPLY | Supply/Implant | $147.58 |
| 6075230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075232 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075238 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6075239 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6075248 | GENERAL SUPPLY | Supply/Implant | $542.46 |
| 6075250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6075259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6075260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6075261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6075264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6075265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6075266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,835.20 |
| 6075277 | SUPPLY IMPLANT | Supply/Implant | $4,427.26 |
| 6075284 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6075288 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,648.96 |
| 6075291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6075297 | ADHESION BARRIER | Supply/Implant | $4,490.78 |
| 6075300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,279.36 |
| 6075302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6075307 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6075310 | SUPPLY IMPLANT | Supply/Implant | $1,049.86 |
| 6075311 | SUPPLY IMPLANT | Supply/Implant | $4,446.08 |
| 6075313 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6075314 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $47,769.60 |
| 6075315 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $45,683.20 |
| 6075317 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $54,016.00 |
| 6075319 | SUPPLY IMPLANT | Supply/Implant | $306.56 |
| 6075329 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6075335 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,529.60 |
| 6075336 | STERILE SUPPLY | Supply/Implant | $863.36 |
| 6075342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6075347 | SUPPLY IMPLANT | Supply/Implant | $60,496.00 |
| 6075361 | SUPPLY IMPLANT | Supply/Implant | $1,839.10 |
| 6075362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6075385 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075386 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075388 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075389 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6075412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,994.24 |
| 6075416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075429 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075432 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075435 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075439 | LEAD, NEUROSTIMULATOR | Supply/Implant | $27,200.00 |
| 6075442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6075446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6075447 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6075448 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6075460 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6075461 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,867.01 |
| 6075465 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6075472 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6075479 | LEAD, NEUROSTIMULATOR | Supply/Implant | $11,456.00 |
| 6075482 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,576.00 |
| 6075487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6075495 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6075509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6075510 | GENERAL SUPPLY | Supply/Implant | $181.38 |
| 6075518 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6075520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,635.20 |
| 6075524 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $52,736.00 |
| 6075526 | SUPPLY IMPLANT | Supply/Implant | $2,534.40 |
| 6075529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6075534 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6075538 | CATH EP COOL-TIP | Supply/Implant | $20,480.00 |
| 6075542 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6075543 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6075545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,352.00 |
| 6075548 | MESH (IMPLANTABLE) | Supply/Implant | $33,945.60 |
| 6075550 | SUPPLY IMPLANT | Supply/Implant | $2,870.78 |
| 6075551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6075556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6075557 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6075558 | STERILE SUPPLY | Supply/Implant | $1,491.46 |
| 6075559 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $13,542.40 |
| 6075560 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $13,542.40 |
| 6075562 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $16,089.60 |
| 6075565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6075582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6075584 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,531.20 |
| 6075585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6075587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,884.03 |
| 6075590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,269.25 |
| 6075594 | GENERAL SUPPLY | Supply/Implant | $508.51 |
| 6075597 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6075600 | SUPPLY IMPLANT | Supply/Implant | $11,184.64 |
| 6075605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6075607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,034.24 |
| 6075608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6075610 | SUPPLY IMPLANT | Supply/Implant | $3,744.00 |
| 6075612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6075613 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6075615 | SUPPLY IMPLANT | Supply/Implant | $31,680.00 |
| 6075618 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6075622 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6075623 | GENERAL SUPPLY | Supply/Implant | $926.85 |
| 6075625 | SUPPLY IMPLANT | Supply/Implant | $38,272.00 |
| 6075626 | CATHETER, GUIDING | Supply/Implant | $21,376.00 |
| 6075627 | SUPPLY IMPLANT | Supply/Implant | $38,272.00 |
| 6075628 | CATHETER, GUIDING | Supply/Implant | $21,376.00 |
| 6075629 | SUPPLY IMPLANT | Supply/Implant | $38,272.00 |
| 6075631 | GENERAL SUPPLY | Supply/Implant | $4,736.00 |
| 6075632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6075633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6075636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,068.80 |
| 6075640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6075641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075643 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6075645 | GENERAL SUPPLY | Supply/Implant | $147.58 |
| 6075647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6075650 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6075654 | INTRO/SHEATH, NON-LASER | Supply/Implant | $261.63 |
| 6075655 | INTRO/SHEATH, NON-LASER | Supply/Implant | $261.63 |
| 6075662 | SUPPLY IMPLANT | Supply/Implant | $9,244.93 |
| 6075663 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6075664 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6075665 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $21,440.00 |
| 6075670 | SUPPLY IMPLANT | Supply/Implant | $296.58 |
| 6075673 | SUPPLY IMPLANT | Supply/Implant | $5,388.80 |
| 6075674 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,035.20 |
| 6075680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,080.64 |
| 6075683 | INTRO/SHEATH, NON-LASER | Supply/Implant | $373.25 |
| 6075684 | CATH, DRAINAGE | Supply/Implant | $13,162.11 |
| 6075693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6075697 | CATHETER, GUIDING | Supply/Implant | $1,216.00 |
| 6075698 | SUPPLY IMPLANT | Supply/Implant | $35,472.64 |
| 6075699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,447.36 |
| 6075701 | SUPPLY IMPLANT | Supply/Implant | $309.76 |
| 6075702 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6075707 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $52,467.20 |
| 6075708 | SUPPLY IMPLANT | Supply/Implant | $2,905.60 |
| 6075722 | SUPPLY IMPLANT | Supply/Implant | $52,044.80 |
| 6075723 | SUPPLY IMPLANT | Supply/Implant | $20,608.00 |
| 6075731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,948.54 |
| 6075733 | INTRO/SHEATH, NON-LASER | Supply/Implant | $43,712.00 |
| 6075734 | INTRO/SHEATH, NON-LASER | Supply/Implant | $43,712.00 |
| 6075736 | INTRO/SHEATH, NON-LASER | Supply/Implant | $43,712.00 |
| 6075740 | SUPPLY IMPLANT | Supply/Implant | $58,976.00 |
| 6075741 | GENERAL SUPPLY | Supply/Implant | $203.01 |
| 6075744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075748 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6075765 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6075766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6075767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6075771 | SUPPLY IMPLANT | Supply/Implant | $674.59 |
| 6075782 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,347.20 |
| 6075783 | SUPPLY IMPLANT | Supply/Implant | $380.67 |
| 6075784 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,426.94 |
| 6075793 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6075797 | STERILE SUPPLY | Supply/Implant | $387.20 |
| 6075800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,283.52 |
| 6075801 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,276.99 |
| 6075803 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,369.60 |
| 6075807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6075865 | SUPPLY IMPLANT | Supply/Implant | $1,440.00 |
| 6075868 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6075869 | GENERAL SUPPLY | Supply/Implant | $6,963.20 |
| 6075870 | GENERAL SUPPLY | Supply/Implant | $10,905.60 |
| 6075871 | GENERAL SUPPLY | Supply/Implant | $12,659.20 |
| 6075872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,771.52 |
| 6075873 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6075877 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6075880 | SUPPLY IMPLANT | Supply/Implant | $9,666.56 |
| 6075881 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6075884 | SUPPLY IMPLANT | Supply/Implant | $3,654.40 |
| 6075891 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,531.20 |
| 6075895 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6075902 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6075903 | STERILE SUPPLY | Supply/Implant | $211.20 |
| 6075908 | STERILE SUPPLY | Supply/Implant | $134.53 |
| 6075915 | SUPPLY IMPLANT | Supply/Implant | $12,710.40 |
| 6075916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6075918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6075928 | CATH OCCLUSION | Supply/Implant | $17,920.00 |
| 6075929 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6075931 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6075946 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,721.60 |
| 6075947 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,531.20 |
| 6075950 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,226.43 |
| 6075958 | SUPPLY IMPLANT | Supply/Implant | $21,478.40 |
| 6075960 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,582.40 |
| 6075961 | CLOSURE DEV, VASC | Supply/Implant | $5,120.00 |
| 6075964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6075971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6075974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6075975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6075978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6075979 | SUPPLY IMPLANT | Supply/Implant | $309.91 |
| 6075980 | SUPPLY IMPLANT | Supply/Implant | $865.14 |
| 6075981 | SUPPLY IMPLANT | Supply/Implant | $415.36 |
| 6075982 | SUPPLY IMPLANT | Supply/Implant | $3,258.44 |
| 6075994 | CLOSURE DEV, VASC | Supply/Implant | $5,120.00 |
| 6075998 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $60,147.20 |
| 6076004 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6076005 | GUIDE WIRE | Supply/Implant | $286.72 |
| 6076027 | GUIDE WIRE | Supply/Implant | $903.17 |
| 6076028 | GENERAL SUPPLY | Supply/Implant | $623.91 |
| 6076031 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $41,344.00 |
| 6076036 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6076040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6076049 | CATH OCCLUSION | Supply/Implant | $18,278.40 |
| 6076052 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6076053 | INTERSPINOUS IMPLANT | Supply/Implant | $48,114.56 |
| 6076056 | SUPPLY IMPLANT | Supply/Implant | $5,593.47 |
| 6076057 | GENERAL SUPPLY | Supply/Implant | $5,958.40 |
| 6076060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076062 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,152.00 |
| 6076065 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,608.00 |
| 6076068 | SUPPLY IMPLANT | Supply/Implant | $10,738.56 |
| 6076073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,262.40 |
| 6076074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076080 | GENERAL SUPPLY | Supply/Implant | $478.59 |
| 6076081 | GENERAL SUPPLY | Supply/Implant | $478.59 |
| 6076082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6076083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6076084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,058.24 |
| 6076086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,318.72 |
| 6076087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,157.12 |
| 6076091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.81 |
| 6076102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,155.39 |
| 6076107 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6076113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6076138 | SUPPLY IMPLANT | Supply/Implant | $48,114.56 |
| 6076150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6076156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6076166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,200.00 |
| 6076168 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6076172 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6076182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,649.28 |
| 6076183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076187 | GENERAL SUPPLY | Supply/Implant | $179.58 |
| 6076192 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $11,456.00 |
| 6076195 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6076196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6076198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,470.40 |
| 6076199 | ALLODERM SKIN SUB | Supply/Implant | $49,945.60 |
| 6076203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,049.47 |
| 6076209 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6076212 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $115,447.50 |
| 6076219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6076222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076230 | SUPPLY IMPLANT | Supply/Implant | $573.44 |
| 6076232 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6076241 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6076246 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6076255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6076256 | SUPPLY IMPLANT | Supply/Implant | $547.71 |
| 6076258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6076259 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,484.80 |
| 6076260 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6076274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6076277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6076278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6076290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6076292 | GENERAL SUPPLY | Supply/Implant | $6,233.60 |
| 6076293 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6076294 | GENERAL SUPPLY | Supply/Implant | $10,905.60 |
| 6076295 | GENERAL SUPPLY | Supply/Implant | $12,659.20 |
| 6076305 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6076307 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6076308 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $13,376.00 |
| 6076312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $743.94 |
| 6076313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $743.94 |
| 6076316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6076317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6076331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6076332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6076337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,561.60 |
| 6076342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,888.00 |
| 6076350 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076351 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076352 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076353 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076354 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076355 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076356 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076357 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6076372 | GENERAL SUPPLY | Supply/Implant | $450.56 |
| 6076389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6076390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,107.33 |
| 6076403 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076404 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076405 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076406 | SUPPLY IMPLANT | Supply/Implant | $1,635.84 |
| 6076407 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6076410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6076411 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,257.60 |
| 6076417 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6076421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,756.54 |
| 6076428 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6076430 | GENERAL SUPPLY | Supply/Implant | $5,056.00 |
| 6076435 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6076436 | CATHETER, INTRASPINAL | Supply/Implant | $13,376.00 |
| 6076446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6076447 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,907.20 |
| 6076448 | TRACHEOSTOMY SPEAKING VALVE | Supply/Implant | $1,050.50 |
| 6076474 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6076475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076478 | SUPPLY IMPLANT | Supply/Implant | $1,771.52 |
| 6076487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6076495 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $208.00 |
| 6076497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6076500 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6076502 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6076504 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076505 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076506 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076510 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076514 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076516 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076517 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076518 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076519 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076520 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076521 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076523 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076524 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076525 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076526 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076527 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076528 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076529 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076530 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076531 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076532 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076533 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076534 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076536 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076537 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076538 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076539 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076540 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076541 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076543 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076544 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076545 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076546 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076547 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076548 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076549 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076554 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076556 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076558 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076559 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076560 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076561 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076562 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076563 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6076564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,651.20 |
| 6076565 | GENERAL SUPPLY | Supply/Implant | $1,497.60 |
| 6076566 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,497.60 |
| 6076567 | SUPPLY IMPLANT | Supply/Implant | $515.84 |
| 6076568 | GUIDE WIRE | Supply/Implant | $2,459.52 |
| 6076569 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,695.49 |
| 6076575 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6076584 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6076596 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,529.60 |
| 6076597 | STERILE SUPPLY | Supply/Implant | $254.72 |
| 6076599 | STERILE SUPPLY | Supply/Implant | $254.72 |
| 6076605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,797.76 |
| 6076608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6076617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6076618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6076625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6076643 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6076644 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6076654 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6076656 | CONN TISS, NON-HUMAN | Supply/Implant | $31,040.00 |
| 6076669 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6076674 | SUPPLY IMPLANT | Supply/Implant | $2,969.73 |
| 6076675 | MESH (IMPLANTABLE) | Supply/Implant | $6,200.32 |
| 6076676 | SUPPLY IMPLANT | Supply/Implant | $3,468.80 |
| 6076679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6076680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,830.78 |
| 6076686 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6076687 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6076690 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,723.20 |
| 6076702 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6076704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6076705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6076706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6076714 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6076715 | CONN TISS, NON-HUMAN | Supply/Implant | $30,400.00 |
| 6076724 | GRAFT, VASCULAR | Supply/Implant | $31,040.00 |
| 6076727 | SUPPLY IMPLANT | Supply/Implant | $1,395.20 |
| 6076729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,249.86 |
| 6076730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6076734 | SUPPLY IMPLANT | Supply/Implant | $656.64 |
| 6076737 | STERILE SUPPLY | Supply/Implant | $187.26 |
| 6076739 | SUPPLY IMPLANT | Supply/Implant | $277.50 |
| 6076746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,684.61 |
| 6076748 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6076749 | GENERAL SUPPLY | Supply/Implant | $7,186.18 |
| 6076762 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076764 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6076774 | REP DEV, URINARY, W/O SLING | Supply/Implant | $7,349.76 |
| 6076776 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6076782 | MESH (IMPLANTABLE) | Supply/Implant | $24,883.20 |
| 6076795 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6076801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,397.50 |
| 6076810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6076822 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6076843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,283.52 |
| 6076850 | SUPPLY IMPLANT | Supply/Implant | $1,305.60 |
| 6076853 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6076857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6076862 | SUPPLY IMPLANT | Supply/Implant | $9,140.74 |
| 6076865 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6076874 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6076876 | SUPPLY IMPLANT | Supply/Implant | $18,752.00 |
| 6076877 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6076878 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6076879 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6076881 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6076887 | GUIDE WIRE | Supply/Implant | $2,448.00 |
| 6076891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6076898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6076899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6076900 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6076904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6076907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6076912 | STERILE SUPPLY | Supply/Implant | $2,419.20 |
| 6076916 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,340.22 |
| 6076920 | SUPPLY IMPLANT | Supply/Implant | $9,856.00 |
| 6076927 | PORT, INDWELLING, IMP | Supply/Implant | $1,536.00 |
| 6076928 | PORT, INDWELLING, IMP | Supply/Implant | $3,225.60 |
| 6076929 | PORT, INDWELLING, IMP | Supply/Implant | $1,830.40 |
| 6076930 | PORT, INDWELLING, IMP | Supply/Implant | $1,830.40 |
| 6076931 | PORT, INDWELLING, IMP | Supply/Implant | $1,536.00 |
| 6076932 | GUIDE WIRE | Supply/Implant | $2,368.00 |
| 6076944 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6076952 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,817.60 |
| 6076958 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6076976 | GENERAL SUPPLY | Supply/Implant | $479.10 |
| 6076977 | GENERAL SUPPLY | Supply/Implant | $355.84 |
| 6076978 | GENERAL SUPPLY | Supply/Implant | $342.66 |
| 6076979 | GENERAL SUPPLY | Supply/Implant | $262.40 |
| 6076980 | GENERAL SUPPLY | Supply/Implant | $328.96 |
| 6076981 | STERILE SUPPLY | Supply/Implant | $144.38 |
| 6076982 | GENERAL SUPPLY | Supply/Implant | $382.08 |
| 6076983 | SUPPLY IMPLANT | Supply/Implant | $296.42 |
| 6076984 | SUPPLY IMPLANT | Supply/Implant | $141.18 |
| 6076985 | SUPPLY IMPLANT | Supply/Implant | $558.08 |
| 6077022 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,753.92 |
| 6077033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6077036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077051 | SUPPLY IMPLANT | Supply/Implant | $170,898.00 |
| 6077052 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6077065 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6077072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6077073 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6077078 | SUPPLY IMPLANT | Supply/Implant | $6,225.66 |
| 6077079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6077085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,588.48 |
| 6077088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6077089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,472.00 |
| 6077090 | GUIDE WIRE | Supply/Implant | $844.80 |
| 6077091 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6077104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077117 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6077118 | STERILE SUPPLY | Supply/Implant | $1,215.10 |
| 6077120 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6077122 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6077125 | SUPPLY IMPLANT | Supply/Implant | $7,872.00 |
| 6077126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,985.60 |
| 6077129 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6077130 | SUPPLY IMPLANT | Supply/Implant | $8,870.40 |
| 6077131 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6077134 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077136 | SUPPLY IMPLANT | Supply/Implant | $19,955.71 |
| 6077137 | SUPPLY IMPLANT | Supply/Implant | $12,803.49 |
| 6077140 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6077143 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077144 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077145 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077146 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6077147 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6077149 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6077151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6077153 | SUPPLY IMPLANT | Supply/Implant | $1,830.40 |
| 6077154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6077155 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6077158 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,384.00 |
| 6077160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6077172 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6077173 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6077182 | SUPPLY IMPLANT | Supply/Implant | $242.94 |
| 6077187 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6077189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6077194 | GUIDE WIRE | Supply/Implant | $2,419.20 |
| 6077196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6077197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,923.33 |
| 6077199 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $425.09 |
| 6077201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6077216 | CATHETER, GUIDING | Supply/Implant | $7,680.00 |
| 6077217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,017.22 |
| 6077220 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077227 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6077228 | SUPPLY IMPLANT | Supply/Implant | $8,857.60 |
| 6077230 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6077232 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077238 | MESH (IMPLANTABLE) | Supply/Implant | $6,389.50 |
| 6077239 | MESH (IMPLANTABLE) | Supply/Implant | $10,048.00 |
| 6077240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077246 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6077253 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6077255 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6077258 | GENERAL SUPPLY | Supply/Implant | $2,099.20 |
| 6077260 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077261 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077262 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6077277 | MESH (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6077278 | MESH (IMPLANTABLE) | Supply/Implant | $24,883.20 |
| 6077285 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077298 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077304 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6077306 | INTERSPINOUS IMPLANT | Supply/Implant | $15,104.00 |
| 6077307 | SUPPLY IMPLANT | Supply/Implant | $465.79 |
| 6077310 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6077318 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6077321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,830.40 |
| 6077322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6077323 | SUPPLY IMPLANT | Supply/Implant | $38,304.00 |
| 6077324 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6077327 | SUPPLY IMPLANT | Supply/Implant | $16,864.00 |
| 6077334 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077335 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077336 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077337 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077338 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077339 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077340 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077341 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077342 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6077348 | SUPPLY IMPLANT | Supply/Implant | $11,276.80 |
| 6077354 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $8,960.00 |
| 6077355 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6077357 | GENERAL SUPPLY | Supply/Implant | $1,740.80 |
| 6077360 | GRAFT, VASCULAR | Supply/Implant | $42,560.00 |
| 6077363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6077365 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6077368 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,984.00 |
| 6077370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,861.50 |
| 6077374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6077379 | STERILE SUPPLY | Supply/Implant | $533.25 |
| 6077380 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6077381 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6077382 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $10,880.00 |
| 6077384 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $15,360.00 |
| 6077385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6077405 | SUPPLY IMPLANT | Supply/Implant | $1,561.60 |
| 6077406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6077408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,819.26 |
| 6077409 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,979.20 |
| 6077419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6077422 | SUPPLY IMPLANT | Supply/Implant | $1,018.50 |
| 6077423 | SUPPLY IMPLANT | Supply/Implant | $1,067.90 |
| 6077424 | SUPPLY IMPLANT | Supply/Implant | $753.79 |
| 6077428 | SUPPLY IMPLANT | Supply/Implant | $1,023.08 |
| 6077429 | SUPPLY IMPLANT | Supply/Implant | $1,023.08 |
| 6077430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077432 | SUPPLY IMPLANT | Supply/Implant | $3,575.68 |
| 6077436 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6077438 | GENERAL SUPPLY | Supply/Implant | $140.80 |
| 6077441 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,336.00 |
| 6077442 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6077444 | GUIDE WIRE | Supply/Implant | $4,032.00 |
| 6077445 | SUPPLY IMPLANT | Supply/Implant | $2,995.20 |
| 6077447 | SUPPLY IMPLANT | Supply/Implant | $14,568.32 |
| 6077450 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6077463 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6077465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077471 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077477 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6077478 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6077484 | STERILE SUPPLY | Supply/Implant | $1,105.92 |
| 6077485 | GENERAL SUPPLY | Supply/Implant | $1,558.66 |
| 6077486 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,889.66 |
| 6077487 | SUPPLY IMPLANT | Supply/Implant | $36,480.00 |
| 6077506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077510 | AUD OSSEO DEV INT/EXT COMP | Supply/Implant | $38,336.00 |
| 6077511 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $88,448.00 |
| 6077514 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6077518 | SUPPLY IMPLANT | Supply/Implant | $6,947.20 |
| 6077521 | GENERAL SUPPLY | Supply/Implant | $3,136.00 |
| 6077524 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077525 | SUPPLY IMPLANT | Supply/Implant | $1,434.11 |
| 6077528 | SUPPLY IMPLANT | Supply/Implant | $16,410.24 |
| 6077530 | SUPPLY IMPLANT | Supply/Implant | $2,099.20 |
| 6077531 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6077532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6077541 | STERILE SUPPLY | Supply/Implant | $10,457.60 |
| 6077548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077549 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6077553 | SUPPLY IMPLANT | Supply/Implant | $241.54 |
| 6077559 | SUPPLY IMPLANT | Supply/Implant | $201.86 |
| 6077571 | SUPPLY IMPLANT | Supply/Implant | $197.89 |
| 6077573 | SUPPLY IMPLANT | Supply/Implant | $258.69 |
| 6077616 | SUPPLY IMPLANT | Supply/Implant | $209.79 |
| 6077621 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6077637 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6077638 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6077639 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6077640 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6077641 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,806.08 |
| 6077642 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $5,806.08 |
| 6077650 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6077651 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6077652 | GENERAL SUPPLY | Supply/Implant | $12,019.20 |
| 6077653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6077655 | GENERAL SUPPLY | Supply/Implant | $698.24 |
| 6077656 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6077660 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077661 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6077673 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6077678 | SUPPLY IMPLANT | Supply/Implant | $4,926.66 |
| 6077679 | SUPPLY IMPLANT | Supply/Implant | $849.54 |
| 6077681 | SUPPLY IMPLANT | Supply/Implant | $13,018.37 |
| 6077690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6077691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6077692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6077694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6077695 | CATHETER, GUIDING | Supply/Implant | $9,185.79 |
| 6077699 | INTEGRA BMWD SKIN SUB | Supply/Implant | $44,876.80 |
| 6077701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6077702 | SUPPLY IMPLANT | Supply/Implant | $12,528.00 |
| 6077703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6077707 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6077710 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6077719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,815.10 |
| 6077723 | GENERAL SUPPLY | Supply/Implant | $479.49 |
| 6077726 | GENERAL SUPPLY | Supply/Implant | $621.52 |
| 6077727 | SUPPLY IMPLANT | Supply/Implant | $20,352.00 |
| 6077736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,200.00 |
| 6077738 | SUPPLY IMPLANT | Supply/Implant | $1,830.40 |
| 6077742 | SUPPLY IMPLANT | Supply/Implant | $59,888.00 |
| 6077743 | SUPPLY IMPLANT | Supply/Implant | $51,984.00 |
| 6077745 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,600.00 |
| 6077746 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,600.00 |
| 6077747 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,600.00 |
| 6077749 | STERILE SUPPLY | Supply/Implant | $2,886.40 |
| 6077758 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6077759 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6077767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6077768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6077774 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6077775 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6077782 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077793 | CATHETER, GUIDING | Supply/Implant | $140.80 |
| 6077798 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $11,456.00 |
| 6077808 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6077818 | GENERAL SUPPLY | Supply/Implant | $4,377.60 |
| 6077819 | LEAD, CORONARY VENOUS | Supply/Implant | $76,800.00 |
| 6077821 | SUPPLY IMPLANT | Supply/Implant | $59,888.00 |
| 6077841 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6077845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6077852 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6077861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,417.60 |
| 6077873 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077874 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077875 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6077879 | SUPPLY IMPLANT | Supply/Implant | $2,115.33 |
| 6077889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6077890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6077891 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6077903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6077904 | SUPPLY IMPLANT | Supply/Implant | $2,598.40 |
| 6077906 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6077909 | INTRO/SHEATH, NON-LASER | Supply/Implant | $598.27 |
| 6077910 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6077911 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6077913 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,088.96 |
| 6077914 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $890.88 |
| 6077916 | SUPPLY IMPLANT | Supply/Implant | $9,140.74 |
| 6077918 | SUPPLY IMPLANT | Supply/Implant | $59,888.00 |
| 6077920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6077921 | SUPPLY IMPLANT | Supply/Implant | $30,955.52 |
| 6077922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,158.40 |
| 6077923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6077924 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6077928 | GENERAL SUPPLY | Supply/Implant | $636.92 |
| 6077937 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6077938 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6077969 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6077971 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6077972 | SUPPLY IMPLANT | Supply/Implant | $514.43 |
| 6077973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6077974 | SUPPLY IMPLANT | Supply/Implant | $799,900.00 |
| 6077979 | SUPPLY IMPLANT | Supply/Implant | $63,360.00 |
| 6077980 | MICROPRESR CU ELEC VAD REP | Supply/Implant | $91,520.00 |
| 6077984 | CHARGER ELEC/COMBO VAD REP | Supply/Implant | $78,080.00 |
| 6077986 | MISC SUP/ACC IMP VAD | Supply/Implant | $5,440.00 |
| 6077987 | SHWR COV ELECT/COMBO VAD REP | Supply/Implant | $3,840.00 |
| 6077994 | GENERAL SUPPLY | Supply/Implant | $277.25 |
| 6078001 | SUPPLY IMPLANT | Supply/Implant | $23,549.70 |
| 6078003 | INTERSPINOUS IMPLANT | Supply/Implant | $14,873.60 |
| 6078004 | INTERSPINOUS IMPLANT | Supply/Implant | $14,873.60 |
| 6078005 | SUPPLY IMPLANT | Supply/Implant | $1,411.20 |
| 6078008 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6078013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,392.00 |
| 6078019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078020 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6078023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,382.40 |
| 6078024 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6078027 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,384.00 |
| 6078028 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6078029 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,384.00 |
| 6078030 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6078036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6078037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6078042 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6078043 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6078047 | GENERAL SUPPLY | Supply/Implant | $266.62 |
| 6078048 | GENERAL SUPPLY | Supply/Implant | $266.62 |
| 6078049 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6078050 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,876.35 |
| 6078053 | SUPPLY IMPLANT | Supply/Implant | $1,081.09 |
| 6078054 | SUPPLY IMPLANT | Supply/Implant | $1,044.86 |
| 6078059 | CONN TISS, NON-HUMAN | Supply/Implant | $14,065.92 |
| 6078062 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078070 | CATHETER, URETERAL | Supply/Implant | $376.32 |
| 6078071 | GENERAL SUPPLY | Supply/Implant | $1,346.66 |
| 6078072 | GENERAL SUPPLY | Supply/Implant | $160.00 |
| 6078073 | GENERAL SUPPLY | Supply/Implant | $503.55 |
| 6078080 | SUPPLY IMPLANT | Supply/Implant | $3,274.55 |
| 6078081 | PORT, INDWELLING, IMP | Supply/Implant | $9,907.20 |
| 6078082 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6078084 | SUPPLY IMPLANT | Supply/Implant | $4,569.60 |
| 6078086 | GENERAL SUPPLY | Supply/Implant | $505.47 |
| 6078088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,014.40 |
| 6078102 | SUPPLY IMPLANT | Supply/Implant | $192.90 |
| 6078104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078108 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6078111 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6078114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6078122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,065.60 |
| 6078136 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6078148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,652.80 |
| 6078149 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,301.44 |
| 6078153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6078158 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078167 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6078168 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6078175 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6078182 | GRAFT, VASCULAR | Supply/Implant | $10,897.92 |
| 6078184 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $25,379.20 |
| 6078185 | SKIN SUBSTITUTE, NOS | Supply/Implant | $44,900.86 |
| 6078192 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6078197 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,752.00 |
| 6078201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6078205 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6078206 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6078209 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6078210 | GRAFT, VASCULAR | Supply/Implant | $14,963.20 |
| 6078216 | GENERAL SUPPLY | Supply/Implant | $197.12 |
| 6078225 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6078227 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6078231 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078233 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078234 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078235 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078236 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078237 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078238 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,640.00 |
| 6078239 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,800.00 |
| 6078240 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6078241 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078242 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078247 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6078249 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6078262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,044.80 |
| 6078264 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,416.00 |
| 6078267 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6078268 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6078275 | GENERAL SUPPLY | Supply/Implant | $156.42 |
| 6078276 | GENERAL SUPPLY | Supply/Implant | $150.22 |
| 6078290 | GENERAL SUPPLY | Supply/Implant | $215.68 |
| 6078291 | GENERAL SUPPLY | Supply/Implant | $205.44 |
| 6078308 | SUPPLY IMPLANT | Supply/Implant | $1,740.80 |
| 6078309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6078310 | INTERSPINOUS IMPLANT | Supply/Implant | $76,800.00 |
| 6078318 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078319 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078320 | PMKR, DUAL, RATE-RESP | Supply/Implant | $66,854.40 |
| 6078321 | AICD, DUAL CHAMBER | Supply/Implant | $194,890.50 |
| 6078345 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078346 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078353 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078357 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078359 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078361 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078362 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078363 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078364 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078365 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078367 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078395 | GENERAL SUPPLY | Supply/Implant | $145.02 |
| 6078396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6078401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,728.00 |
| 6078402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6078403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6078406 | SUPPLY IMPLANT | Supply/Implant | $1,164.80 |
| 6078407 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6078413 | SUPPLY IMPLANT | Supply/Implant | $2,433.28 |
| 6078414 | SUPPLY IMPLANT | Supply/Implant | $2,259.20 |
| 6078420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6078428 | SUPPLY IMPLANT | Supply/Implant | $11,983.36 |
| 6078429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,144.70 |
| 6078432 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6078433 | SUPPLY IMPLANT | Supply/Implant | $2,995.33 |
| 6078437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,379.20 |
| 6078439 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6078443 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6078446 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6078448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6078454 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078455 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078456 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078457 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6078464 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $15,910.40 |
| 6078465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,024.00 |
| 6078469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,894.72 |
| 6078471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,227.52 |
| 6078475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078483 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6078485 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6078488 | SUPPLY IMPLANT | Supply/Implant | $1,690.24 |
| 6078491 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6078504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6078505 | SUPPLY IMPLANT | Supply/Implant | $18,112.00 |
| 6078506 | SUPPLY IMPLANT | Supply/Implant | $1,241.60 |
| 6078508 | SUPPLY IMPLANT | Supply/Implant | $1,521.66 |
| 6078510 | INTERSPINOUS IMPLANT | Supply/Implant | $14,656.00 |
| 6078511 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $207,050.00 |
| 6078516 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6078523 | STERILE SUPPLY | Supply/Implant | $266.37 |
| 6078524 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6078548 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6078549 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,060.80 |
| 6078550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6078551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6078552 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6078558 | SUPPLY IMPLANT | Supply/Implant | $7,274.88 |
| 6078559 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6078560 | MISC SUP/ACC IMP VAD | Supply/Implant | $135.58 |
| 6078563 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6078565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6078574 | SUPPLY IMPLANT | Supply/Implant | $889.60 |
| 6078591 | SUPPLY IMPLANT | Supply/Implant | $1,753.60 |
| 6078604 | CATHETER, GUIDING | Supply/Implant | $711.42 |
| 6078605 | CATHETER, GUIDING | Supply/Implant | $711.42 |
| 6078606 | CATHETER, GUIDING | Supply/Implant | $499.20 |
| 6078607 | CATHETER, GUIDING | Supply/Implant | $499.20 |
| 6078611 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $12,736.00 |
| 6078613 | SUPPLY IMPLANT | Supply/Implant | $311.24 |
| 6078615 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6078626 | SUPPLY IMPLANT | Supply/Implant | $3,916.80 |
| 6078627 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6078629 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6078651 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6078652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6078654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6078663 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078682 | SUPPLY IMPLANT | Supply/Implant | $182.40 |
| 6078683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078691 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,253.44 |
| 6078692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,243.20 |
| 6078694 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6078695 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6078698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078700 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6078701 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6078703 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6078705 | SUPPLY IMPLANT | Supply/Implant | $11,515.39 |
| 6078707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,502.40 |
| 6078708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,535.68 |
| 6078712 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6078720 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6078721 | STERILE SUPPLY | Supply/Implant | $8,064.00 |
| 6078723 | STERILE SUPPLY | Supply/Implant | $3,072.00 |
| 6078724 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6078725 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6078726 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6078727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,044.80 |
| 6078728 | GENERAL SUPPLY | Supply/Implant | $4,480.00 |
| 6078730 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078733 | SUPPLY IMPLANT | Supply/Implant | $18,457.60 |
| 6078738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078742 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6078743 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6078744 | STERILE SUPPLY | Supply/Implant | $190.34 |
| 6078746 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,056.00 |
| 6078747 | SUPPLY IMPLANT | Supply/Implant | $831,250.00 |
| 6078748 | MICROPRESR CU ELEC VAD REP | Supply/Implant | $70,400.00 |
| 6078749 | MICROPRESR CU ELEC VAD REP | Supply/Implant | $6,400.00 |
| 6078751 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,056.00 |
| 6078752 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,760.00 |
| 6078753 | HOLSTER ELEC/COMBO VAD REP | Supply/Implant | $5,056.00 |
| 6078758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,644.80 |
| 6078775 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,088.00 |
| 6078777 | SUPPLY IMPLANT | Supply/Implant | $1,215.62 |
| 6078783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6078785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6078788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $962.56 |
| 6078794 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6078795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6078803 | GENERAL SUPPLY | Supply/Implant | $454.40 |
| 6078804 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6078810 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6078819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6078820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6078822 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078823 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078831 | SUPPLY IMPLANT | Supply/Implant | $6,016.00 |
| 6078832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6078837 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6078838 | CATHETER, GUIDING | Supply/Implant | $31,616.00 |
| 6078840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,920.00 |
| 6078842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,920.00 |
| 6078846 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6078847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6078848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6078849 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6078855 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078856 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078857 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078859 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078860 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078861 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078862 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078863 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078864 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078865 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078867 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078868 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078869 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078870 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078877 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078878 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078879 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078880 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,318.98 |
| 6078882 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078887 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078893 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6078902 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6078906 | SUPPLY IMPLANT | Supply/Implant | $17,088.00 |
| 6078907 | SUPPLY IMPLANT | Supply/Implant | $2,905.60 |
| 6078910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,614.08 |
| 6078912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,034.24 |
| 6078920 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6078921 | STERILE SUPPLY | Supply/Implant | $1,232.90 |
| 6078924 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6078925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6078927 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6078929 | GUIDE WIRE | Supply/Implant | $3,200.00 |
| 6078930 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6078931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6078934 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6078940 | LEAD, NEUROSTIMULATOR | Supply/Implant | $36,992.00 |
| 6078941 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $14,464.00 |
| 6078951 | GENERAL SUPPLY | Supply/Implant | $575.97 |
| 6078953 | CATH, DRAINAGE | Supply/Implant | $1,450.76 |
| 6078954 | CATH, DRAINAGE | Supply/Implant | $5,264.00 |
| 6078956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6078957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6078958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6078959 | SUPPLY IMPLANT | Supply/Implant | $477.44 |
| 6078963 | SUPPLY IMPLANT | Supply/Implant | $6,701.18 |
| 6078971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,116.93 |
| 6078972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $493.18 |
| 6078977 | GENERAL DRUG | Supply/Implant | $143.49 |
| 6078978 | SUPPLY IMPLANT | Supply/Implant | $10,195.62 |
| 6078984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6078986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6078989 | SUPPLY IMPLANT | Supply/Implant | $11,246.94 |
| 6078990 | STERILE SUPPLY | Supply/Implant | $881.06 |
| 6078991 | SUPPLY IMPLANT | Supply/Implant | $692.22 |
| 6078997 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6078998 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079002 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079004 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079006 | SUPPLY IMPLANT | Supply/Implant | $2,355.20 |
| 6079007 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6079010 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $152,565.00 |
| 6079013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,009.60 |
| 6079014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6079015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6079021 | SUPPLY IMPLANT | Supply/Implant | $2,876.67 |
| 6079023 | SUPPLY IMPLANT | Supply/Implant | $5,821.57 |
| 6079031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6079038 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6079039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,150.72 |
| 6079043 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6079060 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6079067 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6079072 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $8,859.01 |
| 6079074 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $7,812.99 |
| 6079081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,131.20 |
| 6079086 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6079087 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6079088 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6079091 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,892.80 |
| 6079092 | SUPPLY IMPLANT | Supply/Implant | $355.71 |
| 6079094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,862.40 |
| 6079097 | SUPPLY IMPLANT | Supply/Implant | $234.65 |
| 6079103 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6079115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079123 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $32,972.80 |
| 6079124 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6079126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6079132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,932.80 |
| 6079133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6079135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6079152 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6079153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6079157 | SUPPLY IMPLANT | Supply/Implant | $115,447.50 |
| 6079163 | CATHETER, URETERAL | Supply/Implant | $247.55 |
| 6079165 | CATHETER, URETERAL | Supply/Implant | $282.75 |
| 6079166 | CATHETER, URETERAL | Supply/Implant | $357.89 |
| 6079167 | CATHETER, URETERAL | Supply/Implant | $357.89 |
| 6079168 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079169 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079170 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079171 | CATHETER, URETERAL | Supply/Implant | $219.01 |
| 6079172 | CATH, DRAINAGE | Supply/Implant | $1,215.87 |
| 6079173 | CATH, DRAINAGE | Supply/Implant | $1,215.87 |
| 6079176 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6079182 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079183 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6079184 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6079185 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079187 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079188 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079189 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079190 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079191 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079193 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079201 | STERILE SUPPLY | Supply/Implant | $471.42 |
| 6079204 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6079214 | INTRO/SHEATH, NON-LASER | Supply/Implant | $755.20 |
| 6079215 | INTRO/SHEATH, NON-LASER | Supply/Implant | $755.20 |
| 6079216 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6079217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6079218 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6079222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079226 | IMPL EXT ACCESS CATH | Supply/Implant | $2,388.74 |
| 6079227 | SUPPLY IMPLANT | Supply/Implant | $264.00 |
| 6079229 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6079231 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $15,360.00 |
| 6079236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6079241 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,158.08 |
| 6079243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,468.80 |
| 6079245 | SUPPLY IMPLANT | Supply/Implant | $272,700.00 |
| 6079249 | SUPPLY IMPLANT | Supply/Implant | $5,286.40 |
| 6079250 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $15,360.00 |
| 6079251 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $15,360.00 |
| 6079252 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $15,360.00 |
| 6079255 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,584.00 |
| 6079256 | SUPPLY IMPLANT | Supply/Implant | $1,058.23 |
| 6079259 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6079262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6079268 | SUPPLY IMPLANT | Supply/Implant | $17,260.80 |
| 6079284 | SUPPLY IMPLANT | Supply/Implant | $1,723.65 |
| 6079290 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079292 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079297 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079298 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,081.79 |
| 6079312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6079325 | STERILE SUPPLY | Supply/Implant | $192.00 |
| 6079326 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,729.60 |
| 6079327 | STERILE SUPPLY | Supply/Implant | $468.48 |
| 6079332 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6079334 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6079335 | SUPPLY IMPLANT | Supply/Implant | $4,055.68 |
| 6079339 | SUPPLY IMPLANT | Supply/Implant | $1,318.84 |
| 6079340 | SUPPLY IMPLANT | Supply/Implant | $895.54 |
| 6079342 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6079345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,361.60 |
| 6079354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6079360 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6079361 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,431.68 |
| 6079362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6079363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,044.80 |
| 6079364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079370 | SUPPLY IMPLANT | Supply/Implant | $3,243.43 |
| 6079420 | SUPPLY IMPLANT | Supply/Implant | $206.34 |
| 6079422 | SUPPLY IMPLANT | Supply/Implant | $211.97 |
| 6079423 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6079425 | GENERAL SUPPLY | Supply/Implant | $180.10 |
| 6079426 | GENERAL SUPPLY | Supply/Implant | $191.23 |
| 6079441 | SUPPLY IMPLANT | Supply/Implant | $433.41 |
| 6079443 | REP DEV, URINARY, W/SLING | Supply/Implant | $19,317.76 |
| 6079446 | GUIDE WIRE | Supply/Implant | $1,303.68 |
| 6079447 | SUPPLY IMPLANT | Supply/Implant | $977.02 |
| 6079451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,278.40 |
| 6079452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,532.80 |
| 6079456 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6079457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,283.20 |
| 6079467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,809.60 |
| 6079468 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079471 | BRACHYTHERAPY NEEDLE | Supply/Implant | $5,235.20 |
| 6079473 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079478 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079487 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6079489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,830.40 |
| 6079491 | SUPPLY IMPLANT | Supply/Implant | $174.08 |
| 6079492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6079493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6079502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,550.08 |
| 6079504 | SUPPLY IMPLANT | Supply/Implant | $7,596.03 |
| 6079516 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079518 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079519 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079521 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079522 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6079524 | GENERAL SUPPLY | Supply/Implant | $345.09 |
| 6079525 | GENERAL SUPPLY | Supply/Implant | $347.78 |
| 6079526 | GENERAL SUPPLY | Supply/Implant | $317.44 |
| 6079528 | OASIS TRI-LAYER WND MATRIX PER 1 SQ CM | Supply/Implant | $29,004.85 |
| 6079529 | OASIS TRI-LAYER WND MATRIX PER 1 SQ CM | Supply/Implant | $14,502.89 |
| 6079530 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079531 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079532 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079535 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079536 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6079542 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6079570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6079586 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6079587 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6079588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6079589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6079590 | SUPPLY IMPLANT | Supply/Implant | $3,417.60 |
| 6079591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,862.40 |
| 6079596 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6079601 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079604 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079607 | GENERAL SUPPLY | Supply/Implant | $138.48 |
| 6079609 | GENERAL SUPPLY | Supply/Implant | $4,736.00 |
| 6079612 | SUPPLY IMPLANT | Supply/Implant | $11,059.20 |
| 6079617 | GENERAL SUPPLY | Supply/Implant | $262.40 |
| 6079621 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6079630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6079642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,494.40 |
| 6079649 | SUPPLY IMPLANT | Supply/Implant | $281.22 |
| 6079650 | SUPPLY IMPLANT | Supply/Implant | $145.79 |
| 6079652 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6079654 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6079661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6079662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6079665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,817.60 |
| 6079667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079677 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079678 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079679 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079680 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,404.80 |
| 6079689 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6079690 | SUPPLY IMPLANT | Supply/Implant | $2,818.69 |
| 6079691 | SUPPLY IMPLANT | Supply/Implant | $1,497.60 |
| 6079693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,979.20 |
| 6079708 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6079724 | SUPPLY IMPLANT | Supply/Implant | $1,094.40 |
| 6079727 | SUPPLY IMPLANT | Supply/Implant | $276.35 |
| 6079730 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079731 | GENERAL SUPPLY | Supply/Implant | $1,175.17 |
| 6079735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,756.22 |
| 6079739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6079741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,891.20 |
| 6079746 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6079747 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6079750 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $28,096.00 |
| 6079752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6079754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6079761 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6079762 | SUPPLY IMPLANT | Supply/Implant | $1,303.55 |
| 6079763 | STERILE SUPPLY | Supply/Implant | $3,072.00 |
| 6079764 | STERILE SUPPLY | Supply/Implant | $3,737.60 |
| 6079765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6079766 | SUPPLY IMPLANT | Supply/Implant | $2,617.60 |
| 6079783 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6079784 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079785 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079786 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079787 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079788 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079789 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079790 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079791 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079792 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079794 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079796 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079798 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079801 | GUIDE WIRE | Supply/Implant | $482.82 |
| 6079802 | SUPPLY IMPLANT | Supply/Implant | $2,802.43 |
| 6079803 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079804 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079805 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079806 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079809 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079811 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079812 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079813 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079814 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079815 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079816 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6079817 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079818 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079819 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079820 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079821 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6079823 | GUIDE WIRE | Supply/Implant | $1,326.34 |
| 6079825 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6079831 | STERILE SUPPLY | Supply/Implant | $247.19 |
| 6079833 | OCULAR IMPLANT | Supply/Implant | $5,632.00 |
| 6079838 | SUPPLY IMPLANT | Supply/Implant | $10,155.01 |
| 6079839 | STERILE SUPPLY | Supply/Implant | $312.06 |
| 6079852 | GENERAL SUPPLY | Supply/Implant | $702.72 |
| 6079853 | SUPPLY IMPLANT | Supply/Implant | $4,408.32 |
| 6079854 | GENERAL SUPPLY | Supply/Implant | $6,225.41 |
| 6079856 | CONN TISS, NON-HUMAN | Supply/Implant | $3,296.00 |
| 6079858 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6079859 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6079862 | GENERAL SUPPLY | Supply/Implant | $1,111.46 |
| 6079869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,012.35 |
| 6079870 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6079875 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6079876 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6079879 | GENERAL SUPPLY | Supply/Implant | $12,800.00 |
| 6079881 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $100,517.12 |
| 6079882 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6079897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6079900 | GENERAL SUPPLY | Supply/Implant | $422.40 |
| 6079902 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $24,396.80 |
| 6079909 | GUIDE WIRE | Supply/Implant | $1,904.64 |
| 6079910 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6079912 | SUPPLY IMPLANT | Supply/Implant | $355.20 |
| 6079916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6079919 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6079921 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6079922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6079923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6079925 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6079928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6079938 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6079939 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6079941 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6079942 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6079943 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6079944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,965.89 |
| 6079945 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,747.90 |
| 6079947 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6079952 | SUPPLY IMPLANT | Supply/Implant | $10,942.72 |
| 6079958 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6079966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6079968 | SUPPLY IMPLANT | Supply/Implant | $4,467.20 |
| 6079969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6079977 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6079978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,920.00 |
| 6079980 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6079989 | SUPPLY IMPLANT | Supply/Implant | $942.98 |
| 6079992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,896.00 |
| 6079994 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6079996 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6080004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6080011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6080012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6080020 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6080024 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6080025 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6080026 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6080027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6080028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6080030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $915.20 |
| 6080050 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6080052 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6080055 | SUPPLY IMPLANT | Supply/Implant | $10,585.60 |
| 6080057 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080061 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $192.00 |
| 6080063 | SUPPLY IMPLANT | Supply/Implant | $2,578.94 |
| 6080072 | GENERAL DRUG | Supply/Implant | $273.15 |
| 6080073 | SUPPLY IMPLANT | Supply/Implant | $13,491.20 |
| 6080077 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6080080 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6080083 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6080084 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6080085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6080086 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6080087 | SUPPLY IMPLANT | Supply/Implant | $293.12 |
| 6080088 | SUPPLY IMPLANT | Supply/Implant | $593.92 |
| 6080089 | SUPPLY IMPLANT | Supply/Implant | $593.92 |
| 6080090 | SUPPLY IMPLANT | Supply/Implant | $333.18 |
| 6080094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080107 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6080108 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6080109 | GENERAL SUPPLY | Supply/Implant | $1,344.00 |
| 6080123 | STERILE SUPPLY | Supply/Implant | $339.44 |
| 6080124 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6080129 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $8,448.00 |
| 6080132 | GENERAL SUPPLY | Supply/Implant | $3,008.00 |
| 6080133 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6080135 | SUPPLY IMPLANT | Supply/Implant | $2,086.40 |
| 6080136 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6080137 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6080138 | SUPPLY IMPLANT | Supply/Implant | $13,376.00 |
| 6080139 | SUPPLY IMPLANT | Supply/Implant | $6,656.00 |
| 6080140 | IMPL EXT ACCESS CATH | Supply/Implant | $21,478.40 |
| 6080142 | STERILE SUPPLY | Supply/Implant | $2,816.00 |
| 6080143 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080144 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080147 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080148 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080149 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080150 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080154 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6080156 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6080157 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6080158 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6080160 | SUPPLY IMPLANT | Supply/Implant | $624.00 |
| 6080161 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,412.10 |
| 6080174 | SUPPLY IMPLANT | Supply/Implant | $3,818.88 |
| 6080176 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6080183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6080187 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6080188 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6080190 | GUIDE WIRE | Supply/Implant | $5,760.00 |
| 6080192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080196 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6080198 | SUPPLY IMPLANT | Supply/Implant | $1,580.80 |
| 6080199 | INTERSPINOUS IMPLANT | Supply/Implant | $60,678.40 |
| 6080200 | GENERAL SUPPLY | Supply/Implant | $1,090.56 |
| 6080201 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6080202 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6080211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6080212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,096.00 |
| 6080218 | SUPPLY IMPLANT | Supply/Implant | $40,396.80 |
| 6080223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080224 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6080233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6080235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $276.48 |
| 6080236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,320.00 |
| 6080237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6080238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6080244 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,460.86 |
| 6080245 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $31,052.80 |
| 6080246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6080248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6080254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,496.00 |
| 6080266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,437.76 |
| 6080267 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6080284 | SUPPLY IMPLANT | Supply/Implant | $3,297.05 |
| 6080289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6080290 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6080307 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6080309 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6080312 | SUPPLY IMPLANT | Supply/Implant | $2,491.65 |
| 6080313 | SUPPLY IMPLANT | Supply/Implant | $2,099.20 |
| 6080315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,209.60 |
| 6080316 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6080323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,592.77 |
| 6080327 | CATHETER, GUIDING | Supply/Implant | $20,467.20 |
| 6080332 | ALLODERM SKIN SUB | Supply/Implant | $69,132.80 |
| 6080340 | VENA CAVA FILTER | Supply/Implant | $21,440.00 |
| 6080341 | VENA CAVA FILTER | Supply/Implant | $21,440.00 |
| 6080347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080350 | SUPPLY IMPLANT | Supply/Implant | $2,231.30 |
| 6080353 | CATH OCCLUSION | Supply/Implant | $21,760.00 |
| 6080358 | SUPPLY IMPLANT | Supply/Implant | $3,967.78 |
| 6080361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $52,160.00 |
| 6080367 | SUPPLY IMPLANT | Supply/Implant | $218.24 |
| 6080369 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6080371 | SUPPLY IMPLANT | Supply/Implant | $5,235.20 |
| 6080372 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6080376 | SUPPLY IMPLANT | Supply/Implant | $1,070.08 |
| 6080379 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6080383 | SUPPLY IMPLANT | Supply/Implant | $364.80 |
| 6080387 | GUIDE WIRE | Supply/Implant | $2,790.40 |
| 6080392 | SUPPLY IMPLANT | Supply/Implant | $1,277.82 |
| 6080396 | GENERAL SUPPLY | Supply/Implant | $1,011.20 |
| 6080398 | SUPPLY IMPLANT | Supply/Implant | $149.89 |
| 6080409 | INTRO/SHEATH, NON-LASER | Supply/Implant | $640.00 |
| 6080410 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6080411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,876.35 |
| 6080413 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6080444 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6080448 | STERILE SUPPLY | Supply/Implant | $2,560.00 |
| 6080456 | SUPPLY IMPLANT | Supply/Implant | $348.29 |
| 6080462 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6080467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6080468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6080469 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6080471 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6080473 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6080478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,164.16 |
| 6080479 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,907.20 |
| 6080486 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6080487 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6080488 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6080489 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6080492 | SUPPLY IMPLANT | Supply/Implant | $30,080.00 |
| 6080494 | GENERAL SUPPLY | Supply/Implant | $189.57 |
| 6080498 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,819.26 |
| 6080499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,087.94 |
| 6080503 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6080505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,275.26 |
| 6080507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,300.80 |
| 6080514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6080516 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,767.04 |
| 6080521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6080523 | GENERAL SUPPLY | Supply/Implant | $4,869.89 |
| 6080527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6080532 | GENERAL SUPPLY | Supply/Implant | $16,857.60 |
| 6080533 | GENERAL SUPPLY | Supply/Implant | $2,497.66 |
| 6080534 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6080537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $120,478.46 |
| 6080543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6080548 | SUPPLY IMPLANT | Supply/Implant | $177.31 |
| 6080550 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080551 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080552 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080554 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6080558 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080568 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6080574 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6080575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6080576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6080577 | SUPPLY IMPLANT | Supply/Implant | $20,553.60 |
| 6080581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,065.60 |
| 6080582 | CATHETER, GUIDING | Supply/Implant | $5,500.29 |
| 6080589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6080591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6080592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6080595 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6080601 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6080604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6080605 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6080606 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6080625 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,040.00 |
| 6080632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,878.53 |
| 6080636 | SEPTAL DEFECT IMP SYS | Supply/Implant | $58,969.60 |
| 6080637 | SUPPLY IMPLANT | Supply/Implant | $3,788.80 |
| 6080646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $142,075.50 |
| 6080649 | GENERAL SUPPLY | Supply/Implant | $586.83 |
| 6080655 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6080665 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6080672 | RET DEV, INSERTABLE | Supply/Implant | $15,756.80 |
| 6080681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6080685 | GRAFT, VASCULAR | Supply/Implant | $11,123.20 |
| 6080686 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6080691 | SUPPLY IMPLANT | Supply/Implant | $810.24 |
| 6080692 | IMPL EXT ACCESS CATH | Supply/Implant | $2,368.00 |
| 6080696 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6080700 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6080710 | IMPL EXT ACCESS CATH | Supply/Implant | $896.00 |
| 6080714 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,969.60 |
| 6080723 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,790.40 |
| 6080732 | INTRO/SHEATH, NON-LASER | Supply/Implant | $10,585.60 |
| 6080733 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6080734 | SUPPLY IMPLANT | Supply/Implant | $215.54 |
| 6080735 | SUPPLY IMPLANT | Supply/Implant | $2,146.18 |
| 6080736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6080744 | LEAD, NEUROSTIMULATOR | Supply/Implant | $16,896.00 |
| 6080745 | SUPPLY IMPLANT | Supply/Implant | $458.34 |
| 6080750 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6080752 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6080755 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6080760 | GENERAL SUPPLY | Supply/Implant | $1,919.36 |
| 6080764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6080767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6080770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6080774 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,169.60 |
| 6080781 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6080785 | STERILE SUPPLY | Supply/Implant | $1,418.11 |
| 6080786 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6080789 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $35,840.00 |
| 6080790 | GENERAL SUPPLY | Supply/Implant | $1,600.00 |
| 6080791 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6080792 | STERILE SUPPLY | Supply/Implant | $4,800.00 |
| 6080794 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6080796 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080798 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080802 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080803 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,480.00 |
| 6080809 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6080811 | STERILE SUPPLY | Supply/Implant | $379.90 |
| 6080815 | EVENT RECORDER CARDIAC | Supply/Implant | $67,776.00 |
| 6080821 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6080827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6080828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,548.80 |
| 6080830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6080832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6080841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6080843 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6080846 | SUPPLY IMPLANT | Supply/Implant | $7,849.47 |
| 6080847 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6080849 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,960.00 |
| 6080852 | STERILE SUPPLY | Supply/Implant | $563.20 |
| 6080853 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080854 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6080855 | SUPPLY IMPLANT | Supply/Implant | $257.41 |
| 6080857 | SUPPLY IMPLANT | Supply/Implant | $20,685.18 |
| 6080858 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6080869 | SUPPLY IMPLANT | Supply/Implant | $663.64 |
| 6080873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,768.38 |
| 6080876 | GENERAL SUPPLY | Supply/Implant | $6,067.20 |
| 6080877 | SUPPLY IMPLANT | Supply/Implant | $1,474.56 |
| 6080878 | SUPPLY IMPLANT | Supply/Implant | $11,456.00 |
| 6080879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,863.68 |
| 6080888 | ALLODERM SKIN SUB | Supply/Implant | $65,369.60 |
| 6080889 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6080910 | SUPPLY IMPLANT | Supply/Implant | $1,235.97 |
| 6080911 | INTERSPINOUS IMPLANT | Supply/Implant | $121,600.00 |
| 6080912 | INTERSPINOUS IMPLANT | Supply/Implant | $121,600.00 |
| 6080913 | SUPPLY IMPLANT | Supply/Implant | $5,286.40 |
| 6080920 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6080921 | GENERAL SUPPLY | Supply/Implant | $2,560.00 |
| 6080922 | GENERAL SUPPLY | Supply/Implant | $6,233.60 |
| 6080923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,822.72 |
| 6080924 | GUIDE WIRE | Supply/Implant | $2,201.60 |
| 6080925 | GUIDE WIRE | Supply/Implant | $1,958.40 |
| 6080935 | GENERAL SUPPLY | Supply/Implant | $3,020.80 |
| 6080938 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $77,616.00 |
| 6080939 | SUPPLY IMPLANT | Supply/Implant | $15,459.84 |
| 6080946 | SUPPLY IMPLANT | Supply/Implant | $181.12 |
| 6080948 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $34,560.00 |
| 6080950 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $2,052.10 |
| 6080951 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $8,640.00 |
| 6080973 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6080978 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6080980 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6080989 | SUPPLY IMPLANT | Supply/Implant | $3,107.33 |
| 6080993 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $107,161.60 |
| 6080996 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,387.20 |
| 6080997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6080999 | SUPPLY IMPLANT | Supply/Implant | $2,451.71 |
| 6081000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,401.60 |
| 6081010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6081011 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6081013 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $84,467.20 |
| 6081014 | MESH (IMPLANTABLE) | Supply/Implant | $22,096.38 |
| 6081015 | MESH (IMPLANTABLE) | Supply/Implant | $12,973.06 |
| 6081016 | MESH (IMPLANTABLE) | Supply/Implant | $9,520.64 |
| 6081017 | CATHETER, GUIDING | Supply/Implant | $4,441.60 |
| 6081021 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6081026 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.13 |
| 6081027 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6081028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,387.20 |
| 6081029 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6081032 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6081033 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,387.20 |
| 6081034 | GENERAL SUPPLY | Supply/Implant | $7,308.80 |
| 6081036 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6081042 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $39,499.26 |
| 6081054 | SUPPLY IMPLANT | Supply/Implant | $10,816.00 |
| 6081062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6081063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6081068 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6081098 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081100 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081101 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081103 | SUPPLY IMPLANT | Supply/Implant | $4,076.80 |
| 6081113 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6081131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,544.00 |
| 6081141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,135.87 |
| 6081142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6081143 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6081149 | GENERAL DRUG | Supply/Implant | $128.00 |
| 6081150 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6081151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.42 |
| 6081156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081160 | SUPPLY IMPLANT | Supply/Implant | $58,969.60 |
| 6081161 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6081166 | GENERAL SUPPLY | Supply/Implant | $2,756.61 |
| 6081167 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6081168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,038.40 |
| 6081171 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6081178 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6081186 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6081189 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6081201 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6081212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6081213 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6081215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6081219 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,706.69 |
| 6081221 | STERILE SUPPLY | Supply/Implant | $264.83 |
| 6081223 | SUPPLY IMPLANT | Supply/Implant | $2,546.82 |
| 6081226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6081228 | SUPPLY IMPLANT | Supply/Implant | $12,945.92 |
| 6081229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6081236 | SUPPLY IMPLANT | Supply/Implant | $46,080.00 |
| 6081241 | SUPPLY IMPLANT | Supply/Implant | $3,225.60 |
| 6081243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6081252 | GENERAL SUPPLY | Supply/Implant | $1,535.36 |
| 6081254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $625.15 |
| 6081257 | SUPPLY IMPLANT | Supply/Implant | $22,540.80 |
| 6081258 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6081260 | GENERAL SUPPLY | Supply/Implant | $195.33 |
| 6081261 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6081262 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6081263 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6081271 | GENERAL SUPPLY | Supply/Implant | $329.34 |
| 6081278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,800.00 |
| 6081279 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6081282 | SUPPLY IMPLANT | Supply/Implant | $36,839.68 |
| 6081291 | GENERAL SUPPLY | Supply/Implant | $686.72 |
| 6081311 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,387.20 |
| 6081318 | LEAD, NEUROSTIMULATOR | Supply/Implant | $1,280.00 |
| 6081321 | SUPPLY IMPLANT | Supply/Implant | $2,438.94 |
| 6081328 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $1,550.34 |
| 6081332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6081334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6081339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6081350 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6081353 | GUIDE WIRE | Supply/Implant | $2,444.80 |
| 6081354 | STERILE SUPPLY | Supply/Implant | $142.08 |
| 6081365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6081366 | GENERAL SUPPLY | Supply/Implant | $145.02 |
| 6081367 | GENERAL SUPPLY | Supply/Implant | $216.96 |
| 6081368 | GENERAL SUPPLY | Supply/Implant | $285.95 |
| 6081369 | GENERAL SUPPLY | Supply/Implant | $192.51 |
| 6081370 | GENERAL SUPPLY | Supply/Implant | $1,065.86 |
| 6081371 | GENERAL SUPPLY | Supply/Implant | $241.66 |
| 6081372 | GENERAL SUPPLY | Supply/Implant | $297.22 |
| 6081376 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6081380 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6081381 | MESH (IMPLANTABLE) | Supply/Implant | $17,439.62 |
| 6081383 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $107,161.60 |
| 6081384 | SUPPLY IMPLANT | Supply/Implant | $518.40 |
| 6081396 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $28,096.00 |
| 6081397 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $28,096.00 |
| 6081399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,812.48 |
| 6081411 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6081418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $890.88 |
| 6081425 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6081433 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6081434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6081435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6081449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6081452 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6081453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6081455 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6081456 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6081457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6081458 | SUPPLY IMPLANT | Supply/Implant | $311.17 |
| 6081460 | SUPPLY IMPLANT | Supply/Implant | $543.10 |
| 6081463 | STERILE SUPPLY | Supply/Implant | $137.65 |
| 6081464 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6081473 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $66,150.40 |
| 6081478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6081479 | GUIDE WIRE | Supply/Implant | $2,990.59 |
| 6081481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,817.60 |
| 6081482 | SUPPLY IMPLANT | Supply/Implant | $2,300.03 |
| 6081483 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6081484 | GRAFT, VASCULAR | Supply/Implant | $6,676.35 |
| 6081485 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $157,500.00 |
| 6081490 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6081491 | SUPPLY IMPLANT | Supply/Implant | $311.04 |
| 6081496 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6081497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,965.89 |
| 6081500 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6081501 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $21,440.00 |
| 6081502 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,148.80 |
| 6081503 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,490.88 |
| 6081507 | MESH (IMPLANTABLE) | Supply/Implant | $2,923.26 |
| 6081509 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6081512 | RET DEV, INSERTABLE | Supply/Implant | $88,960.00 |
| 6081514 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,016.00 |
| 6081518 | SUPPLY IMPLANT | Supply/Implant | $43,584.00 |
| 6081522 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081523 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081524 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081526 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $22,976.00 |
| 6081531 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6081541 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081542 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081543 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081544 | SUPPLY IMPLANT | Supply/Implant | $733.31 |
| 6081555 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $716.80 |
| 6081561 | SUPPLY IMPLANT | Supply/Implant | $80,026.11 |
| 6081562 | CATHETER, INTRASPINAL | Supply/Implant | $320.00 |
| 6081563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6081564 | AICD, DUAL CHAMBER | Supply/Implant | $141,750.00 |
| 6081565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $743.94 |
| 6081567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6081568 | GENERAL SUPPLY | Supply/Implant | $132.10 |
| 6081572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6081586 | SUPPLY IMPLANT | Supply/Implant | $14,118.40 |
| 6081588 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,889.66 |
| 6081589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,819.26 |
| 6081590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,023.94 |
| 6081592 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,721.22 |
| 6081597 | SUPPLY IMPLANT | Supply/Implant | $55,632.00 |
| 6081600 | INTERSPINOUS IMPLANT | Supply/Implant | $25,472.00 |
| 6081608 | SUPPLY IMPLANT | Supply/Implant | $262.46 |
| 6081609 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $93,376.00 |
| 6081614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6081619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081622 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $440.45 |
| 6081624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,880.00 |
| 6081629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6081630 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6081633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.42 |
| 6081634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,287.94 |
| 6081635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.42 |
| 6081644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6081647 | SUPPLY IMPLANT | Supply/Implant | $1,090.56 |
| 6081660 | GENERAL SUPPLY | Supply/Implant | $191.36 |
| 6081663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6081666 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6081668 | STERILE SUPPLY | Supply/Implant | $1,024.00 |
| 6081683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,300.80 |
| 6081685 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $15,360.00 |
| 6081687 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $15,360.00 |
| 6081694 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6081695 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6081696 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6081706 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6081722 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6081738 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $33,500.67 |
| 6081743 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6081745 | STERILE SUPPLY | Supply/Implant | $174.46 |
| 6081748 | SUPPLY IMPLANT | Supply/Implant | $217.37 |
| 6081752 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $768.00 |
| 6081753 | SUPPLY IMPLANT | Supply/Implant | $8,128.00 |
| 6081754 | SUPPLY IMPLANT | Supply/Implant | $1,822.72 |
| 6081786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,132.93 |
| 6081787 | GUIDE WIRE | Supply/Implant | $1,885.31 |
| 6081789 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6081790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6081793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6081802 | CATHETER, GUIDING | Supply/Implant | $16,000.00 |
| 6081819 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6081826 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6081827 | ALLODERM SKIN SUB | Supply/Implant | $17,753.60 |
| 6081831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,625.60 |
| 6081839 | CATHETER, GUIDING | Supply/Implant | $8,268.80 |
| 6081852 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6081858 | SUPPLY IMPLANT | Supply/Implant | $6,701.18 |
| 6081859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6081860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6081861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6081862 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $6,336.00 |
| 6081864 | SUPPLY IMPLANT | Supply/Implant | $2,577.66 |
| 6081865 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6081867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6081869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6081872 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6081874 | GENERAL SUPPLY | Supply/Implant | $296.70 |
| 6081875 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6081878 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,387.20 |
| 6081881 | GENERAL SUPPLY | Supply/Implant | $384.00 |
| 6081886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6081888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,204.48 |
| 6081889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,720.00 |
| 6081911 | SUPPLY IMPLANT | Supply/Implant | $15,577.60 |
| 6081915 | SUPPLY IMPLANT | Supply/Implant | $944.64 |
| 6081916 | SUPPLY IMPLANT | Supply/Implant | $232.70 |
| 6081919 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,116.80 |
| 6081921 | GENERAL SUPPLY | Supply/Implant | $283.52 |
| 6081922 | GENERAL SUPPLY | Supply/Implant | $309.89 |
| 6081923 | GENERAL SUPPLY | Supply/Implant | $355.97 |
| 6081924 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6081925 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6081927 | GRAFT, VASCULAR | Supply/Implant | $30,400.00 |
| 6081931 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6081936 | SUPPLY IMPLANT | Supply/Implant | $2,995.20 |
| 6081937 | SUPPLY IMPLANT | Supply/Implant | $9,280.00 |
| 6081938 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6081939 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081940 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081941 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081942 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081943 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081944 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081948 | SUPPLY IMPLANT | Supply/Implant | $17,856.00 |
| 6081958 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081959 | SUPPLY IMPLANT | Supply/Implant | $25,414.40 |
| 6081961 | SUPPLY IMPLANT | Supply/Implant | $14,604.80 |
| 6081964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $998.40 |
| 6081965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6081966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6081969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,170.24 |
| 6081970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6081971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6081977 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6081978 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6081984 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6081986 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $157,500.00 |
| 6081996 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6082001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6082005 | SUPPLY IMPLANT | Supply/Implant | $23,232.00 |
| 6082007 | SUPPLY IMPLANT | Supply/Implant | $3,289.60 |
| 6082009 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6082014 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,921.60 |
| 6082027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,086.08 |
| 6082028 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $39,513.60 |
| 6082031 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6082032 | SUPPLY IMPLANT | Supply/Implant | $8,576.00 |
| 6082035 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6082038 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6082043 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082044 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,872.13 |
| 6082050 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6082053 | SUPPLY IMPLANT | Supply/Implant | $503.68 |
| 6082057 | SUPPLY IMPLANT | Supply/Implant | $4,266.88 |
| 6082058 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6082060 | GENERAL SUPPLY | Supply/Implant | $241.79 |
| 6082061 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6082064 | SUPPLY IMPLANT | Supply/Implant | $54,886.40 |
| 6082066 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6082067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $556.80 |
| 6082072 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,372.80 |
| 6082073 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6082074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6082076 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6082077 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6082079 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6082081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6082082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6082084 | SUPPLY IMPLANT | Supply/Implant | $41,894.40 |
| 6082085 | SUPPLY IMPLANT | Supply/Implant | $17,664.00 |
| 6082086 | SUPPLY IMPLANT | Supply/Implant | $19,737.60 |
| 6082091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $802.05 |
| 6082093 | STERILE SUPPLY | Supply/Implant | $3,628.80 |
| 6082094 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6082104 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6082106 | SUPPLY IMPLANT | Supply/Implant | $931.84 |
| 6082109 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,567.87 |
| 6082118 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6082121 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082122 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,818.11 |
| 6082123 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082124 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082125 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,818.11 |
| 6082128 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082129 | IMPL EXT ACCESS CATH | Supply/Implant | $11,200.00 |
| 6082130 | IMPL EXT ACCESS CATH | Supply/Implant | $11,200.00 |
| 6082131 | IMPL EXT ACCESS CATH | Supply/Implant | $11,200.00 |
| 6082132 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082133 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082138 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $9,868.80 |
| 6082139 | OCULAR IMPLANT | Supply/Implant | $3,520.00 |
| 6082142 | SUPPLY IMPLANT | Supply/Implant | $2,585.60 |
| 6082143 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082145 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082146 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082147 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6082148 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6082149 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082150 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082151 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6082154 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,672.00 |
| 6082157 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082164 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082165 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082166 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6082167 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,818.11 |
| 6082168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6082175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,149.76 |
| 6082179 | SUPPLY IMPLANT | Supply/Implant | $326.40 |
| 6082183 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6082184 | STERILE SUPPLY | Supply/Implant | $665.60 |
| 6082185 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6082191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6082192 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,065.47 |
| 6082199 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $30,656.00 |
| 6082207 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6082209 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,640.00 |
| 6082211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6082215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6082235 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6082237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082242 | GENERAL SUPPLY | Supply/Implant | $244.15 |
| 6082243 | GENERAL SUPPLY | Supply/Implant | $269.30 |
| 6082244 | GENERAL SUPPLY | Supply/Implant | $284.81 |
| 6082248 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6082250 | SUPPLY IMPLANT | Supply/Implant | $7,692.03 |
| 6082265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,579.20 |
| 6082267 | SUPPLY IMPLANT | Supply/Implant | $23,052.80 |
| 6082268 | SUPPLY IMPLANT | Supply/Implant | $4,893.95 |
| 6082269 | SUPPLY IMPLANT | Supply/Implant | $4,649.34 |
| 6082277 | SUPPLY IMPLANT | Supply/Implant | $2,729.60 |
| 6082279 | SUPPLY IMPLANT | Supply/Implant | $4,244.74 |
| 6082280 | SUPPLY IMPLANT | Supply/Implant | $4,244.74 |
| 6082284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,731.58 |
| 6082285 | STERILE SUPPLY | Supply/Implant | $387.33 |
| 6082289 | SUPPLY IMPLANT | Supply/Implant | $3,097.60 |
| 6082317 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6082327 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,144.32 |
| 6082331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6082332 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6082334 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6082337 | SUPPLY IMPLANT | Supply/Implant | $2,457.22 |
| 6082339 | SUPPLY IMPLANT | Supply/Implant | $2,457.22 |
| 6082348 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $47,462.40 |
| 6082349 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $5,312.13 |
| 6082354 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6082355 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6082358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6082359 | OCULAR IMPLANT | Supply/Implant | $7,232.00 |
| 6082361 | SUPPLY IMPLANT | Supply/Implant | $2,512.13 |
| 6082367 | STERILE SUPPLY | Supply/Implant | $441.98 |
| 6082368 | STERILE SUPPLY | Supply/Implant | $1,789.18 |
| 6082369 | SUPPLY IMPLANT | Supply/Implant | $2,273.28 |
| 6082372 | SUPPLY IMPLANT | Supply/Implant | $354.43 |
| 6082376 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6082379 | SUPPLY IMPLANT | Supply/Implant | $3,676.80 |
| 6082380 | SUPPLY IMPLANT | Supply/Implant | $1,244.16 |
| 6082384 | SUPPLY IMPLANT | Supply/Implant | $4,648.96 |
| 6082387 | SUPPLY IMPLANT | Supply/Implant | $3,744.00 |
| 6082395 | SUPPLY IMPLANT | Supply/Implant | $1,881.60 |
| 6082396 | SUPPLY IMPLANT | Supply/Implant | $2,044.80 |
| 6082397 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6082398 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6082399 | SUPPLY IMPLANT | Supply/Implant | $1,881.60 |
| 6082400 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6082401 | SUPPLY IMPLANT | Supply/Implant | $1,331.20 |
| 6082402 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082403 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082405 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6082410 | SUPPLY IMPLANT | Supply/Implant | $1,132.80 |
| 6082413 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6082417 | SUPPLY IMPLANT | Supply/Implant | $3,085.70 |
| 6082418 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6082426 | SUPPLY IMPLANT | Supply/Implant | $2,215.81 |
| 6082427 | SUPPLY IMPLANT | Supply/Implant | $3,044.99 |
| 6082428 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6082429 | SUPPLY IMPLANT | Supply/Implant | $1,868.80 |
| 6082434 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6082437 | SUPPLY IMPLANT | Supply/Implant | $3,085.70 |
| 6082440 | SUPPLY IMPLANT | Supply/Implant | $2,918.40 |
| 6082441 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6082444 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082445 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082446 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082447 | SUPPLY IMPLANT | Supply/Implant | $372.61 |
| 6082450 | SUPPLY IMPLANT | Supply/Implant | $365.06 |
| 6082455 | SUPPLY IMPLANT | Supply/Implant | $1,612.80 |
| 6082456 | SUPPLY IMPLANT | Supply/Implant | $4,803.20 |
| 6082458 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6082459 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6082461 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082463 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6082472 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6082478 | SUPPLY IMPLANT | Supply/Implant | $5,634.94 |
| 6082479 | GUIDE WIRE | Supply/Implant | $2,534.40 |
| 6082482 | SUPPLY IMPLANT | Supply/Implant | $253.44 |
| 6082483 | SUPPLY IMPLANT | Supply/Implant | $1,996.80 |
| 6082487 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6082491 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6082492 | SUPPLY IMPLANT | Supply/Implant | $1,505.28 |
| 6082494 | SUPPLY IMPLANT | Supply/Implant | $2,400.00 |
| 6082502 | STERILE SUPPLY | Supply/Implant | $759.08 |
| 6082503 | STERILE SUPPLY | Supply/Implant | $491.78 |
| 6082504 | SUPPLY IMPLANT | Supply/Implant | $15,187.20 |
| 6082522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6082524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6082532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082658 | STERILE SUPPLY | Supply/Implant | $1,417.22 |
| 6082669 | WIRELESS PRESSURE SENSOR | Supply/Implant | $251,995.00 |
| 6082672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,880.00 |
| 6082675 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6082676 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6082680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6082681 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,801.60 |
| 6082682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,801.60 |
| 6082684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,801.60 |
| 6082700 | STERILE SUPPLY | Supply/Implant | $212.61 |
| 6082712 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $768.00 |
| 6082731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6082733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6082734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6082745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6082748 | SUPPLY IMPLANT | Supply/Implant | $33,662.72 |
| 6082750 | SUPPLY IMPLANT | Supply/Implant | $6,992.00 |
| 6082758 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6082759 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6082760 | SUPPLY IMPLANT | Supply/Implant | $472.32 |
| 6082761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6082763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6082765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6082768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6082771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,150.72 |
| 6082778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6082781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6082784 | STERILE SUPPLY | Supply/Implant | $699.65 |
| 6082785 | SUPPLY IMPLANT | Supply/Implant | $5,030.40 |
| 6082789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6082791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6082792 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $51,699.20 |
| 6082793 | AICD, SINGLE CHAMBER | Supply/Implant | $131,250.00 |
| 6082794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,383.81 |
| 6082795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6082796 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6082798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6082799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6082800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,188.80 |
| 6082801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6082802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6082803 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6082805 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6082806 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6082813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6082817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,049.47 |
| 6082824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,907.20 |
| 6082834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6082835 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,684.80 |
| 6082836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6082837 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,924.80 |
| 6082838 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,491.20 |
| 6082839 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,478.40 |
| 6082846 | SUPPLY IMPLANT | Supply/Implant | $1,420.80 |
| 6082855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6082857 | REP DEV, URINARY, W/SLING | Supply/Implant | $12,160.00 |
| 6082861 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6082865 | SUPPLY IMPLANT | Supply/Implant | $20,774.40 |
| 6082867 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6082869 | SUPPLY IMPLANT | Supply/Implant | $2,155.52 |
| 6082887 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082906 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082910 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082912 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082913 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,560.00 |
| 6082916 | STERILE SUPPLY | Supply/Implant | $216.83 |
| 6082917 | SUPPLY IMPLANT | Supply/Implant | $917.61 |
| 6082918 | SUPPLY IMPLANT | Supply/Implant | $883.20 |
| 6082920 | SUPPLY IMPLANT | Supply/Implant | $480.00 |
| 6082921 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $192.00 |
| 6082923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,262.40 |
| 6082927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6082934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6082936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6082941 | IMPL EXT ACCESS CATH | Supply/Implant | $4,467.20 |
| 6082951 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6082960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6082963 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6082964 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6082972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,784.26 |
| 6082978 | SUPPLY IMPLANT | Supply/Implant | $6,105.60 |
| 6082984 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,398.27 |
| 6082995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,133.44 |
| 6082997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,924.80 |
| 6083004 | ALLODERM SKIN SUB | Supply/Implant | $10,278.40 |
| 6083005 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6083011 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $960.00 |
| 6083016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,502.40 |
| 6083017 | GUIDE WIRE | Supply/Implant | $627.20 |
| 6083021 | SUPPLY IMPLANT | Supply/Implant | $3,673.60 |
| 6083023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,912.00 |
| 6083031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,867.20 |
| 6083036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,990.40 |
| 6083037 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6083038 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6083039 | GRAFT, VASCULAR | Supply/Implant | $16,819.20 |
| 6083040 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6083041 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6083046 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6083047 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6083048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6083049 | SUPPLY IMPLANT | Supply/Implant | $174.08 |
| 6083055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,000.00 |
| 6083080 | SUPPLY IMPLANT | Supply/Implant | $10,515.07 |
| 6083082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6083083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6083089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6083109 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083110 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083111 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083112 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083113 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083114 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083115 | SUPPLY IMPLANT | Supply/Implant | $18,419.20 |
| 6083117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,035.20 |
| 6083118 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6083121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6083127 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083128 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083130 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083131 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083132 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083133 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083134 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083136 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083138 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083141 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083142 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083143 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083144 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083145 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083146 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083147 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083149 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083150 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083151 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083152 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083154 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083155 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083156 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083157 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083158 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083161 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083162 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083164 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083165 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083166 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083167 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083169 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083171 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083172 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083173 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083175 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083176 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083177 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6083179 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6083191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,376.00 |
| 6083193 | AICD, SINGLE CHAMBER | Supply/Implant | $155,400.00 |
| 6083197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6083198 | MESH (IMPLANTABLE) | Supply/Implant | $390.91 |
| 6083202 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6083204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6083206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083208 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $13,760.00 |
| 6083209 | GUIDE WIRE | Supply/Implant | $2,201.60 |
| 6083216 | MISC SUP/ACC IMP VAD | Supply/Implant | $12,736.00 |
| 6083219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6083224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,048.00 |
| 6083226 | GENERAL SUPPLY | Supply/Implant | $6,359.04 |
| 6083228 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6083229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6083230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6083247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6083280 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6083337 | SUPPLY IMPLANT | Supply/Implant | $4,339.58 |
| 6083339 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $4,172.80 |
| 6083358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,817.60 |
| 6083359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,840.00 |
| 6083366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083382 | GENERAL SUPPLY | Supply/Implant | $2,684.93 |
| 6083383 | GENERAL SUPPLY | Supply/Implant | $356.74 |
| 6083390 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083391 | INTERSPINOUS IMPLANT | Supply/Implant | $10,240.00 |
| 6083392 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083393 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083394 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083395 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6083399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6083400 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6083403 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $7,040.00 |
| 6083405 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6083410 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6083415 | GENERAL SUPPLY | Supply/Implant | $282.62 |
| 6083424 | SUPPLY IMPLANT | Supply/Implant | $5,644.80 |
| 6083425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6083428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6083430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6083431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6083432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6083433 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6083439 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,600.00 |
| 6083447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6083449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,980.03 |
| 6083450 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6083451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6083452 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6083454 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6083455 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6083456 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6083457 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6083458 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6083459 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6083460 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6083461 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6083463 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,491.20 |
| 6083464 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6083467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6083468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,924.80 |
| 6083470 | SUPPLY IMPLANT | Supply/Implant | $761.60 |
| 6083471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6083472 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6083473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6083475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,808.00 |
| 6083476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,011.20 |
| 6083477 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6083480 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6083482 | STERILE SUPPLY | Supply/Implant | $12,544.00 |
| 6083491 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6083493 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6083504 | SUPPLY IMPLANT | Supply/Implant | $1,932.80 |
| 6083505 | STERILE SUPPLY | Supply/Implant | $1,984.00 |
| 6083506 | STERILE SUPPLY | Supply/Implant | $4,556.80 |
| 6083514 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6083516 | SUPPLY IMPLANT | Supply/Implant | $1,140.86 |
| 6083517 | SUPPLY IMPLANT | Supply/Implant | $3,225.60 |
| 6083518 | SUPPLY IMPLANT | Supply/Implant | $3,288.60 |
| 6083525 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6083532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6083533 | SUPPLY IMPLANT | Supply/Implant | $996.74 |
| 6083542 | STERILE SUPPLY | Supply/Implant | $621.39 |
| 6083543 | STERILE SUPPLY | Supply/Implant | $621.44 |
| 6083545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,020.80 |
| 6083546 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6083547 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6083548 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6083550 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6083552 | SUPPLY IMPLANT | Supply/Implant | $370.69 |
| 6083553 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6083554 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,518.08 |
| 6083557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6083560 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6083561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6083564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6083565 | SUPPLY IMPLANT | Supply/Implant | $4,106.24 |
| 6083566 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6083569 | SUPPLY IMPLANT | Supply/Implant | $22,101.50 |
| 6083581 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $77,616.00 |
| 6083583 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,376.00 |
| 6083591 | SUPPLY IMPLANT | Supply/Implant | $250.88 |
| 6083603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6083605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,491.20 |
| 6083606 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6083618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6083619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6083620 | SUPPLY IMPLANT | Supply/Implant | $2,325.89 |
| 6083629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6083636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6083646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $92,761.60 |
| 6083647 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6083649 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6083650 | GENERAL SUPPLY | Supply/Implant | $1,498.50 |
| 6083653 | GENERAL SUPPLY | Supply/Implant | $3,545.60 |
| 6083654 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6083656 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6083657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6083658 | SUPPLY IMPLANT | Supply/Implant | $28,648.83 |
| 6083661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6083662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,520.00 |
| 6083665 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6083666 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6083667 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6083668 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6083673 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6083678 | CATHETER, GUIDING | Supply/Implant | $26,304.00 |
| 6083679 | CATHETER, GUIDING | Supply/Implant | $26,304.00 |
| 6083683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,097.60 |
| 6083684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6083685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6083698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6083699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6083704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6083710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6083711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,705.60 |
| 6083712 | SUPPLY IMPLANT | Supply/Implant | $2,380.80 |
| 6083720 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6083733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083736 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083738 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083740 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $384.00 |
| 6083746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6083747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6083749 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,875.20 |
| 6083750 | SUPPLY IMPLANT | Supply/Implant | $15,646.34 |
| 6083761 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6083764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,136.00 |
| 6083765 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6083766 | CATHETER, GUIDING | Supply/Implant | $486.40 |
| 6083767 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6083771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6083772 | GUIDE WIRE | Supply/Implant | $1,011.20 |
| 6083773 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6083774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6083776 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6083777 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6083781 | CATHETER, GUIDING | Supply/Implant | $278.40 |
| 6083792 | STERILE SUPPLY | Supply/Implant | $318.98 |
| 6083793 | SUPPLY IMPLANT | Supply/Implant | $4,019.20 |
| 6083794 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6083798 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $807.94 |
| 6083801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6083802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6083803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6083804 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6083831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6083832 | INTRO/SHEATH, NON-LASER | Supply/Implant | $755.20 |
| 6083834 | SUPPLY IMPLANT | Supply/Implant | $4,684.80 |
| 6083840 | SUPPLY IMPLANT | Supply/Implant | $2,763.26 |
| 6083846 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6083858 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $716.80 |
| 6083868 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6083872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6083874 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6083875 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6083877 | STERILE SUPPLY | Supply/Implant | $758.27 |
| 6083881 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6083882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,124.80 |
| 6083887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6083890 | SUPPLY IMPLANT | Supply/Implant | $1,067.19 |
| 6083906 | CATHETER, GUIDING | Supply/Implant | $443.52 |
| 6083908 | GUIDE WIRE | Supply/Implant | $526.72 |
| 6083914 | GENERAL SUPPLY | Supply/Implant | $224.38 |
| 6083915 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6083916 | SUPPLY IMPLANT | Supply/Implant | $2,534.40 |
| 6083919 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6083922 | GENERAL SUPPLY | Supply/Implant | $497.92 |
| 6083932 | SUPPLY IMPLANT | Supply/Implant | $6,512.13 |
| 6083933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6083934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $105,356.80 |
| 6083935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,705.60 |
| 6083942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6083945 | GENERAL SUPPLY | Supply/Implant | $204.61 |
| 6083949 | MESH (IMPLANTABLE) | Supply/Implant | $32,531.33 |
| 6083952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,135.87 |
| 6083955 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6083961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6083962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6083964 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6083965 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6083966 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6083967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6083969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6083971 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6083972 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6083973 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $804.99 |
| 6083983 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6083984 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6083986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6083988 | SUPPLY IMPLANT | Supply/Implant | $3,468.80 |
| 6083989 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6084002 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6084004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084025 | SUPPLY IMPLANT | Supply/Implant | $405.50 |
| 6084028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6084029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6084030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6084032 | STERILE SUPPLY | Supply/Implant | $506.88 |
| 6084034 | SUPPLY IMPLANT | Supply/Implant | $6,163.20 |
| 6084038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,328.26 |
| 6084039 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6084041 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $47,462.40 |
| 6084047 | SUPPLY IMPLANT | Supply/Implant | $3,238.40 |
| 6084048 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6084049 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6084050 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6084055 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084056 | CATH, DRAINAGE | Supply/Implant | $4,816.64 |
| 6084062 | GENERAL SUPPLY | Supply/Implant | $229.25 |
| 6084063 | SUPPLY IMPLANT | Supply/Implant | $339.20 |
| 6084065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,240.00 |
| 6084070 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6084072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,868.16 |
| 6084073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6084075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,720.00 |
| 6084079 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6084081 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6084083 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6084089 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6084090 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6084091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6084096 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6084097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6084101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6084103 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6084104 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6084106 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,841.60 |
| 6084117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,561.60 |
| 6084118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,561.60 |
| 6084119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6084120 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6084121 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6084125 | SUPPLY IMPLANT | Supply/Implant | $2,028.80 |
| 6084126 | SUPPLY IMPLANT | Supply/Implant | $2,170.88 |
| 6084127 | GENERAL SUPPLY | Supply/Implant | $405.76 |
| 6084132 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6084133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,862.40 |
| 6084134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6084135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6084136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6084140 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6084142 | SUPPLY IMPLANT | Supply/Implant | $33,662.72 |
| 6084143 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6084145 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6084153 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6084163 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6084164 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6084167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,211.39 |
| 6084172 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6084189 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6084195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6084200 | SUPPLY IMPLANT | Supply/Implant | $2,472.96 |
| 6084201 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6084207 | SUPPLY IMPLANT | Supply/Implant | $2,488.32 |
| 6084208 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084211 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084212 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084213 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084215 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084216 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084217 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084218 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084220 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084221 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084222 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084223 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084225 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084226 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084227 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084228 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084229 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084231 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084232 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084233 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084234 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084235 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084236 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084237 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084240 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084241 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084243 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084244 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084245 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084246 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084248 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084249 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084250 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084251 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084252 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084254 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084255 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084256 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084257 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084261 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084262 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084264 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084265 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084266 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084267 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084268 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084270 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084271 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084272 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084273 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084275 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084276 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084277 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084278 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084279 | GENERAL SUPPLY | Supply/Implant | $305.02 |
| 6084280 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6084281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,705.60 |
| 6084282 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084288 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6084289 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6084296 | SUPPLY IMPLANT | Supply/Implant | $3,983.36 |
| 6084301 | SUPPLY IMPLANT | Supply/Implant | $17,075.20 |
| 6084302 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084303 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,319.55 |
| 6084307 | SUPPLY IMPLANT | Supply/Implant | $7,420.80 |
| 6084310 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,094.40 |
| 6084321 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,040.00 |
| 6084330 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6084332 | SUPPLY IMPLANT | Supply/Implant | $5,419.81 |
| 6084333 | GENERAL SUPPLY | Supply/Implant | $2,048.00 |
| 6084346 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6084347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6084349 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6084350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6084359 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6084360 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,801.60 |
| 6084364 | SUPPLY IMPLANT | Supply/Implant | $2,508.80 |
| 6084365 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6084369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6084370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084377 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6084382 | SUPPLY IMPLANT | Supply/Implant | $2,763.26 |
| 6084397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6084403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,657.60 |
| 6084413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6084414 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $107,161.60 |
| 6084417 | SUPPLY IMPLANT | Supply/Implant | $403.20 |
| 6084421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6084426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,768.00 |
| 6084431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6084432 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6084436 | SUPPLY IMPLANT | Supply/Implant | $1,197.70 |
| 6084442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6084443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6084444 | SUPPLY IMPLANT | Supply/Implant | $9,344.00 |
| 6084445 | SUPPLY IMPLANT | Supply/Implant | $19,916.80 |
| 6084447 | GENERAL SUPPLY | Supply/Implant | $488.45 |
| 6084448 | SUPPLY IMPLANT | Supply/Implant | $8,422.40 |
| 6084449 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6084451 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6084455 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6084461 | INTRO/SHEATH, NON-LASER | Supply/Implant | $311.17 |
| 6084464 | MESH (IMPLANTABLE) | Supply/Implant | $64,424.96 |
| 6084465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,294.40 |
| 6084471 | GENERAL SUPPLY | Supply/Implant | $194.05 |
| 6084472 | GENERAL SUPPLY | Supply/Implant | $290.56 |
| 6084473 | GENERAL SUPPLY | Supply/Implant | $351.36 |
| 6084474 | GENERAL SUPPLY | Supply/Implant | $351.36 |
| 6084475 | GENERAL SUPPLY | Supply/Implant | $441.34 |
| 6084479 | INTERSPINOUS IMPLANT | Supply/Implant | $77,824.00 |
| 6084484 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6084500 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6084504 | SUPPLY IMPLANT | Supply/Implant | $9,853.44 |
| 6084518 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6084519 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $1,152.00 |
| 6084540 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,318.98 |
| 6084543 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6084552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6084553 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,542.91 |
| 6084555 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,907.20 |
| 6084556 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6084557 | PT PRGRM FOR IMPLT NEUROSTIM | Supply/Implant | $5,120.00 |
| 6084558 | SUPPLY IMPLANT | Supply/Implant | $405.50 |
| 6084560 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6084563 | GRAFT, VASCULAR | Supply/Implant | $25,216.00 |
| 6084565 | GRAFT, VASCULAR | Supply/Implant | $48,230.40 |
| 6084569 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6084570 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6084571 | STERILE SUPPLY | Supply/Implant | $1,024.00 |
| 6084573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6084576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6084584 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6084595 | SUPPLY IMPLANT | Supply/Implant | $3,404.80 |
| 6084596 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6084599 | SUPPLY IMPLANT | Supply/Implant | $21,440.00 |
| 6084600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,112.00 |
| 6084604 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,928.70 |
| 6084605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6084606 | SUPPLY IMPLANT | Supply/Implant | $2,828.80 |
| 6084608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6084613 | MESH (IMPLANTABLE) | Supply/Implant | $5,938.94 |
| 6084616 | STERILE SUPPLY | Supply/Implant | $373.25 |
| 6084618 | INTRO/SHEATH, NON-LASER | Supply/Implant | $139.14 |
| 6084622 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6084623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,862.40 |
| 6084626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6084628 | SUPPLY IMPLANT | Supply/Implant | $177.60 |
| 6084629 | SUPPLY IMPLANT | Supply/Implant | $267.65 |
| 6084632 | CLOSURE DEV, VASC | Supply/Implant | $489.74 |
| 6084633 | STERILE SUPPLY | Supply/Implant | $162.87 |
| 6084639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,424.58 |
| 6084640 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6084644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,912.64 |
| 6084645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,662.40 |
| 6084648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,508.80 |
| 6084657 | SUPPLY IMPLANT | Supply/Implant | $4,710.40 |
| 6084664 | SUPPLY IMPLANT | Supply/Implant | $1,598.21 |
| 6084666 | MESH (IMPLANTABLE) | Supply/Implant | $11,457.92 |
| 6084668 | SUPPLY IMPLANT | Supply/Implant | $18,560.00 |
| 6084670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.04 |
| 6084672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6084673 | GRAFT, VASCULAR | Supply/Implant | $36,633.60 |
| 6084674 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6084676 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6084681 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $89,600.00 |
| 6084687 | SUPPLY IMPLANT | Supply/Implant | $1,627.52 |
| 6084689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,404.16 |
| 6084691 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $26,342.40 |
| 6084693 | INTEGRA BMWD SKIN SUB | Supply/Implant | $120,846.34 |
| 6084701 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6084704 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6084706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6084708 | SUPPLY IMPLANT | Supply/Implant | $6,028.80 |
| 6084711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,171.20 |
| 6084712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6084713 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6084715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,639.68 |
| 6084716 | SUPPLY IMPLANT | Supply/Implant | $3,806.46 |
| 6084717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6084719 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $23,488.00 |
| 6084721 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6084747 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,545.92 |
| 6084769 | STENT, COATED/COV W/O DEL SY | Supply/Implant | $48,000.00 |
| 6084790 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $768.00 |
| 6084793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,092.80 |
| 6084807 | SUPPLY IMPLANT | Supply/Implant | $47,257.60 |
| 6084811 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $33,500.67 |
| 6084824 | SUPPLY IMPLANT | Supply/Implant | $13,081.60 |
| 6084825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,617.34 |
| 6084827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6084828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6084836 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6084843 | SUPPLY IMPLANT | Supply/Implant | $2,478.72 |
| 6084845 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6084846 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,072.00 |
| 6084847 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,072.00 |
| 6084848 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $20,992.00 |
| 6084849 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084850 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084851 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084852 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,992.00 |
| 6084853 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084854 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084855 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084856 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,992.00 |
| 6084857 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084858 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084859 | TRANS ANGIOPLASTY CATH | Supply/Implant | $19,072.00 |
| 6084860 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,072.00 |
| 6084863 | GRAFT, VASCULAR | Supply/Implant | $170,898.00 |
| 6084915 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,238.40 |
| 6084917 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6084918 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6084920 | STERILE SUPPLY | Supply/Implant | $4,544.00 |
| 6084921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6084923 | SUPPLY IMPLANT | Supply/Implant | $2,508.80 |
| 6084927 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6084930 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6084932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,657.60 |
| 6084934 | VENA CAVA FILTER | Supply/Implant | $15,347.20 |
| 6084966 | SUPPLY IMPLANT | Supply/Implant | $387.84 |
| 6084970 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6085033 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6085070 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $9,963.52 |
| 6085073 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $9,963.52 |
| 6085074 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6085076 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6085086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6085088 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085089 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085090 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085091 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6085093 | CATHETER, GUIDING | Supply/Implant | $9,984.00 |
| 6085094 | SUPPLY IMPLANT | Supply/Implant | $92,800.00 |
| 6085097 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6085127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085135 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,417.60 |
| 6085137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $588.80 |
| 6085138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $41,190.40 |
| 6085139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $41,190.40 |
| 6085147 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6085148 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6085149 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6085150 | SUPPLY IMPLANT | Supply/Implant | $907.67 |
| 6085160 | SUPPLY IMPLANT | Supply/Implant | $2,898.05 |
| 6085165 | GUIDE WIRE | Supply/Implant | $139.52 |
| 6085171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,862.40 |
| 6085173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6085174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6085177 | SUPPLY IMPLANT | Supply/Implant | $1,315.46 |
| 6085179 | GENERAL SUPPLY | Supply/Implant | $215.04 |
| 6085181 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6085182 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6085184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6085186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6085188 | GENERAL SUPPLY | Supply/Implant | $3,361.75 |
| 6085216 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6085229 | SUPPLY IMPLANT | Supply/Implant | $15,385.60 |
| 6085307 | SUPPLY IMPLANT | Supply/Implant | $4,369.92 |
| 6085325 | VENA CAVA FILTER | Supply/Implant | $15,347.20 |
| 6085341 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6085343 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6085360 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6085367 | SUPPLY IMPLANT | Supply/Implant | $8,053.25 |
| 6085376 | SUPPLY IMPLANT | Supply/Implant | $6,752.26 |
| 6085418 | SUPPLY IMPLANT | Supply/Implant | $3,526.66 |
| 6085441 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,064.32 |
| 6085460 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6085461 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6085465 | SUPPLY IMPLANT | Supply/Implant | $2,037.76 |
| 6085467 | GUIDE WIRE | Supply/Implant | $2,870.78 |
| 6085469 | SUPPLY IMPLANT | Supply/Implant | $2,140.16 |
| 6085470 | SUPPLY IMPLANT | Supply/Implant | $2,795.39 |
| 6085472 | SUPPLY IMPLANT | Supply/Implant | $2,795.39 |
| 6085473 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6085474 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6085496 | SUPPLY IMPLANT | Supply/Implant | $2,537.47 |
| 6085497 | SUPPLY IMPLANT | Supply/Implant | $2,537.47 |
| 6085500 | GUIDE WIRE | Supply/Implant | $2,526.72 |
| 6085519 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6085523 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6085531 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6085777 | STERILE SUPPLY | Supply/Implant | $510.34 |
| 6086015 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6086307 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,299.20 |
| 6086311 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6086315 | GENERAL SUPPLY | Supply/Implant | $156.67 |
| 6086321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6086452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086464 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6086473 | STERILE SUPPLY | Supply/Implant | $486.27 |
| 6086502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6086507 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6086510 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6086511 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,840.70 |
| 6086512 | SUPPLY IMPLANT | Supply/Implant | $120,750.00 |
| 6086517 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6086518 | GENERAL SUPPLY | Supply/Implant | $811.78 |
| 6086522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6086527 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6086528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6086531 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6086532 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6086533 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6086534 | SUPPLY IMPLANT | Supply/Implant | $1,935.36 |
| 6086536 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,680.00 |
| 6086537 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6086540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,594.05 |
| 6086541 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6086542 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6086545 | CATHETER, GUIDING | Supply/Implant | $443.52 |
| 6086547 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,071.49 |
| 6086550 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6086559 | SUPPLY IMPLANT | Supply/Implant | $6,364.93 |
| 6086563 | SUPPLY IMPLANT | Supply/Implant | $484.10 |
| 6086564 | SUPPLY IMPLANT | Supply/Implant | $484.48 |
| 6086568 | SUPPLY IMPLANT | Supply/Implant | $1,257.34 |
| 6086571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6086572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $95,859.20 |
| 6086574 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6086577 | SUPPLY IMPLANT | Supply/Implant | $58,649.60 |
| 6086578 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6086580 | STERILE SUPPLY | Supply/Implant | $284.24 |
| 6086581 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6086586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6086587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6086588 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6086589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6086590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6086593 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6086604 | SUPPLY IMPLANT | Supply/Implant | $17,395.20 |
| 6086608 | SUPPLY IMPLANT | Supply/Implant | $2,246.02 |
| 6086609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6086610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6086616 | SUPPLY IMPLANT | Supply/Implant | $47,257.60 |
| 6086617 | STERILE SUPPLY | Supply/Implant | $134.14 |
| 6086619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,693.12 |
| 6086620 | SUPPLY IMPLANT | Supply/Implant | $3,133.44 |
| 6086621 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6086622 | SUPPLY IMPLANT | Supply/Implant | $2,063.10 |
| 6086624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.29 |
| 6086625 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $91,468.80 |
| 6086643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6086644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,235.20 |
| 6086654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6086655 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $27,840.00 |
| 6086658 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6086660 | CATHETER, GUIDING | Supply/Implant | $11,904.00 |
| 6086666 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6086667 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6086670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,905.60 |
| 6086671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6086677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6086678 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6086680 | STERILE SUPPLY | Supply/Implant | $5,184.00 |
| 6086681 | STERILE SUPPLY | Supply/Implant | $5,248.00 |
| 6086682 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6086683 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6086685 | INTRO/SHEATH, NON-LASER | Supply/Implant | $304.00 |
| 6086689 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6086698 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $14,289.66 |
| 6086699 | SUPPLY IMPLANT | Supply/Implant | $1,757.18 |
| 6086704 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6086705 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6086706 | SUPPLY IMPLANT | Supply/Implant | $2,451.46 |
| 6086858 | SUPPLY IMPLANT | Supply/Implant | $1,924.61 |
| 6086864 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6086865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6086866 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6086879 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6086895 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6086896 | SUPPLY IMPLANT | Supply/Implant | $1,827.84 |
| 6086928 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $40,960.00 |
| 6086929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,146.88 |
| 6086936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,512.00 |
| 6086937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6086992 | GUIDE WIRE | Supply/Implant | $1,720.32 |
| 6087037 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6087210 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,483.78 |
| 6087211 | SUPPLY IMPLANT | Supply/Implant | $1,483.78 |
| 6087212 | SUPPLY IMPLANT | Supply/Implant | $1,483.78 |
| 6087213 | SUPPLY IMPLANT | Supply/Implant | $1,483.78 |
| 6087266 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6087267 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6087268 | SUPPLY IMPLANT | Supply/Implant | $1,938.82 |
| 6087270 | SUPPLY IMPLANT | Supply/Implant | $1,744.77 |
| 6087271 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $1,702.40 |
| 6087278 | SUPPLY IMPLANT | Supply/Implant | $6,818.30 |
| 6087285 | SUPPLY IMPLANT | Supply/Implant | $2,470.40 |
| 6087287 | SUPPLY IMPLANT | Supply/Implant | $2,251.14 |
| 6087288 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,462.34 |
| 6087292 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,436.48 |
| 6087294 | SUPPLY IMPLANT | Supply/Implant | $2,200.45 |
| 6087296 | SUPPLY IMPLANT | Supply/Implant | $2,381.82 |
| 6087297 | SUPPLY IMPLANT | Supply/Implant | $2,259.33 |
| 6087298 | STERILE SUPPLY | Supply/Implant | $2,489.73 |
| 6087299 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,111.87 |
| 6087300 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,419.58 |
| 6087305 | SUPPLY IMPLANT | Supply/Implant | $2,011.14 |
| 6087316 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6087320 | CONN TISS, NON-HUMAN | Supply/Implant | $15,818.24 |
| 6087321 | SUPPLY IMPLANT | Supply/Implant | $7,488.00 |
| 6087328 | SUPPLY IMPLANT | Supply/Implant | $1,594.24 |
| 6087363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,273.28 |
| 6087366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6087368 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6087369 | SUPPLY IMPLANT | Supply/Implant | $47,142.40 |
| 6087374 | SUPPLY IMPLANT | Supply/Implant | $7,104.38 |
| 6087395 | SUPPLY IMPLANT | Supply/Implant | $2,664.70 |
| 6087408 | CATHETER, GUIDING | Supply/Implant | $13,478.40 |
| 6087409 | CATHETER, GUIDING | Supply/Implant | $13,478.40 |
| 6087430 | SUPPLY IMPLANT | Supply/Implant | $12,038.40 |
| 6087476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6087518 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6087558 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,754.24 |
| 6087602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6087675 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6087688 | SUPPLY IMPLANT | Supply/Implant | $1,894.92 |
| 6087697 | SUPPLY IMPLANT | Supply/Implant | $1,667.71 |
| 6087699 | SUPPLY IMPLANT | Supply/Implant | $17,728.00 |
| 6087705 | SUPPLY IMPLANT | Supply/Implant | $3,136.38 |
| 6087730 | INTERSPINOUS IMPLANT | Supply/Implant | $16,889.60 |
| 6087747 | GUIDE WIRE | Supply/Implant | $216.83 |
| 6087748 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6087786 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6087788 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,434.75 |
| 6087789 | RET DEV, INSERTABLE | Supply/Implant | $3,584.00 |
| 6087820 | SUPPLY IMPLANT | Supply/Implant | $5,751.68 |
| 6087827 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6087955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,734.40 |
| 6087985 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6088067 | GENERAL SUPPLY | Supply/Implant | $7,741.44 |
| 6088078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6088080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6088081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6088092 | SUPPLY IMPLANT | Supply/Implant | $1,617.92 |
| 6088099 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6088104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6088112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,732.80 |
| 6088153 | SUPPLY IMPLANT | Supply/Implant | $3,936.00 |
| 6088161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6088163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6088175 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6088176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6088179 | SUPPLY IMPLANT | Supply/Implant | $2,165.76 |
| 6088209 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6088211 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6088225 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088255 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $23,667.20 |
| 6088268 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6088270 | CATHETER, URETERAL | Supply/Implant | $286.77 |
| 6088273 | SUPPLY IMPLANT | Supply/Implant | $908.42 |
| 6088275 | SUPPLY IMPLANT | Supply/Implant | $405.89 |
| 6088282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6088283 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6088301 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6088312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6088318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6088319 | SUPPLY IMPLANT | Supply/Implant | $547.58 |
| 6088320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6088401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6088403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,128.96 |
| 6088405 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6088406 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6088408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6088409 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6088411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6088412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6088422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6088427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $56,000.00 |
| 6088450 | SUPPLY IMPLANT | Supply/Implant | $1,039.36 |
| 6088451 | SUPPLY IMPLANT | Supply/Implant | $1,039.36 |
| 6088458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6088459 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.00 |
| 6088464 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6088465 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6088475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6088477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $798.72 |
| 6088486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6088488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6088493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,715.20 |
| 6088494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,721.60 |
| 6088496 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6088498 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6088504 | STERILE SUPPLY | Supply/Implant | $1,506.30 |
| 6088506 | SUPPLY IMPLANT | Supply/Implant | $3,454.21 |
| 6088510 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,280.00 |
| 6088512 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,280.00 |
| 6088515 | CATHETER, URETERAL | Supply/Implant | $234.62 |
| 6088516 | CATHETER, URETERAL | Supply/Implant | $138.24 |
| 6088518 | CATHETER, URETERAL | Supply/Implant | $232.96 |
| 6088532 | CATHETER, URETERAL | Supply/Implant | $207.17 |
| 6088535 | SUPPLY IMPLANT | Supply/Implant | $3,644.16 |
| 6088545 | SUPPLY IMPLANT | Supply/Implant | $1,450.24 |
| 6088546 | SUPPLY IMPLANT | Supply/Implant | $1,450.24 |
| 6088549 | SUPPLY IMPLANT | Supply/Implant | $3,444.48 |
| 6088552 | SUPPLY IMPLANT | Supply/Implant | $3,942.40 |
| 6088556 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6088557 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6088559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,265.60 |
| 6088563 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6088568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6088570 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088571 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6088572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6088575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6088576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6088577 | STERILE SUPPLY | Supply/Implant | $319.83 |
| 6088579 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6088585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6088586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6088588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6088590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6088591 | MESH (IMPLANTABLE) | Supply/Implant | $12,975.36 |
| 6088596 | SUPPLY IMPLANT | Supply/Implant | $696.32 |
| 6088597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,476.35 |
| 6088598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,828.35 |
| 6088599 | SUPPLY IMPLANT | Supply/Implant | $2,772.61 |
| 6088600 | SUPPLY IMPLANT | Supply/Implant | $2,772.61 |
| 6088601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,261.82 |
| 6088602 | SUPPLY IMPLANT | Supply/Implant | $1,478.40 |
| 6088604 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6088605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6088606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6088607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6088608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6088623 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6088629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6088632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6088633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6088634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6088635 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6088636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6088637 | SUPPLY IMPLANT | Supply/Implant | $21,440.00 |
| 6088651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6088652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6088653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6088654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6088655 | STERILE SUPPLY | Supply/Implant | $1,164.80 |
| 6088659 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6088661 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,841.60 |
| 6088664 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,312.13 |
| 6088666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6088669 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $6,690.82 |
| 6088670 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $6,690.82 |
| 6088676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.13 |
| 6088683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,567.87 |
| 6088685 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6088686 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6088687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6088690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6088691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6088702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,206.21 |
| 6088704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,356.42 |
| 6088705 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6088706 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6088709 | SUPPLY IMPLANT | Supply/Implant | $2,060.80 |
| 6088710 | SUPPLY IMPLANT | Supply/Implant | $2,403.20 |
| 6088711 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6088712 | CATHETER, GUIDING | Supply/Implant | $2,206.85 |
| 6088715 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6088717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,878.53 |
| 6088720 | GENERAL SUPPLY | Supply/Implant | $162.82 |
| 6088724 | SUPPLY IMPLANT | Supply/Implant | $169.73 |
| 6088725 | SUPPLY IMPLANT | Supply/Implant | $1,793.28 |
| 6088727 | GENERAL SUPPLY | Supply/Implant | $748.16 |
| 6088730 | GENERAL SUPPLY | Supply/Implant | $276.86 |
| 6088731 | GENERAL SUPPLY | Supply/Implant | $276.86 |
| 6088735 | SUPPLY IMPLANT | Supply/Implant | $1,090.82 |
| 6088742 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,680.00 |
| 6088745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6088754 | GENERAL SUPPLY | Supply/Implant | $1,536.00 |
| 6088755 | SUPPLY IMPLANT | Supply/Implant | $869.89 |
| 6088756 | SUPPLY IMPLANT | Supply/Implant | $869.89 |
| 6088760 | STERILE SUPPLY | Supply/Implant | $152.28 |
| 6088761 | GENERAL SUPPLY | Supply/Implant | $263.04 |
| 6088762 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6088774 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6088786 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088787 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088788 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088789 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088790 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088791 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088792 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6088796 | SUPPLY IMPLANT | Supply/Implant | $3,686.40 |
| 6088798 | SUPPLY IMPLANT | Supply/Implant | $416.97 |
| 6088799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6088800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6088808 | SUPPLY IMPLANT | Supply/Implant | $257.79 |
| 6088818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6088824 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6088826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6088830 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6088831 | SUPPLY IMPLANT | Supply/Implant | $4,147.20 |
| 6088835 | SUPPLY IMPLANT | Supply/Implant | $701.95 |
| 6088837 | GUIDE WIRE | Supply/Implant | $195.20 |
| 6088841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6088849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6088850 | STERILE SUPPLY | Supply/Implant | $985.96 |
| 6088853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,288.00 |
| 6088855 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6088857 | SUPPLY IMPLANT | Supply/Implant | $1,833.28 |
| 6088858 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6088859 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6088866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6088867 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6088869 | SUPPLY IMPLANT | Supply/Implant | $3,660.80 |
| 6088877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6088879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6088891 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,744.00 |
| 6088892 | GENERAL SUPPLY | Supply/Implant | $222.72 |
| 6088893 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6088894 | GENERAL SUPPLY | Supply/Implant | $222.72 |
| 6088895 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6088896 | GENERAL SUPPLY | Supply/Implant | $1,216.00 |
| 6088897 | CATHETER, GUIDING | Supply/Implant | $11,904.00 |
| 6088898 | SUPPLY IMPLANT | Supply/Implant | $599.04 |
| 6088899 | CATHETER, URETERAL | Supply/Implant | $190.59 |
| 6088900 | CATHETER, URETERAL | Supply/Implant | $301.70 |
| 6088901 | CATHETER, URETERAL | Supply/Implant | $186.75 |
| 6088902 | CATHETER, URETERAL | Supply/Implant | $303.10 |
| 6088905 | SUPPLY IMPLANT | Supply/Implant | $1,718.53 |
| 6088907 | SUPPLY IMPLANT | Supply/Implant | $1,544.96 |
| 6088908 | ARTHROFLEX PER 1 SQ CM | Supply/Implant | $49,280.00 |
| 6088915 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6088916 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6088917 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6088920 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6088921 | SUPPLY IMPLANT | Supply/Implant | $10,530.78 |
| 6088922 | SUPPLY IMPLANT | Supply/Implant | $11,991.45 |
| 6088923 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,867.20 |
| 6088930 | INTRO/SHEATH, NON-LASER | Supply/Implant | $896.00 |
| 6088931 | INTRO/SHEATH, NON-LASER | Supply/Implant | $443.52 |
| 6088936 | GENERAL SUPPLY | Supply/Implant | $174.72 |
| 6088945 | SUPPLY IMPLANT | Supply/Implant | $3,148.80 |
| 6088946 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6088947 | ALLODERM SKIN SUB | Supply/Implant | $52,620.80 |
| 6088965 | SUPPLY IMPLANT | Supply/Implant | $109,410.00 |
| 6088972 | CONN TISS, NON-HUMAN | Supply/Implant | $2,659.20 |
| 6088974 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6088976 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6088977 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6088978 | SUPPLY IMPLANT | Supply/Implant | $632.86 |
| 6088979 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $106,752.00 |
| 6088982 | STERILE SUPPLY | Supply/Implant | $1,611.90 |
| 6088983 | STERILE SUPPLY | Supply/Implant | $1,296.38 |
| 6088986 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6089027 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6089028 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6089033 | SUPPLY IMPLANT | Supply/Implant | $332.16 |
| 6089037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6089044 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $492.16 |
| 6089045 | INTRO/SHEATH, NON-LASER | Supply/Implant | $492.16 |
| 6089048 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6089050 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089051 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089052 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089057 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $17,920.00 |
| 6089060 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6089061 | SUPPLY IMPLANT | Supply/Implant | $306.97 |
| 6089070 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6089071 | SUPPLY IMPLANT | Supply/Implant | $160.00 |
| 6089073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6089082 | SUPPLY IMPLANT | Supply/Implant | $7,321.60 |
| 6089087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,725.70 |
| 6089088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,860.80 |
| 6089098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6089099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6089100 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6089102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6089107 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6089108 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,408.00 |
| 6089109 | INTRO/SHEATH, NON-LASER | Supply/Implant | $280.96 |
| 6089110 | INTRO/SHEATH, NON-LASER | Supply/Implant | $280.96 |
| 6089111 | INTRO/SHEATH, NON-LASER | Supply/Implant | $280.96 |
| 6089114 | SUPPLY IMPLANT | Supply/Implant | $3,193.34 |
| 6089117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6089118 | PMKR, DUAL, RATE-RESP | Supply/Implant | $65,088.00 |
| 6089123 | CATHETER, GUIDING | Supply/Implant | $304.00 |
| 6089126 | SUPPLY IMPLANT | Supply/Implant | $15,296.00 |
| 6089129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6089133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6089134 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6089139 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6089141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6089144 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6089146 | SUPPLY IMPLANT | Supply/Implant | $2,173.06 |
| 6089150 | SUPPLY IMPLANT | Supply/Implant | $473.60 |
| 6089151 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6089152 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6089153 | SUPPLY IMPLANT | Supply/Implant | $283.90 |
| 6089154 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6089157 | SUPPLY IMPLANT | Supply/Implant | $17,561.60 |
| 6089162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6089163 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6089164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6089165 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6089166 | GENERAL SUPPLY | Supply/Implant | $5,145.60 |
| 6089167 | GRAFT, VASCULAR | Supply/Implant | $44,800.00 |
| 6089177 | GENERAL SUPPLY | Supply/Implant | $364.80 |
| 6089184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6089185 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6089188 | SUPPLY IMPLANT | Supply/Implant | $1,226.75 |
| 6089189 | SUPPLY IMPLANT | Supply/Implant | $1,226.75 |
| 6089193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6089196 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089197 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6089199 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089200 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6089201 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089202 | SUPPLY IMPLANT | Supply/Implant | $5,900.80 |
| 6089203 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6089207 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6089208 | SUPPLY IMPLANT | Supply/Implant | $2,450.94 |
| 6089210 | STERILE SUPPLY | Supply/Implant | $5,145.60 |
| 6089212 | STERILE SUPPLY | Supply/Implant | $1,011.20 |
| 6089215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6089218 | SUPPLY IMPLANT | Supply/Implant | $5,794.65 |
| 6089232 | COCHLEAR DEVICE | Supply/Implant | $221,190.00 |
| 6089238 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6089239 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6089242 | RET DEV, INSERTABLE | Supply/Implant | $2,873.34 |
| 6089258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6089259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6089263 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $25,600.00 |
| 6089264 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,387.20 |
| 6089275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6089276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6089277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $119,962.50 |
| 6089278 | SUPPLY IMPLANT | Supply/Implant | $4,113.92 |
| 6089279 | SUPPLY IMPLANT | Supply/Implant | $4,113.92 |
| 6089280 | SUPPLY IMPLANT | Supply/Implant | $5,939.20 |
| 6089281 | SUPPLY IMPLANT | Supply/Implant | $5,939.20 |
| 6089282 | SUPPLY IMPLANT | Supply/Implant | $9,152.00 |
| 6089283 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089284 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089285 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089286 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089287 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6089306 | GENERAL SUPPLY | Supply/Implant | $3,072.00 |
| 6089322 | SUPPLY IMPLANT | Supply/Implant | $7,692.80 |
| 6089334 | STERILE SUPPLY | Supply/Implant | $3,010.56 |
| 6089335 | GENERAL SUPPLY | Supply/Implant | $3,010.56 |
| 6089368 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6089376 | GENERAL SUPPLY | Supply/Implant | $2,931.46 |
| 6089380 | GENERAL SUPPLY | Supply/Implant | $930.69 |
| 6089394 | GENERAL SUPPLY | Supply/Implant | $538.24 |
| 6089399 | GENERAL SUPPLY | Supply/Implant | $481.66 |
| 6089400 | GENERAL SUPPLY | Supply/Implant | $443.65 |
| 6089405 | GENERAL SUPPLY | Supply/Implant | $550.40 |
| 6089406 | GENERAL SUPPLY | Supply/Implant | $597.12 |
| 6089414 | GENERAL SUPPLY | Supply/Implant | $1,145.60 |
| 6089422 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6089426 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $423.42 |
| 6089449 | STERILE SUPPLY | Supply/Implant | $414.72 |
| 6089485 | SUPPLY IMPLANT | Supply/Implant | $403.29 |
| 6089504 | GENERAL SUPPLY | Supply/Implant | $396.80 |
| 6089566 | GENERAL SUPPLY | Supply/Implant | $752.26 |
| 6089573 | GENERAL SUPPLY | Supply/Implant | $390.78 |
| 6089581 | GENERAL SUPPLY | Supply/Implant | $692.99 |
| 6089588 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6089601 | GENERAL SUPPLY | Supply/Implant | $555.39 |
| 6089887 | GENERAL SUPPLY | Supply/Implant | $377.60 |
| 6089903 | STERILE SUPPLY | Supply/Implant | $432.00 |
| 6089914 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6089930 | GENERAL SUPPLY | Supply/Implant | $658.56 |
| 6089931 | GENERAL SUPPLY | Supply/Implant | $447.74 |
| 6089945 | GENERAL SUPPLY | Supply/Implant | $364.42 |
| 6089950 | GENERAL SUPPLY | Supply/Implant | $363.65 |
| 6089966 | GENERAL SUPPLY | Supply/Implant | $358.14 |
| 6090006 | GENERAL SUPPLY | Supply/Implant | $348.80 |
| 6090009 | GENERAL SUPPLY | Supply/Implant | $348.29 |
| 6090017 | GENERAL SUPPLY | Supply/Implant | $345.60 |
| 6090032 | GENERAL SUPPLY | Supply/Implant | $345.60 |
| 6090043 | SUPPLY IMPLANT | Supply/Implant | $335.74 |
| 6090059 | GENERAL SUPPLY | Supply/Implant | $329.73 |
| 6090072 | GENERAL SUPPLY | Supply/Implant | $326.40 |
| 6090088 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6090110 | GENERAL SUPPLY | Supply/Implant | $316.80 |
| 6090120 | SUPPLY IMPLANT | Supply/Implant | $313.60 |
| 6090156 | SUPPLY IMPLANT | Supply/Implant | $302.72 |
| 6090173 | GENERAL SUPPLY | Supply/Implant | $298.62 |
| 6090184 | CATHETER, URETERAL | Supply/Implant | $297.60 |
| 6090185 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090186 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090187 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090188 | SUPPLY IMPLANT | Supply/Implant | $296.32 |
| 6090192 | GENERAL SUPPLY | Supply/Implant | $294.91 |
| 6090200 | GENERAL SUPPLY | Supply/Implant | $292.48 |
| 6090216 | GENERAL SUPPLY | Supply/Implant | $290.56 |
| 6090218 | GENERAL SUPPLY | Supply/Implant | $480.51 |
| 6090223 | GENERAL SUPPLY | Supply/Implant | $324.61 |
| 6090241 | SUPPLY IMPLANT | Supply/Implant | $281.60 |
| 6090246 | GENERAL SUPPLY | Supply/Implant | $339.20 |
| 6090255 | GENERAL SUPPLY | Supply/Implant | $393.86 |
| 6090282 | GENERAL SUPPLY | Supply/Implant | $461.44 |
| 6090294 | GENERAL SUPPLY | Supply/Implant | $303.72 |
| 6090305 | GENERAL SUPPLY | Supply/Implant | $270.85 |
| 6090307 | CATH, BAL TIS DIS, NON-VAS | Supply/Implant | $270.59 |
| 6090308 | GENERAL SUPPLY | Supply/Implant | $352.64 |
| 6090324 | GENERAL SUPPLY | Supply/Implant | $268.16 |
| 6090331 | GENERAL SUPPLY | Supply/Implant | $358.66 |
| 6090343 | GENERAL SUPPLY | Supply/Implant | $262.40 |
| 6090360 | GENERAL SUPPLY | Supply/Implant | $258.56 |
| 6090410 | GENERAL SUPPLY | Supply/Implant | $354.30 |
| 6090427 | GENERAL SUPPLY | Supply/Implant | $243.33 |
| 6090440 | GENERAL SUPPLY | Supply/Implant | $242.30 |
| 6090464 | STERILE SUPPLY | Supply/Implant | $238.00 |
| 6090477 | SUPPLY IMPLANT | Supply/Implant | $234.11 |
| 6090504 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6090550 | GENERAL SUPPLY | Supply/Implant | $221.18 |
| 6090555 | GENERAL SUPPLY | Supply/Implant | $1,385.60 |
| 6090558 | GENERAL SUPPLY | Supply/Implant | $372.48 |
| 6090565 | GUIDE WIRE | Supply/Implant | $217.60 |
| 6090568 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6090579 | GENERAL SUPPLY | Supply/Implant | $215.68 |
| 6090591 | GENERAL SUPPLY | Supply/Implant | $381.57 |
| 6090600 | GENERAL SUPPLY | Supply/Implant | $211.20 |
| 6090608 | SUPPLY IMPLANT | Supply/Implant | $211.20 |
| 6090626 | GENERAL SUPPLY | Supply/Implant | $207.36 |
| 6090629 | GENERAL SUPPLY | Supply/Implant | $206.72 |
| 6090638 | GENERAL SUPPLY | Supply/Implant | $204.80 |
| 6090663 | GENERAL SUPPLY | Supply/Implant | $329.22 |
| 6090672 | GENERAL SUPPLY | Supply/Implant | $202.75 |
| 6090674 | GENERAL SUPPLY | Supply/Implant | $202.62 |
| 6090691 | GENERAL SUPPLY | Supply/Implant | $200.19 |
| 6090762 | GENERAL SUPPLY | Supply/Implant | $390.91 |
| 6090765 | GENERAL SUPPLY | Supply/Implant | $191.68 |
| 6090795 | GENERAL SUPPLY | Supply/Implant | $187.90 |
| 6090806 | GENERAL SUPPLY | Supply/Implant | $497.15 |
| 6090822 | GENERAL SUPPLY | Supply/Implant | $185.60 |
| 6090840 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6090846 | GENERAL SUPPLY | Supply/Implant | $182.66 |
| 6090848 | SUPPLY IMPLANT | Supply/Implant | $182.53 |
| 6090878 | STERILE SUPPLY | Supply/Implant | $213.89 |
| 6090882 | GENERAL SUPPLY | Supply/Implant | $178.56 |
| 6090885 | GENERAL SUPPLY | Supply/Implant | $196.70 |
| 6090886 | GENERAL SUPPLY | Supply/Implant | $239.74 |
| 6090887 | GENERAL SUPPLY | Supply/Implant | $249.22 |
| 6090892 | GENERAL SUPPLY | Supply/Implant | $183.04 |
| 6090897 | GENERAL SUPPLY | Supply/Implant | $176.33 |
| 6090913 | GENERAL SUPPLY | Supply/Implant | $307.37 |
| 6090944 | GENERAL SUPPLY | Supply/Implant | $194.05 |
| 6090953 | GENERAL SUPPLY | Supply/Implant | $167.42 |
| 6090982 | STERILE SUPPLY | Supply/Implant | $164.48 |
| 6090983 | GENERAL SUPPLY | Supply/Implant | $164.26 |
| 6090991 | SUPPLY IMPLANT | Supply/Implant | $265.22 |
| 6090997 | GENERAL SUPPLY | Supply/Implant | $302.98 |
| 6091000 | GENERAL SUPPLY | Supply/Implant | $162.43 |
| 6091004 | SUPPLY IMPLANT | Supply/Implant | $161.92 |
| 6091016 | STERILE SUPPLY | Supply/Implant | $173.70 |
| 6091033 | STERILE SUPPLY | Supply/Implant | $164.99 |
| 6091043 | CATHETER, URETERAL | Supply/Implant | $158.34 |
| 6091046 | GENERAL SUPPLY | Supply/Implant | $247.71 |
| 6091047 | GENERAL SUPPLY | Supply/Implant | $158.21 |
| 6091049 | GENERAL SUPPLY | Supply/Implant | $258.18 |
| 6091054 | GENERAL SUPPLY | Supply/Implant | $176.77 |
| 6091106 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6091114 | GENERAL SUPPLY | Supply/Implant | $152.32 |
| 6091125 | STERILE SUPPLY | Supply/Implant | $220.80 |
| 6091141 | STERILE SUPPLY | Supply/Implant | $149.25 |
| 6091150 | GENERAL SUPPLY | Supply/Implant | $220.67 |
| 6091154 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6091157 | GENERAL SUPPLY | Supply/Implant | $146.69 |
| 6091161 | GENERAL SUPPLY | Supply/Implant | $247.07 |
| 6091192 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6091193 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6091198 | SUPPLY IMPLANT | Supply/Implant | $258.69 |
| 6091199 | SUPPLY IMPLANT | Supply/Implant | $258.69 |
| 6091215 | CATHETER, URETERAL | Supply/Implant | $258.18 |
| 6091216 | CATHETER, URETERAL | Supply/Implant | $149.76 |
| 6091232 | GENERAL SUPPLY | Supply/Implant | $140.54 |
| 6091239 | STERILE SUPPLY | Supply/Implant | $168.45 |
| 6091259 | GENERAL SUPPLY | Supply/Implant | $150.53 |
| 6091265 | GENERAL SUPPLY | Supply/Implant | $137.34 |
| 6091267 | GENERAL SUPPLY | Supply/Implant | $137.22 |
| 6091274 | GENERAL SUPPLY | Supply/Implant | $154.62 |
| 6091283 | GENERAL SUPPLY | Supply/Implant | $135.30 |
| 6091288 | SUPPLY IMPLANT | Supply/Implant | $134.53 |
| 6091289 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6091290 | GENERAL SUPPLY | Supply/Implant | $154.11 |
| 6091294 | SUPPLY IMPLANT | Supply/Implant | $176.38 |
| 6091300 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6091301 | STERILE SUPPLY | Supply/Implant | $134.40 |
| 6091302 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6091303 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6091306 | GENERAL SUPPLY | Supply/Implant | $134.14 |
| 6091318 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6091348 | STERILE SUPPLY | Supply/Implant | $128.77 |
| 6091366 | GENERAL SUPPLY | Supply/Implant | $134.40 |
| 6091368 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6091441 | GENERAL SUPPLY | Supply/Implant | $467.84 |
| 6091478 | GENERAL SUPPLY | Supply/Implant | $182.66 |
| 6091733 | GENERAL SUPPLY | Supply/Implant | $376.32 |
| 6091747 | GENERAL SUPPLY | Supply/Implant | $133.12 |
| 6091758 | GENERAL SUPPLY | Supply/Implant | $166.25 |
| 6091767 | GENERAL SUPPLY | Supply/Implant | $138.24 |
| 6091778 | STERILE SUPPLY | Supply/Implant | $180.35 |
| 6091843 | SUPPLY IMPLANT | Supply/Implant | $365.36 |
| 6091870 | GENERAL SUPPLY | Supply/Implant | $182.23 |
| 6092462 | STERILE SUPPLY | Supply/Implant | $226.65 |
| 6092464 | STERILE SUPPLY | Supply/Implant | $236.60 |
| 6092482 | GENERAL SUPPLY | Supply/Implant | $185.22 |
| 6092946 | STERILE SUPPLY | Supply/Implant | $241.66 |
| 6093502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6093506 | GENERAL SUPPLY | Supply/Implant | $490.24 |
| 6093519 | SUPPLY IMPLANT | Supply/Implant | $1,518.72 |
| 6093521 | SUPPLY IMPLANT | Supply/Implant | $1,287.91 |
| 6093528 | SUPPLY IMPLANT | Supply/Implant | $1,041.92 |
| 6093535 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6093542 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6093543 | SUPPLY IMPLANT | Supply/Implant | $1,161.60 |
| 6093546 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6093547 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6093550 | SUPPLY IMPLANT | Supply/Implant | $1,203.20 |
| 6093553 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6093554 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,254.40 |
| 6093572 | SUPPLY IMPLANT | Supply/Implant | $860.54 |
| 6093576 | SUPPLY IMPLANT | Supply/Implant | $500.22 |
| 6093577 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6093588 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6093604 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6093684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6093708 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6093727 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6093734 | SUPPLY IMPLANT | Supply/Implant | $531.20 |
| 6093744 | SUPPLY IMPLANT | Supply/Implant | $1,236.48 |
| 6093745 | INTRO/SHEATH, NON-LASER | Supply/Implant | $774.14 |
| 6093752 | SUPPLY IMPLANT | Supply/Implant | $1,182.72 |
| 6093753 | CATHETER, URETERAL | Supply/Implant | $218.24 |
| 6093765 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6093827 | SUPPLY IMPLANT | Supply/Implant | $343.68 |
| 6093829 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6093830 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093831 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093832 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093833 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6093834 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6093836 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093837 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093838 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6093840 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093844 | CATH, DRAINAGE | Supply/Implant | $1,344.00 |
| 6093848 | SUPPLY IMPLANT | Supply/Implant | $1,164.80 |
| 6093850 | SUPPLY IMPLANT | Supply/Implant | $1,075.20 |
| 6093853 | SUPPLY IMPLANT | Supply/Implant | $1,038.59 |
| 6093874 | STERILE SUPPLY | Supply/Implant | $1,152.00 |
| 6093884 | SUPPLY IMPLANT | Supply/Implant | $908.80 |
| 6093889 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6093899 | PORT, INDWELLING, IMP | Supply/Implant | $577.02 |
| 6093902 | SUPPLY IMPLANT | Supply/Implant | $754.30 |
| 6093920 | SUPPLY IMPLANT | Supply/Implant | $1,337.86 |
| 6093921 | SUPPLY IMPLANT | Supply/Implant | $969.84 |
| 6093926 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6093928 | SUPPLY IMPLANT | Supply/Implant | $669.36 |
| 6093935 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6093938 | CONN TISS, NON-HUMAN | Supply/Implant | $4,224.64 |
| 6093941 | SUPPLY IMPLANT | Supply/Implant | $527.87 |
| 6093942 | SUPPLY IMPLANT | Supply/Implant | $1,458.87 |
| 6093951 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6093954 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6093961 | SUPPLY IMPLANT | Supply/Implant | $435.71 |
| 6093970 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6093977 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6093978 | SUPPLY IMPLANT | Supply/Implant | $1,559.10 |
| 6093994 | SUPPLY IMPLANT | Supply/Implant | $578.69 |
| 6093997 | SUPPLY IMPLANT | Supply/Implant | $404.99 |
| 6094001 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6094002 | SUPPLY IMPLANT | Supply/Implant | $427.78 |
| 6094009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6094010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6094013 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6094018 | GUIDE WIRE | Supply/Implant | $599.04 |
| 6094045 | GUIDE WIRE | Supply/Implant | $433.92 |
| 6094067 | GUIDE WIRE | Supply/Implant | $392.32 |
| 6094068 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6094071 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6094072 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6094085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6094091 | GUIDE WIRE | Supply/Implant | $373.12 |
| 6094106 | SUPPLY IMPLANT | Supply/Implant | $331.01 |
| 6094112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $317.44 |
| 6094128 | SUPPLY IMPLANT | Supply/Implant | $307.33 |
| 6094129 | SUPPLY IMPLANT | Supply/Implant | $284.80 |
| 6094130 | SUPPLY IMPLANT | Supply/Implant | $648.58 |
| 6094132 | SUPPLY IMPLANT | Supply/Implant | $284.80 |
| 6094158 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6094159 | SUPPLY IMPLANT | Supply/Implant | $217.60 |
| 6094164 | INTRO/SHEATH, NON-LASER | Supply/Implant | $261.63 |
| 6094203 | GUIDE WIRE | Supply/Implant | $154.75 |
| 6094235 | SUPPLY IMPLANT | Supply/Implant | $188.16 |
| 6094236 | SUPPLY IMPLANT | Supply/Implant | $138.24 |
| 6094237 | SUPPLY IMPLANT | Supply/Implant | $134.40 |
| 6094239 | SUPPLY IMPLANT | Supply/Implant | $274.71 |
| 6094240 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6094256 | SUPPLY IMPLANT | Supply/Implant | $1,232.64 |
| 6094291 | SUPPLY IMPLANT | Supply/Implant | $131.46 |
| 6094401 | SUPPLY IMPLANT | Supply/Implant | $154.66 |
| 6094781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6094782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6094790 | SUPPLY IMPLANT | Supply/Implant | $588.03 |
| 6094791 | CLOSURE DEV, VASC | Supply/Implant | $2,026.88 |
| 6094792 | INTRO/SHEATH, NON-LASER | Supply/Implant | $900.35 |
| 6094793 | GUIDE WIRE | Supply/Implant | $1,497.60 |
| 6094823 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6094824 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6094825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,988.80 |
| 6094827 | SUPPLY IMPLANT | Supply/Implant | $368.51 |
| 6094828 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6094831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,909.50 |
| 6094834 | SUPPLY IMPLANT | Supply/Implant | $1,617.66 |
| 6094839 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,224.00 |
| 6094840 | STERILE SUPPLY | Supply/Implant | $684.53 |
| 6094844 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6094847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6094853 | SUPPLY IMPLANT | Supply/Implant | $1,665.54 |
| 6094855 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6094858 | SUPPLY IMPLANT | Supply/Implant | $3,442.69 |
| 6094861 | GENERAL SUPPLY | Supply/Implant | $406.02 |
| 6094863 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,287.94 |
| 6094871 | STERILE SUPPLY | Supply/Implant | $3,000.96 |
| 6094872 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6094873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,996.29 |
| 6094881 | GENERAL SUPPLY | Supply/Implant | $11,831.55 |
| 6094888 | SUPPLY IMPLANT | Supply/Implant | $626.33 |
| 6094889 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094891 | STERILE SUPPLY | Supply/Implant | $206.72 |
| 6094892 | STERILE SUPPLY | Supply/Implant | $437.76 |
| 6094893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6094895 | SUPPLY IMPLANT | Supply/Implant | $32,320.00 |
| 6094915 | COCHLEAR DEVICE | Supply/Implant | $338,350.00 |
| 6094919 | STERILE SUPPLY | Supply/Implant | $703.36 |
| 6094920 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094921 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094922 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094923 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094924 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094925 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094926 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094927 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094928 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094929 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094931 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094934 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094935 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094938 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094939 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094940 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $1,856.00 |
| 6094941 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094942 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094944 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094947 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094948 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094951 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094952 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094953 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094954 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094955 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094957 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094960 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094966 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094967 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094968 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094973 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094979 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,856.00 |
| 6094990 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094991 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6094992 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6094993 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094994 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094995 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6094997 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095000 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095001 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095002 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095003 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095005 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095007 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095009 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095010 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095016 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095017 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095018 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095019 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095020 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095022 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095023 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095025 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095027 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095028 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095029 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095030 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095031 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095033 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095036 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095037 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095038 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095039 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095040 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095042 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6095043 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6095044 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6095045 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6095050 | GENERAL SUPPLY | Supply/Implant | $441.60 |
| 6095058 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,291.20 |
| 6095066 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095068 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095070 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,876.74 |
| 6095072 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,800.00 |
| 6095074 | SUPPLY IMPLANT | Supply/Implant | $1,157.12 |
| 6095076 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6095081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,804.80 |
| 6095084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,149.76 |
| 6095089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,616.00 |
| 6095090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6095091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6095092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,141.44 |
| 6095095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6095096 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6095097 | SUPPLY IMPLANT | Supply/Implant | $3,417.60 |
| 6095098 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6095099 | SUPPLY IMPLANT | Supply/Implant | $3,686.40 |
| 6095100 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6095102 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6095104 | CATHETER, GUIDING | Supply/Implant | $440.45 |
| 6095116 | GRAFT, VASCULAR | Supply/Implant | $57,830.40 |
| 6095119 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6095120 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6095121 | GENERAL SUPPLY | Supply/Implant | $704.00 |
| 6095126 | SUPPLY IMPLANT | Supply/Implant | $23,367.68 |
| 6095127 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6095134 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6095135 | SUPPLY IMPLANT | Supply/Implant | $2,721.59 |
| 6095140 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6095141 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6095147 | STERILE SUPPLY | Supply/Implant | $316.80 |
| 6095148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6095151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6095160 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6095166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095169 | GENERAL SUPPLY | Supply/Implant | $311.46 |
| 6095172 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,381.57 |
| 6095173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,350.40 |
| 6095174 | SUPPLY IMPLANT | Supply/Implant | $4,057.60 |
| 6095179 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $26,342.40 |
| 6095182 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6095188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095189 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095190 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,056.00 |
| 6095203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095204 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6095208 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6095253 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6095254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6095255 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6095256 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6095257 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,760.00 |
| 6095259 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095260 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095261 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6095262 | GENERAL SUPPLY | Supply/Implant | $437.89 |
| 6095267 | SUPPLY IMPLANT | Supply/Implant | $15,296.00 |
| 6095268 | SUPPLY IMPLANT | Supply/Implant | $458.34 |
| 6095274 | STERILE SUPPLY | Supply/Implant | $569.60 |
| 6095275 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6095292 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095295 | STERILE SUPPLY | Supply/Implant | $692.86 |
| 6095296 | GENERAL SUPPLY | Supply/Implant | $719.49 |
| 6095297 | SUPPLY IMPLANT | Supply/Implant | $2,302.85 |
| 6095303 | SUPPLY IMPLANT | Supply/Implant | $1,436.54 |
| 6095311 | SUPPLY IMPLANT | Supply/Implant | $17,395.20 |
| 6095313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6095316 | INTERSPINOUS IMPLANT | Supply/Implant | $32,320.00 |
| 6095317 | INTERSPINOUS IMPLANT | Supply/Implant | $32,320.00 |
| 6095319 | GENERAL SUPPLY | Supply/Implant | $298.11 |
| 6095324 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6095333 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095337 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6095338 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6095345 | CATHETER, GUIDING | Supply/Implant | $4,441.60 |
| 6095346 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6095347 | SUPPLY IMPLANT | Supply/Implant | $5,007.78 |
| 6095348 | SUPPLY IMPLANT | Supply/Implant | $5,712.64 |
| 6095349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6095351 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6095353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6095355 | SUPPLY IMPLANT | Supply/Implant | $160.26 |
| 6095360 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $10,752.00 |
| 6095374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,480.00 |
| 6095375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,480.00 |
| 6095376 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6095379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,936.00 |
| 6095384 | GENERAL SUPPLY | Supply/Implant | $204.80 |
| 6095385 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6095386 | GENERAL SUPPLY | Supply/Implant | $204.80 |
| 6095387 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6095390 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6095391 | STERILE SUPPLY | Supply/Implant | $849.15 |
| 6095395 | GENERAL SUPPLY | Supply/Implant | $593.28 |
| 6095406 | SUPPLY IMPLANT | Supply/Implant | $16,512.00 |
| 6095414 | SUPPLY IMPLANT | Supply/Implant | $24,768.00 |
| 6095432 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095433 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095434 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095435 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6095441 | GRAFT, VASCULAR | Supply/Implant | $15,475.20 |
| 6095444 | GRAFT, VASCULAR | Supply/Implant | $24,902.78 |
| 6095467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,440.00 |
| 6095476 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6095489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6095492 | GENERAL SUPPLY | Supply/Implant | $692.86 |
| 6095496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $93,747.20 |
| 6095500 | GENERAL SUPPLY | Supply/Implant | $500.48 |
| 6095501 | GENERAL SUPPLY | Supply/Implant | $500.48 |
| 6095502 | STERILE SUPPLY | Supply/Implant | $1,452.01 |
| 6095506 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6095516 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095517 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,316.74 |
| 6095518 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6095522 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6095527 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6095529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,639.68 |
| 6095540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6095541 | STERILE SUPPLY | Supply/Implant | $843.89 |
| 6095544 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6095547 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $127,692.80 |
| 6095548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6095549 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6095550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6095560 | SUPPLY IMPLANT | Supply/Implant | $88,320.00 |
| 6095561 | SUPPLY IMPLANT | Supply/Implant | $9,081.60 |
| 6095564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6095567 | SUPPLY IMPLANT | Supply/Implant | $8,896.00 |
| 6095571 | SUPPLY IMPLANT | Supply/Implant | $371.20 |
| 6095572 | SUPPLY IMPLANT | Supply/Implant | $2,790.40 |
| 6095574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,684.80 |
| 6095575 | CATHETER, GUIDING | Supply/Implant | $192.00 |
| 6095579 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6095580 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6095582 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6095585 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,174.40 |
| 6095589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6095591 | SUPPLY IMPLANT | Supply/Implant | $15,552.00 |
| 6095595 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $16,128.00 |
| 6095600 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6095604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6095605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6095607 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6095608 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095611 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095615 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095616 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095619 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095620 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095625 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095629 | SEPTAL DEFECT IMP SYS | Supply/Implant | $149,310.00 |
| 6095633 | SEPTAL DEFECT IMP SYS | Supply/Implant | $163,705.50 |
| 6095639 | SUPPLY IMPLANT | Supply/Implant | $92,800.00 |
| 6095643 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6095644 | SUPPLY IMPLANT | Supply/Implant | $1,064.26 |
| 6095654 | SUPPLY IMPLANT | Supply/Implant | $311.17 |
| 6095666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,539.39 |
| 6095667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6095669 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6095670 | GENERAL SUPPLY | Supply/Implant | $1,185.92 |
| 6095672 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $110,272.00 |
| 6095677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,079.23 |
| 6095679 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $55,040.00 |
| 6095680 | SUPPLY IMPLANT | Supply/Implant | $4,178.05 |
| 6095681 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $29,427.20 |
| 6095683 | INTERSPINOUS IMPLANT | Supply/Implant | $75,008.00 |
| 6095684 | SUPPLY IMPLANT | Supply/Implant | $2,524.16 |
| 6095687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,320.00 |
| 6095696 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6095708 | CATHETER, URETERAL | Supply/Implant | $327.04 |
| 6095715 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6095718 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6095738 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6095739 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6095741 | SUPPLY IMPLANT | Supply/Implant | $10,331.37 |
| 6095748 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6095753 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6095755 | SUPPLY IMPLANT | Supply/Implant | $7,936.00 |
| 6095757 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6095759 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6095770 | BRACHYTHERAPY NEEDLE | Supply/Implant | $2,496.00 |
| 6095775 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,542.91 |
| 6095781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6095788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6095794 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6095795 | GUIDE WIRE | Supply/Implant | $332.80 |
| 6095796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6095797 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6095798 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6095799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,754.75 |
| 6095800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,893.25 |
| 6095801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,383.81 |
| 6095811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6095814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6095815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6095817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6095825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6095826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6095827 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6095829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6095830 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6095831 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6095840 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6095853 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,522.69 |
| 6095855 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $16,611.84 |
| 6095857 | STERILE SUPPLY | Supply/Implant | $5,568.00 |
| 6095858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6095859 | SUPPLY IMPLANT | Supply/Implant | $1,485.18 |
| 6095861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6095865 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6095866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6095867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6095869 | SUPPLY IMPLANT | Supply/Implant | $3,199.36 |
| 6095871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,872.00 |
| 6095872 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,020.80 |
| 6095875 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6095876 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,977.60 |
| 6095877 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,320.00 |
| 6095878 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,417.60 |
| 6095880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,457.60 |
| 6095882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,457.60 |
| 6095885 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6095888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6095889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,818.56 |
| 6095890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,021.44 |
| 6095892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,490.88 |
| 6095896 | SUPPLY IMPLANT | Supply/Implant | $3,494.40 |
| 6095897 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,476.80 |
| 6095899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6095907 | STERILE SUPPLY | Supply/Implant | $250.11 |
| 6095908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6095918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6095920 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $13,555.20 |
| 6095921 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6095922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.73 |
| 6095923 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,459.39 |
| 6095926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6095927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6095930 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6095931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6095932 | GENERAL SUPPLY | Supply/Implant | $185.20 |
| 6095933 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6095934 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6095936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,287.94 |
| 6095943 | SUPPLY IMPLANT | Supply/Implant | $195,108.06 |
| 6095950 | SUPPLY IMPLANT | Supply/Implant | $8,803.20 |
| 6095953 | GENERAL SUPPLY | Supply/Implant | $553.22 |
| 6095955 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $15,360.00 |
| 6095956 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $15,360.00 |
| 6095958 | LEAD, NEUROSTIMULATOR | Supply/Implant | $32,000.00 |
| 6095959 | LEAD, NEUROSTIMULATOR | Supply/Implant | $32,000.00 |
| 6095962 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $15,360.00 |
| 6095964 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $23,040.00 |
| 6095969 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095970 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095971 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095973 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6095974 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6095975 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,560.00 |
| 6095981 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $10,240.00 |
| 6095983 | GENERAL DRUG | Supply/Implant | $208.83 |
| 6095984 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6095992 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6095997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096001 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6096003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096008 | STERILE SUPPLY | Supply/Implant | $454.14 |
| 6096034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6096036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6096041 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6096042 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,760.00 |
| 6096046 | GENERAL SUPPLY | Supply/Implant | $362.62 |
| 6096047 | GENERAL SUPPLY | Supply/Implant | $369.15 |
| 6096050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6096051 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6096052 | CATHETER, GUIDING | Supply/Implant | $25,536.00 |
| 6096064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,284.03 |
| 6096069 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6096071 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6096073 | STERILE SUPPLY | Supply/Implant | $159.21 |
| 6096074 | STERILE SUPPLY | Supply/Implant | $236.54 |
| 6096079 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6096095 | CATHETER, GUIDING | Supply/Implant | $31,616.00 |
| 6096097 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6096098 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6096099 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6096102 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6096104 | STERILE SUPPLY | Supply/Implant | $5,568.00 |
| 6096105 | SUPPLY IMPLANT | Supply/Implant | $92,800.00 |
| 6096107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6096112 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,840.00 |
| 6096114 | SUPPLY IMPLANT | Supply/Implant | $28,206.08 |
| 6096115 | AICD, DUAL CHAMBER | Supply/Implant | $193,315.50 |
| 6096122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6096123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6096129 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6096130 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6096131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6096135 | GENERAL SUPPLY | Supply/Implant | $315.52 |
| 6096137 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6096138 | GENERAL SUPPLY | Supply/Implant | $156.03 |
| 6096139 | GENERAL SUPPLY | Supply/Implant | $155.26 |
| 6096147 | SUPPLY IMPLANT | Supply/Implant | $178.82 |
| 6096150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,754.75 |
| 6096151 | SUPPLY IMPLANT | Supply/Implant | $3,408.00 |
| 6096153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096155 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096156 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6096175 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6096176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6096180 | MESH (IMPLANTABLE) | Supply/Implant | $28,552.70 |
| 6096186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6096187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6096188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,304.00 |
| 6096191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6096205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6096210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6096213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $712.83 |
| 6096215 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096236 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096237 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096241 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6096245 | MISC SUP/ACC IMP VAD | Supply/Implant | $135.68 |
| 6096275 | SUPPLY IMPLANT | Supply/Implant | $563.20 |
| 6096402 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6096403 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6096404 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6096405 | SUPPLY IMPLANT | Supply/Implant | $20,685.18 |
| 6096406 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $107,200.00 |
| 6096407 | GENERAL SUPPLY | Supply/Implant | $1,406.72 |
| 6096417 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,083.20 |
| 6096419 | SUPPLY IMPLANT | Supply/Implant | $1,977.60 |
| 6096420 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6096421 | SUPPLY IMPLANT | Supply/Implant | $4,473.60 |
| 6096424 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6096425 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6096428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,881.28 |
| 6096429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6096430 | MESH (IMPLANTABLE) | Supply/Implant | $14,195.46 |
| 6096432 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6096436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6096438 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6096441 | INTERSPINOUS IMPLANT | Supply/Implant | $75,008.00 |
| 6096454 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6096460 | MESH (IMPLANTABLE) | Supply/Implant | $13,824.00 |
| 6096475 | SUPPLY IMPLANT | Supply/Implant | $2,155.52 |
| 6096477 | MESH (IMPLANTABLE) | Supply/Implant | $7,110.78 |
| 6096481 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6096482 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6096483 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,201.60 |
| 6096484 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6096491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6096506 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $45,273.60 |
| 6096522 | GENERAL SUPPLY | Supply/Implant | $954.24 |
| 6096524 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6096526 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6096544 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6096545 | SUPPLY IMPLANT | Supply/Implant | $2,598.40 |
| 6096546 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6096556 | STERILE SUPPLY | Supply/Implant | $168.83 |
| 6096557 | STERILE SUPPLY | Supply/Implant | $1,110.78 |
| 6096560 | GENERAL SUPPLY | Supply/Implant | $227.84 |
| 6096561 | GUIDE WIRE | Supply/Implant | $6,374.40 |
| 6096562 | SUPPLY IMPLANT | Supply/Implant | $43,379.20 |
| 6096563 | CATHETER, GUIDING | Supply/Implant | $37,619.20 |
| 6096564 | SUPPLY IMPLANT | Supply/Implant | $5,696.00 |
| 6096565 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $24,819.20 |
| 6096576 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6096580 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $55,040.00 |
| 6096583 | LEAD, NEUROSTIMULATOR | Supply/Implant | $7,040.00 |
| 6096584 | SUPPLY IMPLANT | Supply/Implant | $9,267.20 |
| 6096592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6096593 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6096594 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6096597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6096599 | GENERAL SUPPLY | Supply/Implant | $129.79 |
| 6096600 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6096603 | SUPPLY IMPLANT | Supply/Implant | $7,776.51 |
| 6096610 | GENERAL SUPPLY | Supply/Implant | $5,940.35 |
| 6096635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6096636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6096638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6096640 | SUPPLY IMPLANT | Supply/Implant | $2,512.13 |
| 6096648 | SUPPLY IMPLANT | Supply/Implant | $2,620.80 |
| 6096649 | SUPPLY IMPLANT | Supply/Implant | $2,572.80 |
| 6096650 | SUPPLY IMPLANT | Supply/Implant | $4,368.00 |
| 6096653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6096691 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6096694 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6096696 | SUPPLY IMPLANT | Supply/Implant | $2,078.21 |
| 6096697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6096698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6096699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6096701 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6096703 | SUPPLY IMPLANT | Supply/Implant | $3,315.20 |
| 6096704 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6096717 | STERILE SUPPLY | Supply/Implant | $3,812.99 |
| 6096733 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096734 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096735 | SUPPLY IMPLANT | Supply/Implant | $13,570.88 |
| 6096736 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096737 | SUPPLY IMPLANT | Supply/Implant | $10,066.78 |
| 6096739 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6096741 | STERILE SUPPLY | Supply/Implant | $155.24 |
| 6096742 | STERILE SUPPLY | Supply/Implant | $164.04 |
| 6096743 | SUPPLY IMPLANT | Supply/Implant | $7,099.78 |
| 6096745 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6096746 | AICD, DUAL CHAMBER | Supply/Implant | $586,045.50 |
| 6096749 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6096750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6096754 | CATH, DRAINAGE | Supply/Implant | $10,854.40 |
| 6096755 | CATHETER, URETERAL | Supply/Implant | $488.86 |
| 6096756 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6096760 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6096767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6096769 | GRAFT, VASCULAR | Supply/Implant | $14,016.00 |
| 6096771 | STERILE SUPPLY | Supply/Implant | $1,497.60 |
| 6096775 | SEPTAL DEFECT IMP SYS | Supply/Implant | $111,360.00 |
| 6096776 | SEPTAL DEFECT IMP SYS | Supply/Implant | $111,360.00 |
| 6096777 | SEPTAL DEFECT IMP SYS | Supply/Implant | $111,360.00 |
| 6096779 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6096780 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6096789 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096790 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096791 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096792 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096797 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6096800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6096803 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6096804 | SUPPLY IMPLANT | Supply/Implant | $1,648.51 |
| 6096809 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6096819 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6096824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6096825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6096826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,737.60 |
| 6096827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6096828 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6096829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6096859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6096860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6096867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,606.40 |
| 6096870 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6096873 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6096879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,310.72 |
| 6096881 | GENERAL SUPPLY | Supply/Implant | $3,659.39 |
| 6096887 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6096889 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,417.60 |
| 6096901 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6096903 | CATHETER, GUIDING | Supply/Implant | $473.60 |
| 6096911 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,937.54 |
| 6096916 | SUPPLY IMPLANT | Supply/Implant | $4,595.20 |
| 6096922 | SUPPLY IMPLANT | Supply/Implant | $4,178.05 |
| 6096925 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6096926 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6096928 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6096929 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,299.20 |
| 6096930 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,299.20 |
| 6096937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6096939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6096941 | SUPPLY IMPLANT | Supply/Implant | $3,187.20 |
| 6096942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6096943 | SUPPLY IMPLANT | Supply/Implant | $480.00 |
| 6096945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,448.00 |
| 6096951 | GENERAL SUPPLY | Supply/Implant | $10,809.60 |
| 6096954 | SUPPLY IMPLANT | Supply/Implant | $5,926.78 |
| 6096959 | CONN TISS, NON-HUMAN | Supply/Implant | $26,560.00 |
| 6096960 | GRAFT, VASCULAR | Supply/Implant | $26,560.00 |
| 6096961 | GRAFT, VASCULAR | Supply/Implant | $26,560.00 |
| 6096962 | GRAFT, VASCULAR | Supply/Implant | $27,200.00 |
| 6096963 | GRAFT, VASCULAR | Supply/Implant | $27,200.00 |
| 6096966 | GRAFT, VASCULAR | Supply/Implant | $15,680.00 |
| 6096967 | CONN TISS, NON-HUMAN | Supply/Implant | $21,440.00 |
| 6096970 | CONN TISS, NON-HUMAN | Supply/Implant | $21,440.00 |
| 6096978 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6096980 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6096982 | STERILE SUPPLY | Supply/Implant | $355.71 |
| 6096987 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6096988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6096990 | SUPPLY IMPLANT | Supply/Implant | $547.20 |
| 6096991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6096992 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6096997 | SUPPLY IMPLANT | Supply/Implant | $6,931.20 |
| 6097001 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,600.00 |
| 6097003 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6097004 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6097005 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6097008 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6097010 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6097012 | SUPPLY IMPLANT | Supply/Implant | $28,966.40 |
| 6097015 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6097021 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6097029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6097032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6097041 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6097052 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6097056 | GENERAL SUPPLY | Supply/Implant | $448.00 |
| 6097064 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $48,064.00 |
| 6097073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,516.80 |
| 6097087 | GRAFT, VASCULAR | Supply/Implant | $15,219.20 |
| 6097094 | SUPPLY IMPLANT | Supply/Implant | $1,197.70 |
| 6097097 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6097104 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6097121 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6097122 | SUPPLY IMPLANT | Supply/Implant | $1,120.64 |
| 6097125 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,547.20 |
| 6097135 | RET DEV, INSERTABLE | Supply/Implant | $94,707.20 |
| 6097136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6097141 | CATHETER, GUIDING | Supply/Implant | $14,131.20 |
| 6097143 | SUPPLY IMPLANT | Supply/Implant | $8,737.15 |
| 6097144 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6097145 | STERILE SUPPLY | Supply/Implant | $1,987.20 |
| 6097146 | STERILE SUPPLY | Supply/Implant | $614.40 |
| 6097147 | GENERAL SUPPLY | Supply/Implant | $715.78 |
| 6097149 | GUIDE WIRE | Supply/Implant | $1,334.91 |
| 6097153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6097163 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,713.60 |
| 6097164 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6097167 | CATHETER, GUIDING | Supply/Implant | $16,115.20 |
| 6097168 | CATHETER, GUIDING | Supply/Implant | $16,115.20 |
| 6097169 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $24,819.20 |
| 6097172 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $9,715.20 |
| 6097174 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $14,579.20 |
| 6097175 | STERILE SUPPLY | Supply/Implant | $4,672.00 |
| 6097176 | GRAFT, VASCULAR | Supply/Implant | $57,830.40 |
| 6097177 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6097178 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6097181 | SUPPLY IMPLANT | Supply/Implant | $3,996.29 |
| 6097186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,752.00 |
| 6097195 | GENERAL SUPPLY | Supply/Implant | $213.12 |
| 6097196 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6097197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6097201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6097203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6097209 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6097210 | VENA CAVA FILTER | Supply/Implant | $13,440.00 |
| 6097211 | VENA CAVA FILTER | Supply/Implant | $15,360.00 |
| 6097213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,408.00 |
| 6097217 | SUPPLY IMPLANT | Supply/Implant | $106,752.00 |
| 6097218 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $4,236.80 |
| 6097222 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6097225 | INTRO/SHEATH, NON-LASER | Supply/Implant | $900.35 |
| 6097229 | GUIDE WIRE | Supply/Implant | $7,027.20 |
| 6097230 | GUIDE WIRE | Supply/Implant | $5,120.00 |
| 6097235 | CATH, DRAINAGE | Supply/Implant | $1,657.86 |
| 6097236 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6097238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $65,735.04 |
| 6097247 | SUPPLY IMPLANT | Supply/Implant | $168,301.46 |
| 6097251 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6097252 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6097253 | SUPPLY IMPLANT | Supply/Implant | $2,969.60 |
| 6097261 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6097262 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6097263 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6097277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,644.86 |
| 6097279 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6097280 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097283 | SUPPLY IMPLANT | Supply/Implant | $2,911.36 |
| 6097285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6097287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6097289 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6097291 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6097292 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6097293 | GUIDE WIRE | Supply/Implant | $912.38 |
| 6097294 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $10,048.00 |
| 6097295 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6097296 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6097301 | SUPPLY IMPLANT | Supply/Implant | $17,728.00 |
| 6097302 | INTERSPINOUS IMPLANT | Supply/Implant | $61,440.00 |
| 6097304 | GENERAL SUPPLY | Supply/Implant | $565.25 |
| 6097308 | SUPPLY IMPLANT | Supply/Implant | $2,969.60 |
| 6097309 | LEAD, NEUROSTIMULATOR | Supply/Implant | $35,840.00 |
| 6097311 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6097312 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6097314 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,360.00 |
| 6097315 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,360.00 |
| 6097316 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,512.00 |
| 6097318 | SUPPLY IMPLANT | Supply/Implant | $9,024.00 |
| 6097319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6097330 | STERILE SUPPLY | Supply/Implant | $2,560.00 |
| 6097338 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6097339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6097340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097341 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6097342 | SUPPLY IMPLANT | Supply/Implant | $484.10 |
| 6097345 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6097349 | SUPPLY IMPLANT | Supply/Implant | $37,476.10 |
| 6097352 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6097353 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6097359 | BRACHYTHERAPY NEEDLE | Supply/Implant | $6,336.00 |
| 6097364 | SUPPLY IMPLANT | Supply/Implant | $2,280.45 |
| 6097365 | SUPPLY IMPLANT | Supply/Implant | $796.80 |
| 6097368 | SUPPLY IMPLANT | Supply/Implant | $1,448.19 |
| 6097369 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6097370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,030.40 |
| 6097371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6097372 | SUPPLY IMPLANT | Supply/Implant | $2,280.45 |
| 6097376 | SUPPLY IMPLANT | Supply/Implant | $2,598.40 |
| 6097381 | SUPPLY IMPLANT | Supply/Implant | $665.60 |
| 6097383 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6097393 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6097400 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $95,091.20 |
| 6097401 | SUPPLY IMPLANT | Supply/Implant | $5,427.20 |
| 6097404 | SUPPLY IMPLANT | Supply/Implant | $3,993.60 |
| 6097407 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $32,000.00 |
| 6097408 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,631.68 |
| 6097412 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6097415 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $906.88 |
| 6097416 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $906.88 |
| 6097417 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6097425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6097428 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097429 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097430 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097431 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6097433 | SUPPLY IMPLANT | Supply/Implant | $1,447.04 |
| 6097435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6097437 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $10,048.00 |
| 6097438 | GENERAL SUPPLY | Supply/Implant | $132.35 |
| 6097448 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6097449 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6097454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6097459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6097460 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097461 | GENERAL SUPPLY | Supply/Implant | $1,033.22 |
| 6097463 | GENERAL SUPPLY | Supply/Implant | $1,467.52 |
| 6097465 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6097466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097467 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6097468 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6097470 | SUPPLY IMPLANT | Supply/Implant | $9,024.00 |
| 6097475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097480 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6097481 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097482 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6097483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6097485 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6097487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6097488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6097490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6097491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6097497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6097499 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6097524 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097525 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097526 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097527 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097528 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097529 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097530 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097531 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097532 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097533 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097534 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097535 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097536 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097537 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097538 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097539 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097540 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097541 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097542 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097543 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097544 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097545 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097546 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097547 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097548 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097549 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097550 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097551 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097552 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097553 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097554 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097555 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097556 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097557 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097558 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097559 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097560 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097561 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097562 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097563 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097564 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097565 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097566 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097567 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097568 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097569 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097570 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097571 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097575 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6097578 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6097580 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6097583 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6097584 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6097602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,248.00 |
| 6097603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,880.00 |
| 6097604 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6097605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6097606 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6097617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6097618 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6097619 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6097620 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6097623 | SUPPLY IMPLANT | Supply/Implant | $3,430.91 |
| 6097625 | GENERAL SUPPLY | Supply/Implant | $599.17 |
| 6097629 | PROSTHETIC IMPLANT NOS | Supply/Implant | $40,192.00 |
| 6097631 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6097632 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6097633 | SUPPLY IMPLANT | Supply/Implant | $9,678.34 |
| 6097634 | SUPPLY IMPLANT | Supply/Implant | $4,126.85 |
| 6097638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6097639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6097641 | SUPPLY IMPLANT | Supply/Implant | $656.64 |
| 6097642 | SUPPLY IMPLANT | Supply/Implant | $838.40 |
| 6097643 | SUPPLY IMPLANT | Supply/Implant | $2,225.92 |
| 6097648 | GUIDE WIRE | Supply/Implant | $6,571.78 |
| 6097658 | GUIDE WIRE | Supply/Implant | $2,841.60 |
| 6097659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6097660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6097667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,315.20 |
| 6097669 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6097670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6097671 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6097672 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6097673 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,680.00 |
| 6097684 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6097685 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6097686 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6097695 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6097698 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6097700 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097701 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097710 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6097711 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6097730 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6097731 | SUPPLY IMPLANT | Supply/Implant | $2,969.60 |
| 6097732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,840.00 |
| 6097733 | SUPPLY IMPLANT | Supply/Implant | $23,680.00 |
| 6097734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,299.20 |
| 6097735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,483.20 |
| 6097736 | SUPPLY IMPLANT | Supply/Implant | $13,440.00 |
| 6097737 | SUPPLY IMPLANT | Supply/Implant | $6,041.60 |
| 6097738 | STERILE SUPPLY | Supply/Implant | $678.40 |
| 6097739 | STERILE SUPPLY | Supply/Implant | $6,462.72 |
| 6097740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6097745 | GRAFT, VASCULAR | Supply/Implant | $83,200.00 |
| 6097757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,852.80 |
| 6097758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,092.80 |
| 6097760 | SUPPLY IMPLANT | Supply/Implant | $11,302.40 |
| 6097762 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6097763 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6097765 | GENERAL SUPPLY | Supply/Implant | $558.72 |
| 6097766 | SUPPLY IMPLANT | Supply/Implant | $496.77 |
| 6097777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,256.96 |
| 6097784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6097785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6097787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6097789 | SUPPLY IMPLANT | Supply/Implant | $36,032.00 |
| 6097790 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6097794 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097795 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097796 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097799 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097807 | SUPPLY IMPLANT | Supply/Implant | $1,648.38 |
| 6097808 | SUPPLY IMPLANT | Supply/Implant | $1,648.38 |
| 6097809 | SUPPLY IMPLANT | Supply/Implant | $1,648.38 |
| 6097818 | SUPPLY IMPLANT | Supply/Implant | $4,963.97 |
| 6097821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6097823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,924.80 |
| 6097825 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6097826 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6097827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6097833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6097850 | STERILE SUPPLY | Supply/Implant | $257.54 |
| 6097860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6097861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6097862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6097868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,644.86 |
| 6097869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,052.80 |
| 6097871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6097872 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,640.00 |
| 6097876 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6097879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,701.44 |
| 6097880 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6097882 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097883 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097884 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6097885 | SUPPLY IMPLANT | Supply/Implant | $547.20 |
| 6097886 | SUPPLY IMPLANT | Supply/Implant | $547.20 |
| 6097890 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,321.60 |
| 6097896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6097897 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6097901 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,091.20 |
| 6097902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,091.20 |
| 6097903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $842.24 |
| 6097911 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,998.40 |
| 6097914 | SUPPLY IMPLANT | Supply/Implant | $18,790.40 |
| 6097915 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6097926 | SUPPLY IMPLANT | Supply/Implant | $12,441.60 |
| 6097926 | SUPPLY IMPLANT | Supply/Implant | $25,294.85 |
| 6097928 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6097930 | SUPPLY IMPLANT | Supply/Implant | $511.36 |
| 6097937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6097945 | SUPPLY IMPLANT | Supply/Implant | $194.69 |
| 6097946 | BRACHYTHERAPY NEEDLE | Supply/Implant | $5,056.00 |
| 6097947 | SUPPLY IMPLANT | Supply/Implant | $83,968.00 |
| 6097952 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6097955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,174.27 |
| 6097956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6097957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6097973 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $76,864.00 |
| 6097975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $99,673.60 |
| 6097976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,148.80 |
| 6097977 | SUPPLY IMPLANT | Supply/Implant | $14,040.96 |
| 6097978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6097981 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097982 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6097984 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6097991 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6098046 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,072.00 |
| 6098048 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,125.25 |
| 6098049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,790.40 |
| 6098050 | SUPPLY IMPLANT | Supply/Implant | $18,790.40 |
| 6098051 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6098054 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6098055 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6098064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,017.60 |
| 6098065 | GENERAL SUPPLY | Supply/Implant | $327.42 |
| 6098066 | GENERAL SUPPLY | Supply/Implant | $163.71 |
| 6098067 | GENERAL SUPPLY | Supply/Implant | $318.08 |
| 6098068 | GENERAL SUPPLY | Supply/Implant | $318.08 |
| 6098069 | GENERAL SUPPLY | Supply/Implant | $318.08 |
| 6098070 | GENERAL SUPPLY | Supply/Implant | $278.40 |
| 6098074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6098075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6098079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6098082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6098083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,153.60 |
| 6098084 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6098085 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6098087 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6098088 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6098089 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6098090 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6098091 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6098093 | GRAFT, VASCULAR | Supply/Implant | $23,667.20 |
| 6098095 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6098100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,588.48 |
| 6098102 | SUPPLY IMPLANT | Supply/Implant | $1,737.09 |
| 6098104 | ALLODERM SKIN SUB | Supply/Implant | $65,369.60 |
| 6098106 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098110 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098111 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098114 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098115 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098116 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,984.00 |
| 6098118 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098119 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098120 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,960.00 |
| 6098124 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $25,984.00 |
| 6098126 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,960.00 |
| 6098140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6098141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $374.40 |
| 6098146 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6098153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6098154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6098155 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6098159 | SUPPLY IMPLANT | Supply/Implant | $23,546.88 |
| 6098161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6098162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6098164 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6098171 | SUPPLY IMPLANT | Supply/Implant | $13,760.00 |
| 6098177 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6098189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6098190 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6098191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6098201 | SUPPLY IMPLANT | Supply/Implant | $5,043.97 |
| 6098202 | SUPPLY IMPLANT | Supply/Implant | $1,421.44 |
| 6098203 | SUPPLY IMPLANT | Supply/Implant | $2,727.90 |
| 6098207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6098208 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6098209 | SUPPLY IMPLANT | Supply/Implant | $5,735.17 |
| 6098211 | SUPPLY IMPLANT | Supply/Implant | $4,663.77 |
| 6098212 | SUPPLY IMPLANT | Supply/Implant | $6,113.32 |
| 6098220 | GUIDE WIRE | Supply/Implant | $5,312.00 |
| 6098229 | GUIDE WIRE | Supply/Implant | $2,163.20 |
| 6098236 | GENERAL SUPPLY | Supply/Implant | $358.40 |
| 6098240 | SUPPLY IMPLANT | Supply/Implant | $5,632.00 |
| 6098246 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $2,560.00 |
| 6098248 | CATH OCCLUSION | Supply/Implant | $8,320.00 |
| 6098256 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6098259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,582.40 |
| 6098260 | STERILE SUPPLY | Supply/Implant | $2,764.80 |
| 6098262 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098263 | GENERAL SUPPLY | Supply/Implant | $298.88 |
| 6098269 | CATH OCCLUSION | Supply/Implant | $5,504.00 |
| 6098272 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6098273 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6098275 | GENERAL SUPPLY | Supply/Implant | $212.10 |
| 6098277 | GENERAL SUPPLY | Supply/Implant | $155.39 |
| 6098284 | GUIDE WIRE | Supply/Implant | $332.80 |
| 6098286 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6098287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6098300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6098307 | SUPPLY IMPLANT | Supply/Implant | $6,364.93 |
| 6098308 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6098309 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $3,497.45 |
| 6098322 | MESH (IMPLANTABLE) | Supply/Implant | $69,760.00 |
| 6098323 | MESH (IMPLANTABLE) | Supply/Implant | $116,480.00 |
| 6098324 | MESH (IMPLANTABLE) | Supply/Implant | $143,587.50 |
| 6098325 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098327 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098335 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6098343 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098345 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098347 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,432.00 |
| 6098350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6098352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6098353 | STERILE SUPPLY | Supply/Implant | $3,571.20 |
| 6098355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6098356 | SUPPLY IMPLANT | Supply/Implant | $1,561.60 |
| 6098357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,630.40 |
| 6098359 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,312.00 |
| 6098367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,196.16 |
| 6098369 | SUPPLY IMPLANT | Supply/Implant | $38,326.40 |
| 6098373 | GENERAL SUPPLY | Supply/Implant | $2,904.83 |
| 6098374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $977.41 |
| 6098376 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098378 | AICD, SINGLE CHAMBER | Supply/Implant | $169,312.50 |
| 6098388 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6098398 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6098401 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,600.00 |
| 6098402 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,600.00 |
| 6098405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,582.40 |
| 6098406 | STERILE SUPPLY | Supply/Implant | $1,013.38 |
| 6098408 | SUPPLY IMPLANT | Supply/Implant | $745.34 |
| 6098414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6098416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6098419 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $707.84 |
| 6098427 | SUPPLY IMPLANT | Supply/Implant | $524.80 |
| 6098429 | SUPPLY IMPLANT | Supply/Implant | $530.82 |
| 6098430 | SUPPLY IMPLANT | Supply/Implant | $12,672.00 |
| 6098438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6098443 | SUPPLY IMPLANT | Supply/Implant | $225.54 |
| 6098444 | SUPPLY IMPLANT | Supply/Implant | $137.42 |
| 6098449 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $793.60 |
| 6098450 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $793.60 |
| 6098455 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6098457 | CATH, DRAINAGE | Supply/Implant | $168.32 |
| 6098461 | SUPPLY IMPLANT | Supply/Implant | $170.79 |
| 6098465 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098466 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098467 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098468 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098469 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098470 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098471 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6098472 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098473 | CATH, DRAINAGE | Supply/Implant | $228.52 |
| 6098474 | SUPPLY IMPLANT | Supply/Implant | $3,912.70 |
| 6098475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,413.18 |
| 6098479 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6098481 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6098485 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,421.76 |
| 6098486 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6098496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,421.76 |
| 6098497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098498 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098500 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098501 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,705.79 |
| 6098502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,421.76 |
| 6098506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,091.20 |
| 6098511 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6098517 | STERILE SUPPLY | Supply/Implant | $1,007.10 |
| 6098518 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6098524 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6098525 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6098526 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6098532 | SUPPLY IMPLANT | Supply/Implant | $50,560.00 |
| 6098534 | GRAFT, VASCULAR | Supply/Implant | $108,267.01 |
| 6098535 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6098536 | STERILE SUPPLY | Supply/Implant | $180.22 |
| 6098541 | STERILE SUPPLY | Supply/Implant | $4,300.93 |
| 6098543 | GENERAL SUPPLY | Supply/Implant | $231.55 |
| 6098546 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6098554 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6098560 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6098564 | SUPPLY IMPLANT | Supply/Implant | $2,179.20 |
| 6098579 | CATH, DRAINAGE | Supply/Implant | $4,257.79 |
| 6098581 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,553.86 |
| 6098583 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6098585 | GENERAL SUPPLY | Supply/Implant | $162.43 |
| 6098590 | GENERAL SUPPLY | Supply/Implant | $712.45 |
| 6098598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,006.40 |
| 6098603 | GENERAL SUPPLY | Supply/Implant | $739.84 |
| 6098608 | STERILE SUPPLY | Supply/Implant | $701.18 |
| 6098609 | STERILE SUPPLY | Supply/Implant | $1,024.51 |
| 6098611 | GENERAL SUPPLY | Supply/Implant | $534.78 |
| 6098612 | STERILE SUPPLY | Supply/Implant | $1,113.73 |
| 6098613 | STERILE SUPPLY | Supply/Implant | $2,264.45 |
| 6098614 | STERILE SUPPLY | Supply/Implant | $923.07 |
| 6098615 | STERILE SUPPLY | Supply/Implant | $1,062.66 |
| 6098616 | STERILE SUPPLY | Supply/Implant | $1,688.70 |
| 6098618 | STERILE SUPPLY | Supply/Implant | $1,618.05 |
| 6098619 | STERILE SUPPLY | Supply/Implant | $946.94 |
| 6098620 | GENERAL SUPPLY | Supply/Implant | $1,182.85 |
| 6098621 | STERILE SUPPLY | Supply/Implant | $1,059.71 |
| 6098625 | STERILE SUPPLY | Supply/Implant | $650.50 |
| 6098626 | STERILE SUPPLY | Supply/Implant | $554.37 |
| 6098628 | GENERAL SUPPLY | Supply/Implant | $198.78 |
| 6098639 | GENERAL SUPPLY | Supply/Implant | $146.56 |
| 6098644 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6098645 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6098652 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098653 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098655 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098656 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098657 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098659 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098660 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098664 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098665 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098669 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098671 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098672 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098673 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098674 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098678 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098679 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098680 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098681 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098682 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098684 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098685 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098687 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098688 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098689 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098690 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098691 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098692 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098693 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098694 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098695 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098696 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098706 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098710 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098711 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098712 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,161.60 |
| 6098716 | GUIDE WIRE | Supply/Implant | $597.76 |
| 6098720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6098724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6098725 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6098726 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,559.04 |
| 6098727 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6098729 | STERILE SUPPLY | Supply/Implant | $264.58 |
| 6098758 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6098762 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6098766 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6098770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6098771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,100.80 |
| 6098780 | SUPPLY IMPLANT | Supply/Implant | $29,387.14 |
| 6098781 | SUPPLY IMPLANT | Supply/Implant | $14,040.96 |
| 6098782 | SUPPLY IMPLANT | Supply/Implant | $16,089.60 |
| 6098783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6098784 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6098787 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6098788 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6098795 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6098800 | GENERAL SUPPLY | Supply/Implant | $1,653.38 |
| 6098801 | CONN TISS, NON-HUMAN | Supply/Implant | $6,144.00 |
| 6098803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6098804 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6098805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6098806 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6098810 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6098824 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6098826 | SUPPLY IMPLANT | Supply/Implant | $37,657.60 |
| 6098831 | GENERAL SUPPLY | Supply/Implant | $162.94 |
| 6098838 | SUPPLY IMPLANT | Supply/Implant | $3,403.52 |
| 6098839 | SUPPLY IMPLANT | Supply/Implant | $2,659.20 |
| 6098841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6098845 | BRACHYTHERAPY NEEDLE | Supply/Implant | $219.90 |
| 6098846 | SUPPLY IMPLANT | Supply/Implant | $140.16 |
| 6098854 | GENERAL SUPPLY | Supply/Implant | $204.67 |
| 6098859 | SUPPLY IMPLANT | Supply/Implant | $2,418.43 |
| 6098860 | EVENT RECORDER CARDIAC | Supply/Implant | $63,936.00 |
| 6098861 | GENERAL SUPPLY | Supply/Implant | $723.30 |
| 6098870 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098871 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098873 | STERILE SUPPLY | Supply/Implant | $259.58 |
| 6098883 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,953.54 |
| 6098887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6098888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6098892 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6098893 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6098894 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6098895 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6098907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,786.56 |
| 6098908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,786.56 |
| 6098931 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,945.73 |
| 6098933 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6098943 | SUPPLY IMPLANT | Supply/Implant | $19,909.12 |
| 6098945 | SUPPLY IMPLANT | Supply/Implant | $6,118.40 |
| 6098946 | SUPPLY IMPLANT | Supply/Implant | $6,118.40 |
| 6098948 | SUPPLY IMPLANT | Supply/Implant | $49,523.20 |
| 6098951 | SUPPLY IMPLANT | Supply/Implant | $63,308.80 |
| 6098952 | SUPPLY IMPLANT | Supply/Implant | $63,308.80 |
| 6098953 | SUPPLY IMPLANT | Supply/Implant | $63,308.80 |
| 6098954 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6098957 | SUPPLY IMPLANT | Supply/Implant | $672.55 |
| 6098962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6098963 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6098971 | GENERAL SUPPLY | Supply/Implant | $820.22 |
| 6098973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6098974 | GUIDE WIRE | Supply/Implant | $204.29 |
| 6098975 | STERILE SUPPLY | Supply/Implant | $149.45 |
| 6098984 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6098991 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6098992 | SUPPLY IMPLANT | Supply/Implant | $1,720.19 |
| 6098993 | SUPPLY IMPLANT | Supply/Implant | $1,755.26 |
| 6098994 | SUPPLY IMPLANT | Supply/Implant | $1,624.45 |
| 6098995 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6098996 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6098998 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6099000 | SUPPLY IMPLANT | Supply/Implant | $864.00 |
| 6099009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6099011 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6099016 | STERILE SUPPLY | Supply/Implant | $318.34 |
| 6099018 | GENERAL SUPPLY | Supply/Implant | $797.95 |
| 6099030 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6099031 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099032 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099033 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099039 | STERILE SUPPLY | Supply/Implant | $133.89 |
| 6099045 | STERILE SUPPLY | Supply/Implant | $7,616.00 |
| 6099046 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6099056 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6099057 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6099059 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6099060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099061 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099063 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6099074 | GENERAL SUPPLY | Supply/Implant | $1,327.10 |
| 6099075 | GENERAL SUPPLY | Supply/Implant | $160.13 |
| 6099101 | GENERAL SUPPLY | Supply/Implant | $585.98 |
| 6099131 | GENERAL SUPPLY | Supply/Implant | $1,445.50 |
| 6099162 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6099170 | SUPPLY IMPLANT | Supply/Implant | $19,033.60 |
| 6099175 | STERILE SUPPLY | Supply/Implant | $6,336.00 |
| 6099177 | SUPPLY IMPLANT | Supply/Implant | $199.68 |
| 6099178 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $284.98 |
| 6099182 | GENERAL SUPPLY | Supply/Implant | $531.58 |
| 6099183 | SUPPLY IMPLANT | Supply/Implant | $4,722.69 |
| 6099184 | SUPPLY IMPLANT | Supply/Implant | $4,200.83 |
| 6099188 | CATHETER, GUIDING | Supply/Implant | $282.11 |
| 6099189 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,977.60 |
| 6099190 | SUPPLY IMPLANT | Supply/Implant | $611.71 |
| 6099191 | CATHETER, GUIDING | Supply/Implant | $2,162.18 |
| 6099192 | CATHETER, GUIDING | Supply/Implant | $2,162.18 |
| 6099193 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099196 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099198 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099199 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6099201 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,977.60 |
| 6099202 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6099204 | STERILE SUPPLY | Supply/Implant | $154.11 |
| 6099206 | STERILE SUPPLY | Supply/Implant | $321.79 |
| 6099207 | STERILE SUPPLY | Supply/Implant | $892.16 |
| 6099211 | GENERAL SUPPLY | Supply/Implant | $207.99 |
| 6099215 | STERILE SUPPLY | Supply/Implant | $160.64 |
| 6099227 | SUPPLY IMPLANT | Supply/Implant | $569.09 |
| 6099231 | STERILE SUPPLY | Supply/Implant | $223.74 |
| 6099234 | SUPPLY IMPLANT | Supply/Implant | $182.27 |
| 6099237 | STERILE SUPPLY | Supply/Implant | $245.38 |
| 6099239 | STERILE SUPPLY | Supply/Implant | $146.33 |
| 6099243 | GENERAL SUPPLY | Supply/Implant | $722.18 |
| 6099244 | STERILE SUPPLY | Supply/Implant | $443.72 |
| 6099250 | GENERAL SUPPLY | Supply/Implant | $277.38 |
| 6099251 | GENERAL SUPPLY | Supply/Implant | $224.00 |
| 6099256 | GENERAL SUPPLY | Supply/Implant | $194.56 |
| 6099259 | GENERAL SUPPLY | Supply/Implant | $151.68 |
| 6099264 | STERILE SUPPLY | Supply/Implant | $140.54 |
| 6099266 | STERILE SUPPLY | Supply/Implant | $546.69 |
| 6099270 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099271 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099274 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099275 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099276 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099279 | GUIDE WIRE | Supply/Implant | $478.59 |
| 6099281 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,769.60 |
| 6099282 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6099285 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099291 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,090.88 |
| 6099293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6099294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6099295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6099296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6099301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6099305 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6099306 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6099307 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6099321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,863.68 |
| 6099349 | SUPPLY IMPLANT | Supply/Implant | $3,302.66 |
| 6099350 | SUPPLY IMPLANT | Supply/Implant | $2,044.80 |
| 6099352 | SUPPLY IMPLANT | Supply/Implant | $669.18 |
| 6099359 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6099363 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6099364 | STERILE SUPPLY | Supply/Implant | $254.72 |
| 6099365 | SUPPLY IMPLANT | Supply/Implant | $206.22 |
| 6099368 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,504.00 |
| 6099369 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6099371 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6099372 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6099373 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6099374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,950.40 |
| 6099376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6099377 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6099378 | SUPPLY IMPLANT | Supply/Implant | $6,310.40 |
| 6099384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6099385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6099386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6099387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6099394 | SUPPLY IMPLANT | Supply/Implant | $2,795.52 |
| 6099398 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6099399 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6099400 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6099405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6099406 | SUPPLY IMPLANT | Supply/Implant | $2,741.76 |
| 6099407 | SUPPLY IMPLANT | Supply/Implant | $2,634.24 |
| 6099408 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6099409 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6099411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6099415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6099417 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6099418 | CATHETER, GUIDING | Supply/Implant | $1,365.76 |
| 6099419 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099421 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6099422 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6099425 | STERILE SUPPLY | Supply/Implant | $206.08 |
| 6099428 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6099429 | INTRO/SHEATH, NON-LASER | Supply/Implant | $614.40 |
| 6099432 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $39,635.20 |
| 6099434 | STERILE SUPPLY | Supply/Implant | $5,824.00 |
| 6099520 | STERILE SUPPLY | Supply/Implant | $165.38 |
| 6099529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $543.62 |
| 6099530 | SUPPLY IMPLANT | Supply/Implant | $559.36 |
| 6099546 | GENERAL SUPPLY | Supply/Implant | $227.84 |
| 6099547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6099552 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099553 | SUPPLY IMPLANT | Supply/Implant | $163.20 |
| 6099554 | PORT, INDWELLING, IMP | Supply/Implant | $15,374.34 |
| 6099555 | SUPPLY IMPLANT | Supply/Implant | $22,476.29 |
| 6099562 | CATHETER, GUIDING | Supply/Implant | $619.52 |
| 6099574 | STERILE SUPPLY | Supply/Implant | $187.26 |
| 6099575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,120.32 |
| 6099590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6099591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6099593 | SUPPLY IMPLANT | Supply/Implant | $3,123.20 |
| 6099595 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,242.30 |
| 6099600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6099603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6099604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6099607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6099608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099611 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6099617 | INTRO/SHEATH, NON-LASER | Supply/Implant | $598.27 |
| 6099618 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,504.00 |
| 6099619 | SUPPLY IMPLANT | Supply/Implant | $25,241.60 |
| 6099621 | SUPPLY IMPLANT | Supply/Implant | $25,241.60 |
| 6099622 | SUPPLY IMPLANT | Supply/Implant | $25,241.60 |
| 6099623 | SUPPLY IMPLANT | Supply/Implant | $15,987.20 |
| 6099625 | RET DEV, INSERTABLE | Supply/Implant | $95,936.00 |
| 6099629 | STERILE SUPPLY | Supply/Implant | $2,112.00 |
| 6099632 | PROSTHETIC IMPLANT NOS | Supply/Implant | $50,560.00 |
| 6099633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6099634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6099637 | SUPPLY IMPLANT | Supply/Implant | $34,560.00 |
| 6099643 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6099644 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6099645 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6099647 | GENERAL SUPPLY | Supply/Implant | $211.33 |
| 6099651 | GENERAL SUPPLY | Supply/Implant | $163.33 |
| 6099653 | GENERAL SUPPLY | Supply/Implant | $961.02 |
| 6099657 | GENERAL SUPPLY | Supply/Implant | $820.22 |
| 6099658 | SUPPLY IMPLANT | Supply/Implant | $672.55 |
| 6099667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6099674 | SUPPLY IMPLANT | Supply/Implant | $2,805.76 |
| 6099675 | GENERAL SUPPLY | Supply/Implant | $2,560.00 |
| 6099677 | GENERAL SUPPLY | Supply/Implant | $2,528.00 |
| 6099678 | GENERAL SUPPLY | Supply/Implant | $5,440.00 |
| 6099686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6099688 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6099689 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6099691 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6099693 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6099694 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $54,732.80 |
| 6099695 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $53,580.80 |
| 6099697 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099699 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099702 | MESH (IMPLANTABLE) | Supply/Implant | $66,496.00 |
| 6099719 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6099720 | SUPPLY IMPLANT | Supply/Implant | $89,600.00 |
| 6099721 | SUPPLY IMPLANT | Supply/Implant | $87,040.00 |
| 6099722 | SUPPLY IMPLANT | Supply/Implant | $92,160.00 |
| 6099723 | SUPPLY IMPLANT | Supply/Implant | $74,124.80 |
| 6099724 | STERILE SUPPLY | Supply/Implant | $738.43 |
| 6099725 | STERILE SUPPLY | Supply/Implant | $154.21 |
| 6099737 | SUPPLY IMPLANT | Supply/Implant | $569.22 |
| 6099738 | GENERAL SUPPLY | Supply/Implant | $569.22 |
| 6099739 | GENERAL SUPPLY | Supply/Implant | $193.41 |
| 6099743 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6099744 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6099746 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6099748 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6099756 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6099757 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099758 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099759 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6099761 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,136.00 |
| 6099762 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099763 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099764 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6099765 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,040.00 |
| 6099767 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099768 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $22,976.00 |
| 6099769 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6099770 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6099777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,612.80 |
| 6099778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6099788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6099791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6099793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6099794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6099799 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6099802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.86 |
| 6099831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099864 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6099869 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6099874 | CATHETER, GUIDING | Supply/Implant | $38,272.00 |
| 6099875 | STERILE SUPPLY | Supply/Implant | $3,660.80 |
| 6099879 | SUPPLY IMPLANT | Supply/Implant | $435.67 |
| 6099886 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6099887 | SUPPLY IMPLANT | Supply/Implant | $12,840.96 |
| 6099895 | SUPPLY IMPLANT | Supply/Implant | $6,430.59 |
| 6099896 | SUPPLY IMPLANT | Supply/Implant | $6,430.59 |
| 6099897 | MESH (IMPLANTABLE) | Supply/Implant | $58,438.66 |
| 6099905 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $17,920.00 |
| 6099909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,953.54 |
| 6099913 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6099929 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6099938 | SUPPLY IMPLANT | Supply/Implant | $5,081.60 |
| 6099939 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6099942 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6099945 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6099948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,472.00 |
| 6099954 | SUPPLY IMPLANT | Supply/Implant | $8,908.80 |
| 6099956 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6099960 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6099964 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099966 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099967 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099968 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099970 | SUPPLY IMPLANT | Supply/Implant | $32,968.96 |
| 6099971 | CATHETER, GUIDING | Supply/Implant | $19,430.40 |
| 6099972 | CATHETER, GUIDING | Supply/Implant | $26,969.60 |
| 6099973 | CATHETER, GUIDING | Supply/Implant | $26,969.60 |
| 6099979 | SUPPLY IMPLANT | Supply/Implant | $1,318.40 |
| 6099981 | SUPPLY IMPLANT | Supply/Implant | $7,659.52 |
| 6099984 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $665.60 |
| 6099992 | SUPPLY IMPLANT | Supply/Implant | $1,100.80 |
| 6099993 | SUPPLY IMPLANT | Supply/Implant | $2,700.80 |
| 6099998 | SUPPLY IMPLANT | Supply/Implant | $5,411.20 |
| 6100001 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6100002 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6100004 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $21,120.00 |
| 6100005 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,641.60 |
| 6100016 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,000.00 |
| 6100021 | SUPPLY IMPLANT | Supply/Implant | $22,976.00 |
| 6100023 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6100024 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6100027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6100039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6100046 | STERILE SUPPLY | Supply/Implant | $2,688.00 |
| 6100047 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6100048 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6100049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6100052 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6100058 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6100060 | SUPPLY IMPLANT | Supply/Implant | $30,528.00 |
| 6100062 | SUPPLY IMPLANT | Supply/Implant | $30,528.00 |
| 6100064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6100065 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6100066 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6100076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6100077 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6100082 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6100084 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6100085 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6100091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6100099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6100100 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6100101 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6100102 | SUPPLY IMPLANT | Supply/Implant | $6,476.80 |
| 6100103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,705.60 |
| 6100104 | STERILE SUPPLY | Supply/Implant | $1,728.00 |
| 6100105 | SUPPLY IMPLANT | Supply/Implant | $3,958.95 |
| 6100106 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,521.86 |
| 6100116 | GENERAL SUPPLY | Supply/Implant | $281.60 |
| 6100119 | GUIDE WIRE | Supply/Implant | $3,087.74 |
| 6100124 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6100130 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100136 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100141 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100142 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100143 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100148 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6100157 | SUPPLY IMPLANT | Supply/Implant | $15,027.20 |
| 6100161 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6100176 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6100182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6100186 | SUPPLY IMPLANT | Supply/Implant | $11,814.40 |
| 6100191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,120.00 |
| 6100194 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100195 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100198 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100201 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100206 | SUPPLY IMPLANT | Supply/Implant | $29,120.00 |
| 6100212 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6100217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,760.00 |
| 6100229 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6100234 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6100237 | GRAFT, VASCULAR | Supply/Implant | $127,987.20 |
| 6100238 | GRAFT, VASCULAR | Supply/Implant | $51,187.20 |
| 6100244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,231.68 |
| 6100245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6100250 | SUPPLY IMPLANT | Supply/Implant | $478.72 |
| 6100254 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6100255 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6100256 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,580.80 |
| 6100258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6100264 | STERILE SUPPLY | Supply/Implant | $173.70 |
| 6100268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6100271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6100277 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6100278 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6100279 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6100287 | GENERAL SUPPLY | Supply/Implant | $1,046.91 |
| 6100289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6100290 | SUPPLY IMPLANT | Supply/Implant | $2,060.80 |
| 6100293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,469.95 |
| 6100294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6100301 | SUPPLY IMPLANT | Supply/Implant | $14,673.79 |
| 6100306 | SUPPLY IMPLANT | Supply/Implant | $1,177.60 |
| 6100310 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6100315 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6100316 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6100317 | SUPPLY IMPLANT | Supply/Implant | $6,284.80 |
| 6100318 | SUPPLY IMPLANT | Supply/Implant | $1,421.44 |
| 6100319 | SUPPLY IMPLANT | Supply/Implant | $2,918.23 |
| 6100322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6100323 | SUPPLY IMPLANT | Supply/Implant | $9,932.80 |
| 6100324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6100325 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6100328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6100330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6100331 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6100333 | LEAD, NEUROSTIMULATOR | Supply/Implant | $92,032.00 |
| 6100334 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6100340 | SUPPLY IMPLANT | Supply/Implant | $1,550.34 |
| 6100342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,141.44 |
| 6100343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6100345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6100346 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6100347 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6100366 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,880.00 |
| 6100371 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,880.00 |
| 6100372 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6100373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6100374 | STERILE SUPPLY | Supply/Implant | $625.79 |
| 6100381 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6100386 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6100388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $259.84 |
| 6100389 | SUPPLY IMPLANT | Supply/Implant | $2,467.84 |
| 6100394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6100396 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6100400 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6100402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6100403 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6100409 | SUPPLY IMPLANT | Supply/Implant | $282,800.00 |
| 6100412 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6100414 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6100417 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6100418 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6100419 | SUPPLY IMPLANT | Supply/Implant | $2,645.38 |
| 6100420 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6100421 | SUPPLY IMPLANT | Supply/Implant | $362.88 |
| 6100428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,280.00 |
| 6100430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,606.40 |
| 6100433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6100434 | GENERAL SUPPLY | Supply/Implant | $313.60 |
| 6100447 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6100448 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $124,800.00 |
| 6100449 | GUIDE WIRE | Supply/Implant | $129.02 |
| 6100466 | SUPPLY IMPLANT | Supply/Implant | $1,305.60 |
| 6100467 | STERILE SUPPLY | Supply/Implant | $234.88 |
| 6100477 | SUPPLY IMPLANT | Supply/Implant | $248.06 |
| 6100478 | SUPPLY IMPLANT | Supply/Implant | $442.38 |
| 6100479 | SUPPLY IMPLANT | Supply/Implant | $248.06 |
| 6100480 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6100482 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $184.58 |
| 6100483 | SUPPLY IMPLANT | Supply/Implant | $951.04 |
| 6100484 | SUPPLY IMPLANT | Supply/Implant | $951.04 |
| 6100485 | CATHETER, GUIDING | Supply/Implant | $21,120.00 |
| 6100486 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6100487 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6100495 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,193.41 |
| 6100497 | SUPPLY IMPLANT | Supply/Implant | $46,771.20 |
| 6100502 | SUPPLY IMPLANT | Supply/Implant | $1,885.31 |
| 6100504 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6100509 | SUPPLY IMPLANT | Supply/Implant | $1,532.16 |
| 6100510 | GUIDE WIRE | Supply/Implant | $229.89 |
| 6100514 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6100515 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6100516 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $13,760.00 |
| 6100517 | SUPPLY IMPLANT | Supply/Implant | $496.00 |
| 6100518 | SUPPLY IMPLANT | Supply/Implant | $496.00 |
| 6100521 | SUPPLY IMPLANT | Supply/Implant | $294.66 |
| 6100523 | GUIDE WIRE | Supply/Implant | $129.02 |
| 6100525 | GUIDE WIRE | Supply/Implant | $129.02 |
| 6100526 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $1,056.00 |
| 6100531 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6100537 | INTRO/SHEATH, NON-LASER | Supply/Implant | $293.12 |
| 6100546 | GRAFT, VASCULAR | Supply/Implant | $19,827.20 |
| 6100552 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6100553 | GENERAL SUPPLY | Supply/Implant | $230.40 |
| 6100561 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6100562 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6100563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6100572 | GENERAL SUPPLY | Supply/Implant | $2,312.32 |
| 6100573 | SUPPLY IMPLANT | Supply/Implant | $1,530.11 |
| 6100576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,400.32 |
| 6100577 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6100582 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,164.80 |
| 6100586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6100587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6100588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,504.00 |
| 6100593 | PORT, INDWELLING, IMP | Supply/Implant | $4,800.00 |
| 6100595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6100604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $277.76 |
| 6100608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6100609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6100619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100622 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6100628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6100630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6100631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6100633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6100634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6100635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6100636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6100637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6100638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6100639 | CATH, DRAINAGE | Supply/Implant | $8,817.41 |
| 6100640 | CATHETER, GUIDING | Supply/Implant | $1,337.60 |
| 6100641 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6100642 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,056.00 |
| 6100643 | CATHETER, GUIDING | Supply/Implant | $385.92 |
| 6100652 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,792.00 |
| 6100658 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6100668 | STERILE SUPPLY | Supply/Implant | $131.07 |
| 6100689 | STERILE SUPPLY | Supply/Implant | $639.10 |
| 6100696 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6100701 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6100710 | SUPPLY IMPLANT | Supply/Implant | $2,087.68 |
| 6100711 | SUPPLY IMPLANT | Supply/Implant | $3,834.88 |
| 6100712 | SUPPLY IMPLANT | Supply/Implant | $2,805.76 |
| 6100777 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100778 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100779 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100800 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100801 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100814 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6100815 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100816 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6100819 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,480.00 |
| 6100820 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6100821 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6100824 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6100836 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100839 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100840 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100844 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100845 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100847 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100848 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100849 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100850 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100852 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100853 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100856 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100858 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100859 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100860 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100861 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100862 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100878 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100902 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100916 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100917 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6100969 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6100992 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6101028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6101035 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,760.00 |
| 6101036 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,760.00 |
| 6101038 | SUPPLY IMPLANT | Supply/Implant | $3,691.52 |
| 6101065 | GUIDE WIRE | Supply/Implant | $1,276.80 |
| 6101068 | GENERAL SUPPLY | Supply/Implant | $490.62 |
| 6101108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6101110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,118.78 |
| 6101111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101121 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6101131 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6101134 | INTRO/SHEATH, NON-LASER | Supply/Implant | $640.00 |
| 6101204 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,432.00 |
| 6101207 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,916.80 |
| 6101217 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6101296 | STERILE SUPPLY | Supply/Implant | $9,984.00 |
| 6101305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6101306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6101311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6101312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6101316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,542.72 |
| 6101330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,478.40 |
| 6101343 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6101344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,778.88 |
| 6101345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,970.56 |
| 6101352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6101356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,811.20 |
| 6101357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,811.20 |
| 6101358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,811.20 |
| 6101364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6101367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6101391 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101401 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101453 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101456 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101464 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101467 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6101495 | SUPPLY IMPLANT | Supply/Implant | $6,048.00 |
| 6101521 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6101524 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6101526 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6101555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6101556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6101561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6101586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6101608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6101623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6101624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6101625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6101642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6101643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6101652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6101660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6101672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6101680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6101682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6101693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6101700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6101705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6101708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6101709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6101710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6101711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6101712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6101713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6101721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6101723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6101724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6101727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,470.59 |
| 6101729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6101770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6101776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6101824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6101841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6101872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6101894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6101895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6101896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6102071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,765.12 |
| 6102072 | CATH, DRAINAGE | Supply/Implant | $7,966.08 |
| 6102073 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6102080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6102081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6102082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6102088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6102093 | GENERAL SUPPLY | Supply/Implant | $536.19 |
| 6102095 | CATHETER, GUIDING | Supply/Implant | $443.52 |
| 6102097 | MESH (IMPLANTABLE) | Supply/Implant | $8,307.20 |
| 6102099 | GRAFT, VASCULAR | Supply/Implant | $57,830.40 |
| 6102100 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6102106 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6102110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6102116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102129 | SUPPLY IMPLANT | Supply/Implant | $9,081.60 |
| 6102132 | GENERAL SUPPLY | Supply/Implant | $479.87 |
| 6102133 | GENERAL SUPPLY | Supply/Implant | $466.83 |
| 6102134 | GENERAL SUPPLY | Supply/Implant | $670.85 |
| 6102135 | GENERAL SUPPLY | Supply/Implant | $708.86 |
| 6102138 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6102139 | STERILE SUPPLY | Supply/Implant | $182.66 |
| 6102140 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6102141 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6102145 | CATH, DRAINAGE | Supply/Implant | $1,600.00 |
| 6102152 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6102153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6102154 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,321.60 |
| 6102157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,356.80 |
| 6102158 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6102164 | GRAFT, VASCULAR | Supply/Implant | $3,316.61 |
| 6102165 | GRAFT, VASCULAR | Supply/Implant | $5,725.70 |
| 6102175 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,235.84 |
| 6102200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6102201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6102217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,816.00 |
| 6102218 | GENERAL SUPPLY | Supply/Implant | $7,270.40 |
| 6102221 | GENERAL SUPPLY | Supply/Implant | $11,266.56 |
| 6102230 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6102231 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $54,732.80 |
| 6102232 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,304.00 |
| 6102233 | SUPPLY IMPLANT | Supply/Implant | $4,940.80 |
| 6102235 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,312.00 |
| 6102240 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6102241 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6102242 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6102243 | SUPPLY IMPLANT | Supply/Implant | $220.16 |
| 6102244 | SUPPLY IMPLANT | Supply/Implant | $1,248.00 |
| 6102245 | SUPPLY IMPLANT | Supply/Implant | $2,238.59 |
| 6102247 | SUPPLY IMPLANT | Supply/Implant | $1,410.94 |
| 6102249 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6102250 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6102251 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6102252 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6102253 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6102301 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6102302 | CATHETER, GUIDING | Supply/Implant | $465.92 |
| 6102303 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6102304 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6102306 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6102307 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6102314 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6102315 | CATHETER, URETERAL | Supply/Implant | $210.18 |
| 6102317 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6102318 | GUIDE WIRE | Supply/Implant | $1,423.36 |
| 6102319 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6102320 | CATHETER, GUIDING | Supply/Implant | $473.60 |
| 6102322 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,728.00 |
| 6102323 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6102325 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6102327 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6102331 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6102334 | SUPPLY IMPLANT | Supply/Implant | $480.81 |
| 6102335 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6102336 | GRAFT, VASCULAR | Supply/Implant | $25,972.22 |
| 6102340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6102341 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6102345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6102350 | GENERAL SUPPLY | Supply/Implant | $167.81 |
| 6102351 | GENERAL SUPPLY | Supply/Implant | $1,146.88 |
| 6102356 | SUPPLY IMPLANT | Supply/Implant | $1,190.40 |
| 6102358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6102367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6102368 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6102370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6102371 | GENERAL SUPPLY | Supply/Implant | $243.20 |
| 6102372 | GENERAL SUPPLY | Supply/Implant | $202.62 |
| 6102379 | SUPPLY IMPLANT | Supply/Implant | $33,095.68 |
| 6102380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6102383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6102385 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6102386 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6102387 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6102388 | SUPPLY IMPLANT | Supply/Implant | $7,155.71 |
| 6102390 | CATHETER, GUIDING | Supply/Implant | $7,811.48 |
| 6102396 | GENERAL SUPPLY | Supply/Implant | $158.59 |
| 6102398 | STERILE SUPPLY | Supply/Implant | $221.44 |
| 6102411 | STERILE SUPPLY | Supply/Implant | $888.19 |
| 6102425 | INTRO/SHEATH, NON-LASER | Supply/Implant | $605.57 |
| 6102429 | GENERAL SUPPLY | Supply/Implant | $142.11 |
| 6102438 | CATHETER, URETERAL | Supply/Implant | $197.38 |
| 6102439 | CATHETER, URETERAL | Supply/Implant | $197.38 |
| 6102440 | STERILE SUPPLY | Supply/Implant | $208.13 |
| 6102455 | STERILE SUPPLY | Supply/Implant | $128.26 |
| 6102459 | STERILE SUPPLY | Supply/Implant | $596.48 |
| 6102477 | STERILE SUPPLY | Supply/Implant | $130.44 |
| 6102479 | STERILE SUPPLY | Supply/Implant | $156.80 |
| 6102488 | STERILE SUPPLY | Supply/Implant | $3,487.74 |
| 6102495 | GENERAL SUPPLY | Supply/Implant | $6,952.70 |
| 6102497 | STERILE SUPPLY | Supply/Implant | $196.99 |
| 6102500 | GENERAL SUPPLY | Supply/Implant | $157.36 |
| 6102505 | SUPPLY IMPLANT | Supply/Implant | $392.83 |
| 6102506 | SUPPLY IMPLANT | Supply/Implant | $668.03 |
| 6102507 | STERILE SUPPLY | Supply/Implant | $273.97 |
| 6102508 | SUPPLY IMPLANT | Supply/Implant | $1,092.61 |
| 6102509 | STERILE SUPPLY | Supply/Implant | $2,307.20 |
| 6102510 | SUPPLY IMPLANT | Supply/Implant | $1,540.61 |
| 6102511 | GENERAL SUPPLY | Supply/Implant | $342.40 |
| 6102512 | SUPPLY IMPLANT | Supply/Implant | $240.38 |
| 6102516 | SUPPLY IMPLANT | Supply/Implant | $34,975.49 |
| 6102523 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6102527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6102528 | SUPPLY IMPLANT | Supply/Implant | $4,523.14 |
| 6102530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102531 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102532 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,972.16 |
| 6102533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6102536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102538 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6102540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6102551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6102554 | SUPPLY IMPLANT | Supply/Implant | $396.80 |
| 6102555 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102556 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102558 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102559 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102560 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102561 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102562 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102563 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102564 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102565 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102566 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102567 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102568 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6102572 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $5,760.00 |
| 6102573 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,760.00 |
| 6102575 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6102579 | SUPPLY IMPLANT | Supply/Implant | $5,693.44 |
| 6102580 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6102586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6102587 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6102589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102602 | STERILE SUPPLY | Supply/Implant | $6,123.52 |
| 6102603 | SUPPLY IMPLANT | Supply/Implant | $1,967.10 |
| 6102604 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6102605 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6102606 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6102608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6102612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6102613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6102614 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6102616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6102620 | SUPPLY IMPLANT | Supply/Implant | $18,714.62 |
| 6102624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6102626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6102627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6102628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6102629 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6102630 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6102634 | CATHETER, GUIDING | Supply/Implant | $3,392.00 |
| 6102637 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6102641 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6102642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,424.64 |
| 6102643 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6102649 | SUPPLY IMPLANT | Supply/Implant | $1,594.88 |
| 6102653 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6102656 | SUPPLY IMPLANT | Supply/Implant | $367.36 |
| 6102657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $851.20 |
| 6102662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6102663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6102664 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6102673 | SUPPLY IMPLANT | Supply/Implant | $5,158.91 |
| 6102684 | SUPPLY IMPLANT | Supply/Implant | $1,457.66 |
| 6102685 | SUPPLY IMPLANT | Supply/Implant | $2,634.24 |
| 6102687 | SUPPLY IMPLANT | Supply/Implant | $193.66 |
| 6102688 | SUPPLY IMPLANT | Supply/Implant | $539.14 |
| 6102696 | CATHETER, GUIDING | Supply/Implant | $1,632.00 |
| 6102698 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6102699 | STERILE SUPPLY | Supply/Implant | $332.80 |
| 6102700 | SUPPLY IMPLANT | Supply/Implant | $9,907.71 |
| 6102703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6102706 | SUPPLY IMPLANT | Supply/Implant | $1,658.88 |
| 6102707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6102708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6102709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,496.00 |
| 6102711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,888.00 |
| 6102712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,778.88 |
| 6102713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,370.24 |
| 6102717 | CATH, DRAINAGE | Supply/Implant | $312.83 |
| 6102719 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6102735 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,680.00 |
| 6102738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6102739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6102753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6102766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6102767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6102777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $519.68 |
| 6102778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $636.16 |
| 6102785 | SUPPLY IMPLANT | Supply/Implant | $1,067.19 |
| 6102786 | IMPL EXT ACCESS CATH | Supply/Implant | $2,368.00 |
| 6102787 | IMPL EXT ACCESS CATH | Supply/Implant | $2,368.00 |
| 6102789 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6102792 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6102793 | SUPPLY IMPLANT | Supply/Implant | $3,897.98 |
| 6102796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6102797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6102800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6102812 | SUPPLY IMPLANT | Supply/Implant | $1,788.16 |
| 6102813 | CATHETER, URETERAL | Supply/Implant | $499.20 |
| 6102824 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,048.00 |
| 6102828 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6102840 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6102843 | SUPPLY IMPLANT | Supply/Implant | $3,690.62 |
| 6102846 | GUIDE WIRE | Supply/Implant | $1,227.52 |
| 6102848 | INTERSPINOUS IMPLANT | Supply/Implant | $76,800.00 |
| 6102851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6102855 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6102856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,764.80 |
| 6102857 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,617.34 |
| 6102858 | SUPPLY IMPLANT | Supply/Implant | $4,396.80 |
| 6102861 | INTRO/SHEATH, NON-LASER | Supply/Implant | $704.00 |
| 6102863 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,523.58 |
| 6102866 | SUPPLY IMPLANT | Supply/Implant | $2,114.56 |
| 6102871 | SUPPLY IMPLANT | Supply/Implant | $1,273.22 |
| 6102872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6102873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6102875 | GENERAL SUPPLY | Supply/Implant | $223.36 |
| 6102876 | SUPPLY IMPLANT | Supply/Implant | $19,169.28 |
| 6102879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6102882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6102886 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $2,546.94 |
| 6102887 | GUIDE WIRE | Supply/Implant | $635.39 |
| 6102895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6102898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,012.35 |
| 6102899 | STERILE SUPPLY | Supply/Implant | $408.58 |
| 6102900 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6102909 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6102910 | STERILE SUPPLY | Supply/Implant | $579.20 |
| 6102915 | STERILE SUPPLY | Supply/Implant | $261.64 |
| 6102928 | STERILE SUPPLY | Supply/Implant | $349.70 |
| 6102929 | STERILE SUPPLY | Supply/Implant | $570.20 |
| 6102950 | STERILE SUPPLY | Supply/Implant | $356.75 |
| 6102959 | STERILE SUPPLY | Supply/Implant | $160.00 |
| 6102971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6102972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $519.68 |
| 6102974 | SUPPLY IMPLANT | Supply/Implant | $4,612.61 |
| 6102979 | GRAFT, VASCULAR | Supply/Implant | $18,509.95 |
| 6102985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6102988 | SUPPLY IMPLANT | Supply/Implant | $3,521.28 |
| 6102989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,057.28 |
| 6102990 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,470.59 |
| 6102991 | SUPPLY IMPLANT | Supply/Implant | $25,527.04 |
| 6102997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,778.88 |
| 6102999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6103001 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6103004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6103005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,132.16 |
| 6103007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6103008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6103009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6103023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6103026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6103028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,559.04 |
| 6103029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6103030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,370.24 |
| 6103033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,559.04 |
| 6103037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,132.16 |
| 6103041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6103044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6103045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6103046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,209.28 |
| 6103048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $779.52 |
| 6103049 | SUPPLY IMPLANT | Supply/Implant | $22,426.88 |
| 6103050 | SUPPLY IMPLANT | Supply/Implant | $6,191.36 |
| 6103051 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,469.95 |
| 6103088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6103096 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6103100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6103102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6103105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,904.00 |
| 6103106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,904.00 |
| 6103121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6103124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,540.80 |
| 6103129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6103136 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103151 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6103162 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6103165 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103168 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103169 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6103170 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103171 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103172 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103174 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103177 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103178 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103179 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6103190 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,544.00 |
| 6103213 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6103215 | SUPPLY IMPLANT | Supply/Implant | $483.17 |
| 6103217 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,171.07 |
| 6103225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,476.80 |
| 6103227 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6103228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,668.80 |
| 6103230 | CONN TISS, NON-HUMAN | Supply/Implant | $37,440.00 |
| 6103233 | GUIDE WIRE | Supply/Implant | $2,448.00 |
| 6103237 | GRAFT, VASCULAR | Supply/Implant | $28,736.00 |
| 6103238 | GRAFT, VASCULAR | Supply/Implant | $21,401.60 |
| 6103241 | SUPPLY IMPLANT | Supply/Implant | $1,199.74 |
| 6103242 | SUPPLY IMPLANT | Supply/Implant | $521.47 |
| 6103243 | SUPPLY IMPLANT | Supply/Implant | $1,094.27 |
| 6103244 | SUPPLY IMPLANT | Supply/Implant | $154.24 |
| 6103246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,388.80 |
| 6103248 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6103249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6103257 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6103258 | STERILE SUPPLY | Supply/Implant | $601.60 |
| 6103259 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6103271 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $121,296.00 |
| 6103280 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,923.52 |
| 6103285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6103300 | GENERAL SUPPLY | Supply/Implant | $1,109.25 |
| 6103313 | STERILE SUPPLY | Supply/Implant | $280.45 |
| 6103318 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6103319 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6103330 | STERILE SUPPLY | Supply/Implant | $339.20 |
| 6103334 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,360.00 |
| 6103337 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6103338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6103342 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6103345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6103346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6103351 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $2,188.80 |
| 6103352 | STERILE SUPPLY | Supply/Implant | $4,377.60 |
| 6103363 | STERILE SUPPLY | Supply/Implant | $1,177.60 |
| 6103364 | STERILE SUPPLY | Supply/Implant | $1,177.60 |
| 6103365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,660.80 |
| 6103367 | STERILE SUPPLY | Supply/Implant | $8,952.32 |
| 6103368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6103369 | SUPPLY IMPLANT | Supply/Implant | $22,080.00 |
| 6103370 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6103372 | SUPPLY IMPLANT | Supply/Implant | $925.44 |
| 6103380 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,000.00 |
| 6103384 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103388 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6103392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $421.12 |
| 6103403 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6103409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,305.60 |
| 6103417 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103419 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103426 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103427 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103428 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103429 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103432 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103433 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6103438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103440 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103441 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103442 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103451 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103462 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $70,400.00 |
| 6103471 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103472 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103476 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,240.00 |
| 6103502 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $97,792.00 |
| 6103503 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103520 | SUPPLY IMPLANT | Supply/Implant | $8,867.84 |
| 6103526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6103528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,224.00 |
| 6103532 | GENERAL SUPPLY | Supply/Implant | $5,183.36 |
| 6103537 | STERILE SUPPLY | Supply/Implant | $4,619.78 |
| 6103538 | STERILE SUPPLY | Supply/Implant | $3,182.98 |
| 6103539 | STERILE SUPPLY | Supply/Implant | $399.74 |
| 6103541 | INTRO/SHEATH, NON-LASER | Supply/Implant | $737.28 |
| 6103545 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,382.40 |
| 6103550 | GRAFT, VASCULAR | Supply/Implant | $31,294.08 |
| 6103553 | GENERAL SUPPLY | Supply/Implant | $340.10 |
| 6103555 | SUPPLY IMPLANT | Supply/Implant | $319.23 |
| 6103557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6103558 | SUPPLY IMPLANT | Supply/Implant | $36,288.00 |
| 6103560 | SUPPLY IMPLANT | Supply/Implant | $54,996.48 |
| 6103561 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,665.92 |
| 6103562 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6103563 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,803.20 |
| 6103564 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6103570 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6103571 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $10,880.00 |
| 6103574 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6103575 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6103576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6103577 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103578 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103579 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103580 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,776.00 |
| 6103583 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103584 | SUPPLY IMPLANT | Supply/Implant | $1,632.00 |
| 6103588 | SUPPLY IMPLANT | Supply/Implant | $5,822.72 |
| 6103591 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6103595 | STERILE SUPPLY | Supply/Implant | $2,073.47 |
| 6103596 | STERILE SUPPLY | Supply/Implant | $3,914.50 |
| 6103597 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $487.30 |
| 6103598 | GENERAL SUPPLY | Supply/Implant | $3,712.00 |
| 6103599 | GENERAL SUPPLY | Supply/Implant | $2,096.64 |
| 6103600 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6103604 | GENERAL SUPPLY | Supply/Implant | $1,161.60 |
| 6103607 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6103608 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6103609 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6103613 | STERILE SUPPLY | Supply/Implant | $1,989.63 |
| 6103614 | STERILE SUPPLY | Supply/Implant | $1,807.62 |
| 6103615 | STERILE SUPPLY | Supply/Implant | $3,504.90 |
| 6103616 | GENERAL SUPPLY | Supply/Implant | $2,795.39 |
| 6103618 | STERILE SUPPLY | Supply/Implant | $7,702.91 |
| 6103621 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6103622 | GENERAL SUPPLY | Supply/Implant | $2,032.13 |
| 6103625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,852.80 |
| 6103630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6103631 | SUPPLY IMPLANT | Supply/Implant | $11,827.20 |
| 6103638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6103648 | SUPPLY IMPLANT | Supply/Implant | $421.50 |
| 6103649 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6103652 | MESH (IMPLANTABLE) | Supply/Implant | $5,347.46 |
| 6103653 | MESH (IMPLANTABLE) | Supply/Implant | $8,432.51 |
| 6103655 | CONN TISS, NON-HUMAN | Supply/Implant | $3,296.00 |
| 6103658 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6103659 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6103661 | CONN TISS, NON-HUMAN | Supply/Implant | $3,296.00 |
| 6103662 | MESH (IMPLANTABLE) | Supply/Implant | $11,238.91 |
| 6103663 | MESH (IMPLANTABLE) | Supply/Implant | $5,712.00 |
| 6103667 | GENERAL SUPPLY | Supply/Implant | $318.23 |
| 6103668 | GENERAL SUPPLY | Supply/Implant | $318.23 |
| 6103675 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,544.00 |
| 6103683 | MESH (IMPLANTABLE) | Supply/Implant | $6,389.50 |
| 6103686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,472.96 |
| 6103691 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $10,555.14 |
| 6103731 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6103734 | SUPPLY IMPLANT | Supply/Implant | $317.06 |
| 6103738 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103740 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6103748 | GUIDE WIRE | Supply/Implant | $1,011.20 |
| 6103760 | SUPPLY IMPLANT | Supply/Implant | $92,032.00 |
| 6103762 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,237.12 |
| 6103770 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6103772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6103773 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,953.60 |
| 6103774 | SUPPLY IMPLANT | Supply/Implant | $243.79 |
| 6103776 | GUIDE WIRE | Supply/Implant | $1,172.61 |
| 6103789 | STERILE SUPPLY | Supply/Implant | $146.56 |
| 6103790 | GENERAL SUPPLY | Supply/Implant | $2,410.37 |
| 6103800 | GENERAL SUPPLY | Supply/Implant | $329.47 |
| 6103807 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103808 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103809 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103810 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103811 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103812 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103813 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103814 | GENERAL SUPPLY | Supply/Implant | $177.54 |
| 6103829 | GENERAL SUPPLY | Supply/Implant | $423.55 |
| 6103840 | WHFO,NO JOINT, PREFABRICATED | Supply/Implant | $313.47 |
| 6103851 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6103852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6103853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6103854 | SUPPLY IMPLANT | Supply/Implant | $1,673.98 |
| 6103855 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6103858 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6103865 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6103866 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6103867 | SUPPLY IMPLANT | Supply/Implant | $43,452.54 |
| 6103878 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6103880 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6103881 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,265.60 |
| 6103883 | GENERAL SUPPLY | Supply/Implant | $537.60 |
| 6103884 | GENERAL SUPPLY | Supply/Implant | $537.60 |
| 6103885 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,196.16 |
| 6103889 | GENERAL SUPPLY | Supply/Implant | $433.02 |
| 6103893 | SUPPLY IMPLANT | Supply/Implant | $2,634.24 |
| 6103894 | SUPPLY IMPLANT | Supply/Implant | $367.36 |
| 6103895 | SUPPLY IMPLANT | Supply/Implant | $367.36 |
| 6103902 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103903 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103904 | SUPPLY IMPLANT | Supply/Implant | $6,397.44 |
| 6103910 | GENERAL SUPPLY | Supply/Implant | $193.02 |
| 6103919 | SUPPLY IMPLANT | Supply/Implant | $801.09 |
| 6103920 | MESH (IMPLANTABLE) | Supply/Implant | $22,134.91 |
| 6103921 | MESH (IMPLANTABLE) | Supply/Implant | $28,960.90 |
| 6103923 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $59,008.00 |
| 6103924 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103925 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103926 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103927 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103928 | LEAD, CORONARY VENOUS | Supply/Implant | $30,720.00 |
| 6103936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,776.00 |
| 6103937 | GENERAL SUPPLY | Supply/Implant | $266.75 |
| 6103938 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6103939 | SUPPLY IMPLANT | Supply/Implant | $398.30 |
| 6103941 | MESH (IMPLANTABLE) | Supply/Implant | $35,124.22 |
| 6103946 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6103947 | PMKR, DUAL, RATE-RESP | Supply/Implant | $66,944.00 |
| 6103948 | PMKR, DUAL, RATE-RESP | Supply/Implant | $69,504.00 |
| 6103949 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103950 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103951 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103952 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103953 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103954 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103955 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6103957 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6103962 | STERILE SUPPLY | Supply/Implant | $5,080.19 |
| 6103966 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103967 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6103968 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6103969 | SUPPLY IMPLANT | Supply/Implant | $193.13 |
| 6103971 | MESH (IMPLANTABLE) | Supply/Implant | $23,399.68 |
| 6103974 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6103980 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103982 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103984 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6103986 | SUPPLY IMPLANT | Supply/Implant | $226.30 |
| 6103988 | RET DEV, INSERTABLE | Supply/Implant | $9,251.84 |
| 6103989 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6103990 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6103991 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6103995 | SUPPLY IMPLANT | Supply/Implant | $47,868.42 |
| 6103998 | LEAD, CORONARY VENOUS | Supply/Implant | $38,336.00 |
| 6104005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104011 | SUPPLY IMPLANT | Supply/Implant | $3,302.40 |
| 6104014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104016 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,164.16 |
| 6104017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,552.00 |
| 6104019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104021 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6104022 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6104023 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6104025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104026 | RET DEV, INSERTABLE | Supply/Implant | $87,040.00 |
| 6104029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6104030 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6104032 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6104033 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,968.00 |
| 6104035 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6104036 | STERILE SUPPLY | Supply/Implant | $3,072.00 |
| 6104041 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6104044 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6104045 | SUPPLY IMPLANT | Supply/Implant | $2,478.72 |
| 6104046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,193.34 |
| 6104047 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,055.87 |
| 6104048 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $8,960.00 |
| 6104066 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6104076 | SUPPLY IMPLANT | Supply/Implant | $16,886.49 |
| 6104077 | SUPPLY IMPLANT | Supply/Implant | $9,287.56 |
| 6104079 | GENERAL SUPPLY | Supply/Implant | $868.84 |
| 6104080 | GRAFT, VASCULAR | Supply/Implant | $16,431.62 |
| 6104082 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6104090 | CLOSURE DEV, VASC | Supply/Implant | $2,496.00 |
| 6104091 | CLOSURE DEV, VASC | Supply/Implant | $2,496.00 |
| 6104092 | CATHETER, GUIDING | Supply/Implant | $166.40 |
| 6104093 | CATHETER, GUIDING | Supply/Implant | $1,943.04 |
| 6104094 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $448.00 |
| 6104098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6104099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104101 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $10,240.00 |
| 6104104 | MISC SUP/ACC IMP VAD | Supply/Implant | $12,736.00 |
| 6104105 | CATHETER, GUIDING | Supply/Implant | $9,088.00 |
| 6104106 | CATHETER, GUIDING | Supply/Implant | $9,088.00 |
| 6104107 | CATHETER, GUIDING | Supply/Implant | $8,576.00 |
| 6104112 | OCULAR IMPLANT | Supply/Implant | $174.08 |
| 6104113 | OCULAR IMPLANT | Supply/Implant | $166.40 |
| 6104127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104128 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104130 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6104131 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6104132 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6104134 | GENERAL SUPPLY | Supply/Implant | $32,000.00 |
| 6104137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6104138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6104139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6104143 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6104144 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6104146 | STERILE SUPPLY | Supply/Implant | $170.21 |
| 6104155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6104157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,170.24 |
| 6104160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6104161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6104164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,381.76 |
| 6104167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $122,535.00 |
| 6104170 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6104171 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6104172 | SUPPLY IMPLANT | Supply/Implant | $13,450.75 |
| 6104174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104180 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104181 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104182 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104183 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6104189 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $329,108.50 |
| 6104193 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $121,296.00 |
| 6104194 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $60,496.00 |
| 6104195 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $77,824.00 |
| 6104200 | GENERAL SUPPLY | Supply/Implant | $1,088.00 |
| 6104204 | SUPPLY IMPLANT | Supply/Implant | $943.74 |
| 6104205 | MESH (IMPLANTABLE) | Supply/Implant | $20,336.64 |
| 6104208 | GENERAL SUPPLY | Supply/Implant | $142.49 |
| 6104210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104212 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104214 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104215 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6104216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6104217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104218 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104226 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104229 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6104230 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6104242 | SUPPLY IMPLANT | Supply/Implant | $122,367.00 |
| 6104243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,638.40 |
| 6104245 | GUIDE WIRE | Supply/Implant | $1,472.00 |
| 6104248 | SUPPLY IMPLANT | Supply/Implant | $426.50 |
| 6104249 | SUPPLY IMPLANT | Supply/Implant | $426.50 |
| 6104250 | SUPPLY IMPLANT | Supply/Implant | $426.50 |
| 6104256 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6104260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,632.00 |
| 6104262 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6104263 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6104267 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6104268 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6104269 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $50,150.40 |
| 6104271 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $640.00 |
| 6104272 | SUPPLY IMPLANT | Supply/Implant | $1,725.82 |
| 6104273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,080.77 |
| 6104275 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104280 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $92,800.00 |
| 6104281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6104282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6104283 | SUPPLY IMPLANT | Supply/Implant | $1,265.41 |
| 6104284 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104285 | STERILE SUPPLY | Supply/Implant | $2,531.84 |
| 6104287 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6104288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,049.60 |
| 6104289 | SUPPLY IMPLANT | Supply/Implant | $6,791.68 |
| 6104292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6104294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6104297 | STERILE SUPPLY | Supply/Implant | $979.20 |
| 6104298 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104300 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104301 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104302 | GENERAL SUPPLY | Supply/Implant | $155.78 |
| 6104309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,738.24 |
| 6104310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6104311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6104313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6104314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6104316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6104322 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6104323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6104324 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6104328 | GUIDE WIRE | Supply/Implant | $2,624.00 |
| 6104330 | CATH OCCLUSION | Supply/Implant | $9,088.00 |
| 6104333 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $19,576.45 |
| 6104336 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6104337 | CATHETER, GUIDING | Supply/Implant | $282.11 |
| 6104340 | SUPPLY IMPLANT | Supply/Implant | $712.83 |
| 6104341 | STERILE SUPPLY | Supply/Implant | $1,048.32 |
| 6104342 | CONN TISS, NON-HUMAN | Supply/Implant | $3,245.44 |
| 6104345 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6104346 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6104347 | INTRO/SHEATH, NON-LASER | Supply/Implant | $409.60 |
| 6104349 | SUPPLY IMPLANT | Supply/Implant | $2,005.18 |
| 6104353 | SUPPLY IMPLANT | Supply/Implant | $1,630.72 |
| 6104357 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,750.40 |
| 6104358 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $59,888.00 |
| 6104359 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,454.66 |
| 6104367 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6104369 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,968.00 |
| 6104373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6104375 | SUPPLY IMPLANT | Supply/Implant | $8,073.47 |
| 6104380 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6104381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6104386 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6104389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6104408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6104410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6104412 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6104418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,406.08 |
| 6104419 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6104420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6104422 | SUPPLY IMPLANT | Supply/Implant | $1,418.75 |
| 6104423 | SUPPLY IMPLANT | Supply/Implant | $1,550.08 |
| 6104430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104432 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6104434 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6104435 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,856.00 |
| 6104437 | GENERAL SUPPLY | Supply/Implant | $603.01 |
| 6104440 | STERILE SUPPLY | Supply/Implant | $5,569.15 |
| 6104442 | SUPPLY IMPLANT | Supply/Implant | $1,703.94 |
| 6104443 | SUPPLY IMPLANT | Supply/Implant | $1,202.05 |
| 6104444 | SUPPLY IMPLANT | Supply/Implant | $5,775.62 |
| 6104449 | SUPPLY IMPLANT | Supply/Implant | $5,744.90 |
| 6104450 | SUPPLY IMPLANT | Supply/Implant | $1,234.94 |
| 6104451 | SUPPLY IMPLANT | Supply/Implant | $4,306.05 |
| 6104453 | SUPPLY IMPLANT | Supply/Implant | $718.34 |
| 6104455 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6104456 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6104457 | SUPPLY IMPLANT | Supply/Implant | $557.31 |
| 6104462 | SUPPLY IMPLANT | Supply/Implant | $186.50 |
| 6104467 | CATHETER, URETERAL | Supply/Implant | $353.28 |
| 6104468 | SUPPLY IMPLANT | Supply/Implant | $1,967.10 |
| 6104469 | SUPPLY IMPLANT | Supply/Implant | $1,472.64 |
| 6104471 | SUPPLY IMPLANT | Supply/Implant | $6,012.16 |
| 6104473 | SUPPLY IMPLANT | Supply/Implant | $6,361.86 |
| 6104474 | SUPPLY IMPLANT | Supply/Implant | $639.36 |
| 6104475 | STERILE SUPPLY | Supply/Implant | $1,331.20 |
| 6104476 | SUPPLY IMPLANT | Supply/Implant | $6,361.86 |
| 6104477 | STERILE SUPPLY | Supply/Implant | $709.12 |
| 6104481 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6104486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,556.86 |
| 6104498 | STERILE SUPPLY | Supply/Implant | $241.77 |
| 6104501 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $35,840.00 |
| 6104503 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,960.00 |
| 6104508 | SUPPLY IMPLANT | Supply/Implant | $1,416.83 |
| 6104511 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6104513 | GRAFT, VASCULAR | Supply/Implant | $3,801.60 |
| 6104517 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6104518 | GUIDE WIRE | Supply/Implant | $3,456.00 |
| 6104519 | GUIDE WIRE | Supply/Implant | $3,456.00 |
| 6104520 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6104521 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6104523 | STERILE SUPPLY | Supply/Implant | $995.71 |
| 6104526 | BRACHYTHERAPY NEEDLE | Supply/Implant | $2,368.00 |
| 6104527 | LEAD, NEUROSTIMULATOR | Supply/Implant | $58,304.00 |
| 6104528 | SUPPLY IMPLANT | Supply/Implant | $1,376.41 |
| 6104534 | CATHETER, URETERAL | Supply/Implant | $504.19 |
| 6104537 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6104538 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6104539 | STERILE SUPPLY | Supply/Implant | $496.77 |
| 6104540 | CONN TISS, NON-HUMAN | Supply/Implant | $5,903.10 |
| 6104541 | CONN TISS, NON-HUMAN | Supply/Implant | $8,095.74 |
| 6104542 | STERILE SUPPLY | Supply/Implant | $396.67 |
| 6104544 | CONN TISS, NON-HUMAN | Supply/Implant | $7,785.98 |
| 6104546 | SUPPLY IMPLANT | Supply/Implant | $206.08 |
| 6104547 | SUPPLY IMPLANT | Supply/Implant | $1,317.89 |
| 6104548 | SUPPLY IMPLANT | Supply/Implant | $1,225.86 |
| 6104549 | SUPPLY IMPLANT | Supply/Implant | $449.36 |
| 6104552 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,371.39 |
| 6104553 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6104554 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6104557 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,841.60 |
| 6104562 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104563 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104564 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6104566 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $303,000.00 |
| 6104567 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $303,000.00 |
| 6104570 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,000.00 |
| 6104572 | GRAFT, VASCULAR | Supply/Implant | $38,464.00 |
| 6104585 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6104590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6104596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6104598 | SUPPLY IMPLANT | Supply/Implant | $14,040.96 |
| 6104599 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6104601 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6104603 | STERILE SUPPLY | Supply/Implant | $671.62 |
| 6104604 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6104605 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6104607 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104608 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6104609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104613 | GENERAL SUPPLY | Supply/Implant | $634.88 |
| 6104614 | SUPPLY IMPLANT | Supply/Implant | $22,976.00 |
| 6104617 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6104629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6104633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6104637 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6104640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6104653 | CORNEAL TISSUE PROCESSING | Supply/Implant | $56,320.00 |
| 6104655 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6104656 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6104657 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6104659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104660 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6104661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,204.80 |
| 6104662 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6104666 | SUPPLY IMPLANT | Supply/Implant | $8,908.80 |
| 6104667 | GENERAL SUPPLY | Supply/Implant | $1,024.00 |
| 6104672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,800.00 |
| 6104674 | SUPPLY IMPLANT | Supply/Implant | $3,615.23 |
| 6104676 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6104677 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6104681 | GENERAL SUPPLY | Supply/Implant | $160.44 |
| 6104690 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6104691 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6104693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6104696 | SUPPLY IMPLANT | Supply/Implant | $395.78 |
| 6104701 | MESH (IMPLANTABLE) | Supply/Implant | $4,810.62 |
| 6104704 | SUPPLY IMPLANT | Supply/Implant | $484.74 |
| 6104707 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $832.38 |
| 6104710 | CATHETER, GUIDING | Supply/Implant | $593.92 |
| 6104711 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $648.32 |
| 6104715 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $276.48 |
| 6104716 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $593.92 |
| 6104717 | CATHETER, GUIDING | Supply/Implant | $276.48 |
| 6104718 | CATHETER, GUIDING | Supply/Implant | $2,821.38 |
| 6104720 | CATHETER, GUIDING | Supply/Implant | $2,099.20 |
| 6104721 | CATHETER, GUIDING | Supply/Implant | $273.92 |
| 6104723 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,852.80 |
| 6104725 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6104732 | STERILE SUPPLY | Supply/Implant | $342.53 |
| 6104739 | SUPPLY IMPLANT | Supply/Implant | $17,167.36 |
| 6104741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6104742 | STERILE SUPPLY | Supply/Implant | $402.56 |
| 6104744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6104745 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6104749 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6104751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,164.80 |
| 6104752 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6104758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,848.00 |
| 6104767 | SUPPLY IMPLANT | Supply/Implant | $23,334.40 |
| 6104768 | SUPPLY IMPLANT | Supply/Implant | $12,850.82 |
| 6104769 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6104770 | SUPPLY IMPLANT | Supply/Implant | $16,960.00 |
| 6104780 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6104785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6104789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,552.00 |
| 6104790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6104791 | SUPPLY IMPLANT | Supply/Implant | $480.26 |
| 6104792 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,476.74 |
| 6104794 | SUPPLY IMPLANT | Supply/Implant | $6,310.40 |
| 6104799 | STERILE SUPPLY | Supply/Implant | $2,124.80 |
| 6104800 | GENERAL SUPPLY | Supply/Implant | $1,113.60 |
| 6104801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6104816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6104817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6104818 | CATHETER, URETERAL | Supply/Implant | $197.38 |
| 6104820 | GUIDE WIRE | Supply/Implant | $2,222.08 |
| 6104821 | CONN TISS, NON-HUMAN | Supply/Implant | $19,868.16 |
| 6104823 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $832.38 |
| 6104826 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6104827 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6104828 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104829 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6104836 | SUPPLY IMPLANT | Supply/Implant | $471.55 |
| 6104843 | STERILE SUPPLY | Supply/Implant | $26,854.40 |
| 6104844 | GENERAL SUPPLY | Supply/Implant | $42,214.40 |
| 6104845 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6104846 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6104853 | STERILE SUPPLY | Supply/Implant | $1,206.53 |
| 6104855 | STERILE SUPPLY | Supply/Implant | $317.82 |
| 6104856 | SUPPLY IMPLANT | Supply/Implant | $5,956.19 |
| 6104859 | GENERAL SUPPLY | Supply/Implant | $1,939.71 |
| 6104861 | GRAFT, VASCULAR | Supply/Implant | $2,001.79 |
| 6104862 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6104863 | STERILE SUPPLY | Supply/Implant | $247.17 |
| 6104864 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $26,816.00 |
| 6104865 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $26,816.00 |
| 6104866 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $26,816.00 |
| 6104875 | SUPPLY IMPLANT | Supply/Implant | $668.03 |
| 6104877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6104896 | STERILE SUPPLY | Supply/Implant | $397.70 |
| 6104900 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,382.53 |
| 6104903 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $8,859.01 |
| 6104922 | MESH (IMPLANTABLE) | Supply/Implant | $5,347.46 |
| 6104923 | MESH (IMPLANTABLE) | Supply/Implant | $8,432.49 |
| 6104927 | CATHETER, GUIDING | Supply/Implant | $648.58 |
| 6104928 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6104929 | GUIDE WIRE | Supply/Implant | $6,935.04 |
| 6104931 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $178,500.00 |
| 6104944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6104945 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $85,337.60 |
| 6104947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6104948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,272.00 |
| 6104959 | CONN TISS, NON-HUMAN | Supply/Implant | $2,992.77 |
| 6104964 | MESH (IMPLANTABLE) | Supply/Implant | $2,907.90 |
| 6104965 | MESH (IMPLANTABLE) | Supply/Implant | $2,907.90 |
| 6104969 | GENERAL SUPPLY | Supply/Implant | $276.86 |
| 6104989 | GRAFT, VASCULAR | Supply/Implant | $11,618.82 |
| 6105009 | SUPPLY IMPLANT | Supply/Implant | $1,661.44 |
| 6105010 | SUPPLY IMPLANT | Supply/Implant | $480.81 |
| 6105012 | GUIDE WIRE | Supply/Implant | $2,457.60 |
| 6105013 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6105014 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6105019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6105020 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6105021 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6105022 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6105025 | GENERAL SUPPLY | Supply/Implant | $283.20 |
| 6105026 | SUPPLY IMPLANT | Supply/Implant | $2,470.40 |
| 6105027 | CATH OCCLUSION | Supply/Implant | $17,920.00 |
| 6105028 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6105030 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $9,280.00 |
| 6105031 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6105032 | SUPPLY IMPLANT | Supply/Implant | $271.24 |
| 6105034 | CONN TISS, NON-HUMAN | Supply/Implant | $3,871.74 |
| 6105037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105045 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6105054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6105062 | SUPPLY IMPLANT | Supply/Implant | $4,855.04 |
| 6105065 | GENERAL SUPPLY | Supply/Implant | $422.40 |
| 6105067 | SUPPLY IMPLANT | Supply/Implant | $200.38 |
| 6105068 | SUPPLY IMPLANT | Supply/Implant | $315.52 |
| 6105069 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6105071 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6105073 | STERILE SUPPLY | Supply/Implant | $257.28 |
| 6105075 | STERILE SUPPLY | Supply/Implant | $3,123.20 |
| 6105077 | STERILE SUPPLY | Supply/Implant | $4,318.59 |
| 6105079 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $8,320.00 |
| 6105092 | PORT, INDWELLING, IMP | Supply/Implant | $3,476.86 |
| 6105093 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6105094 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6105096 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,380.80 |
| 6105102 | CATHETER, GUIDING | Supply/Implant | $678.40 |
| 6105103 | CATHETER, GUIDING | Supply/Implant | $678.40 |
| 6105108 | SUPPLY IMPLANT | Supply/Implant | $2,300.03 |
| 6105110 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6105111 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6105115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,785.47 |
| 6105116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,017.28 |
| 6105118 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6105121 | SUPPLY IMPLANT | Supply/Implant | $682.37 |
| 6105126 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6105127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,520.00 |
| 6105128 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6105129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6105134 | GENERAL SUPPLY | Supply/Implant | $316.54 |
| 6105138 | SUPPLY IMPLANT | Supply/Implant | $745.22 |
| 6105141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6105143 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6105145 | SUPPLY IMPLANT | Supply/Implant | $12,864.00 |
| 6105147 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6105149 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6105151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,312.00 |
| 6105156 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,571.20 |
| 6105157 | GENERAL SUPPLY | Supply/Implant | $308.61 |
| 6105160 | STERILE SUPPLY | Supply/Implant | $361.86 |
| 6105166 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6105168 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6105175 | GENERAL SUPPLY | Supply/Implant | $19,200.00 |
| 6105177 | GENERAL SUPPLY | Supply/Implant | $18,560.00 |
| 6105184 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6105185 | GENERAL SUPPLY | Supply/Implant | $364.80 |
| 6105192 | SUPPLY IMPLANT | Supply/Implant | $11,808.77 |
| 6105193 | SUPPLY IMPLANT | Supply/Implant | $1,446.53 |
| 6105199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6105209 | SUPPLY IMPLANT | Supply/Implant | $7,385.60 |
| 6105214 | GRAFT, VASCULAR | Supply/Implant | $15,836.16 |
| 6105219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6105223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6105224 | SUPPLY IMPLANT | Supply/Implant | $13,178.88 |
| 6105227 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $33,868.80 |
| 6105229 | STERILE SUPPLY | Supply/Implant | $249.60 |
| 6105230 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6105231 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $832.38 |
| 6105232 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6105238 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6105239 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6105247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,000.00 |
| 6105256 | GRAFT, VASCULAR | Supply/Implant | $14,579.20 |
| 6105257 | GRAFT, VASCULAR | Supply/Implant | $15,219.20 |
| 6105258 | CATH, DRAINAGE | Supply/Implant | $174.72 |
| 6105259 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6105260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6105261 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6105262 | SUPPLY IMPLANT | Supply/Implant | $50,560.00 |
| 6105269 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105272 | GENERAL SUPPLY | Supply/Implant | $2,467.84 |
| 6105273 | CATH OCCLUSION | Supply/Implant | $3,392.00 |
| 6105274 | STERILE SUPPLY | Supply/Implant | $1,092.10 |
| 6105281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $71,428.48 |
| 6105286 | SUPPLY IMPLANT | Supply/Implant | $343.42 |
| 6105292 | CATHETER, GUIDING | Supply/Implant | $2,521.60 |
| 6105294 | CATH OCCLUSION | Supply/Implant | $2,521.60 |
| 6105308 | SUPPLY IMPLANT | Supply/Implant | $11,569.79 |
| 6105309 | GENERAL SUPPLY | Supply/Implant | $384.00 |
| 6105313 | SUPPLY IMPLANT | Supply/Implant | $8,944.00 |
| 6105316 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6105335 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6105337 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6105347 | SUPPLY IMPLANT | Supply/Implant | $181.50 |
| 6105348 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6105353 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6105354 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $60,496.00 |
| 6105359 | GRAFT, VASCULAR | Supply/Implant | $90,880.00 |
| 6105360 | GRAFT, VASCULAR | Supply/Implant | $90,880.00 |
| 6105362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6105366 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6105368 | AICD, SINGLE CHAMBER | Supply/Implant | $138,127.50 |
| 6105373 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6105374 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6105375 | SUPPLY IMPLANT | Supply/Implant | $6,640.00 |
| 6105379 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6105382 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6105384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,398.40 |
| 6105385 | GENERAL SUPPLY | Supply/Implant | $648.96 |
| 6105389 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $102,400.00 |
| 6105390 | GENERAL SUPPLY | Supply/Implant | $448.26 |
| 6105391 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6105392 | CONN TISS, NON-HUMAN | Supply/Implant | $8,095.74 |
| 6105394 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6105402 | SUPPLY IMPLANT | Supply/Implant | $2,764.80 |
| 6105403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6105404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,035.20 |
| 6105408 | SUPPLY IMPLANT | Supply/Implant | $5,888.00 |
| 6105409 | SUPPLY IMPLANT | Supply/Implant | $13,378.56 |
| 6105411 | STERILE SUPPLY | Supply/Implant | $1,317.12 |
| 6105413 | STERILE SUPPLY | Supply/Implant | $467.20 |
| 6105415 | SUPPLY IMPLANT | Supply/Implant | $33,095.68 |
| 6105421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,209.28 |
| 6105422 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $75,072.00 |
| 6105424 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6105425 | STERILE SUPPLY | Supply/Implant | $172.54 |
| 6105432 | SUPPLY IMPLANT | Supply/Implant | $2,257.92 |
| 6105435 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6105448 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $35,712.00 |
| 6105455 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6105456 | GENERAL SUPPLY | Supply/Implant | $262.02 |
| 6105457 | GENERAL SUPPLY | Supply/Implant | $870.82 |
| 6105458 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6105459 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6105461 | SUPPLY IMPLANT | Supply/Implant | $2,214.40 |
| 6105463 | RET DEV, INSERTABLE | Supply/Implant | $8,320.00 |
| 6105464 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105465 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105466 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105467 | PROSTHETIC IMPLANT NOS | Supply/Implant | $76,800.00 |
| 6105470 | STERILE SUPPLY | Supply/Implant | $279.04 |
| 6105471 | SUPPLY IMPLANT | Supply/Implant | $3,655.68 |
| 6105472 | GUIDE WIRE | Supply/Implant | $2,005.18 |
| 6105479 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6105482 | STERILE SUPPLY | Supply/Implant | $865.28 |
| 6105489 | SUPPLY IMPLANT | Supply/Implant | $1,698.56 |
| 6105491 | SUPPLY IMPLANT | Supply/Implant | $7,659.52 |
| 6105492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6105493 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6105495 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,863.23 |
| 6105497 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6105499 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6105500 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6105506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6105529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6105530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,079.68 |
| 6105543 | GRAFT, VASCULAR | Supply/Implant | $29,440.00 |
| 6105549 | SUPPLY IMPLANT | Supply/Implant | $2,477.06 |
| 6105554 | SUPPLY IMPLANT | Supply/Implant | $1,830.40 |
| 6105555 | CATHETER, URETERAL | Supply/Implant | $143.74 |
| 6105556 | CATHETER, URETERAL | Supply/Implant | $143.74 |
| 6105557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,779.20 |
| 6105560 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6105561 | SUPPLY IMPLANT | Supply/Implant | $449.36 |
| 6105563 | GUIDE WIRE | Supply/Implant | $294.40 |
| 6105565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,594.88 |
| 6105578 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6105582 | SUPPLY IMPLANT | Supply/Implant | $4,837.12 |
| 6105587 | GENERAL SUPPLY | Supply/Implant | $160.26 |
| 6105588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6105589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6105590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6105592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6105593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6105594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6105595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $772.99 |
| 6105598 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,504.00 |
| 6105599 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $17,830.40 |
| 6105602 | GUIDE WIRE | Supply/Implant | $2,293.76 |
| 6105603 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6105604 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,888.00 |
| 6105606 | SUPPLY IMPLANT | Supply/Implant | $48,320.00 |
| 6105609 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6105620 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6105621 | GUIDE WIRE | Supply/Implant | $1,228.80 |
| 6105634 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6105647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105660 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6105665 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6105671 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6105672 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6105673 | STERILE SUPPLY | Supply/Implant | $294.94 |
| 6105675 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6105679 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6105688 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,031.36 |
| 6105692 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6105693 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6105697 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6105699 | GENERAL SUPPLY | Supply/Implant | $1,472.00 |
| 6105700 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6105701 | GENERAL SUPPLY | Supply/Implant | $332.80 |
| 6105702 | GENERAL SUPPLY | Supply/Implant | $5,760.00 |
| 6105704 | GENERAL SUPPLY | Supply/Implant | $704.00 |
| 6105706 | SUPPLY IMPLANT | Supply/Implant | $1,006.72 |
| 6105707 | GENERAL SUPPLY | Supply/Implant | $24,729.60 |
| 6105708 | GENERAL SUPPLY | Supply/Implant | $21,504.00 |
| 6105712 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6105720 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,369.60 |
| 6105721 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,186.18 |
| 6105723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6105727 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,040.00 |
| 6105728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6105740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6105741 | SUPPLY IMPLANT | Supply/Implant | $1,062.40 |
| 6105742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,489.28 |
| 6105744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,596.80 |
| 6105749 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6105750 | SUPPLY IMPLANT | Supply/Implant | $28,019.20 |
| 6105755 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105756 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105757 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105759 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6105762 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6105763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,560.00 |
| 6105765 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6105766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6105767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6105768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6105769 | CATH OCCLUSION | Supply/Implant | $14,860.80 |
| 6105770 | CATH OCCLUSION | Supply/Implant | $14,860.80 |
| 6105771 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6105772 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6105778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6105779 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6105780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,740.80 |
| 6105788 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6105807 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6105808 | GENERAL SUPPLY | Supply/Implant | $397.70 |
| 6105812 | BRACHYTHERAPY NEEDLE | Supply/Implant | $1,664.00 |
| 6105813 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6105814 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6105815 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,174.34 |
| 6105824 | SUPPLY IMPLANT | Supply/Implant | $283.26 |
| 6105825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6105832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6105840 | STERILE SUPPLY | Supply/Implant | $1,034.88 |
| 6105845 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6105847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6105855 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6105865 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,040.00 |
| 6105866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $79,897.60 |
| 6105874 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6105875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6105876 | GENERAL SUPPLY | Supply/Implant | $23,040.00 |
| 6105894 | AICD, SINGLE CHAMBER | Supply/Implant | $207,050.00 |
| 6105895 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $39,603.20 |
| 6105896 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $39,603.20 |
| 6105897 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $39,603.20 |
| 6105925 | AICD, SINGLE CHAMBER | Supply/Implant | $153,877.50 |
| 6105937 | STERILE SUPPLY | Supply/Implant | $4,614.40 |
| 6105940 | SUPPLY IMPLANT | Supply/Implant | $678.40 |
| 6105952 | SUPPLY IMPLANT | Supply/Implant | $4,073.47 |
| 6105957 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6105963 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6105964 | GRAFT, VASCULAR | Supply/Implant | $113,064.00 |
| 6105965 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6105966 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6105973 | SUPPLY IMPLANT | Supply/Implant | $339.46 |
| 6105976 | CATHETER, GUIDING | Supply/Implant | $640.00 |
| 6105992 | SUPPLY IMPLANT | Supply/Implant | $2,146.18 |
| 6105993 | SUPPLY IMPLANT | Supply/Implant | $2,146.18 |
| 6105995 | SUPPLY IMPLANT | Supply/Implant | $252.16 |
| 6105997 | SUPPLY IMPLANT | Supply/Implant | $1,267.20 |
| 6105999 | SUPPLY IMPLANT | Supply/Implant | $174.08 |
| 6106000 | SUPPLY IMPLANT | Supply/Implant | $2,649.22 |
| 6106001 | STERILE SUPPLY | Supply/Implant | $229.25 |
| 6106002 | SUPPLY IMPLANT | Supply/Implant | $5,665.60 |
| 6106005 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,687.55 |
| 6106009 | CATHETER, GUIDING | Supply/Implant | $385.92 |
| 6106010 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6106016 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $94,707.20 |
| 6106025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,038.98 |
| 6106029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $888.32 |
| 6106030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,845.95 |
| 6106034 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $4,352.00 |
| 6106045 | STERILE SUPPLY | Supply/Implant | $352.00 |
| 6106046 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6106049 | SUPPLY IMPLANT | Supply/Implant | $176.55 |
| 6106053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6106059 | SUPPLY IMPLANT | Supply/Implant | $652.93 |
| 6106060 | SUPPLY IMPLANT | Supply/Implant | $1,357.18 |
| 6106061 | SUPPLY IMPLANT | Supply/Implant | $1,357.18 |
| 6106071 | GENERAL SUPPLY | Supply/Implant | $734.72 |
| 6106088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6106097 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6106134 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6106136 | MESH (IMPLANTABLE) | Supply/Implant | $762.24 |
| 6106138 | SUPPLY IMPLANT | Supply/Implant | $2,622.46 |
| 6106139 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $14,289.66 |
| 6106140 | GUIDE WIRE | Supply/Implant | $231.30 |
| 6106147 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6106149 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6106163 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6106166 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6106168 | GENERAL SUPPLY | Supply/Implant | $1,009.41 |
| 6106172 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6106173 | STERILE SUPPLY | Supply/Implant | $130.82 |
| 6106178 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6106179 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,244.61 |
| 6106183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6106184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6106192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,658.56 |
| 6106195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,064.00 |
| 6106197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.46 |
| 6106198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.46 |
| 6106200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,786.56 |
| 6106202 | CATH, DRAINAGE | Supply/Implant | $4,257.79 |
| 6106203 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $20,864.00 |
| 6106207 | SUPPLY IMPLANT | Supply/Implant | $2,329.08 |
| 6106208 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,240.00 |
| 6106212 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6106213 | GENERAL SUPPLY | Supply/Implant | $194.56 |
| 6106215 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6106221 | SUPPLY IMPLANT | Supply/Implant | $7,847.30 |
| 6106223 | SUPPLY IMPLANT | Supply/Implant | $1,417.31 |
| 6106224 | CATH,HEMODIALYSIS,SHORT-TERM | Supply/Implant | $2,549.76 |
| 6106241 | CATHETER, GUIDING | Supply/Implant | $14,400.00 |
| 6106242 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6106244 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $576.00 |
| 6106251 | GENERAL SUPPLY | Supply/Implant | $4,616.19 |
| 6106252 | STERILE SUPPLY | Supply/Implant | $759.81 |
| 6106253 | STERILE SUPPLY | Supply/Implant | $8,486.40 |
| 6106254 | STERILE SUPPLY | Supply/Implant | $732.16 |
| 6106256 | STERILE SUPPLY | Supply/Implant | $2,875.39 |
| 6106257 | STERILE SUPPLY | Supply/Implant | $1,304.58 |
| 6106268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,936.00 |
| 6106273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6106274 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $768.00 |
| 6106275 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6106277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6106278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6106279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6106280 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6106281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6106282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6106283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6106284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6106285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,971.20 |
| 6106287 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6106288 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6106289 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6106290 | CATHETER, GUIDING | Supply/Implant | $4,352.00 |
| 6106291 | CATHETER, GUIDING | Supply/Implant | $4,352.00 |
| 6106292 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6106293 | GENERAL SUPPLY | Supply/Implant | $704.00 |
| 6106295 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $10,624.00 |
| 6106302 | CATHETER, URETERAL | Supply/Implant | $470.53 |
| 6106303 | CATHETER, URETERAL | Supply/Implant | $470.53 |
| 6106304 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6106307 | CATHETER, GUIDING | Supply/Implant | $1,943.04 |
| 6106308 | GUIDE WIRE | Supply/Implant | $2,675.20 |
| 6106310 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6106314 | GENERAL SUPPLY | Supply/Implant | $184.96 |
| 6106315 | GUIDE WIRE | Supply/Implant | $4,012.80 |
| 6106317 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6106324 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6106337 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $94,707.20 |
| 6106339 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,511.04 |
| 6106432 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6106433 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6106446 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6106450 | SUPPLY IMPLANT | Supply/Implant | $17,395.20 |
| 6106461 | CATHETER, URETERAL | Supply/Implant | $374.14 |
| 6106462 | CATHETER, URETERAL | Supply/Implant | $374.14 |
| 6106463 | CATHETER, URETERAL | Supply/Implant | $374.14 |
| 6106464 | CATHETER, URETERAL | Supply/Implant | $331.14 |
| 6106467 | SUPPLY IMPLANT | Supply/Implant | $1,667.97 |
| 6106468 | SUPPLY IMPLANT | Supply/Implant | $1,667.97 |
| 6106471 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6106477 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,595.52 |
| 6106482 | SUPPLY IMPLANT | Supply/Implant | $2,185.38 |
| 6106483 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6106485 | GUIDE WIRE | Supply/Implant | $2,124.80 |
| 6106486 | CATH, DRAINAGE | Supply/Implant | $832.00 |
| 6106491 | SUPPLY IMPLANT | Supply/Implant | $2,518.53 |
| 6106517 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6106523 | STERILE SUPPLY | Supply/Implant | $43,456.00 |
| 6106524 | SUPPLY IMPLANT | Supply/Implant | $2,506.24 |
| 6106533 | SUPPLY IMPLANT | Supply/Implant | $909.34 |
| 6106548 | SUPPLY IMPLANT | Supply/Implant | $174.82 |
| 6106549 | SUPPLY IMPLANT | Supply/Implant | $175.55 |
| 6106551 | SUPPLY IMPLANT | Supply/Implant | $156.67 |
| 6106555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,193.34 |
| 6106556 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,120.45 |
| 6106558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6106559 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,818.88 |
| 6106566 | SUPPLY IMPLANT | Supply/Implant | $1,953.28 |
| 6106567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6106571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,318.78 |
| 6106572 | SUPPLY IMPLANT | Supply/Implant | $3,055.87 |
| 6106573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $980.22 |
| 6106577 | SUPPLY IMPLANT | Supply/Implant | $20,303.36 |
| 6106595 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6106606 | SUPPLY IMPLANT | Supply/Implant | $2,717.26 |
| 6106617 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $872.83 |
| 6106620 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6106621 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6106631 | SUPPLY IMPLANT | Supply/Implant | $1,205.12 |
| 6106634 | SUPPLY IMPLANT | Supply/Implant | $2,294.78 |
| 6106635 | SUPPLY IMPLANT | Supply/Implant | $2,876.67 |
| 6106636 | CLOSURE DEV, VASC | Supply/Implant | $3,687.94 |
| 6106637 | SUPPLY IMPLANT | Supply/Implant | $3,818.85 |
| 6106640 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,595.26 |
| 6106641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,943.04 |
| 6106643 | STERILE SUPPLY | Supply/Implant | $533.50 |
| 6106644 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6106647 | SUPPLY IMPLANT | Supply/Implant | $583.55 |
| 6106650 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6106651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,596.80 |
| 6106655 | GRAFT, VASCULAR | Supply/Implant | $115,689.00 |
| 6106656 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6106658 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,052.80 |
| 6106668 | GENERAL SUPPLY | Supply/Implant | $188.16 |
| 6106677 | STERILE SUPPLY | Supply/Implant | $2,127.56 |
| 6106678 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6106679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,964.16 |
| 6106680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6106681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6106691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $788.74 |
| 6106693 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6106694 | SUPPLY IMPLANT | Supply/Implant | $457.60 |
| 6106695 | LEAD, NEUROSTIMULATOR | Supply/Implant | $52,224.00 |
| 6106696 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $226,543.00 |
| 6106697 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6106698 | SUPPLY IMPLANT | Supply/Implant | $1,038.21 |
| 6106699 | CATHETER, GUIDING | Supply/Implant | $3,878.40 |
| 6106700 | CATHETER, GUIDING | Supply/Implant | $3,878.40 |
| 6106701 | GENERAL SUPPLY | Supply/Implant | $140.80 |
| 6106704 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6106706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6106707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6106717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6106721 | SUPPLY IMPLANT | Supply/Implant | $128.00 |
| 6106722 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6106725 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6106726 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6106728 | GENERAL SUPPLY | Supply/Implant | $149.76 |
| 6106729 | GENERAL SUPPLY | Supply/Implant | $161.28 |
| 6106744 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6106751 | CATH, DRAINAGE | Supply/Implant | $1,792.00 |
| 6106757 | CATH, DRAINAGE | Supply/Implant | $1,792.00 |
| 6106758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,798.40 |
| 6106762 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106763 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106764 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106765 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106766 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,044.16 |
| 6106780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,312.00 |
| 6106792 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6106801 | SUPPLY IMPLANT | Supply/Implant | $143.36 |
| 6106807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6106808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6106809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6106810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6106811 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,069.76 |
| 6106815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6106832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6106834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,732.80 |
| 6106835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,732.80 |
| 6106850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,352.96 |
| 6106851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,352.96 |
| 6106853 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6106858 | CATHETER, GUIDING | Supply/Implant | $1,632.00 |
| 6106860 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6106861 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6106862 | CONN TISS, NON-HUMAN | Supply/Implant | $1,025.66 |
| 6106873 | GENERAL SUPPLY | Supply/Implant | $5,888.00 |
| 6106876 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6106877 | GENERAL SUPPLY | Supply/Implant | $307.20 |
| 6106879 | GENERAL SUPPLY | Supply/Implant | $32,768.00 |
| 6106880 | GENERAL SUPPLY | Supply/Implant | $1,023.36 |
| 6106881 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,843.20 |
| 6106883 | SUPPLY IMPLANT | Supply/Implant | $1,228.03 |
| 6106884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6106885 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $38,336.00 |
| 6106887 | SUPPLY IMPLANT | Supply/Implant | $1,407.10 |
| 6106888 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6106890 | GENERAL SUPPLY | Supply/Implant | $717.06 |
| 6106892 | BRACHYTHERAPY NEEDLE | Supply/Implant | $160.00 |
| 6106893 | BRACHYTHERAPY NEEDLE | Supply/Implant | $176.90 |
| 6106896 | STERILE SUPPLY | Supply/Implant | $312.06 |
| 6106897 | STERILE SUPPLY | Supply/Implant | $491.78 |
| 6106916 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $22,912.00 |
| 6106918 | CATHETER, GUIDING | Supply/Implant | $652.80 |
| 6106919 | GUIDE WIRE | Supply/Implant | $12,160.00 |
| 6106924 | SUPPLY IMPLANT | Supply/Implant | $1,273.60 |
| 6106929 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $14,464.00 |
| 6106931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6106934 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6106935 | GUIDE WIRE | Supply/Implant | $1,228.80 |
| 6106937 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,689.60 |
| 6106938 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,689.60 |
| 6106944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6106952 | SUPPLY IMPLANT | Supply/Implant | $415.36 |
| 6106953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,289.28 |
| 6106955 | SUPPLY IMPLANT | Supply/Implant | $398.34 |
| 6106957 | GRAFT, VASCULAR | Supply/Implant | $6,130.56 |
| 6106958 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $6,690.82 |
| 6106959 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6106962 | SUPPLY IMPLANT | Supply/Implant | $121,296.00 |
| 6106967 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6106968 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6106975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,611.52 |
| 6106983 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $32,640.00 |
| 6106985 | GRAFT, VASCULAR | Supply/Implant | $121,296.00 |
| 6106994 | CATHETER, GUIDING | Supply/Implant | $19,456.00 |
| 6106995 | CATHETER, GUIDING | Supply/Implant | $19,456.00 |
| 6106998 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6107014 | SUPPLY IMPLANT | Supply/Implant | $3,241.60 |
| 6107015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6107018 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6107019 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6107027 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6107028 | SUPPLY IMPLANT | Supply/Implant | $1,032.19 |
| 6107034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,844.80 |
| 6107040 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6107041 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6107043 | SUPPLY IMPLANT | Supply/Implant | $1,265.66 |
| 6107048 | CATH, DRAINAGE | Supply/Implant | $832.00 |
| 6107049 | CATH, DRAINAGE | Supply/Implant | $832.00 |
| 6107053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6107055 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6107060 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6107066 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6107068 | SUPPLY IMPLANT | Supply/Implant | $13,465.60 |
| 6107071 | GENERAL SUPPLY | Supply/Implant | $671.59 |
| 6107082 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6107083 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6107086 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6107087 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6107091 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,655.04 |
| 6107092 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $4,992.00 |
| 6107096 | PROSTHETIC IMPLANT NOS | Supply/Implant | $178,820.25 |
| 6107104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,228.16 |
| 6107106 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6107112 | GUIDE WIRE | Supply/Implant | $633.60 |
| 6107113 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6107131 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6107133 | GUIDE WIRE | Supply/Implant | $6,952.70 |
| 6107142 | SUPPLY IMPLANT | Supply/Implant | $4,467.20 |
| 6107146 | SUPPLY IMPLANT | Supply/Implant | $5,683.20 |
| 6107151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6107152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6107155 | GUIDE WIRE | Supply/Implant | $2,726.40 |
| 6107158 | SUPPLY IMPLANT | Supply/Implant | $10,892.80 |
| 6107159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $323.97 |
| 6107160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6107161 | SUPPLY IMPLANT | Supply/Implant | $9,256.96 |
| 6107162 | SUPPLY IMPLANT | Supply/Implant | $9,256.96 |
| 6107165 | IMPL EXT ACCESS CATH | Supply/Implant | $12,386.30 |
| 6107166 | IMPL EXT ACCESS CATH | Supply/Implant | $9,256.96 |
| 6107169 | IMPL EXT ACCESS CATH | Supply/Implant | $4,928.00 |
| 6107170 | IMPL EXT ACCESS CATH | Supply/Implant | $4,928.00 |
| 6107171 | SUPPLY IMPLANT | Supply/Implant | $4,320.00 |
| 6107177 | INTRO/SHEATH, NON-LASER | Supply/Implant | $640.00 |
| 6107179 | GENERAL SUPPLY | Supply/Implant | $242.18 |
| 6107180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6107181 | STERILE SUPPLY | Supply/Implant | $244.35 |
| 6107185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,600.32 |
| 6107192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.51 |
| 6107193 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6107194 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $106,752.00 |
| 6107198 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6107209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6107211 | GUIDE WIRE | Supply/Implant | $335.87 |
| 6107213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6107215 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6107218 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6107219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6107221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6107223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6107224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6107226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,267.20 |
| 6107229 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6107230 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6107231 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6107236 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6107237 | GENERAL SUPPLY | Supply/Implant | $1,344.00 |
| 6107241 | STERILE SUPPLY | Supply/Implant | $595.20 |
| 6107242 | STERILE SUPPLY | Supply/Implant | $928.00 |
| 6107243 | GENERAL SUPPLY | Supply/Implant | $947.20 |
| 6107244 | STERILE SUPPLY | Supply/Implant | $560.00 |
| 6107251 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $75,072.00 |
| 6107257 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,871.68 |
| 6107258 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,871.68 |
| 6107259 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $16,871.68 |
| 6107275 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6107286 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6107289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6107290 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6107293 | SUPPLY IMPLANT | Supply/Implant | $931.46 |
| 6107302 | SUPPLY IMPLANT | Supply/Implant | $4,684.80 |
| 6107304 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6107305 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6107307 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,928.70 |
| 6107324 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6107325 | GUIDE WIRE | Supply/Implant | $4,352.00 |
| 6107330 | SUPPLY IMPLANT | Supply/Implant | $27,584.00 |
| 6107354 | STERILE SUPPLY | Supply/Implant | $622.34 |
| 6107355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6107370 | SUPPLY IMPLANT | Supply/Implant | $32,988.03 |
| 6107372 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6107375 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6107381 | SUPPLY IMPLANT | Supply/Implant | $12,608.00 |
| 6107409 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $948.48 |
| 6107410 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,923.84 |
| 6107411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6107412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6107416 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6107417 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107418 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107419 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107420 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $896.00 |
| 6107422 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6107423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6107424 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6107425 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6107426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $563.20 |
| 6107427 | SUPPLY IMPLANT | Supply/Implant | $588.80 |
| 6107428 | SUPPLY IMPLANT | Supply/Implant | $563.20 |
| 6107429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6107430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,600.00 |
| 6107432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6107434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6107442 | SUPPLY IMPLANT | Supply/Implant | $187.65 |
| 6107453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6107458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6107459 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6107463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,254.40 |
| 6107465 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6107466 | INTERSPINOUS IMPLANT | Supply/Implant | $3,200.00 |
| 6107467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6107478 | STERILE SUPPLY | Supply/Implant | $128.26 |
| 6107491 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6107492 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,852.80 |
| 6107494 | INTRO/SHEATH, NON-LASER | Supply/Implant | $268.80 |
| 6107496 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6107498 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6107499 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6107500 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6107501 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6107502 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6107507 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6107510 | SUPPLY IMPLANT | Supply/Implant | $2,062.08 |
| 6107514 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6107515 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6107518 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6107520 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $1,983.36 |
| 6107524 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6107527 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6107528 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6107536 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $14,144.00 |
| 6107537 | CATHETER, GUIDING | Supply/Implant | $13,760.00 |
| 6107538 | CATHETER, GUIDING | Supply/Implant | $13,760.00 |
| 6107539 | CATHETER, GUIDING | Supply/Implant | $22,361.60 |
| 6107540 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6107541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,852.80 |
| 6107542 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,240.00 |
| 6107546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6107551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,288.00 |
| 6107553 | OCULAR IMPLANT | Supply/Implant | $7,616.00 |
| 6107557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6107558 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107560 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6107561 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6107562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6107563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,822.40 |
| 6107564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,822.40 |
| 6107565 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,152.00 |
| 6107598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6107632 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107636 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107638 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6107774 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6107775 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6107776 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,055.36 |
| 6107777 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6107778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6107779 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6107780 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6107782 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6107790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6107858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6107862 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6107866 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6107870 | GUIDE WIRE | Supply/Implant | $3,398.40 |
| 6107871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6107872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6107880 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6107882 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6107883 | SUPPLY IMPLANT | Supply/Implant | $16,721.92 |
| 6107884 | CATHETER, GUIDING | Supply/Implant | $424.96 |
| 6107888 | GENERAL SUPPLY | Supply/Implant | $128.64 |
| 6107933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6107934 | SUPPLY IMPLANT | Supply/Implant | $444.80 |
| 6107937 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6107942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6107943 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,585.92 |
| 6107953 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6107956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,344.96 |
| 6107997 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6108076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6108093 | SUPPLY IMPLANT | Supply/Implant | $7,270.40 |
| 6108094 | STERILE SUPPLY | Supply/Implant | $206.85 |
| 6108100 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6108101 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,240.00 |
| 6108153 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,624.00 |
| 6108234 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,693.25 |
| 6108238 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,693.25 |
| 6108240 | SUPPLY IMPLANT | Supply/Implant | $180.10 |
| 6108241 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6108244 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6108245 | SUPPLY IMPLANT | Supply/Implant | $207.87 |
| 6108247 | GUIDE WIRE | Supply/Implant | $443.90 |
| 6108259 | STERILE SUPPLY | Supply/Implant | $386.07 |
| 6108260 | STERILE SUPPLY | Supply/Implant | $645.12 |
| 6108261 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $178,500.00 |
| 6108263 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $32,000.00 |
| 6108264 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6108266 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6108281 | STERILE SUPPLY | Supply/Implant | $10,531.46 |
| 6108286 | SUPPLY IMPLANT | Supply/Implant | $632.32 |
| 6108289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6108291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6108292 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6108293 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6108294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6108295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6108300 | GUIDE WIRE | Supply/Implant | $3,324.16 |
| 6108302 | SUPPLY IMPLANT | Supply/Implant | $189,378.00 |
| 6108308 | SUPPLY IMPLANT | Supply/Implant | $345.34 |
| 6108309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6108310 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $1,280.00 |
| 6108311 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,600.00 |
| 6108312 | GENERAL SUPPLY | Supply/Implant | $138.62 |
| 6108315 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6108319 | SUPPLY IMPLANT | Supply/Implant | $268.16 |
| 6108320 | SUPPLY IMPLANT | Supply/Implant | $2,259.20 |
| 6108321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6108325 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $6,336.00 |
| 6108326 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6108330 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6108331 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6108335 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6108336 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6108342 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6108343 | GENERAL SUPPLY | Supply/Implant | $516.61 |
| 6108344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6108361 | SUPPLY IMPLANT | Supply/Implant | $209.29 |
| 6108362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,590.40 |
| 6108363 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6108369 | SUPPLY IMPLANT | Supply/Implant | $1,544.96 |
| 6108379 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6108380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6108381 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,378.56 |
| 6108386 | LEAD, NEUROSTIMULATOR | Supply/Implant | $50,560.00 |
| 6108387 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $322,442.50 |
| 6108388 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,800.00 |
| 6108389 | LEAD, NEUROSTIMULATOR | Supply/Implant | $50,560.00 |
| 6108392 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,200.00 |
| 6108397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,622.40 |
| 6108400 | GRAFT, VASCULAR | Supply/Implant | $65,280.00 |
| 6108402 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6108404 | CATHETER, GUIDING | Supply/Implant | $14,144.00 |
| 6108422 | STERILE SUPPLY | Supply/Implant | $545.28 |
| 6108423 | STERILE SUPPLY | Supply/Implant | $491.52 |
| 6108425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6108429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,867.20 |
| 6108430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6108431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6108432 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6108434 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6108435 | INTRO/SHEATH, NON-LASER | Supply/Implant | $448.00 |
| 6108436 | INTRO/SHEATH, NON-LASER | Supply/Implant | $173.31 |
| 6108437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,364.80 |
| 6108451 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6108455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6108456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6108457 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6108458 | CATHETER, GUIDING | Supply/Implant | $2,137.60 |
| 6108460 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6108462 | SUPPLY IMPLANT | Supply/Implant | $243.79 |
| 6108463 | SUPPLY IMPLANT | Supply/Implant | $243.79 |
| 6108467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,536.00 |
| 6108485 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,920.00 |
| 6108493 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,484.93 |
| 6108506 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,678.59 |
| 6108514 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,484.93 |
| 6108539 | SUPPLY IMPLANT | Supply/Implant | $774.78 |
| 6108542 | SUPPLY IMPLANT | Supply/Implant | $1,368.70 |
| 6108545 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6108546 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6108547 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $43,456.00 |
| 6108548 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6108552 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6108554 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6108565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6108568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6108569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6108570 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6108575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6108576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6108577 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6108581 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $15,129.60 |
| 6108582 | SUPPLY IMPLANT | Supply/Implant | $22,131.20 |
| 6108583 | HFO W/JOINT(S) CF | Supply/Implant | $20,800.00 |
| 6108591 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,664.00 |
| 6108592 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,664.00 |
| 6108593 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,664.00 |
| 6108594 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6108596 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6108600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,144.32 |
| 6108606 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6108608 | SUPPLY IMPLANT | Supply/Implant | $203.26 |
| 6108611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,120.00 |
| 6108612 | SUPPLY IMPLANT | Supply/Implant | $1,779.20 |
| 6108615 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,000.00 |
| 6108620 | SUPPLY IMPLANT | Supply/Implant | $113,064.00 |
| 6108621 | SUPPLY IMPLANT | Supply/Implant | $38,464.00 |
| 6108622 | SUPPLY IMPLANT | Supply/Implant | $38,464.00 |
| 6108623 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6108624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6108632 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,800.00 |
| 6108636 | STERILE SUPPLY | Supply/Implant | $662.78 |
| 6108639 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,752.00 |
| 6108642 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6108643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6108644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6108645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6108646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6108647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,176.96 |
| 6108648 | CATH, SUPRAPUBIC/CYSTOSCOPIC | Supply/Implant | $518.40 |
| 6108660 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6108661 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6108662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,752.00 |
| 6108674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,206.40 |
| 6108676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,008.00 |
| 6108680 | GENERAL SUPPLY | Supply/Implant | $7,489.79 |
| 6108684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,510.78 |
| 6108685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,991.42 |
| 6108688 | SUPPLY IMPLANT | Supply/Implant | $2,994.69 |
| 6108690 | SUPPLY IMPLANT | Supply/Implant | $5,385.98 |
| 6108691 | SUPPLY IMPLANT | Supply/Implant | $11,956.74 |
| 6108699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6108702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6108704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6108705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6108706 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6108707 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6108708 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6108711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6108712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6108713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6108718 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6108721 | SUPPLY IMPLANT | Supply/Implant | $887.81 |
| 6108736 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,816.00 |
| 6108738 | SUPPLY IMPLANT | Supply/Implant | $1,407.05 |
| 6108739 | SUPPLY IMPLANT | Supply/Implant | $5,940.48 |
| 6108740 | SUPPLY IMPLANT | Supply/Implant | $5,940.48 |
| 6108741 | SUPPLY IMPLANT | Supply/Implant | $236.80 |
| 6108747 | GENERAL SUPPLY | Supply/Implant | $341.63 |
| 6108751 | INTERSPINOUS IMPLANT | Supply/Implant | $33,932.80 |
| 6108752 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $431.10 |
| 6108757 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6108766 | GENERAL SUPPLY | Supply/Implant | $186.88 |
| 6108767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,745.28 |
| 6108785 | SUPPLY IMPLANT | Supply/Implant | $18,048.00 |
| 6108788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6108794 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6108795 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6108799 | SUPPLY IMPLANT | Supply/Implant | $1,516.16 |
| 6108801 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6108803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6108806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6108807 | SUPPLY IMPLANT | Supply/Implant | $2,828.80 |
| 6108815 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6108816 | SUPPLY IMPLANT | Supply/Implant | $15,518.85 |
| 6108818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6108823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,896.00 |
| 6108824 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6108828 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6108835 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6108837 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,624.00 |
| 6108848 | CRYOABLATION PROBE | Supply/Implant | $35,840.00 |
| 6108849 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6108864 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $10,560.00 |
| 6108865 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $7,680.00 |
| 6108866 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $8,140.80 |
| 6108867 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $25,344.00 |
| 6108869 | SUPPLY IMPLANT | Supply/Implant | $12,772.22 |
| 6108871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6108878 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $112,512.00 |
| 6108881 | SUPPLY IMPLANT | Supply/Implant | $53,785.60 |
| 6108884 | SUPPLY IMPLANT | Supply/Implant | $12,608.00 |
| 6108893 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6108894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6108900 | SUPPLY IMPLANT | Supply/Implant | $807.55 |
| 6108902 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,676.80 |
| 6108908 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6108946 | SUPPLY IMPLANT | Supply/Implant | $1,447.04 |
| 6108952 | GENERAL SUPPLY | Supply/Implant | $319.62 |
| 6108965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6108966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6108967 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6108968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6108969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6108970 | SUPPLY IMPLANT | Supply/Implant | $2,114.56 |
| 6108971 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6108972 | SUPPLY IMPLANT | Supply/Implant | $2,836.48 |
| 6108973 | INTRO/SHEATH, NON-LASER | Supply/Implant | $934.40 |
| 6108979 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,452.80 |
| 6108989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $764.67 |
| 6108991 | GENERAL SUPPLY | Supply/Implant | $1,516.16 |
| 6108995 | STERILE SUPPLY | Supply/Implant | $23,040.00 |
| 6109000 | SUPPLY IMPLANT | Supply/Implant | $7,028.74 |
| 6109004 | GENERAL SUPPLY | Supply/Implant | $722.94 |
| 6109005 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,395.20 |
| 6109006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,803.20 |
| 6109007 | PROSTHETIC IMPLANT NOS | Supply/Implant | $149,765.60 |
| 6109011 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109012 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109013 | SUPPLY IMPLANT | Supply/Implant | $177.60 |
| 6109016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6109018 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6109022 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6109024 | CATHETER, INTRASPINAL | Supply/Implant | $847.49 |
| 6109025 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6109028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,288.32 |
| 6109041 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6109042 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6109043 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6109046 | SUPPLY IMPLANT | Supply/Implant | $4,903.42 |
| 6109047 | SUPPLY IMPLANT | Supply/Implant | $14,454.40 |
| 6109048 | SUPPLY IMPLANT | Supply/Implant | $24,772.86 |
| 6109049 | SUPPLY IMPLANT | Supply/Implant | $34,560.00 |
| 6109054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6109057 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6109060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $409.60 |
| 6109063 | GENERAL SUPPLY | Supply/Implant | $470.40 |
| 6109069 | GENERAL SUPPLY | Supply/Implant | $1,044.48 |
| 6109074 | SUPPLY IMPLANT | Supply/Implant | $12,147.20 |
| 6109077 | SUPPLY IMPLANT | Supply/Implant | $368.51 |
| 6109085 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $183,750.00 |
| 6109088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,060.80 |
| 6109095 | STERILE SUPPLY | Supply/Implant | $339.46 |
| 6109098 | STERILE SUPPLY | Supply/Implant | $670.34 |
| 6109100 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6109104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6109106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,060.80 |
| 6109107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6109108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6109114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6109136 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6109137 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6109149 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $161,437.50 |
| 6109154 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $5,124.74 |
| 6109182 | AUD OSSEO DEV INT/EXT COMP | Supply/Implant | $23,283.20 |
| 6109183 | STERILE SUPPLY | Supply/Implant | $160.13 |
| 6109194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6109195 | STERILE SUPPLY | Supply/Implant | $481.92 |
| 6109197 | STERILE SUPPLY | Supply/Implant | $238.08 |
| 6109199 | SUPPLY IMPLANT | Supply/Implant | $2,231.30 |
| 6109200 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6109208 | STERILE SUPPLY | Supply/Implant | $256.17 |
| 6109220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,912.00 |
| 6109221 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6109222 | SUPPLY IMPLANT | Supply/Implant | $332.90 |
| 6109225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6109228 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6109245 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6109246 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6109247 | SUPPLY IMPLANT | Supply/Implant | $3,205.38 |
| 6109248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109251 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6109255 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109256 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109265 | SUPPLY IMPLANT | Supply/Implant | $2,616.32 |
| 6109279 | GENERAL SUPPLY | Supply/Implant | $1,039.72 |
| 6109280 | SUPPLY IMPLANT | Supply/Implant | $462.23 |
| 6109281 | SUPPLY IMPLANT | Supply/Implant | $502.91 |
| 6109282 | STERILE SUPPLY | Supply/Implant | $13,440.00 |
| 6109284 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6109285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,188.80 |
| 6109287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6109291 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,335.36 |
| 6109292 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $7,368.96 |
| 6109295 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6109304 | STERILE SUPPLY | Supply/Implant | $475.90 |
| 6109305 | ORTH/DEVIC/DRUG BN/BN,TIS/BN | Supply/Implant | $42,496.00 |
| 6109314 | SUPPLY IMPLANT | Supply/Implant | $5,401.60 |
| 6109316 | SUPPLY IMPLANT | Supply/Implant | $1,966.46 |
| 6109317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,023.36 |
| 6109321 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6109323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6109325 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6109351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6109352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6109353 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6109354 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6109366 | SUPPLY IMPLANT | Supply/Implant | $957.70 |
| 6109373 | STERILE SUPPLY | Supply/Implant | $819.20 |
| 6109379 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6109380 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6109384 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6109385 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6109390 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6109395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,920.00 |
| 6109396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,036.80 |
| 6109402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6109410 | GENERAL SUPPLY | Supply/Implant | $520.19 |
| 6109412 | GENERAL SUPPLY | Supply/Implant | $239.62 |
| 6109413 | STERILE SUPPLY | Supply/Implant | $432.51 |
| 6109415 | SUPPLY IMPLANT | Supply/Implant | $168.06 |
| 6109416 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6109423 | SUPPLY IMPLANT | Supply/Implant | $4,915.20 |
| 6109429 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6109455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $91,200.00 |
| 6109456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6109457 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6109458 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,600.00 |
| 6109459 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $576.00 |
| 6109461 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6109464 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,580.80 |
| 6109465 | INTRO/SHEATH, NON-LASER | Supply/Implant | $5,580.80 |
| 6109490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6109498 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6109499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,872.64 |
| 6109539 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,426.94 |
| 6109541 | GENERAL SUPPLY | Supply/Implant | $1,740.80 |
| 6109558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,328.83 |
| 6109561 | GENERAL SUPPLY | Supply/Implant | $304.00 |
| 6109565 | SUPPLY IMPLANT | Supply/Implant | $14,808.32 |
| 6109570 | GENERAL SUPPLY | Supply/Implant | $159.74 |
| 6109574 | AICD, SINGLE CHAMBER | Supply/Implant | $153,877.50 |
| 6109592 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6109593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6109595 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6109598 | SUPPLY IMPLANT | Supply/Implant | $1,045.89 |
| 6109609 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6109611 | STERILE SUPPLY | Supply/Implant | $1,508.61 |
| 6109612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,944.32 |
| 6109613 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6109619 | SUPPLY IMPLANT | Supply/Implant | $538.88 |
| 6109620 | SUPPLY IMPLANT | Supply/Implant | $538.88 |
| 6109621 | SUPPLY IMPLANT | Supply/Implant | $538.88 |
| 6109623 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $127,936.00 |
| 6109624 | SEPTAL DEFECT IMP SYS | Supply/Implant | $127,936.00 |
| 6109629 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6109634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6109635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6109637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6109638 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6109639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,023.36 |
| 6109647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6109651 | GENERAL SUPPLY | Supply/Implant | $156.60 |
| 6109656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6109657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6109658 | GUIDE WIRE | Supply/Implant | $4,352.00 |
| 6109660 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,970.37 |
| 6109662 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $13,440.00 |
| 6109664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6109666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6109668 | SUPPLY IMPLANT | Supply/Implant | $506.88 |
| 6109674 | CATHETER, GUIDING | Supply/Implant | $1,774.08 |
| 6109675 | CATHETER, GUIDING | Supply/Implant | $2,112.00 |
| 6109677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6109678 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $92,800.00 |
| 6109689 | SKIN SUBSTITUTE, NOS | Supply/Implant | $3,970.05 |
| 6109690 | SKIN SUBSTITUTE, NOS | Supply/Implant | $5,923.84 |
| 6109691 | SUPPLY IMPLANT | Supply/Implant | $6,976.64 |
| 6109692 | SUPPLY IMPLANT | Supply/Implant | $10,812.93 |
| 6109693 | SUPPLY IMPLANT | Supply/Implant | $15,039.62 |
| 6109694 | SKIN SUBSTITUTE, NOS | Supply/Implant | $21,117.31 |
| 6109697 | SUPPLY IMPLANT | Supply/Implant | $6,976.64 |
| 6109699 | SUPPLY IMPLANT | Supply/Implant | $15,862.53 |
| 6109700 | SUPPLY IMPLANT | Supply/Implant | $9,099.39 |
| 6109702 | STERILE SUPPLY | Supply/Implant | $1,428.48 |
| 6109703 | AICD, DUAL CHAMBER | Supply/Implant | $168,735.00 |
| 6109704 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6109716 | SUPPLY IMPLANT | Supply/Implant | $7,859.20 |
| 6109717 | SUPPLY IMPLANT | Supply/Implant | $11,264.00 |
| 6109718 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6109726 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6109738 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109739 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6109740 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109743 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109744 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109745 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109746 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $10,176.00 |
| 6109749 | GRAFT, VASCULAR | Supply/Implant | $118,387.50 |
| 6109764 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6109768 | PMKR, DUAL, RATE-RESP | Supply/Implant | $51,200.00 |
| 6109770 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $44,800.00 |
| 6109771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,817.60 |
| 6109773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6109774 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6109775 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6109776 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6109777 | SUPPLY IMPLANT | Supply/Implant | $4,999.68 |
| 6109779 | GUIDE WIRE | Supply/Implant | $341.25 |
| 6109785 | GRAFT, VASCULAR | Supply/Implant | $4,305.41 |
| 6109789 | INTRO/SHEATH, NON-LASER | Supply/Implant | $956.16 |
| 6109802 | SUPPLY IMPLANT | Supply/Implant | $1,751.04 |
| 6109803 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,907.20 |
| 6109809 | SUPPLY IMPLANT | Supply/Implant | $570.75 |
| 6109813 | SUPPLY IMPLANT | Supply/Implant | $4,288.00 |
| 6109820 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6109826 | SUPPLY IMPLANT | Supply/Implant | $10,270.72 |
| 6109828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,369.60 |
| 6109831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,328.83 |
| 6109832 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $716.80 |
| 6109835 | STERILE SUPPLY | Supply/Implant | $8,292.74 |
| 6109840 | GENERAL SUPPLY | Supply/Implant | $625.79 |
| 6109840 | GENERAL SUPPLY | Supply/Implant | $648.91 |
| 6109841 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6109843 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6109848 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $5,696.00 |
| 6109852 | SUPPLY IMPLANT | Supply/Implant | $1,136.51 |
| 6109861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6109862 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6109863 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6109865 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6109867 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6109868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6109870 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,969.60 |
| 6109873 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6109874 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6109875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,780.48 |
| 6109876 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,836.80 |
| 6109878 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,148.80 |
| 6109882 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6109884 | STERILE SUPPLY | Supply/Implant | $8,960.00 |
| 6109891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6109894 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6109896 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6109923 | SUPPLY IMPLANT | Supply/Implant | $1,318.40 |
| 6109927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6109928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6109932 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6109933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6109935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6109943 | MESH (IMPLANTABLE) | Supply/Implant | $98,944.00 |
| 6109945 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $26,304.00 |
| 6109949 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,539.20 |
| 6109970 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6109973 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6109974 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6109975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6109976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6109978 | OCULAR IMPLANT | Supply/Implant | $7,680.00 |
| 6109981 | STERILE SUPPLY | Supply/Implant | $965.63 |
| 6109985 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6109986 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6109988 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6109989 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,224.00 |
| 6109992 | SUPPLY IMPLANT | Supply/Implant | $6,361.86 |
| 6109997 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6109998 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6110000 | STERILE SUPPLY | Supply/Implant | $1,122.69 |
| 6110002 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6110003 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6110005 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6110008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6110009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6110012 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6110013 | GRAFT, VASCULAR | Supply/Implant | $77,824.00 |
| 6110014 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,980.80 |
| 6110019 | GENERAL SUPPLY | Supply/Implant | $133.89 |
| 6110020 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6110027 | CATH, DRAINAGE | Supply/Implant | $17,164.80 |
| 6110028 | CATH, DRAINAGE | Supply/Implant | $17,164.80 |
| 6110031 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6110035 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6110042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6110043 | SUPPLY IMPLANT | Supply/Implant | $3,727.36 |
| 6110046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6110048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6110049 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6110051 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6110052 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $14,016.00 |
| 6110056 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110060 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6110075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,484.48 |
| 6110077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,836.16 |
| 6110079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6110080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6110081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6110083 | SUPPLY IMPLANT | Supply/Implant | $566.91 |
| 6110084 | SUPPLY IMPLANT | Supply/Implant | $566.91 |
| 6110089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6110099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6110101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6110104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6110108 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6110115 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6110119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6110124 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6110126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6110127 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6110129 | GUIDE WIRE | Supply/Implant | $8,064.00 |
| 6110132 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6110133 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6110134 | SUPPLY IMPLANT | Supply/Implant | $3,467.14 |
| 6110135 | STERILE SUPPLY | Supply/Implant | $2,249.60 |
| 6110137 | SUPPLY IMPLANT | Supply/Implant | $38,438.40 |
| 6110138 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6110145 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,681.22 |
| 6110150 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6110151 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6110153 | GUIDE WIRE | Supply/Implant | $3,596.80 |
| 6110154 | GUIDE WIRE | Supply/Implant | $3,840.00 |
| 6110155 | GUIDE WIRE | Supply/Implant | $3,532.80 |
| 6110156 | GUIDE WIRE | Supply/Implant | $3,776.00 |
| 6110158 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,152.00 |
| 6110159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6110162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,815.36 |
| 6110163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,687.36 |
| 6110167 | SUPPLY IMPLANT | Supply/Implant | $2,129.54 |
| 6110173 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6110174 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6110175 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6110184 | SUPPLY IMPLANT | Supply/Implant | $114,726.40 |
| 6110185 | SUPPLY IMPLANT | Supply/Implant | $114,726.40 |
| 6110186 | SUPPLY IMPLANT | Supply/Implant | $34,560.00 |
| 6110189 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6110190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6110194 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6110206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6110223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6110231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6110232 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6110233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6110241 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6110242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6110243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,424.00 |
| 6110250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6110307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6110308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110309 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110310 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110313 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6110315 | STERILE SUPPLY | Supply/Implant | $14,904.83 |
| 6110316 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $1,280.00 |
| 6110317 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $12,736.00 |
| 6110323 | STERILE SUPPLY | Supply/Implant | $774.14 |
| 6110324 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,484.80 |
| 6110344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6110348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6110349 | SUPPLY IMPLANT | Supply/Implant | $401,071.00 |
| 6110350 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6110365 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6110366 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6110367 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6110368 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6110369 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6110370 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6110372 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6110373 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6110374 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6110376 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $180.86 |
| 6110378 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $180.86 |
| 6110380 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $180.86 |
| 6110384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6110388 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6110391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,788.80 |
| 6110393 | CATHETER, GUIDING | Supply/Implant | $134.40 |
| 6110396 | STERILE SUPPLY | Supply/Implant | $128.00 |
| 6110398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,750.40 |
| 6110405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6110411 | SUPPLY IMPLANT | Supply/Implant | $20,352.00 |
| 6110412 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6110413 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6110414 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6110415 | GENERAL SUPPLY | Supply/Implant | $4,628.74 |
| 6110418 | STERILE SUPPLY | Supply/Implant | $343.01 |
| 6110419 | SUPPLY IMPLANT | Supply/Implant | $1,361.41 |
| 6110420 | PROS, URINARY SPH, IMP | Supply/Implant | $7,616.00 |
| 6110421 | PROS, URINARY SPH, IMP | Supply/Implant | $7,616.00 |
| 6110433 | CATHETER, GUIDING | Supply/Implant | $13,312.00 |
| 6110435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6110440 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,800.00 |
| 6110442 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $10,880.00 |
| 6110457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6110476 | SUPPLY IMPLANT | Supply/Implant | $1,621.76 |
| 6110479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6110480 | STERILE SUPPLY | Supply/Implant | $208.13 |
| 6110484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6110487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110496 | GENERAL SUPPLY | Supply/Implant | $640.00 |
| 6110499 | GUIDE WIRE | Supply/Implant | $5,747.20 |
| 6110500 | CATHETER, GUIDING | Supply/Implant | $8,896.00 |
| 6110501 | CATHETER, GUIDING | Supply/Implant | $9,075.20 |
| 6110506 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6110590 | SUPPLY IMPLANT | Supply/Implant | $14,041.60 |
| 6110591 | GENERAL SUPPLY | Supply/Implant | $208.64 |
| 6110597 | SUPPLY IMPLANT | Supply/Implant | $5,909.50 |
| 6110599 | SUPPLY IMPLANT | Supply/Implant | $5,909.50 |
| 6110656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6110661 | SUPPLY IMPLANT | Supply/Implant | $19,936.00 |
| 6110666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110669 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110670 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6110671 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6110679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6110682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,064.00 |
| 6110683 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6110685 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6110695 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6110701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6110703 | STERILE SUPPLY | Supply/Implant | $666.93 |
| 6110704 | STERILE SUPPLY | Supply/Implant | $12,800.00 |
| 6110705 | VENA CAVA FILTER | Supply/Implant | $3,200.00 |
| 6110721 | SUPPLY IMPLANT | Supply/Implant | $390.49 |
| 6110722 | SUPPLY IMPLANT | Supply/Implant | $211.29 |
| 6110723 | SUPPLY IMPLANT | Supply/Implant | $202.24 |
| 6110728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,800.00 |
| 6110731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6110735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6110752 | SUPPLY IMPLANT | Supply/Implant | $4,100.22 |
| 6110753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6110755 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6110757 | LEAD, NEUROSTIMULATOR | Supply/Implant | $92,710.40 |
| 6110761 | MESH (IMPLANTABLE) | Supply/Implant | $66,594.94 |
| 6110763 | SUPPLY IMPLANT | Supply/Implant | $864.00 |
| 6110765 | SUPPLY IMPLANT | Supply/Implant | $1,057.41 |
| 6110766 | RET DEV, INSERTABLE | Supply/Implant | $4,736.00 |
| 6110768 | RET DEV, INSERTABLE | Supply/Implant | $4,736.00 |
| 6110776 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,080.00 |
| 6110779 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $35,776.00 |
| 6110784 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,688.00 |
| 6110785 | SUPPLY IMPLANT | Supply/Implant | $55,296.00 |
| 6110788 | GUIDE WIRE | Supply/Implant | $226.30 |
| 6110790 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $30,246.40 |
| 6110791 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,690.82 |
| 6110792 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6110793 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6110794 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6110797 | GUIDE WIRE | Supply/Implant | $985.60 |
| 6110800 | SUPPLY IMPLANT | Supply/Implant | $6,520.96 |
| 6110801 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6110802 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6110803 | SUPPLY IMPLANT | Supply/Implant | $13,450.75 |
| 6110804 | SUPPLY IMPLANT | Supply/Implant | $13,450.75 |
| 6110807 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6110808 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6110809 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6110811 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6110813 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6110814 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6110815 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6110823 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6110826 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6110828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,456.00 |
| 6110835 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,500.29 |
| 6110839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6110840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6110842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6110843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6110846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6110848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6110858 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $178,500.00 |
| 6110863 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6110864 | SUPPLY IMPLANT | Supply/Implant | $59,174.40 |
| 6110865 | SUPPLY IMPLANT | Supply/Implant | $59,174.40 |
| 6110868 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6110873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6110876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6110879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110885 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6110888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6110889 | SUPPLY IMPLANT | Supply/Implant | $41,651.20 |
| 6110900 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $1,004.29 |
| 6110902 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6110905 | GENERAL SUPPLY | Supply/Implant | $266.62 |
| 6110906 | GENERAL SUPPLY | Supply/Implant | $242.18 |
| 6110908 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6110909 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6110912 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6110916 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6110920 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,219.20 |
| 6110928 | INTERSPINOUS IMPLANT | Supply/Implant | $37,888.00 |
| 6110929 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6110930 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6110931 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6110949 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6110953 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6110954 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6110961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6110962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6110989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6110990 | SUPPLY IMPLANT | Supply/Implant | $188,227.62 |
| 6110993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,594.11 |
| 6111013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6111019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111020 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111021 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111029 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,054.40 |
| 6111030 | SUPPLY IMPLANT | Supply/Implant | $455.17 |
| 6111031 | SUPPLY IMPLANT | Supply/Implant | $1,507.84 |
| 6111032 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6111033 | SUPPLY IMPLANT | Supply/Implant | $4,070.40 |
| 6111042 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6111044 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6111063 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6111065 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6111071 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6111074 | MESH (IMPLANTABLE) | Supply/Implant | $28,552.70 |
| 6111079 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6111080 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6111081 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6111086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6111089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6111090 | SUPPLY IMPLANT | Supply/Implant | $1,965.22 |
| 6111093 | LEAD, CORONARY VENOUS | Supply/Implant | $48,640.00 |
| 6111094 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $55,040.00 |
| 6111105 | MISC SUP/ACC IMP VAD | Supply/Implant | $640.00 |
| 6111107 | SUPPLY IMPLANT | Supply/Implant | $18,509.95 |
| 6111121 | SUPPLY IMPLANT | Supply/Implant | $226.30 |
| 6111126 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6111131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6111135 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6111141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6111142 | OCULAR IMP AQUEOUS DRAIN | Supply/Implant | $26,240.00 |
| 6111144 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6111146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,046.40 |
| 6111148 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6111149 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $86,016.00 |
| 6111156 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6111161 | SUPPLY IMPLANT | Supply/Implant | $115,699.50 |
| 6111162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,492.80 |
| 6111165 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,586.18 |
| 6111192 | GENERAL SUPPLY | Supply/Implant | $48,000.00 |
| 6111194 | GENERAL SUPPLY | Supply/Implant | $998.40 |
| 6111195 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6111196 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6111198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6111236 | SUPPLY IMPLANT | Supply/Implant | $5,162.62 |
| 6111240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6111241 | SUPPLY IMPLANT | Supply/Implant | $1,369.60 |
| 6111242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6111244 | STERILE SUPPLY | Supply/Implant | $290.18 |
| 6111266 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6111267 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $329,108.50 |
| 6111268 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6111271 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,681.60 |
| 6111273 | CATHETER, GUIDING | Supply/Implant | $21,120.00 |
| 6111279 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6111284 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6111306 | GENERAL SUPPLY | Supply/Implant | $608.00 |
| 6111307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,016.00 |
| 6111314 | SUPPLY IMPLANT | Supply/Implant | $82,619.65 |
| 6111318 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6111320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6111325 | SUPPLY IMPLANT | Supply/Implant | $26,791.81 |
| 6111327 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6111329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6111330 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6111342 | AMNIOTIC MEMBRANE | Supply/Implant | $5,734.40 |
| 6111343 | AMNIOTIC MEMBRANE | Supply/Implant | $7,040.00 |
| 6111344 | AMNIOTIC MEMBRANE | Supply/Implant | $9,164.80 |
| 6111345 | AMNIOTIC MEMBRANE | Supply/Implant | $13,388.80 |
| 6111347 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6111369 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6111378 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6111380 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6111383 | PORT, INDWELLING, IMP | Supply/Implant | $10,357.76 |
| 6111387 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,278.40 |
| 6111388 | SUPPLY IMPLANT | Supply/Implant | $8,640.00 |
| 6111391 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $793.60 |
| 6111392 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $121,296.00 |
| 6111401 | CATHETER, GUIDING | Supply/Implant | $9,664.00 |
| 6111403 | CATHETER, GUIDING | Supply/Implant | $10,598.40 |
| 6111404 | CATHETER, GUIDING | Supply/Implant | $10,598.40 |
| 6111405 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6111415 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6111419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6111420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,580.48 |
| 6111430 | SUPPLY IMPLANT | Supply/Implant | $23,546.88 |
| 6111431 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111432 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111433 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6111436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,484.48 |
| 6111437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111440 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6111452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6111453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6111454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6111463 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6111464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6111471 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6111472 | LEAD, CORONARY VENOUS | Supply/Implant | $120,640.00 |
| 6111473 | SUPPLY IMPLANT | Supply/Implant | $6,179.58 |
| 6111474 | SUPPLY IMPLANT | Supply/Implant | $6,179.58 |
| 6111476 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6111478 | SUPPLY IMPLANT | Supply/Implant | $532.22 |
| 6111479 | GENERAL DRUG | Supply/Implant | $1,626.37 |
| 6111481 | SUPPLY IMPLANT | Supply/Implant | $6,284.80 |
| 6111488 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6111490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,914.30 |
| 6111491 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6111496 | SUPPLY IMPLANT | Supply/Implant | $581.38 |
| 6111502 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6111505 | STERILE SUPPLY | Supply/Implant | $584.06 |
| 6111519 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6111520 | SUPPLY IMPLANT | Supply/Implant | $70,272.00 |
| 6111521 | CATHETER, GUIDING | Supply/Implant | $6,156.80 |
| 6111525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6111529 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6111533 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6111536 | SUPPLY IMPLANT | Supply/Implant | $2,380.80 |
| 6111537 | INTRO/SHEATH, NON-LASER | Supply/Implant | $434.53 |
| 6111538 | SUPPLY IMPLANT | Supply/Implant | $9,907.71 |
| 6111541 | GENERAL SUPPLY | Supply/Implant | $3,407.36 |
| 6111543 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $23,155.20 |
| 6111544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6111550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6111554 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6111555 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,228.16 |
| 6111557 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6111562 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6111563 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6111591 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111594 | SUPPLY IMPLANT | Supply/Implant | $1,740.80 |
| 6111595 | GENERAL SUPPLY | Supply/Implant | $210.70 |
| 6111600 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6111601 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6111602 | GENERAL SUPPLY | Supply/Implant | $518.78 |
| 6111609 | SUPPLY IMPLANT | Supply/Implant | $559.36 |
| 6111618 | STERILE SUPPLY | Supply/Implant | $212.67 |
| 6111622 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111623 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111624 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111625 | GENERAL SUPPLY | Supply/Implant | $57,600.00 |
| 6111638 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,539.20 |
| 6111641 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,259.20 |
| 6111642 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,539.20 |
| 6111644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6111645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6111646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6111654 | GUIDE WIRE | Supply/Implant | $1,331.20 |
| 6111655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6111659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6111665 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6111666 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6111667 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6111669 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $332.80 |
| 6111673 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6111675 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6111679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6111684 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,689.34 |
| 6111685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,689.34 |
| 6111686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,507.52 |
| 6111687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,265.92 |
| 6111689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6111691 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6111692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6111704 | SUPPLY IMPLANT | Supply/Implant | $25,527.04 |
| 6111707 | SUPPLY IMPLANT | Supply/Implant | $4,019.20 |
| 6111709 | STERILE SUPPLY | Supply/Implant | $428.54 |
| 6111710 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6111711 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6111741 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6111742 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6111745 | GENERAL SUPPLY | Supply/Implant | $7,673.60 |
| 6111748 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,440.00 |
| 6111756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $960.00 |
| 6111757 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111758 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6111760 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6111761 | SUPPLY IMPLANT | Supply/Implant | $7,052.80 |
| 6111762 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6111775 | GENERAL SUPPLY | Supply/Implant | $2,275.00 |
| 6111776 | GENERAL SUPPLY | Supply/Implant | $2,206.85 |
| 6111781 | STERILE SUPPLY | Supply/Implant | $839.42 |
| 6111782 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $354.37 |
| 6111784 | LOCM 200-299MG/ML IODINE,1ML | Supply/Implant | $326.40 |
| 6111786 | STERILE SUPPLY | Supply/Implant | $391.55 |
| 6111787 | STERILE SUPPLY | Supply/Implant | $363.65 |
| 6111788 | STERILE SUPPLY | Supply/Implant | $383.62 |
| 6111789 | SUPPLY IMPLANT | Supply/Implant | $4,096.26 |
| 6111791 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6111792 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,304.00 |
| 6111793 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6111794 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6111795 | GUIDE WIRE | Supply/Implant | $2,618.88 |
| 6111796 | GUIDE WIRE | Supply/Implant | $2,618.88 |
| 6111797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6111799 | GENERAL SUPPLY | Supply/Implant | $435.20 |
| 6111800 | STERILE SUPPLY | Supply/Implant | $247.32 |
| 6111802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6111803 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,836.80 |
| 6111804 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,836.80 |
| 6111805 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $39,040.00 |
| 6111806 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $39,040.00 |
| 6111807 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $39,040.00 |
| 6111815 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $39,040.00 |
| 6111821 | SUPPLY IMPLANT | Supply/Implant | $5,043.20 |
| 6111824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6111826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6111827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6111828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6111840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,184.00 |
| 6111847 | GUIDE WIRE | Supply/Implant | $294.40 |
| 6111851 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6111852 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6111872 | GRAFT, VASCULAR | Supply/Implant | $43,241.98 |
| 6111874 | GRAFT, VASCULAR | Supply/Implant | $31,040.00 |
| 6111875 | GRAFT, VASCULAR | Supply/Implant | $43,241.98 |
| 6111887 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6111892 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6111895 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,063.36 |
| 6111896 | SUPPLY IMPLANT | Supply/Implant | $14,090.37 |
| 6111921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,138.56 |
| 6111929 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6111932 | SUPPLY IMPLANT | Supply/Implant | $115,437.00 |
| 6111933 | SUPPLY IMPLANT | Supply/Implant | $521.47 |
| 6111934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,577.60 |
| 6111937 | SUPPLY IMPLANT | Supply/Implant | $165.89 |
| 6111946 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6111952 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,651.20 |
| 6111955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6111960 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6111961 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6111973 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6111980 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,496.64 |
| 6111982 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6111983 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6111984 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6111985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6111990 | CATHETER, GUIDING | Supply/Implant | $448.00 |
| 6111992 | GENERAL SUPPLY | Supply/Implant | $264.58 |
| 6111994 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6112001 | GENERAL SUPPLY | Supply/Implant | $151.04 |
| 6112002 | SUPPLY IMPLANT | Supply/Implant | $572.06 |
| 6112003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6112023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6112028 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6112033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6112034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6112038 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6112042 | INTRO/SHEATH, NON-LASER | Supply/Implant | $286.72 |
| 6112049 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6112057 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6112081 | SUPPLY IMPLANT | Supply/Implant | $1,218.56 |
| 6112085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6112087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,149.76 |
| 6112099 | LEAD, NEUROSTIMULATOR | Supply/Implant | $84,480.00 |
| 6112102 | STERILE SUPPLY | Supply/Implant | $1,459.65 |
| 6112104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6112105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6112107 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6112108 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $9,792.00 |
| 6112109 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $9,792.00 |
| 6112111 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6112115 | SUPPLY IMPLANT | Supply/Implant | $3,110.40 |
| 6112116 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $22,808.32 |
| 6112117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6112120 | GENERAL SUPPLY | Supply/Implant | $1,667.97 |
| 6112121 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6112122 | STERILE SUPPLY | Supply/Implant | $12,544.00 |
| 6112124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6112125 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6112126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6112127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6112132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,943.04 |
| 6112133 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6112140 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $761.73 |
| 6112157 | GENERAL SUPPLY | Supply/Implant | $186.88 |
| 6112158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,742.40 |
| 6112160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6112161 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112162 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112174 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6112180 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6112181 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,875.20 |
| 6112186 | SUPPLY IMPLANT | Supply/Implant | $142.85 |
| 6112188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6112189 | INTERSPINOUS IMPLANT | Supply/Implant | $26,944.00 |
| 6112194 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6112196 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $9,600.00 |
| 6112197 | SUPPLY IMPLANT | Supply/Implant | $2,323.20 |
| 6112198 | GENERAL SUPPLY | Supply/Implant | $745.98 |
| 6112199 | STERILE SUPPLY | Supply/Implant | $332.03 |
| 6112200 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6112206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6112210 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6112211 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6112213 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6112214 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6112217 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6112227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6112228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6112234 | SUPPLY IMPLANT | Supply/Implant | $170.65 |
| 6112238 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112240 | SUPPLY IMPLANT | Supply/Implant | $1,516.16 |
| 6112257 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6112258 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6112259 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,068.80 |
| 6112260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6112261 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112262 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112263 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112264 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112265 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,756.48 |
| 6112306 | SUPPLY IMPLANT | Supply/Implant | $19,936.00 |
| 6112307 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,408.13 |
| 6112313 | SUPPLY IMPLANT | Supply/Implant | $36,480.00 |
| 6112318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112322 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6112324 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6112327 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6112328 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6112338 | SUPPLY IMPLANT | Supply/Implant | $162,750.00 |
| 6112339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6112340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6112345 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112348 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112349 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112350 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112351 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112352 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112353 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112354 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112355 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112356 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112357 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112358 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112359 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112360 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112361 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112362 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112363 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112364 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112365 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112366 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112367 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112368 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112369 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112370 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112371 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112374 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112375 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112376 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112377 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112378 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112379 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112380 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,840.00 |
| 6112385 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6112387 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112388 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112389 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112390 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112391 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112392 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112393 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112394 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112395 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112396 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112397 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112398 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112399 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112400 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112401 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112403 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6112407 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112408 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112409 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112410 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112411 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112412 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112413 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112414 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112415 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112416 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112417 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112418 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112419 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112420 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112421 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112422 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112423 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $16,576.00 |
| 6112438 | STERILE SUPPLY | Supply/Implant | $1,837.06 |
| 6112439 | GENERAL SUPPLY | Supply/Implant | $522.82 |
| 6112444 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,356.80 |
| 6112445 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $63,500.80 |
| 6112447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6112448 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6112449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6112451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6112453 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $14,016.00 |
| 6112455 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112456 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112457 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112458 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112459 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112460 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112461 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112462 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112464 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112465 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6112468 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,008.00 |
| 6112469 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,374.40 |
| 6112470 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $17,740.80 |
| 6112472 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,740.80 |
| 6112473 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,374.40 |
| 6112474 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,008.00 |
| 6112475 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,008.00 |
| 6112478 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,812.48 |
| 6112479 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,740.80 |
| 6112481 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $19,008.00 |
| 6112482 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $19,008.00 |
| 6112483 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,374.40 |
| 6112484 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $17,740.80 |
| 6112486 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,740.80 |
| 6112490 | SUPPLY IMPLANT | Supply/Implant | $50,937.60 |
| 6112492 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6112495 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6112501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6112504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6112513 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6112519 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6112525 | SUPPLY IMPLANT | Supply/Implant | $291.33 |
| 6112528 | SUPPLY IMPLANT | Supply/Implant | $1,446.40 |
| 6112533 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6112534 | SUPPLY IMPLANT | Supply/Implant | $127,936.00 |
| 6112536 | SUPPLY IMPLANT | Supply/Implant | $419.84 |
| 6112539 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6112540 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6112542 | STERILE SUPPLY | Supply/Implant | $888.58 |
| 6112543 | CATH, DRAINAGE | Supply/Implant | $950.40 |
| 6112544 | CATH, DRAINAGE | Supply/Implant | $950.40 |
| 6112545 | SUPPLY IMPLANT | Supply/Implant | $950.40 |
| 6112546 | SUPPLY IMPLANT | Supply/Implant | $950.40 |
| 6112547 | SUPPLY IMPLANT | Supply/Implant | $887.04 |
| 6112568 | SUPPLY IMPLANT | Supply/Implant | $241.92 |
| 6112570 | SUPPLY IMPLANT | Supply/Implant | $4,288.00 |
| 6112575 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,088.00 |
| 6112578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6112580 | MESH (IMPLANTABLE) | Supply/Implant | $18,240.00 |
| 6112581 | MESH (IMPLANTABLE) | Supply/Implant | $38,016.00 |
| 6112585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,520.00 |
| 6112592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6112602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6112605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6112606 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6112607 | SUPPLY IMPLANT | Supply/Implant | $729.60 |
| 6112608 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112609 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112610 | SUPPLY IMPLANT | Supply/Implant | $6,976.00 |
| 6112611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,251.26 |
| 6112613 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112614 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112626 | SUPPLY IMPLANT | Supply/Implant | $2,523.26 |
| 6112627 | GENERAL SUPPLY | Supply/Implant | $430.46 |
| 6112634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6112638 | SUPPLY IMPLANT | Supply/Implant | $2,161.28 |
| 6112639 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6112640 | SUPPLY IMPLANT | Supply/Implant | $3,543.30 |
| 6112643 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $241.66 |
| 6112647 | GENERAL SUPPLY | Supply/Implant | $1,805.31 |
| 6112650 | SUPPLY IMPLANT | Supply/Implant | $18,624.00 |
| 6112651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6112654 | SUPPLY IMPLANT | Supply/Implant | $130.56 |
| 6112655 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6112656 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6112657 | INTRO/SHEATH, NON-LASER | Supply/Implant | $238.72 |
| 6112658 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6112668 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6112669 | SUPPLY IMPLANT | Supply/Implant | $282.24 |
| 6112670 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6112672 | GRAFT, VASCULAR | Supply/Implant | $121,296.00 |
| 6112673 | INTRO/SHEATH, NON-LASER | Supply/Implant | $832.00 |
| 6112677 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $178,500.00 |
| 6112678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,643.14 |
| 6112679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6112681 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6112695 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6112697 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6112700 | CATHETER, GUIDING | Supply/Implant | $678.40 |
| 6112707 | STERILE SUPPLY | Supply/Implant | $612.99 |
| 6112713 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112714 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112715 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112716 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112717 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112718 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6112725 | GENERAL SUPPLY | Supply/Implant | $311.30 |
| 6112726 | GENERAL SUPPLY | Supply/Implant | $291.20 |
| 6112728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,120.00 |
| 6112742 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,707.20 |
| 6112753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6112758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6112759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6112760 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6112761 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6112809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6112814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6112815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6112817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $698.88 |
| 6112818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6112835 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $8,960.00 |
| 6112842 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6112843 | VENA CAVA FILTER | Supply/Implant | $13,440.00 |
| 6112849 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112850 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112852 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112853 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112854 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112855 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112856 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112859 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112860 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112862 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6112864 | TRANS ANGIOPLASTY CATH | Supply/Implant | $22,400.00 |
| 6112865 | TRANS ANGIOPLASTY CATH | Supply/Implant | $22,400.00 |
| 6112881 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6112882 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6112884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6112902 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6112903 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6112915 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6112916 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6112917 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6112918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,097.60 |
| 6112922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6112927 | GENERAL SUPPLY | Supply/Implant | $268.99 |
| 6112941 | STERILE SUPPLY | Supply/Implant | $1,081.60 |
| 6112945 | SUPPLY IMPLANT | Supply/Implant | $277.76 |
| 6112972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,966.40 |
| 6112973 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6112978 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6112982 | SUPPLY IMPLANT | Supply/Implant | $2,694.40 |
| 6112984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6112987 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6112994 | PORT, INDWELLING, IMP | Supply/Implant | $5,107.20 |
| 6112995 | PORT, INDWELLING, IMP | Supply/Implant | $5,107.20 |
| 6112999 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $202,000.00 |
| 6113002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6113004 | LEAD, CORONARY VENOUS | Supply/Implant | $38,400.00 |
| 6113005 | LEAD, CORONARY VENOUS | Supply/Implant | $38,400.00 |
| 6113007 | SUPPLY IMPLANT | Supply/Implant | $177.28 |
| 6113019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6113020 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113021 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6113022 | RET DEV, INSERTABLE | Supply/Implant | $313.60 |
| 6113026 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6113028 | CATHETER, URETERAL | Supply/Implant | $142.72 |
| 6113037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6113039 | SUPPLY IMPLANT | Supply/Implant | $9,935.74 |
| 6113044 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6113045 | SUPPLY IMPLANT | Supply/Implant | $28,448.00 |
| 6113050 | SUPPLY IMPLANT | Supply/Implant | $9,379.33 |
| 6113052 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6113056 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6113061 | STERILE SUPPLY | Supply/Implant | $695.71 |
| 6113062 | STERILE SUPPLY | Supply/Implant | $420.86 |
| 6113070 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6113079 | MESH (IMPLANTABLE) | Supply/Implant | $1,842.43 |
| 6113080 | GENERAL SUPPLY | Supply/Implant | $206.08 |
| 6113087 | SUPPLY IMPLANT | Supply/Implant | $16,256.00 |
| 6113089 | SUPPLY IMPLANT | Supply/Implant | $1,605.12 |
| 6113092 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6113099 | SUPPLY IMPLANT | Supply/Implant | $4,096.00 |
| 6113100 | SUPPLY IMPLANT | Supply/Implant | $2,694.40 |
| 6113101 | SUPPLY IMPLANT | Supply/Implant | $9,496.83 |
| 6113102 | SUPPLY IMPLANT | Supply/Implant | $11,139.07 |
| 6113103 | SUPPLY IMPLANT | Supply/Implant | $11,180.22 |
| 6113108 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6113109 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6113110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,544.00 |
| 6113115 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113116 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113118 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113119 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6113124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,712.00 |
| 6113125 | SUPPLY IMPLANT | Supply/Implant | $6,649.60 |
| 6113127 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6113139 | SUPPLY IMPLANT | Supply/Implant | $214.53 |
| 6113143 | GENERAL SUPPLY | Supply/Implant | $441.60 |
| 6113144 | CATHETER, GUIDING | Supply/Implant | $6,336.00 |
| 6113157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6113158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6113159 | SUPPLY IMPLANT | Supply/Implant | $17,387.52 |
| 6113167 | DRUG/DETAILED CODING REQUIRED | Supply/Implant | $1,446.40 |
| 6113170 | INTRO/SHEATH, NON-LASER | Supply/Implant | $273.43 |
| 6113176 | STERILE SUPPLY | Supply/Implant | $162.05 |
| 6113179 | STERILE SUPPLY | Supply/Implant | $287.62 |
| 6113180 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6113186 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6113200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,321.15 |
| 6113201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,749.70 |
| 6113202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,153.60 |
| 6113203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,484.48 |
| 6113207 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $556.80 |
| 6113235 | CATHETER, GUIDING | Supply/Implant | $3,648.00 |
| 6113250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6113253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6113260 | SUPPLY IMPLANT | Supply/Implant | $768.51 |
| 6113262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6113264 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6113269 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6113270 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $100,480.00 |
| 6113279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6113280 | SUPPLY IMPLANT | Supply/Implant | $6,447.36 |
| 6113285 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6113286 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6113287 | CATHETER, GUIDING | Supply/Implant | $6,169.60 |
| 6113290 | CATHETER, URETERAL | Supply/Implant | $146.05 |
| 6113292 | CATHETER, URETERAL | Supply/Implant | $146.05 |
| 6113297 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6113301 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6113313 | STERILE SUPPLY | Supply/Implant | $449.79 |
| 6113314 | STERILE SUPPLY | Supply/Implant | $705.66 |
| 6113315 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6113325 | GENERAL SUPPLY | Supply/Implant | $282.88 |
| 6113326 | STERILE SUPPLY | Supply/Implant | $278.78 |
| 6113327 | STERILE SUPPLY | Supply/Implant | $318.21 |
| 6113331 | GENERAL SUPPLY | Supply/Implant | $2,094.72 |
| 6113333 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6113339 | STERILE SUPPLY | Supply/Implant | $566.91 |
| 6113406 | SUPPLY IMPLANT | Supply/Implant | $106,854.40 |
| 6113407 | COCHLEAR DEVICE | Supply/Implant | $221,190.00 |
| 6113412 | CONN TISS, NON-HUMAN | Supply/Implant | $3,264.00 |
| 6113413 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6113416 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113423 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $5,696.00 |
| 6113446 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6113475 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113477 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113478 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6113480 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,176.00 |
| 6113485 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6113486 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6113488 | SUPPLY IMPLANT | Supply/Implant | $249.60 |
| 6113492 | INTRO/SHEATH, NON-LASER | Supply/Implant | $611.97 |
| 6113504 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $8,960.00 |
| 6113507 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113510 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113513 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113515 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113517 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6113523 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6113528 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6113529 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6113530 | SUPPLY IMPLANT | Supply/Implant | $113,920.00 |
| 6113533 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,960.00 |
| 6113537 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113551 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,689.54 |
| 6113552 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,689.54 |
| 6113554 | STERILE SUPPLY | Supply/Implant | $84,480.00 |
| 6113557 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $45,273.60 |
| 6113558 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6113560 | CATHETER, GUIDING | Supply/Implant | $20,467.20 |
| 6113564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6113565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6113566 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113567 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113568 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113569 | GENERAL SUPPLY | Supply/Implant | $793.60 |
| 6113570 | GENERAL SUPPLY | Supply/Implant | $659.20 |
| 6113572 | GENERAL SUPPLY | Supply/Implant | $831.87 |
| 6113573 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113574 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113575 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113577 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113580 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6113584 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113596 | GUIDE WIRE | Supply/Implant | $3,187.20 |
| 6113598 | REP DEV, URINARY, W/SLING | Supply/Implant | $8,320.00 |
| 6113603 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6113607 | SUPPLY IMPLANT | Supply/Implant | $154.24 |
| 6113612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6113613 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6113623 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $467.97 |
| 6113629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6113630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6113632 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6113638 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113639 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113640 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113641 | STERILE SUPPLY | Supply/Implant | $1,344.00 |
| 6113646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,520.00 |
| 6113655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $696.32 |
| 6113662 | PMKR, DUAL, RATE-RESP | Supply/Implant | $77,926.40 |
| 6113667 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $39,040.00 |
| 6113671 | RET DEV, INSERTABLE | Supply/Implant | $88,320.00 |
| 6113672 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $11,776.00 |
| 6113673 | NON-CARDIAC ENDOVASC CATH | Supply/Implant | $11,776.00 |
| 6113677 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,289.92 |
| 6113678 | SUPPLY IMPLANT | Supply/Implant | $12,615.42 |
| 6113681 | CATHETER, GUIDING | Supply/Implant | $2,240.00 |
| 6113682 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113683 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113687 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6113690 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,840.70 |
| 6113691 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,840.70 |
| 6113692 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6113693 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6113698 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6113707 | GENERAL SUPPLY | Supply/Implant | $176.13 |
| 6113708 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6113709 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6113710 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6113711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6113715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6113716 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6113717 | GUIDE WIRE | Supply/Implant | $663.04 |
| 6113721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6113724 | SUPPLY IMPLANT | Supply/Implant | $139.78 |
| 6113738 | STERILE SUPPLY | Supply/Implant | $343.94 |
| 6113742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6113743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6113744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,126.40 |
| 6113754 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6113755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6113758 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6113759 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6113761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6113762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6113763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6113766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6113769 | GUIDE WIRE | Supply/Implant | $1,727.74 |
| 6113770 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6113772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,766.40 |
| 6113777 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6113779 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,768.64 |
| 6113780 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113781 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113783 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6113784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6113785 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6113786 | SUPPLY IMPLANT | Supply/Implant | $739.07 |
| 6113787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6113793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6113796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,280.00 |
| 6113798 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6113801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6113802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6113803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6113810 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6113811 | SUPPLY IMPLANT | Supply/Implant | $4,010.37 |
| 6113814 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6113815 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $21,056.00 |
| 6113822 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6113828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,777.60 |
| 6113829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,899.20 |
| 6113830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,777.60 |
| 6113833 | PROSTHETIC IMPLANT NOS | Supply/Implant | $8,960.00 |
| 6113839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,812.80 |
| 6113840 | SUPPLY IMPLANT | Supply/Implant | $96,908.80 |
| 6113849 | SUPPLY IMPLANT | Supply/Implant | $1,516.16 |
| 6113850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6113859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,777.28 |
| 6113862 | INTRO/SHEATH, NON-LASER | Supply/Implant | $713.73 |
| 6113868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6113869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6113872 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6113875 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6113879 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6113889 | SUPPLY IMPLANT | Supply/Implant | $4,575.74 |
| 6113890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,948.67 |
| 6113894 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $101,120.00 |
| 6113895 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6113900 | SUPPLY IMPLANT | Supply/Implant | $5,594.88 |
| 6113901 | SUPPLY IMPLANT | Supply/Implant | $5,594.88 |
| 6113902 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6113916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6113921 | STERILE SUPPLY | Supply/Implant | $251.78 |
| 6113922 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6113925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,595.52 |
| 6113926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6113927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6113931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6113933 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6113934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6113935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,952.00 |
| 6113938 | GENERAL SUPPLY | Supply/Implant | $280.96 |
| 6113954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6113957 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,052.80 |
| 6113959 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,292.80 |
| 6113964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6113985 | SUPPLY IMPLANT | Supply/Implant | $433.92 |
| 6113986 | GUIDE WIRE | Supply/Implant | $166.07 |
| 6113987 | GUIDE WIRE | Supply/Implant | $262.66 |
| 6113991 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6113992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6113993 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,061.50 |
| 6114001 | SUPPLY IMPLANT | Supply/Implant | $18,662.40 |
| 6114004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,303.30 |
| 6114017 | STERILE SUPPLY | Supply/Implant | $501.12 |
| 6114018 | SUPPLY IMPLANT | Supply/Implant | $13,952.00 |
| 6114019 | SUPPLY IMPLANT | Supply/Implant | $19,072.00 |
| 6114020 | SUPPLY IMPLANT | Supply/Implant | $19,072.00 |
| 6114021 | SUPPLY IMPLANT | Supply/Implant | $19,072.00 |
| 6114023 | SUPPLY IMPLANT | Supply/Implant | $6,493.18 |
| 6114024 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6114027 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6114028 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6114036 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6114043 | GENERAL SUPPLY | Supply/Implant | $635.39 |
| 6114044 | SUPPLY IMPLANT | Supply/Implant | $95,936.00 |
| 6114045 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6114046 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6114048 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6114055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,864.00 |
| 6114064 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6114065 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6114067 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6114068 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6114082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6114083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6114085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6114094 | GENERAL SUPPLY | Supply/Implant | $3,120.13 |
| 6114095 | GENERAL SUPPLY | Supply/Implant | $7,590.40 |
| 6114096 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114097 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114099 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114100 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114101 | SUPPLY IMPLANT | Supply/Implant | $2,461.18 |
| 6114103 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114104 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114105 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6114107 | GENERAL SUPPLY | Supply/Implant | $1,236.99 |
| 6114111 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6114112 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6114113 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6114114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6114116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6114117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114122 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6114124 | GENERAL SUPPLY | Supply/Implant | $288.51 |
| 6114127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114131 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6114132 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6114140 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6114142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6114144 | STERILE SUPPLY | Supply/Implant | $298.88 |
| 6114146 | INTRO/SHEATH, NON-LASER | Supply/Implant | $166.40 |
| 6114147 | SUPPLY IMPLANT | Supply/Implant | $8,051.20 |
| 6114148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6114153 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $30,720.00 |
| 6114156 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6114161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6114163 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6114165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6114169 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6114177 | GENERAL SUPPLY | Supply/Implant | $192.00 |
| 6114178 | GENERAL SUPPLY | Supply/Implant | $7,488.00 |
| 6114179 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $108,288.00 |
| 6114181 | SUPPLY IMPLANT | Supply/Implant | $242.69 |
| 6114183 | GENERAL SUPPLY | Supply/Implant | $201.22 |
| 6114187 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6114190 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6114191 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6114192 | SUPPLY IMPLANT | Supply/Implant | $125,580.00 |
| 6114193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114194 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114196 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6114197 | GENERAL SUPPLY | Supply/Implant | $282.75 |
| 6114198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,441.60 |
| 6114199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114216 | GUIDE WIRE | Supply/Implant | $2,291.20 |
| 6114223 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6114224 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6114225 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6114226 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6114229 | SUPPLY IMPLANT | Supply/Implant | $12,275.20 |
| 6114231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,702.02 |
| 6114235 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6114237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6114239 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114254 | CRYOABLATION PROBE | Supply/Implant | $16,000.00 |
| 6114257 | GENERAL SUPPLY | Supply/Implant | $280.96 |
| 6114260 | GENERAL SUPPLY | Supply/Implant | $344.96 |
| 6114263 | GENERAL SUPPLY | Supply/Implant | $974.59 |
| 6114266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,096.00 |
| 6114270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114276 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6114277 | STERILE SUPPLY | Supply/Implant | $318.21 |
| 6114290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6114303 | GENERAL SUPPLY | Supply/Implant | $269.95 |
| 6114307 | STERILE SUPPLY | Supply/Implant | $140.60 |
| 6114308 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,047.04 |
| 6114315 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6114320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6114324 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6114328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6114329 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6114333 | GENERAL SUPPLY | Supply/Implant | $146.05 |
| 6114341 | STERILE SUPPLY | Supply/Implant | $294.91 |
| 6114345 | STERILE SUPPLY | Supply/Implant | $1,154.01 |
| 6114347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6114348 | MESH (IMPLANTABLE) | Supply/Implant | $2,111.10 |
| 6114352 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6114360 | GENERAL SUPPLY | Supply/Implant | $267.17 |
| 6114362 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $416,242.50 |
| 6114377 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6114382 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114383 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114384 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6114391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,518.40 |
| 6114394 | SUPPLY IMPLANT | Supply/Implant | $77,824.00 |
| 6114405 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6114406 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6114407 | CLOSURE DEV, VASC | Supply/Implant | $3,840.00 |
| 6114411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6114412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6114413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,665.60 |
| 6114415 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114416 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6114418 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6114422 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6114424 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6114425 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6114486 | SUPPLY IMPLANT | Supply/Implant | $214.32 |
| 6114489 | GENERAL SUPPLY | Supply/Implant | $185.75 |
| 6114494 | GENERAL SUPPLY | Supply/Implant | $214.32 |
| 6114496 | GENERAL SUPPLY | Supply/Implant | $172.54 |
| 6114499 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6114501 | SUPPLY IMPLANT | Supply/Implant | $7,692.03 |
| 6114502 | SUPPLY IMPLANT | Supply/Implant | $7,776.51 |
| 6114509 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6114512 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $183,750.00 |
| 6114513 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $131,250.00 |
| 6114515 | SUPPLY IMPLANT | Supply/Implant | $183,750.00 |
| 6114516 | SUPPLY IMPLANT | Supply/Implant | $74,880.00 |
| 6114517 | SUPPLY IMPLANT | Supply/Implant | $121,600.00 |
| 6114520 | SUPPLY IMPLANT | Supply/Implant | $199.68 |
| 6114526 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6114539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,705.60 |
| 6114540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6114542 | RET DEV, INSERTABLE | Supply/Implant | $384.00 |
| 6114546 | SUPPLY IMPLANT | Supply/Implant | $11,532.80 |
| 6114547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6114550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6114552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114558 | SUPPLY IMPLANT | Supply/Implant | $78,979.20 |
| 6114559 | SUPPLY IMPLANT | Supply/Implant | $77,824.00 |
| 6114567 | SUPPLY IMPLANT | Supply/Implant | $282,800.00 |
| 6114569 | SUPPLY IMPLANT | Supply/Implant | $1,530.62 |
| 6114571 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114575 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,840.70 |
| 6114577 | SUPPLY IMPLANT | Supply/Implant | $2,873.34 |
| 6114578 | RET DEV, INSERTABLE | Supply/Implant | $2,873.34 |
| 6114579 | RET DEV, INSERTABLE | Supply/Implant | $2,873.34 |
| 6114580 | GUIDE WIRE | Supply/Implant | $7,099.78 |
| 6114581 | GUIDE WIRE | Supply/Implant | $3,628.54 |
| 6114586 | SUPPLY IMPLANT | Supply/Implant | $62,835.20 |
| 6114596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,160.00 |
| 6114601 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $8,896.00 |
| 6114602 | SUPPLY IMPLANT | Supply/Implant | $224.00 |
| 6114603 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6114604 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6114605 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6114606 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6114608 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6114615 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6114616 | SUPPLY IMPLANT | Supply/Implant | $2,980.61 |
| 6114617 | SUPPLY IMPLANT | Supply/Implant | $2,980.61 |
| 6114623 | STERILE SUPPLY | Supply/Implant | $169.60 |
| 6114624 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6114625 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6114631 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6114632 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6114638 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $94,707.20 |
| 6114641 | SUPPLY IMPLANT | Supply/Implant | $200.06 |
| 6114653 | GENERAL SUPPLY | Supply/Implant | $135.31 |
| 6114664 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114665 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114666 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114667 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114668 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114669 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114670 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114671 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114672 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114673 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114674 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114675 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114676 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114677 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114678 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6114680 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,886.85 |
| 6114688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6114691 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6114692 | INTEGRA MATRIX SKIN SUB | Supply/Implant | $3,644.93 |
| 6114696 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6114707 | GENERAL SUPPLY | Supply/Implant | $8,481.79 |
| 6114709 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6114716 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114718 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6114726 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114727 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6114729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6114730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6114739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6114742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,104.00 |
| 6114746 | GENERAL SUPPLY | Supply/Implant | $21,120.00 |
| 6114747 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6114750 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6114751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6114752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6114758 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6114759 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114762 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6114763 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6114764 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6114765 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6114776 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6114777 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6114786 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6114791 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6114795 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6114800 | SUPPLY IMPLANT | Supply/Implant | $2,757.12 |
| 6114807 | TRANS ANGIOPLASTY CATH | Supply/Implant | $24,320.00 |
| 6114808 | SUPPLY IMPLANT | Supply/Implant | $55,552.00 |
| 6114810 | SUPPLY IMPLANT | Supply/Implant | $850.94 |
| 6114811 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6114812 | SUPPLY IMPLANT | Supply/Implant | $2,407.55 |
| 6114813 | SUPPLY IMPLANT | Supply/Implant | $3,010.94 |
| 6114814 | SUPPLY IMPLANT | Supply/Implant | $5,841.02 |
| 6114815 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6114816 | MESH (IMPLANTABLE) | Supply/Implant | $3,245.44 |
| 6114817 | MESH (IMPLANTABLE) | Supply/Implant | $3,278.46 |
| 6114818 | MESH (IMPLANTABLE) | Supply/Implant | $3,311.36 |
| 6114822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,948.67 |
| 6114823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,395.97 |
| 6114824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,848.32 |
| 6114825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,482.82 |
| 6114826 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6114830 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6114831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6114833 | STERILE SUPPLY | Supply/Implant | $1,036.80 |
| 6114838 | GENERAL SUPPLY | Supply/Implant | $692.86 |
| 6114846 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6114847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6114848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6114849 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6114850 | SUPPLY IMPLANT | Supply/Implant | $51,136.00 |
| 6114860 | SUPPLY IMPLANT | Supply/Implant | $39,486.08 |
| 6114865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6114866 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6114869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6114872 | SUPPLY IMPLANT | Supply/Implant | $27,611.52 |
| 6114873 | GENERAL SUPPLY | Supply/Implant | $1,536.00 |
| 6114880 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6114881 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6114882 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6114883 | SUPPLY IMPLANT | Supply/Implant | $46,720.00 |
| 6114884 | GENERAL DRUG | Supply/Implant | $181.25 |
| 6114888 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6114894 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114895 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114896 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114897 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6114913 | SUPPLY IMPLANT | Supply/Implant | $5,693.44 |
| 6114920 | GENERAL SUPPLY | Supply/Implant | $187.14 |
| 6114921 | GENERAL SUPPLY | Supply/Implant | $3,484.80 |
| 6114922 | SUPPLY IMPLANT | Supply/Implant | $4,080.00 |
| 6114924 | GENERAL SUPPLY | Supply/Implant | $3,120.00 |
| 6114925 | GENERAL SUPPLY | Supply/Implant | $3,542.40 |
| 6114927 | GENERAL SUPPLY | Supply/Implant | $7,200.00 |
| 6114942 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6114944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6114945 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6114946 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6114947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6114954 | SUPPLY IMPLANT | Supply/Implant | $5,772.80 |
| 6114958 | SUPPLY IMPLANT | Supply/Implant | $3,010.62 |
| 6114960 | SUPPLY IMPLANT | Supply/Implant | $2,426.88 |
| 6114961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6114962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,659.33 |
| 6114963 | SUPPLY IMPLANT | Supply/Implant | $78,979.20 |
| 6114964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6114966 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $356,237.10 |
| 6114977 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,544.00 |
| 6114979 | EVENT RECORDER CARDIAC | Supply/Implant | $58,880.00 |
| 6114981 | GENERAL SUPPLY | Supply/Implant | $446.46 |
| 6114982 | GENERAL SUPPLY | Supply/Implant | $446.46 |
| 6114993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,630.72 |
| 6115015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6115016 | SUPPLY IMPLANT | Supply/Implant | $3,558.40 |
| 6115017 | STERILE SUPPLY | Supply/Implant | $152.83 |
| 6115018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6115022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6115024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6115028 | SUPPLY IMPLANT | Supply/Implant | $63,360.00 |
| 6115029 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6115030 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $63,360.00 |
| 6115031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6115035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6115054 | SUPPLY IMPLANT | Supply/Implant | $2,038.40 |
| 6115058 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6115060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,558.72 |
| 6115076 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6115077 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6115121 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6115124 | GENERAL SUPPLY | Supply/Implant | $8,179.20 |
| 6115132 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115133 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115134 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115136 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6115141 | STERILE SUPPLY | Supply/Implant | $1,920.00 |
| 6115142 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $10,112.00 |
| 6115145 | SUPPLY IMPLANT | Supply/Implant | $1,273.22 |
| 6115148 | SUPPLY IMPLANT | Supply/Implant | $2,498.56 |
| 6115153 | GENERAL SUPPLY | Supply/Implant | $3,104.00 |
| 6115162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,433.92 |
| 6115165 | STERILE SUPPLY | Supply/Implant | $329.34 |
| 6115166 | SUPPLY IMPLANT | Supply/Implant | $1,833.34 |
| 6115167 | STERILE SUPPLY | Supply/Implant | $813.70 |
| 6115170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6115176 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6115196 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6115203 | SUPPLY IMPLANT | Supply/Implant | $1,594.88 |
| 6115224 | CRYOABLATION PROBE | Supply/Implant | $18,240.00 |
| 6115227 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6115230 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6115234 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6115238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,225.60 |
| 6115245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6115246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6115252 | SUPPLY IMPLANT | Supply/Implant | $2,066.69 |
| 6115259 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6115270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,480.00 |
| 6115274 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6115275 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6115277 | SUPPLY IMPLANT | Supply/Implant | $18,035.20 |
| 6115278 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $8,512.00 |
| 6115281 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,040.00 |
| 6115282 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6115284 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6115287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,192.00 |
| 6115289 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6115302 | GUIDE WIRE | Supply/Implant | $8,960.00 |
| 6115304 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6115305 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,840.00 |
| 6115364 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,891.97 |
| 6115365 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,891.97 |
| 6115405 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6115480 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6115494 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6115495 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6115496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6115739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,956.16 |
| 6115740 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,956.16 |
| 6115758 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6115759 | SUPPLY IMPLANT | Supply/Implant | $11,865.60 |
| 6115761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,219.20 |
| 6115762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6115763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6115764 | CATHETER, URETERAL | Supply/Implant | $917.25 |
| 6115779 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6115780 | GUIDE WIRE | Supply/Implant | $2,304.00 |
| 6115784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6115785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6115786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6115788 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6115791 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6115792 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6115796 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6115798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6115800 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6115802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6115803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6115807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6115810 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $162,750.00 |
| 6115812 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6116283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6116340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,549.76 |
| 6116341 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6116342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6116346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6116399 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6116401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6116404 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6116407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6116410 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,570.24 |
| 6116413 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,688.00 |
| 6116417 | SUPPLY IMPLANT | Supply/Implant | $114,261.00 |
| 6116418 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6116423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6116424 | GENERAL SUPPLY | Supply/Implant | $384.00 |
| 6116426 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6116427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6116430 | GENERAL SUPPLY | Supply/Implant | $1,445.63 |
| 6116431 | SUPPLY IMPLANT | Supply/Implant | $20,104.58 |
| 6116432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6116433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6116438 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $221,695.00 |
| 6116439 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $19,200.00 |
| 6116440 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $25,600.00 |
| 6116441 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $4,160.00 |
| 6116442 | SUPPLY IMPLANT | Supply/Implant | $3,095.04 |
| 6116443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6116446 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,201.28 |
| 6116448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,376.00 |
| 6116449 | STERILE SUPPLY | Supply/Implant | $1,300.10 |
| 6116453 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6116454 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6116455 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6116456 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6116457 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6116460 | SUPPLY IMPLANT | Supply/Implant | $345.60 |
| 6116462 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,408.00 |
| 6116463 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $76,326.40 |
| 6116467 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6116468 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6116472 | GUIDE WIRE | Supply/Implant | $2,839.04 |
| 6116473 | GUIDE WIRE | Supply/Implant | $2,839.04 |
| 6116490 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6116495 | GUIDE WIRE | Supply/Implant | $1,018.88 |
| 6116501 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6116506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6116509 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6116514 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6116520 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6116522 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6116531 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6116533 | CATHETER, GUIDING | Supply/Implant | $422.40 |
| 6116535 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116538 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116541 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116544 | CATHETER, GUIDING | Supply/Implant | $704.00 |
| 6116546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6116550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6116554 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,084.80 |
| 6116559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116560 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6116562 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,450.24 |
| 6116563 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6116567 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116569 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116572 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6116574 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116576 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116579 | SUPPLY IMPLANT | Supply/Implant | $2,421.95 |
| 6116581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $869.12 |
| 6116582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6116583 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6116585 | SUPPLY IMPLANT | Supply/Implant | $13,350.40 |
| 6116586 | SUPPLY IMPLANT | Supply/Implant | $13,350.40 |
| 6116588 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6116589 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6116590 | SUPPLY IMPLANT | Supply/Implant | $1,268.35 |
| 6116592 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6116594 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6116595 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6116599 | GUIDE WIRE | Supply/Implant | $2,304.00 |
| 6116600 | STERILE SUPPLY | Supply/Implant | $251.65 |
| 6116605 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,331.01 |
| 6116613 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6116614 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6116617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,914.05 |
| 6116618 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6116619 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6116621 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6116630 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6116638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6116639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6116640 | CATHETER, GUIDING | Supply/Implant | $6,438.40 |
| 6116641 | SUPPLY IMPLANT | Supply/Implant | $152,250.00 |
| 6116642 | STERILE SUPPLY | Supply/Implant | $3,411.33 |
| 6116643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6116645 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6116646 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6116648 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6116652 | SUPPLY IMPLANT | Supply/Implant | $27,507.20 |
| 6116656 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6116658 | GUIDE WIRE | Supply/Implant | $3,072.00 |
| 6116662 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116663 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116664 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116665 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6116666 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116667 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116668 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6116677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6116678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6116680 | SUPPLY IMPLANT | Supply/Implant | $17,387.52 |
| 6116682 | GUIDE WIRE | Supply/Implant | $1,204.25 |
| 6116686 | RET DEV, INSERTABLE | Supply/Implant | $5,120.00 |
| 6116690 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6116694 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $20,864.00 |
| 6116696 | STERILE SUPPLY | Supply/Implant | $257.54 |
| 6116698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6116699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6116715 | SUPPLY IMPLANT | Supply/Implant | $27,046.66 |
| 6116716 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6116717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6116718 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6116719 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6116727 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6116731 | CATHETER, GUIDING | Supply/Implant | $1,984.00 |
| 6116737 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6116741 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,728.00 |
| 6116745 | SUPPLY IMPLANT | Supply/Implant | $360.83 |
| 6116746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6116747 | SUPPLY IMPLANT | Supply/Implant | $212,605.00 |
| 6116751 | SUPPLY IMPLANT | Supply/Implant | $239.74 |
| 6116752 | SUPPLY IMPLANT | Supply/Implant | $317.82 |
| 6116754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,472.06 |
| 6116755 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6116756 | SUPPLY IMPLANT | Supply/Implant | $715.14 |
| 6116758 | GENERAL SUPPLY | Supply/Implant | $1,440.00 |
| 6116760 | CATHETER, GUIDING | Supply/Implant | $793.60 |
| 6116762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6116764 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6116776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6116779 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6116780 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6116781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,444.80 |
| 6116782 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6116783 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6116784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116786 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,000.00 |
| 6116790 | CATH, DRAINAGE | Supply/Implant | $742.40 |
| 6116793 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,692.80 |
| 6116806 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6116807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,950.40 |
| 6116812 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6116813 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6116816 | STERILE SUPPLY | Supply/Implant | $8,486.40 |
| 6116819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6116821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6116824 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116825 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116826 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116827 | GUIDE WIRE | Supply/Implant | $2,525.34 |
| 6116837 | SUPPLY IMPLANT | Supply/Implant | $1,131.01 |
| 6116853 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6116859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116860 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,136.00 |
| 6116861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116862 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6116863 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6116864 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6116867 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6116872 | SUPPLY IMPLANT | Supply/Implant | $3,801.60 |
| 6116873 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6116874 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6116875 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6116876 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6116881 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6116886 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6116890 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6116920 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6116931 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6116940 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116941 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116942 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116943 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116944 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116945 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116946 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116948 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6116950 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6116974 | STERILE SUPPLY | Supply/Implant | $389.12 |
| 6116975 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,008.64 |
| 6116978 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,075.20 |
| 6116980 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6116983 | GENERAL SUPPLY | Supply/Implant | $601.60 |
| 6116984 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,008.64 |
| 6116985 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,075.20 |
| 6116988 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,024.00 |
| 6116992 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6116993 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $993.28 |
| 6116994 | SUPPLY IMPLANT | Supply/Implant | $993.28 |
| 6116995 | STERILE SUPPLY | Supply/Implant | $614.40 |
| 6116996 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $993.28 |
| 6116997 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,455.17 |
| 6116998 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6117001 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $12,160.00 |
| 6117002 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $12,160.00 |
| 6117005 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $12,160.00 |
| 6117007 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117008 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6117009 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117010 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117011 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6117013 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117017 | CATHETER, GUIDING | Supply/Implant | $12,384.00 |
| 6117018 | CATHETER, GUIDING | Supply/Implant | $11,648.00 |
| 6117019 | CATHETER, GUIDING | Supply/Implant | $12,672.00 |
| 6117020 | CATHETER, GUIDING | Supply/Implant | $12,352.00 |
| 6117021 | CATHETER, GUIDING | Supply/Implant | $12,352.00 |
| 6117022 | CATHETER, GUIDING | Supply/Implant | $12,672.00 |
| 6117023 | CATHETER, GUIDING | Supply/Implant | $11,283.20 |
| 6117024 | CATHETER, GUIDING | Supply/Implant | $12,352.00 |
| 6117025 | CATHETER, GUIDING | Supply/Implant | $11,448.32 |
| 6117026 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6117027 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6117047 | GENERAL SUPPLY | Supply/Implant | $258.57 |
| 6117050 | SUPPLY IMPLANT | Supply/Implant | $5,030.40 |
| 6117058 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6117062 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6117086 | SUPPLY IMPLANT | Supply/Implant | $121,296.00 |
| 6117089 | GENERAL SUPPLY | Supply/Implant | $218.11 |
| 6117090 | GENERAL SUPPLY | Supply/Implant | $131.88 |
| 6117096 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117097 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6117104 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6117107 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6117108 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6117116 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6117117 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6117130 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117133 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117138 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6117153 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6117154 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $17,600.00 |
| 6117176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6117177 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117178 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117179 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117181 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117182 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117183 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6117184 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6117206 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6117226 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6117228 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6117299 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6117300 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6117302 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6117316 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6117317 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6117318 | SUPPLY IMPLANT | Supply/Implant | $5,621.76 |
| 6117320 | STERILE SUPPLY | Supply/Implant | $250.88 |
| 6117324 | SUPPLY IMPLANT | Supply/Implant | $21,954.56 |
| 6117329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,676.80 |
| 6117330 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6117331 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6117334 | SUPPLY IMPLANT | Supply/Implant | $278.40 |
| 6117335 | SUPPLY IMPLANT | Supply/Implant | $141.88 |
| 6117338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6117347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6117353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6117354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6117356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6117357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,734.08 |
| 6117362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6117364 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6117365 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117366 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117367 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117368 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117369 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117371 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117373 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117374 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117375 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117376 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117377 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117378 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117379 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117380 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117382 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117383 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117385 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117386 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117387 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117388 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117389 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117391 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $9,932.80 |
| 6117396 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6117397 | SUPPLY IMPLANT | Supply/Implant | $2,784.00 |
| 6117398 | SUPPLY IMPLANT | Supply/Implant | $2,784.00 |
| 6117409 | STERILE SUPPLY | Supply/Implant | $1,700.86 |
| 6117411 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117416 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117419 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117420 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117422 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117424 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117431 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117432 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117433 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117435 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117437 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117440 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117442 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117444 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117446 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117452 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117453 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117454 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117459 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,920.00 |
| 6117461 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,280.00 |
| 6117490 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6117496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6117499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6117500 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6117503 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6117504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6117505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6117510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6117517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6117520 | STERILE SUPPLY | Supply/Implant | $2,323.58 |
| 6117521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6117523 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6117557 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6117559 | STERILE SUPPLY | Supply/Implant | $3,851.52 |
| 6117562 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $21,760.00 |
| 6117564 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6117565 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6117566 | SUPPLY IMPLANT | Supply/Implant | $4,172.80 |
| 6117567 | SUPPLY IMPLANT | Supply/Implant | $3,814.40 |
| 6117568 | SUPPLY IMPLANT | Supply/Implant | $4,300.80 |
| 6117571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,292.74 |
| 6117573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6117575 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6117576 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6117584 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6117585 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6117586 | CATHETER, GUIDING | Supply/Implant | $5,913.60 |
| 6117589 | STERILE SUPPLY | Supply/Implant | $189.31 |
| 6117590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6117591 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6117593 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6117594 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6117595 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6117596 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6117598 | SUPPLY IMPLANT | Supply/Implant | $10,227.20 |
| 6117599 | ALLODERM SKIN SUB | Supply/Implant | $36,827.14 |
| 6117600 | FLEXHD OR ALLOPATCH HD PER 1 SQ CM | Supply/Implant | $44,826.62 |
| 6117601 | ALLODERM SKIN SUB | Supply/Implant | $57,526.27 |
| 6117602 | SUPPLY IMPLANT | Supply/Implant | $1,615.23 |
| 6117608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6117609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,368.00 |
| 6117610 | SUPPLY IMPLANT | Supply/Implant | $11,302.40 |
| 6117611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6117615 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6117617 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6117619 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6117620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6117624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6117625 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6117627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,241.28 |
| 6117631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,701.44 |
| 6117634 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6117635 | SUPPLY IMPLANT | Supply/Implant | $141.82 |
| 6117646 | GENERAL SUPPLY | Supply/Implant | $241.28 |
| 6117647 | SUPPLY IMPLANT | Supply/Implant | $1,703.30 |
| 6117656 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6117658 | GUIDE WIRE | Supply/Implant | $742.02 |
| 6117661 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6117662 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6117663 | GUIDE WIRE | Supply/Implant | $742.02 |
| 6117669 | SUPPLY IMPLANT | Supply/Implant | $1,231.36 |
| 6117670 | SUPPLY IMPLANT | Supply/Implant | $1,527.68 |
| 6117671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6117673 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6117675 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6117677 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6117698 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6117701 | SUPPLY IMPLANT | Supply/Implant | $1,149.18 |
| 6117702 | STERILE SUPPLY | Supply/Implant | $221.70 |
| 6117706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6117707 | GENERAL SUPPLY | Supply/Implant | $1,747.97 |
| 6117708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6117709 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6117710 | SUPPLY IMPLANT | Supply/Implant | $870.14 |
| 6117711 | SUPPLY IMPLANT | Supply/Implant | $870.14 |
| 6117712 | SUPPLY IMPLANT | Supply/Implant | $870.14 |
| 6117714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6117715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6117716 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6117717 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6117718 | GENERAL SUPPLY | Supply/Implant | $736.00 |
| 6117720 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6117766 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117767 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117768 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117770 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117771 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117772 | SUPPLY IMPLANT | Supply/Implant | $3,737.60 |
| 6117774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6117781 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6117782 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,880.00 |
| 6117785 | CATHETER, GUIDING | Supply/Implant | $487.42 |
| 6117788 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6117789 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,200.00 |
| 6117791 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6117792 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,472.00 |
| 6117795 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6117804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6117806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,368.00 |
| 6117811 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6117812 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6117813 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $21,760.00 |
| 6117815 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6117816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6117819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6117821 | SUPPLY IMPLANT | Supply/Implant | $1,900.80 |
| 6117822 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6117825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6117826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6117839 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117842 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117845 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117847 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117849 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117853 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117854 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117855 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117856 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6117858 | SUPPLY IMPLANT | Supply/Implant | $5,491.20 |
| 6117860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6117861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6117862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6117875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,136.00 |
| 6117878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117882 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6117885 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6117886 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6117887 | SUPPLY IMPLANT | Supply/Implant | $2,265.98 |
| 6117888 | BELT/VEST ELEC/COMBO VAD REP | Supply/Implant | $5,440.00 |
| 6117892 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6117893 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6117894 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6117895 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6117914 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117926 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6117948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6117971 | SUPPLY IMPLANT | Supply/Implant | $8,819.20 |
| 6117975 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,800.00 |
| 6117989 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6117994 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6118002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118005 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118009 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $137.73 |
| 6118012 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118014 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118028 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,841.09 |
| 6118038 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6118043 | SUPPLY IMPLANT | Supply/Implant | $1,801.09 |
| 6118050 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118054 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118064 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,292.54 |
| 6118077 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,188.48 |
| 6118081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6118083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6118084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6118098 | GUIDE WIRE | Supply/Implant | $1,648.64 |
| 6118100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $96,908.80 |
| 6118103 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6118104 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6118105 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6118107 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6118123 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118127 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118128 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118130 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6118132 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6118141 | GENERAL SUPPLY | Supply/Implant | $767.36 |
| 6118142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118147 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6118148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118149 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6118152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6118156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6118158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,848.00 |
| 6118159 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6118160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6118162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6118167 | SUPPLY IMPLANT | Supply/Implant | $41,261.44 |
| 6118174 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6118175 | SUPPLY IMPLANT | Supply/Implant | $152,250.00 |
| 6118184 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6118201 | STERILE SUPPLY | Supply/Implant | $194.56 |
| 6118203 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6118212 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6118213 | CATHETER, GUIDING | Supply/Implant | $7,616.00 |
| 6118214 | CATHETER, GUIDING | Supply/Implant | $8,896.00 |
| 6118215 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6118219 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6118220 | SUPPLY IMPLANT | Supply/Implant | $644.35 |
| 6118227 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118231 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118232 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118233 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6118241 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,736.00 |
| 6118245 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,736.00 |
| 6118248 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118251 | CATHETER, GUIDING | Supply/Implant | $6,148.86 |
| 6118252 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6118253 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6118254 | SUPPLY IMPLANT | Supply/Implant | $4,561.92 |
| 6118255 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6118259 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6118263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6118283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,576.96 |
| 6118287 | SUPPLY IMPLANT | Supply/Implant | $13,754.88 |
| 6118289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6118291 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6118300 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6118302 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6118305 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6118309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6118310 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6118311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,121.60 |
| 6118312 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6118313 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6118323 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6118331 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118332 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118333 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118334 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118338 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118339 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118340 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118341 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118343 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118344 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118345 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118347 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,480.00 |
| 6118351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6118352 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6118354 | GENERAL SUPPLY | Supply/Implant | $319.36 |
| 6118355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,773.95 |
| 6118356 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6118360 | SUPPLY IMPLANT | Supply/Implant | $4,428.80 |
| 6118371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6118372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6118383 | GENERAL SUPPLY | Supply/Implant | $318.46 |
| 6118387 | SUPPLY IMPLANT | Supply/Implant | $40,960.00 |
| 6118388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,968.00 |
| 6118401 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6118403 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6118407 | LEAD, AICD, NON SING/DUAL | Supply/Implant | $51,200.00 |
| 6118418 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6118419 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6118422 | SUPPLY IMPLANT | Supply/Implant | $349.18 |
| 6118426 | GENERAL SUPPLY | Supply/Implant | $444.80 |
| 6118431 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6118433 | SUPPLY IMPLANT | Supply/Implant | $673.66 |
| 6118437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6118442 | GUIDE WIRE | Supply/Implant | $2,803.20 |
| 6118447 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6118448 | SUPPLY IMPLANT | Supply/Implant | $1,627.52 |
| 6118449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6118450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6118451 | PROSTHETIC IMPLANT NOS | Supply/Implant | $28,096.00 |
| 6118452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6118453 | PROSTHETIC IMPLANT NOS | Supply/Implant | $28,096.00 |
| 6118454 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6118460 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118461 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118462 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118463 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6118467 | GENERAL SUPPLY | Supply/Implant | $16,000.00 |
| 6118470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,428.48 |
| 6118488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6118492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6118493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6118495 | SUPPLY IMPLANT | Supply/Implant | $44,160.00 |
| 6118504 | INTERSPINOUS IMPLANT | Supply/Implant | $7,616.00 |
| 6118505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,920.00 |
| 6118509 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6118519 | SUPPLY IMPLANT | Supply/Implant | $10,496.00 |
| 6118520 | SUPPLY IMPLANT | Supply/Implant | $16,576.00 |
| 6118521 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6118525 | SUPPLY IMPLANT | Supply/Implant | $57,830.40 |
| 6118528 | SUPPLY IMPLANT | Supply/Implant | $305.54 |
| 6118534 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6118538 | SUPPLY IMPLANT | Supply/Implant | $131.84 |
| 6118541 | CATHETER, GUIDING | Supply/Implant | $371.20 |
| 6118547 | SUPPLY IMPLANT | Supply/Implant | $6,707.20 |
| 6118560 | GENERAL SUPPLY | Supply/Implant | $246.53 |
| 6118565 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6118570 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6118571 | SUPPLY IMPLANT | Supply/Implant | $1,028.35 |
| 6118572 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6118580 | INTRO/SHEATH, NON-LASER | Supply/Implant | $737.28 |
| 6118581 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6118582 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6118584 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6118586 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6118589 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6118591 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6118595 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6118596 | STERILE SUPPLY | Supply/Implant | $671.87 |
| 6118599 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6118600 | SUPPLY IMPLANT | Supply/Implant | $1,120.00 |
| 6118605 | GUIDE WIRE | Supply/Implant | $997.50 |
| 6118608 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6118609 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6118611 | STERILE SUPPLY | Supply/Implant | $522.50 |
| 6118614 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6118615 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6118616 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6118617 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6118618 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6118637 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,867.20 |
| 6118640 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,867.20 |
| 6118644 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,867.20 |
| 6118650 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,720.00 |
| 6118651 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,720.00 |
| 6118677 | GENERAL SUPPLY | Supply/Implant | $1,503.87 |
| 6118681 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6118694 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6118695 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6118696 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6118698 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6118699 | GENERAL SUPPLY | Supply/Implant | $388.99 |
| 6118728 | STERILE SUPPLY | Supply/Implant | $13,056.00 |
| 6118737 | STERILE SUPPLY | Supply/Implant | $186.24 |
| 6118747 | STERILE SUPPLY | Supply/Implant | $129.34 |
| 6118749 | STERILE SUPPLY | Supply/Implant | $490.24 |
| 6118750 | STERILE SUPPLY | Supply/Implant | $368.13 |
| 6118751 | STERILE SUPPLY | Supply/Implant | $225.15 |
| 6118752 | STERILE SUPPLY | Supply/Implant | $519.94 |
| 6118754 | STERILE SUPPLY | Supply/Implant | $498.05 |
| 6118755 | STERILE SUPPLY | Supply/Implant | $563.84 |
| 6118756 | STERILE SUPPLY | Supply/Implant | $195.84 |
| 6118757 | STERILE SUPPLY | Supply/Implant | $448.77 |
| 6118758 | STERILE SUPPLY | Supply/Implant | $2,176.13 |
| 6118759 | STERILE SUPPLY | Supply/Implant | $205.57 |
| 6118771 | SUPPLY IMPLANT | Supply/Implant | $137.98 |
| 6118779 | GENERAL SUPPLY | Supply/Implant | $367.87 |
| 6118780 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6118784 | SUPPLY IMPLANT | Supply/Implant | $3,860.48 |
| 6118790 | SUPPLY IMPLANT | Supply/Implant | $25,472.00 |
| 6118791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6118792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6118810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6118811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6118812 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6118818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6118819 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118820 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118821 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118822 | GUIDE WIRE | Supply/Implant | $494.59 |
| 6118828 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118832 | INTERSPINOUS IMPLANT | Supply/Implant | $14,080.00 |
| 6118835 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6118848 | CATH OCCLUSION | Supply/Implant | $19,136.00 |
| 6118855 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6118857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6118861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6118952 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6118957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6118958 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $52,480.00 |
| 6118959 | PMKR, DUAL, RATE-RESP | Supply/Implant | $58,880.00 |
| 6118960 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6118961 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,656.00 |
| 6118963 | GUIDE WIRE | Supply/Implant | $2,944.00 |
| 6118964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6118965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6118968 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6118969 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6118971 | GUIDE WIRE | Supply/Implant | $1,996.80 |
| 6118973 | GUIDE WIRE | Supply/Implant | $537.60 |
| 6118993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6118996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6119001 | GENERAL SUPPLY | Supply/Implant | $203.78 |
| 6119002 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,473.15 |
| 6119014 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6119017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6119018 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6119030 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119034 | GENERAL SUPPLY | Supply/Implant | $182.30 |
| 6119071 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6119072 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $1,600.00 |
| 6119075 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6119076 | PORT, INDWELLING, IMP | Supply/Implant | $7,040.00 |
| 6119077 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,185.60 |
| 6119080 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6119083 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6119084 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6119086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119091 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6119092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6119094 | STERILE SUPPLY | Supply/Implant | $5,825.08 |
| 6119095 | CATHETER, GUIDING | Supply/Implant | $422.40 |
| 6119107 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $3,520.00 |
| 6119110 | SUPPLY IMPLANT | Supply/Implant | $7,561.60 |
| 6119118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6119119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6119121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119131 | SUPPLY IMPLANT | Supply/Implant | $1,032.32 |
| 6119134 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6119135 | GENERAL SUPPLY | Supply/Implant | $344.83 |
| 6119136 | GENERAL SUPPLY | Supply/Implant | $344.83 |
| 6119137 | GENERAL SUPPLY | Supply/Implant | $344.83 |
| 6119145 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6119146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,433.92 |
| 6119147 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6119149 | CATHETER, GUIDING | Supply/Implant | $31,616.00 |
| 6119153 | CATHETER, GUIDING | Supply/Implant | $1,600.00 |
| 6119164 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6119172 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6119174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6119176 | SUPPLY IMPLANT | Supply/Implant | $5,053.95 |
| 6119177 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6119179 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6119182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119185 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6119187 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6119193 | SUPPLY IMPLANT | Supply/Implant | $1,062.40 |
| 6119194 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6119195 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6119196 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6119197 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6119198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119201 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6119202 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6119203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119204 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119205 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6119208 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119209 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119211 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6119214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6119220 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6119222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $91,110.40 |
| 6119225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6119230 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,728.00 |
| 6119231 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6119233 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6119234 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6119235 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6119237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $205,030.00 |
| 6119238 | SUPPLY IMPLANT | Supply/Implant | $41,261.44 |
| 6119239 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6119240 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6119242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,710.40 |
| 6119244 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $42,176.00 |
| 6119252 | SUPPLY IMPLANT | Supply/Implant | $4,561.92 |
| 6119253 | SUPPLY IMPLANT | Supply/Implant | $4,561.92 |
| 6119254 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6119257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6119270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6119271 | SUPPLY IMPLANT | Supply/Implant | $307,534.90 |
| 6119302 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $15,552.00 |
| 6119304 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6119306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,163.20 |
| 6119307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $921.60 |
| 6119312 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6119314 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,937.60 |
| 6119315 | STERILE SUPPLY | Supply/Implant | $16,576.00 |
| 6119317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6119320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,512.00 |
| 6119322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,512.00 |
| 6119324 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6119334 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,224.00 |
| 6119335 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6119338 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6119340 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6119343 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $10,823.68 |
| 6119347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119355 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6119356 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6119357 | STERILE SUPPLY | Supply/Implant | $244.74 |
| 6119360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $97,044.48 |
| 6119367 | STERILE SUPPLY | Supply/Implant | $12,544.00 |
| 6119368 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6119372 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6119382 | MESH (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6119384 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6119385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6119388 | GUIDE WIRE | Supply/Implant | $6,987.39 |
| 6119401 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6119403 | SUPPLY IMPLANT | Supply/Implant | $7,616.00 |
| 6119408 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6119409 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6119410 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6119411 | STERILE SUPPLY | Supply/Implant | $172.80 |
| 6119416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119417 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6119450 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6119451 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6119475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6119478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6119502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6119503 | STERILE SUPPLY | Supply/Implant | $603.01 |
| 6119507 | STERILE SUPPLY | Supply/Implant | $1,920.00 |
| 6119508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6119616 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,268.48 |
| 6119617 | CATHETER, GUIDING | Supply/Implant | $4,800.00 |
| 6119619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,904.00 |
| 6119622 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6119624 | GUIDE WIRE | Supply/Implant | $13,760.00 |
| 6119625 | EMBOLIZATION PROTECT SYST | Supply/Implant | $48,000.00 |
| 6119627 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6119632 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $31,936.00 |
| 6119639 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6119640 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6119641 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6119642 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6119643 | INTERSPINOUS IMPLANT | Supply/Implant | $75,008.00 |
| 6119646 | SUPPLY IMPLANT | Supply/Implant | $916.99 |
| 6119649 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119657 | STERILE SUPPLY | Supply/Implant | $893.82 |
| 6119683 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,632.00 |
| 6119684 | INTRO/SHEATH, NON-LASER | Supply/Implant | $819.20 |
| 6119687 | STERILE SUPPLY | Supply/Implant | $847.87 |
| 6119689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6119691 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,560.00 |
| 6119697 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6119698 | STERILE SUPPLY | Supply/Implant | $207.36 |
| 6119699 | STERILE SUPPLY | Supply/Implant | $912.00 |
| 6119700 | GENERAL SUPPLY | Supply/Implant | $691.20 |
| 6119701 | SUPPLY IMPLANT | Supply/Implant | $3,546.50 |
| 6119702 | SUPPLY IMPLANT | Supply/Implant | $3,546.50 |
| 6119703 | SUPPLY IMPLANT | Supply/Implant | $4,100.22 |
| 6119709 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,124.74 |
| 6119718 | INTRO/SHEATH, NON-LASER | Supply/Implant | $140.16 |
| 6119719 | GUIDE WIRE | Supply/Implant | $589.85 |
| 6119725 | SUPPLY IMPLANT | Supply/Implant | $435.97 |
| 6119727 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $26,752.00 |
| 6119728 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6119729 | STERILE SUPPLY | Supply/Implant | $3,417.73 |
| 6119730 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6119735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,649.60 |
| 6119737 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119740 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6119741 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6119743 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6119745 | CATH, TRANS ATHERECTOMY, DIR | Supply/Implant | $46,336.00 |
| 6119748 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6119749 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6119750 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6119755 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6119762 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,268.29 |
| 6119767 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6119768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6119769 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,876.16 |
| 6119771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,544.00 |
| 6119786 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6119787 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6119788 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6119791 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6119793 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6119794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6119796 | INTERSPINOUS IMPLANT | Supply/Implant | $13,754.88 |
| 6119798 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119799 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119800 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119801 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119802 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119803 | SUPPLY IMPLANT | Supply/Implant | $94,080.00 |
| 6119804 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6119805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6119807 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6119811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6119814 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119815 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119816 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119817 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119818 | SUPPLY IMPLANT | Supply/Implant | $251.83 |
| 6119820 | CATHETER, GUIDING | Supply/Implant | $951.04 |
| 6119821 | GEN, NEURO, NON-HF RECHG BAT | Supply/Implant | $373,700.00 |
| 6119830 | GUIDE WIRE | Supply/Implant | $19,576.45 |
| 6119833 | SUPPLY IMPLANT | Supply/Implant | $2,726.40 |
| 6119834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,592.00 |
| 6119842 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6119845 | SUPPLY IMPLANT | Supply/Implant | $7,872.00 |
| 6119853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6119854 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6119855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119858 | SUPPLY IMPLANT | Supply/Implant | $6,520.32 |
| 6119859 | SUPPLY IMPLANT | Supply/Implant | $6,520.32 |
| 6119866 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6119868 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,081.22 |
| 6119877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,856.96 |
| 6119879 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6119884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6119885 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,169.28 |
| 6119887 | SUPPLY IMPLANT | Supply/Implant | $26,752.00 |
| 6119888 | SUPPLY IMPLANT | Supply/Implant | $819.20 |
| 6119893 | CATHETER, URETERAL | Supply/Implant | $504.19 |
| 6119899 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $322,695.00 |
| 6119900 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $35,840.00 |
| 6119903 | SUPPLY IMPLANT | Supply/Implant | $2,266.02 |
| 6119907 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119908 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119909 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119910 | GENERAL SUPPLY | Supply/Implant | $666.88 |
| 6119915 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6119917 | CATH EP COOL-TIP | Supply/Implant | $23,680.00 |
| 6119921 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119922 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119923 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119924 | SUPPLY IMPLANT | Supply/Implant | $65,280.00 |
| 6119925 | MESH (IMPLANTABLE) | Supply/Implant | $7,900.03 |
| 6119926 | MESH (IMPLANTABLE) | Supply/Implant | $7,900.03 |
| 6119929 | MESH (IMPLANTABLE) | Supply/Implant | $7,026.56 |
| 6119933 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6119941 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6119944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6119949 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6119950 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6119952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6119955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,368.00 |
| 6119957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6119969 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6119976 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6119977 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6119978 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119979 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119980 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119981 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119982 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119983 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119984 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119985 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119986 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119987 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119988 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119989 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119990 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119991 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119992 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119993 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119994 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119995 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119996 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119997 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119998 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6119999 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120000 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120001 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120002 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120003 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120004 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120005 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120006 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120007 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120008 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120009 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120010 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120011 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120012 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120013 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120014 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120015 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120016 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120017 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120018 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120019 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120020 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120021 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120022 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120023 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120024 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120025 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120026 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120027 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120028 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120029 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120030 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120031 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120032 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120033 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $13,440.00 |
| 6120038 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6120039 | SUPPLY IMPLANT | Supply/Implant | $5,053.95 |
| 6120045 | STERILE SUPPLY | Supply/Implant | $603.01 |
| 6120053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,905.60 |
| 6120055 | INTRO/SHEATH, NON-LASER | Supply/Implant | $286.72 |
| 6120056 | GENERAL SUPPLY | Supply/Implant | $274.50 |
| 6120059 | SUPPLY IMPLANT | Supply/Implant | $155.90 |
| 6120061 | STERILE SUPPLY | Supply/Implant | $1,259.85 |
| 6120071 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120075 | STERILE SUPPLY | Supply/Implant | $184.19 |
| 6120077 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6120140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6120141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6120142 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6120143 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6120144 | CATHETER, GUIDING | Supply/Implant | $290.05 |
| 6120148 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120150 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120151 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6120185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6120188 | STERILE SUPPLY | Supply/Implant | $528.13 |
| 6120190 | STERILE SUPPLY | Supply/Implant | $135.68 |
| 6120253 | STERILE SUPPLY | Supply/Implant | $199.04 |
| 6120259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $819.20 |
| 6120270 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,648.00 |
| 6120271 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,518.40 |
| 6120272 | SUPPLY IMPLANT | Supply/Implant | $149,765.60 |
| 6120276 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6120280 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,553.86 |
| 6120282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6120286 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $82,579.20 |
| 6120289 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $13,056.00 |
| 6120300 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,441.60 |
| 6120303 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6120307 | GENERAL SUPPLY | Supply/Implant | $541.98 |
| 6120309 | STERILE SUPPLY | Supply/Implant | $336.69 |
| 6120310 | STERILE SUPPLY | Supply/Implant | $254.84 |
| 6120311 | CATHETER, GUIDING | Supply/Implant | $10,880.00 |
| 6120312 | GUIDE WIRE | Supply/Implant | $4,672.00 |
| 6120313 | STERILE SUPPLY | Supply/Implant | $207.23 |
| 6120318 | GENERAL SUPPLY | Supply/Implant | $242.18 |
| 6120325 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6120328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,424.00 |
| 6120330 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6120334 | GENERAL SUPPLY | Supply/Implant | $536.19 |
| 6120335 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $46,144.00 |
| 6120336 | STERILE SUPPLY | Supply/Implant | $166.40 |
| 6120337 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6120384 | SUPPLY IMPLANT | Supply/Implant | $5,135.36 |
| 6120385 | SUPPLY IMPLANT | Supply/Implant | $7,561.60 |
| 6120386 | SUPPLY IMPLANT | Supply/Implant | $7,561.60 |
| 6120387 | SUPPLY IMPLANT | Supply/Implant | $5,135.36 |
| 6120390 | SUPPLY IMPLANT | Supply/Implant | $5,102.72 |
| 6120396 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6120397 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6120398 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6120399 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6120408 | SUPPLY IMPLANT | Supply/Implant | $7,485.44 |
| 6120410 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6120411 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6120414 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,840.00 |
| 6120415 | CATH, DRAINAGE | Supply/Implant | $912.90 |
| 6120416 | SUPPLY IMPLANT | Supply/Implant | $379.65 |
| 6120417 | GENERAL SUPPLY | Supply/Implant | $188.70 |
| 6120420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6120421 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6120426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6120427 | GENERAL SUPPLY | Supply/Implant | $21,760.00 |
| 6120428 | GENERAL SUPPLY | Supply/Implant | $24,256.00 |
| 6120429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6120430 | GENERAL SUPPLY | Supply/Implant | $44,800.00 |
| 6120433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,096.00 |
| 6120436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6120438 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6120440 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6120445 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6120446 | GENERAL SUPPLY | Supply/Implant | $349.38 |
| 6120455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6120457 | SUPPLY IMPLANT | Supply/Implant | $62,976.00 |
| 6120458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6120459 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6120468 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,864.96 |
| 6120471 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6120474 | SUPPLY IMPLANT | Supply/Implant | $15,040.00 |
| 6120477 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6120478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6120479 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6120484 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6120485 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6120487 | GENERAL SUPPLY | Supply/Implant | $3,072.00 |
| 6120572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6120573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6120574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6120673 | GENERAL SUPPLY | Supply/Implant | $142.08 |
| 6120706 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6120707 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120708 | SUPPLY IMPLANT | Supply/Implant | $25,510.40 |
| 6120716 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,541.38 |
| 6120721 | INTERSPINOUS IMPLANT | Supply/Implant | $16,256.00 |
| 6120774 | SUPPLY IMPLANT | Supply/Implant | $807.04 |
| 6120779 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6120780 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6120781 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6120789 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6120790 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6120791 | SUPPLY IMPLANT | Supply/Implant | $2,931.20 |
| 6120792 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6120793 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6120794 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6120795 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6120800 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,432.00 |
| 6120801 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,432.00 |
| 6120803 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,432.00 |
| 6120809 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120812 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120815 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120816 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,288.00 |
| 6120817 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6120818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6120819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6120821 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6120832 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6120833 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6120834 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6120835 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6120836 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6120841 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6120842 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6120843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6120844 | SUPPLY IMPLANT | Supply/Implant | $777.60 |
| 6120848 | SUPPLY IMPLANT | Supply/Implant | $10,432.00 |
| 6120850 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120851 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,060.80 |
| 6120870 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6120876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6120877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6120886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,019.90 |
| 6120888 | STERILE SUPPLY | Supply/Implant | $2,803.20 |
| 6120891 | STERILE SUPPLY | Supply/Implant | $755.20 |
| 6120900 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6120902 | GUIDE WIRE | Supply/Implant | $257.66 |
| 6120907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6120912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,302.40 |
| 6120914 | SUPPLY IMPLANT | Supply/Implant | $211.46 |
| 6120915 | STERILE SUPPLY | Supply/Implant | $319.65 |
| 6120916 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6120920 | SUPPLY IMPLANT | Supply/Implant | $4,518.40 |
| 6120921 | SUPPLY IMPLANT | Supply/Implant | $4,518.40 |
| 6120926 | CATHETER, GUIDING | Supply/Implant | $172.80 |
| 6120933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6120934 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6120935 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6120936 | SUPPLY IMPLANT | Supply/Implant | $1,582.85 |
| 6120939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,022.40 |
| 6120941 | GUIDE WIRE | Supply/Implant | $507.85 |
| 6120942 | GUIDE WIRE | Supply/Implant | $335.87 |
| 6120943 | CATHETER, GUIDING | Supply/Implant | $35,200.00 |
| 6120944 | GUIDE WIRE | Supply/Implant | $333.18 |
| 6120948 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $5,760.00 |
| 6120951 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6120952 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6120953 | SUPPLY IMPLANT | Supply/Implant | $7,541.25 |
| 6120959 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6120961 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $22,272.00 |
| 6120962 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6120963 | SUPPLY IMPLANT | Supply/Implant | $156.80 |
| 6120965 | INTRO/SHEATH, NON-LASER | Supply/Implant | $948.99 |
| 6120966 | GUIDE WIRE | Supply/Implant | $562.12 |
| 6120968 | GUIDE WIRE | Supply/Implant | $717.21 |
| 6120969 | GUIDE WIRE | Supply/Implant | $625.56 |
| 6120970 | GUIDE WIRE | Supply/Implant | $661.27 |
| 6120971 | GUIDE WIRE | Supply/Implant | $661.27 |
| 6120975 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6120976 | SUPPLY IMPLANT | Supply/Implant | $1,629.57 |
| 6120977 | SUPPLY IMPLANT | Supply/Implant | $811.78 |
| 6120979 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6120981 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6120985 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6120987 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6120993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6120994 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6120996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6120997 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120998 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6120999 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6121001 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6121003 | SUPPLY IMPLANT | Supply/Implant | $331.01 |
| 6121005 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6121006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6121007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6121011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6121012 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6121018 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6121019 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6121023 | SUPPLY IMPLANT | Supply/Implant | $21,900.80 |
| 6121024 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6121027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121029 | SUPPLY IMPLANT | Supply/Implant | $6,348.80 |
| 6121033 | GENERAL SUPPLY | Supply/Implant | $698.75 |
| 6121034 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6121035 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6121050 | SUPPLY IMPLANT | Supply/Implant | $24,819.20 |
| 6121051 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $345.60 |
| 6121053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121054 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121059 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6121061 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6121067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6121070 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,032.00 |
| 6121079 | SUPPLY IMPLANT | Supply/Implant | $2,306.69 |
| 6121084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,473.60 |
| 6121085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $81,868.42 |
| 6121086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6121091 | STERILE SUPPLY | Supply/Implant | $6,673.92 |
| 6121092 | STERILE SUPPLY | Supply/Implant | $7,782.40 |
| 6121093 | SUPPLY IMPLANT | Supply/Implant | $12,014.08 |
| 6121097 | SUPPLY IMPLANT | Supply/Implant | $66,162.56 |
| 6121103 | SUPPLY IMPLANT | Supply/Implant | $496.77 |
| 6121104 | INTRO/SHEATH, NON-LASER | Supply/Implant | $496.77 |
| 6121105 | STERILE SUPPLY | Supply/Implant | $988.80 |
| 6121107 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6121112 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6121115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,216.00 |
| 6121116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,344.00 |
| 6121120 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $186.37 |
| 6121124 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6121127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121135 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $13,414.40 |
| 6121136 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6121137 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6121138 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6121139 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6121141 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6121142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,020.80 |
| 6121143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,020.80 |
| 6121149 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6121151 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,160.00 |
| 6121152 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $4,160.00 |
| 6121157 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6121161 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,832.38 |
| 6121162 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6121163 | STERILE SUPPLY | Supply/Implant | $275.07 |
| 6121164 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6121167 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6121168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121175 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121187 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6121188 | STERILE SUPPLY | Supply/Implant | $222.21 |
| 6121191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121194 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6121201 | SUPPLY IMPLANT | Supply/Implant | $1,532.16 |
| 6121203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,260.54 |
| 6121206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121209 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121210 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6121213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6121215 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6121216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $583.68 |
| 6121217 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,347.52 |
| 6121222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6121224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6121229 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6121232 | ORTH/DEVIC/DRUG BN/BN,TIS/BN | Supply/Implant | $42,496.00 |
| 6121235 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6121236 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6121239 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6121240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6121242 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6121250 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6121251 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,619.71 |
| 6121253 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121254 | SUPPLY IMPLANT | Supply/Implant | $199.55 |
| 6121255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6121256 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,888.00 |
| 6121265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6121266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6121269 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,508.42 |
| 6121275 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6121277 | STERILE SUPPLY | Supply/Implant | $467.25 |
| 6121301 | INTERSPINOUS IMPLANT | Supply/Implant | $125,952.00 |
| 6121302 | INTERSPINOUS IMPLANT | Supply/Implant | $125,952.00 |
| 6121303 | INTERSPINOUS IMPLANT | Supply/Implant | $111,585.60 |
| 6121336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121596 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121604 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6121671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121693 | INTERSPINOUS IMPLANT | Supply/Implant | $24,742.40 |
| 6121715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6121738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121749 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6121821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6121835 | INTERSPINOUS IMPLANT | Supply/Implant | $111,132.00 |
| 6121845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6121928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6121943 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6121956 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6121982 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6121985 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6121989 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6122012 | INTERSPINOUS IMPLANT | Supply/Implant | $115,589.12 |
| 6122059 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6122082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6122086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6122092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122113 | INTERSPINOUS IMPLANT | Supply/Implant | $111,132.00 |
| 6122370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122401 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122494 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6122508 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122513 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122519 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122528 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122530 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122531 | INTERSPINOUS IMPLANT | Supply/Implant | $5,734.40 |
| 6122710 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6122727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,908.80 |
| 6122785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6122833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6122838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6122880 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6123044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6123049 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123052 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6123054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6123061 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123109 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6123112 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6123114 | INTERSPINOUS IMPLANT | Supply/Implant | $112,896.00 |
| 6123117 | INTERSPINOUS IMPLANT | Supply/Implant | $115,589.12 |
| 6123118 | INTERSPINOUS IMPLANT | Supply/Implant | $115,589.12 |
| 6123124 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6123155 | SUPPLY IMPLANT | Supply/Implant | $19,271.68 |
| 6123213 | SUPPLY IMPLANT | Supply/Implant | $13,455.36 |
| 6123295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6123325 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6123571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6123701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6123824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6123830 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6123853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,730.88 |
| 6123937 | SUPPLY IMPLANT | Supply/Implant | $3,622.40 |
| 6123986 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6124006 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6124010 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6124019 | SUPPLY IMPLANT | Supply/Implant | $3,673.60 |
| 6124050 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,181.12 |
| 6124051 | STERILE SUPPLY | Supply/Implant | $251.01 |
| 6124054 | STERILE SUPPLY | Supply/Implant | $28,160.00 |
| 6124055 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $32,000.00 |
| 6124059 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6124062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6124073 | STERILE SUPPLY | Supply/Implant | $219.90 |
| 6124076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6124081 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6124086 | GUIDE WIRE | Supply/Implant | $358.40 |
| 6124088 | GUIDE WIRE | Supply/Implant | $1,779.20 |
| 6124089 | GUIDE WIRE | Supply/Implant | $358.40 |
| 6124110 | GUIDE WIRE | Supply/Implant | $6,144.00 |
| 6124113 | GUIDE WIRE | Supply/Implant | $6,144.00 |
| 6124260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124299 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124303 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,107.20 |
| 6124347 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6124349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6124351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $307.20 |
| 6124355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $307.20 |
| 6124365 | SUPPLY IMPLANT | Supply/Implant | $857.60 |
| 6124367 | SUPPLY IMPLANT | Supply/Implant | $857.60 |
| 6124369 | SUPPLY IMPLANT | Supply/Implant | $857.60 |
| 6124430 | SUPPLY IMPLANT | Supply/Implant | $3,891.20 |
| 6124451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124460 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6124484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6124501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6124502 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124503 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124504 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124505 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6124510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,911.74 |
| 6124514 | SUPPLY IMPLANT | Supply/Implant | $1,011.20 |
| 6124518 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6124519 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $133,297.50 |
| 6124522 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6124545 | SUPPLY IMPLANT | Supply/Implant | $11,387.65 |
| 6124546 | SUPPLY IMPLANT | Supply/Implant | $11,299.33 |
| 6124547 | SUPPLY IMPLANT | Supply/Implant | $11,299.33 |
| 6124552 | SUPPLY IMPLANT | Supply/Implant | $11,299.33 |
| 6124559 | SUPPLY IMPLANT | Supply/Implant | $8,297.98 |
| 6124560 | SUPPLY IMPLANT | Supply/Implant | $8,297.98 |
| 6124561 | SUPPLY IMPLANT | Supply/Implant | $8,297.98 |
| 6124568 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124569 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124573 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124575 | SUPPLY IMPLANT | Supply/Implant | $10,151.68 |
| 6124602 | SUPPLY IMPLANT | Supply/Implant | $8,908.80 |
| 6124611 | STERILE SUPPLY | Supply/Implant | $417.02 |
| 6124612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124613 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124615 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6124616 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6124618 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6124619 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6124623 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6124624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6124627 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6124630 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6124636 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,785.47 |
| 6124641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6124643 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6124650 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6124652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6124653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $580.74 |
| 6124656 | STERILE SUPPLY | Supply/Implant | $386.05 |
| 6124666 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6124667 | STERILE SUPPLY | Supply/Implant | $10,457.60 |
| 6124669 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6124675 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6124676 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6124679 | GUIDE WIRE | Supply/Implant | $1,152.00 |
| 6124680 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6124687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6124688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6124689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6124695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6124698 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,815.36 |
| 6124699 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6124702 | SUPPLY IMPLANT | Supply/Implant | $8,585.47 |
| 6124705 | SUPPLY IMPLANT | Supply/Implant | $5,546.62 |
| 6124707 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6124708 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6124709 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6124713 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6124716 | SUPPLY IMPLANT | Supply/Implant | $934.40 |
| 6124717 | SUPPLY IMPLANT | Supply/Implant | $1,139.20 |
| 6124718 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6124719 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6124722 | GENERAL SUPPLY | Supply/Implant | $494.09 |
| 6124723 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6124724 | SUPPLY IMPLANT | Supply/Implant | $698.88 |
| 6124725 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6124728 | SUPPLY IMPLANT | Supply/Implant | $422.03 |
| 6124730 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6124731 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6124732 | SUPPLY IMPLANT | Supply/Implant | $2,188.80 |
| 6124733 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6124734 | SUPPLY IMPLANT | Supply/Implant | $926.85 |
| 6124736 | GENERAL SUPPLY | Supply/Implant | $1,223.40 |
| 6124738 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6124741 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6124742 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124743 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124745 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124748 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124749 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124750 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6124751 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6124752 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,880.00 |
| 6124753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,096.96 |
| 6124754 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6124755 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6124756 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6124757 | INTERSPINOUS IMPLANT | Supply/Implant | $101,120.00 |
| 6124759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6124764 | SUPPLY IMPLANT | Supply/Implant | $3,008.00 |
| 6124765 | SUPPLY IMPLANT | Supply/Implant | $3,104.64 |
| 6124768 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6124784 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6124785 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6124786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6124787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6124791 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6124792 | SUPPLY IMPLANT | Supply/Implant | $289.31 |
| 6124793 | SUPPLY IMPLANT | Supply/Implant | $760.58 |
| 6124794 | SUPPLY IMPLANT | Supply/Implant | $729.60 |
| 6124795 | GENERAL SUPPLY | Supply/Implant | $4,480.00 |
| 6124796 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6124811 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $231.68 |
| 6124813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6124814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,959.68 |
| 6124815 | GENERAL SUPPLY | Supply/Implant | $1,035.14 |
| 6124816 | STERILE SUPPLY | Supply/Implant | $4,736.00 |
| 6124817 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,760.00 |
| 6124820 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6124824 | PROSTHETIC EYE OTHER TYPE | Supply/Implant | $230.40 |
| 6124825 | PROSTHETIC EYE OTHER TYPE | Supply/Implant | $230.40 |
| 6124834 | GENERAL SUPPLY | Supply/Implant | $5,875.20 |
| 6124854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6124855 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6124885 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $29,376.00 |
| 6124886 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6124892 | SUPPLY IMPLANT | Supply/Implant | $15,040.00 |
| 6124893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6124894 | SUPPLY IMPLANT | Supply/Implant | $947.20 |
| 6124907 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6124914 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6124940 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6124943 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6124957 | STERILE SUPPLY | Supply/Implant | $263.68 |
| 6124959 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6124991 | GENERAL SUPPLY | Supply/Implant | $7,360.00 |
| 6125013 | GENERAL SUPPLY | Supply/Implant | $2,442.24 |
| 6125018 | SUPPLY IMPLANT | Supply/Implant | $3,310.08 |
| 6125044 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6125056 | CATH, DRAINAGE | Supply/Implant | $1,728.00 |
| 6125078 | GUIDE WIRE | Supply/Implant | $147.20 |
| 6125097 | STERILE SUPPLY | Supply/Implant | $532.22 |
| 6125108 | STERILE SUPPLY | Supply/Implant | $205.95 |
| 6125118 | SUPPLY IMPLANT | Supply/Implant | $406.91 |
| 6125124 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,163.20 |
| 6125126 | SUPPLY IMPLANT | Supply/Implant | $405.50 |
| 6125127 | CATHETER, URETERAL | Supply/Implant | $204.67 |
| 6125130 | INDWELLING CATHETER FOLEY TYPE | Supply/Implant | $204.67 |
| 6125174 | SUPPLY IMPLANT | Supply/Implant | $1,843.20 |
| 6125234 | SUPPLY IMPLANT | Supply/Implant | $407.24 |
| 6125274 | GENERAL SUPPLY | Supply/Implant | $161.19 |
| 6125278 | CATHETER, GUIDING | Supply/Implant | $14,400.00 |
| 6125280 | SUPPLY IMPLANT | Supply/Implant | $3,839.10 |
| 6125282 | GENERAL SUPPLY | Supply/Implant | $4,662.66 |
| 6125291 | SUPPLY IMPLANT | Supply/Implant | $2,437.63 |
| 6125302 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,394.75 |
| 6125304 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125325 | GRAFT, VASCULAR | Supply/Implant | $7,907.46 |
| 6125332 | STERILE SUPPLY | Supply/Implant | $176.38 |
| 6125343 | SUPPLY IMPLANT | Supply/Implant | $585.98 |
| 6125348 | SUPPLY IMPLANT | Supply/Implant | $748.80 |
| 6125360 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6125368 | SUPPLY IMPLANT | Supply/Implant | $792.58 |
| 6125396 | SUPPLY IMPLANT | Supply/Implant | $1,509.76 |
| 6125407 | SUPPLY IMPLANT | Supply/Implant | $194.71 |
| 6125409 | SUPPLY IMPLANT | Supply/Implant | $551.55 |
| 6125424 | SUPPLY IMPLANT | Supply/Implant | $574.46 |
| 6125437 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6125501 | CATH, DRAINAGE | Supply/Implant | $501.12 |
| 6125511 | STERILE SUPPLY | Supply/Implant | $612.22 |
| 6125519 | CATHETER, URETERAL | Supply/Implant | $11,251.20 |
| 6125548 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,052.10 |
| 6125558 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125569 | SUPPLY IMPLANT | Supply/Implant | $1,361.31 |
| 6125592 | GENERAL SUPPLY | Supply/Implant | $1,692.80 |
| 6125593 | STERILE SUPPLY | Supply/Implant | $245.89 |
| 6125614 | STERILE SUPPLY | Supply/Implant | $166.22 |
| 6125622 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6125631 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6125636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,180.80 |
| 6125658 | STERILE SUPPLY | Supply/Implant | $10,931.20 |
| 6125664 | GENERAL SUPPLY | Supply/Implant | $2,928.38 |
| 6125670 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125671 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $1,378.94 |
| 6125680 | SUPPLY IMPLANT | Supply/Implant | $1,265.66 |
| 6125681 | SUPPLY IMPLANT | Supply/Implant | $1,414.53 |
| 6125690 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6125705 | GRAFT, VASCULAR | Supply/Implant | $7,907.46 |
| 6125712 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,360.00 |
| 6125716 | SUPPLY IMPLANT | Supply/Implant | $1,548.80 |
| 6125721 | STERILE SUPPLY | Supply/Implant | $349.98 |
| 6125724 | SUPPLY IMPLANT | Supply/Implant | $1,651.20 |
| 6125726 | SUPPLY IMPLANT | Supply/Implant | $1,651.20 |
| 6125732 | STERILE SUPPLY | Supply/Implant | $772.86 |
| 6125748 | SUPPLY IMPLANT | Supply/Implant | $283.78 |
| 6125751 | STERILE SUPPLY | Supply/Implant | $773.12 |
| 6125757 | GENERAL SUPPLY | Supply/Implant | $3,264.00 |
| 6125790 | GUIDE WIRE | Supply/Implant | $1,172.61 |
| 6125796 | SUPPLY IMPLANT | Supply/Implant | $1,996.80 |
| 6125802 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6125819 | SUPPLY IMPLANT | Supply/Implant | $257.28 |
| 6125846 | SUPPLY IMPLANT | Supply/Implant | $403.78 |
| 6125854 | SUPPLY IMPLANT | Supply/Implant | $327.30 |
| 6125868 | CATH, DRAINAGE | Supply/Implant | $918.14 |
| 6125873 | SUPPLY IMPLANT | Supply/Implant | $602.11 |
| 6125877 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6125888 | SUPPLY IMPLANT | Supply/Implant | $144.00 |
| 6125891 | SUPPLY IMPLANT | Supply/Implant | $2,243.20 |
| 6125895 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6125911 | GRAFT, VASCULAR | Supply/Implant | $4,075.26 |
| 6125938 | APLIGRAF SKIN SUB | Supply/Implant | $16,576.00 |
| 6125977 | SUPPLY IMPLANT | Supply/Implant | $551.55 |
| 6125978 | STERILE SUPPLY | Supply/Implant | $342.02 |
| 6125995 | STERILE SUPPLY | Supply/Implant | $286.72 |
| 6126001 | SUPPLY IMPLANT | Supply/Implant | $148.74 |
| 6126006 | GUIDE WIRE | Supply/Implant | $139.52 |
| 6126008 | GENERAL SUPPLY | Supply/Implant | $848.00 |
| 6126064 | INTRO/SHEATH, NON-LASER | Supply/Implant | $824.32 |
| 6126150 | STERILE SUPPLY | Supply/Implant | $168.96 |
| 6126169 | SUPPLY IMPLANT | Supply/Implant | $132.48 |
| 6126180 | SUPPLY IMPLANT | Supply/Implant | $4,285.44 |
| 6126189 | SUPPLY IMPLANT | Supply/Implant | $166.45 |
| 6126202 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6126254 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6126257 | STERILE SUPPLY | Supply/Implant | $727.68 |
| 6126258 | SUPPLY IMPLANT | Supply/Implant | $3,310.08 |
| 6126299 | SUPPLY IMPLANT | Supply/Implant | $131.58 |
| 6126318 | STERILE SUPPLY | Supply/Implant | $740.99 |
| 6126348 | SUPPLY IMPLANT | Supply/Implant | $7,567.62 |
| 6126371 | SUPPLY IMPLANT | Supply/Implant | $1,769.98 |
| 6126379 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $4,596.48 |
| 6126386 | GRAFT, VASCULAR | Supply/Implant | $16,972.80 |
| 6126388 | GRAFT, VASCULAR | Supply/Implant | $16,294.40 |
| 6126395 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $157.31 |
| 6126397 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $157.31 |
| 6126404 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,080.00 |
| 6126405 | SUPPLY IMPLANT | Supply/Implant | $481.22 |
| 6126409 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6126412 | GUIDE WIRE | Supply/Implant | $132.86 |
| 6126454 | STERILE SUPPLY | Supply/Implant | $370.69 |
| 6126466 | SUPPLY IMPLANT | Supply/Implant | $8,005.38 |
| 6126468 | STERILE SUPPLY | Supply/Implant | $1,766.40 |
| 6126480 | GENERAL SUPPLY | Supply/Implant | $1,427.20 |
| 6126485 | GUIDE WIRE | Supply/Implant | $364.29 |
| 6126509 | GENERAL SUPPLY | Supply/Implant | $772.61 |
| 6126515 | GENERAL SUPPLY | Supply/Implant | $683.52 |
| 6126518 | GENERAL SUPPLY | Supply/Implant | $772.35 |
| 6126536 | STERILE SUPPLY | Supply/Implant | $137.22 |
| 6126538 | GENERAL SUPPLY | Supply/Implant | $2,368.00 |
| 6126550 | STERILE SUPPLY | Supply/Implant | $2,114.82 |
| 6126552 | STERILE SUPPLY | Supply/Implant | $284.80 |
| 6126569 | GENERAL SUPPLY | Supply/Implant | $774.66 |
| 6126575 | SUPPLY IMPLANT | Supply/Implant | $156.42 |
| 6126577 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6126586 | SUPPLY IMPLANT | Supply/Implant | $3,750.40 |
| 6126587 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $3,273.22 |
| 6126593 | STERILE SUPPLY | Supply/Implant | $3,293.95 |
| 6126594 | STERILE SUPPLY | Supply/Implant | $5,993.60 |
| 6126595 | STERILE SUPPLY | Supply/Implant | $2,157.31 |
| 6126596 | STERILE SUPPLY | Supply/Implant | $4,528.51 |
| 6126597 | STERILE SUPPLY | Supply/Implant | $1,567.62 |
| 6126598 | STERILE SUPPLY | Supply/Implant | $542.98 |
| 6126599 | STERILE SUPPLY | Supply/Implant | $2,249.73 |
| 6126600 | STERILE SUPPLY | Supply/Implant | $930.56 |
| 6126601 | STERILE SUPPLY | Supply/Implant | $2,197.12 |
| 6126602 | STERILE SUPPLY | Supply/Implant | $2,231.94 |
| 6126603 | STERILE SUPPLY | Supply/Implant | $1,603.84 |
| 6126604 | STERILE SUPPLY | Supply/Implant | $878.34 |
| 6126605 | STERILE SUPPLY | Supply/Implant | $1,280.26 |
| 6126606 | STERILE SUPPLY | Supply/Implant | $841.22 |
| 6126607 | STERILE SUPPLY | Supply/Implant | $6,556.54 |
| 6126608 | STERILE SUPPLY | Supply/Implant | $4,020.86 |
| 6126609 | STERILE SUPPLY | Supply/Implant | $577.02 |
| 6126610 | STERILE SUPPLY | Supply/Implant | $1,245.44 |
| 6126611 | STERILE SUPPLY | Supply/Implant | $4,795.78 |
| 6126613 | STERILE SUPPLY | Supply/Implant | $800.64 |
| 6126614 | STERILE SUPPLY | Supply/Implant | $3,303.42 |
| 6126634 | STERILE SUPPLY | Supply/Implant | $639.10 |
| 6126638 | STERILE SUPPLY | Supply/Implant | $374.40 |
| 6126716 | CATH, DRAINAGE | Supply/Implant | $1,516.80 |
| 6126717 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6126737 | GENERAL SUPPLY | Supply/Implant | $261.12 |
| 6126757 | STERILE SUPPLY | Supply/Implant | $521.10 |
| 6126762 | INTRO/SHEATH, NON-LASER | Supply/Implant | $438.78 |
| 6126763 | STERILE SUPPLY | Supply/Implant | $272.64 |
| 6126789 | STERILE SUPPLY | Supply/Implant | $503.68 |
| 6126790 | STERILE SUPPLY | Supply/Implant | $1,469.06 |
| 6126794 | STERILE SUPPLY | Supply/Implant | $1,928.70 |
| 6126795 | GENERAL SUPPLY | Supply/Implant | $188.54 |
| 6126798 | SUPPLY IMPLANT | Supply/Implant | $1,550.46 |
| 6126800 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6126826 | GENERAL SUPPLY | Supply/Implant | $1,970.82 |
| 6126827 | STERILE SUPPLY | Supply/Implant | $1,263.87 |
| 6126828 | STERILE SUPPLY | Supply/Implant | $2,723.20 |
| 6126829 | STERILE SUPPLY | Supply/Implant | $1,421.82 |
| 6126830 | STERILE SUPPLY | Supply/Implant | $2,538.75 |
| 6126831 | GENERAL SUPPLY | Supply/Implant | $3,854.59 |
| 6126832 | STERILE SUPPLY | Supply/Implant | $601.60 |
| 6126849 | STERILE SUPPLY | Supply/Implant | $525.31 |
| 6126854 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6126863 | GUIDE WIRE | Supply/Implant | $6,054.40 |
| 6126873 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $14,080.00 |
| 6126895 | CATHETER, GUIDING | Supply/Implant | $5,286.40 |
| 6126925 | GENERAL SUPPLY | Supply/Implant | $1,749.12 |
| 6126938 | SUPPLY IMPLANT | Supply/Implant | $3,752.06 |
| 6126940 | SUPPLY IMPLANT | Supply/Implant | $1,549.31 |
| 6126955 | STERILE SUPPLY | Supply/Implant | $2,072.45 |
| 6126989 | SUPPLY IMPLANT | Supply/Implant | $523.49 |
| 6126994 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6127065 | SUPPLY IMPLANT | Supply/Implant | $1,193.60 |
| 6127182 | GENERAL SUPPLY | Supply/Implant | $231.00 |
| 6127216 | STERILE SUPPLY | Supply/Implant | $8,937.34 |
| 6127241 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6127248 | SUPPLY IMPLANT | Supply/Implant | $1,357.80 |
| 6127271 | SUPPLY IMPLANT | Supply/Implant | $231.94 |
| 6127311 | SUPPLY IMPLANT | Supply/Implant | $352.00 |
| 6127321 | SUPPLY IMPLANT | Supply/Implant | $321.41 |
| 6127327 | SUPPLY IMPLANT | Supply/Implant | $323.84 |
| 6127337 | GUIDE WIRE | Supply/Implant | $2,180.35 |
| 6127352 | SUPPLY IMPLANT | Supply/Implant | $338.69 |
| 6127573 | CATH, DRAINAGE | Supply/Implant | $319.10 |
| 6127579 | STERILE SUPPLY | Supply/Implant | $158.76 |
| 6127627 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $1,843.20 |
| 6127628 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $5,760.00 |
| 6127660 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6127716 | GUIDE WIRE | Supply/Implant | $168.70 |
| 6127727 | SUPPLY IMPLANT | Supply/Implant | $165.91 |
| 6127748 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6127766 | GENERAL SUPPLY | Supply/Implant | $576.00 |
| 6127784 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6127807 | GENERAL SUPPLY | Supply/Implant | $220.95 |
| 6127808 | STERILE SUPPLY | Supply/Implant | $292.10 |
| 6127810 | SUPPLY IMPLANT | Supply/Implant | $339.99 |
| 6127822 | SUPPLY IMPLANT | Supply/Implant | $170.50 |
| 6127843 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6127849 | STERILE SUPPLY | Supply/Implant | $3,172.35 |
| 6127850 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $20,480.00 |
| 6127852 | STERILE SUPPLY | Supply/Implant | $1,670.91 |
| 6127866 | GUIDE WIRE | Supply/Implant | $832.00 |
| 6127904 | CATHETER, GUIDING | Supply/Implant | $792.83 |
| 6127906 | STERILE SUPPLY | Supply/Implant | $468.22 |
| 6127908 | CATHETER, GUIDING | Supply/Implant | $419.84 |
| 6128031 | STERILE SUPPLY | Supply/Implant | $2,137.60 |
| 6128094 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6128114 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.12 |
| 6128117 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6128123 | STERILE SUPPLY | Supply/Implant | $76,800.00 |
| 6128184 | STERILE SUPPLY | Supply/Implant | $139.65 |
| 6128185 | STERILE SUPPLY | Supply/Implant | $164.35 |
| 6128189 | SUPPLY IMPLANT | Supply/Implant | $4,167.68 |
| 6128217 | SUPPLY IMPLANT | Supply/Implant | $227.20 |
| 6128252 | GUIDE WIRE | Supply/Implant | $160.00 |
| 6128265 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6128280 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,426.30 |
| 6128285 | STERILE SUPPLY | Supply/Implant | $229.12 |
| 6128299 | STERILE SUPPLY | Supply/Implant | $1,206.66 |
| 6128308 | GUIDE WIRE | Supply/Implant | $2,180.35 |
| 6128309 | GUIDE WIRE | Supply/Implant | $2,180.35 |
| 6128310 | SUPPLY IMPLANT | Supply/Implant | $893.95 |
| 6128315 | SUPPLY IMPLANT | Supply/Implant | $322.43 |
| 6128317 | SUPPLY IMPLANT | Supply/Implant | $353.41 |
| 6128349 | STERILE SUPPLY | Supply/Implant | $489.02 |
| 6128379 | GUIDE WIRE | Supply/Implant | $857.60 |
| 6128400 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,680.00 |
| 6128401 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6128409 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,710.40 |
| 6128429 | SUPPLY IMPLANT | Supply/Implant | $137.22 |
| 6128433 | GENERAL SUPPLY | Supply/Implant | $297.86 |
| 6128434 | GENERAL SUPPLY | Supply/Implant | $311.42 |
| 6128435 | GENERAL SUPPLY | Supply/Implant | $318.21 |
| 6128436 | GENERAL SUPPLY | Supply/Implant | $311.42 |
| 6128438 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6128439 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6128440 | GENERAL SUPPLY | Supply/Implant | $347.26 |
| 6128447 | SUPPLY IMPLANT | Supply/Implant | $369.78 |
| 6128460 | STERILE SUPPLY | Supply/Implant | $170.37 |
| 6128461 | STERILE SUPPLY | Supply/Implant | $250.62 |
| 6128463 | STERILE SUPPLY | Supply/Implant | $366.59 |
| 6128465 | STERILE SUPPLY | Supply/Implant | $339.05 |
| 6128486 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $20,800.00 |
| 6128490 | SUPPLY IMPLANT | Supply/Implant | $307.20 |
| 6128504 | GUIDE WIRE | Supply/Implant | $845.82 |
| 6128538 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6128544 | GUIDE WIRE | Supply/Implant | $2,754.43 |
| 6128555 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6128556 | GENERAL SUPPLY | Supply/Implant | $716.54 |
| 6128559 | SUPPLY IMPLANT | Supply/Implant | $2,213.89 |
| 6128675 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128676 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128677 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128678 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,918.40 |
| 6128692 | ALGINATE DRSG >16 <=48 SQ IN | Supply/Implant | $269.70 |
| 6128695 | SUPPLY IMPLANT | Supply/Implant | $182.55 |
| 6128726 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,049.60 |
| 6128738 | SUPPLY IMPLANT | Supply/Implant | $659.20 |
| 6128745 | GENERAL SUPPLY | Supply/Implant | $1,024.00 |
| 6128758 | SUPPLY IMPLANT | Supply/Implant | $1,669.12 |
| 6128801 | SUPPLY IMPLANT | Supply/Implant | $5,308.67 |
| 6128802 | SUPPLY IMPLANT | Supply/Implant | $546.05 |
| 6128803 | SUPPLY IMPLANT | Supply/Implant | $546.05 |
| 6128813 | STERILE SUPPLY | Supply/Implant | $613.25 |
| 6128843 | STERILE SUPPLY | Supply/Implant | $1,355.52 |
| 6128844 | SUPPLY IMPLANT | Supply/Implant | $1,768.96 |
| 6128849 | STERILE SUPPLY | Supply/Implant | $138.37 |
| 6128908 | INTRO/SHEATH, NON-LASER | Supply/Implant | $359.55 |
| 6128918 | GUIDE WIRE | Supply/Implant | $5,760.00 |
| 6128931 | SUPPLY IMPLANT | Supply/Implant | $301.18 |
| 6128944 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6128953 | GUIDE WIRE | Supply/Implant | $3,600.64 |
| 6128967 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6128971 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6128978 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6128989 | SUPPLY IMPLANT | Supply/Implant | $676.61 |
| 6128992 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.12 |
| 6129004 | CATHETER, GUIDING | Supply/Implant | $11,587.58 |
| 6129005 | CATHETER, GUIDING | Supply/Implant | $11,587.58 |
| 6129009 | GENERAL SUPPLY | Supply/Implant | $418.05 |
| 6129021 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129025 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6129078 | GENERAL SUPPLY | Supply/Implant | $563.20 |
| 6129096 | GENERAL SUPPLY | Supply/Implant | $3,040.00 |
| 6129105 | GENERAL SUPPLY | Supply/Implant | $12,160.00 |
| 6129107 | GENERAL SUPPLY | Supply/Implant | $4,032.00 |
| 6129111 | GENERAL SUPPLY | Supply/Implant | $1,881.60 |
| 6129115 | STERILE SUPPLY | Supply/Implant | $1,272.06 |
| 6129124 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6129126 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6129129 | GUIDE WIRE | Supply/Implant | $5,248.00 |
| 6129130 | CATHETER, GUIDING | Supply/Implant | $5,248.00 |
| 6129131 | CATHETER, GUIDING | Supply/Implant | $11,808.00 |
| 6129141 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129142 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $6,849.28 |
| 6129154 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $304.77 |
| 6129180 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6129182 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,152.00 |
| 6129198 | CATHETER, GUIDING | Supply/Implant | $5,048.58 |
| 6129199 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6129200 | STERILE SUPPLY | Supply/Implant | $1,154.43 |
| 6129202 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6129204 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6129216 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $6,873.60 |
| 6129236 | RET DEV, INSERTABLE | Supply/Implant | $25,856.00 |
| 6129239 | MESH (IMPLANTABLE) | Supply/Implant | $6,156.93 |
| 6129257 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6129260 | STERILE SUPPLY | Supply/Implant | $750.08 |
| 6129263 | CATHETER, GUIDING | Supply/Implant | $12,395.78 |
| 6129299 | SUPPLY IMPLANT | Supply/Implant | $679.68 |
| 6129302 | CATHETER, GUIDING | Supply/Implant | $9,632.00 |
| 6129307 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6129308 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6129333 | SUPPLY IMPLANT | Supply/Implant | $268.67 |
| 6129349 | GENERAL SUPPLY | Supply/Implant | $269.18 |
| 6129350 | GENERAL SUPPLY | Supply/Implant | $269.18 |
| 6129357 | STERILE SUPPLY | Supply/Implant | $131.07 |
| 6129362 | SUPPLY IMPLANT | Supply/Implant | $3,842.05 |
| 6129364 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6129385 | SUPPLY IMPLANT | Supply/Implant | $248.70 |
| 6129386 | GENERAL SUPPLY | Supply/Implant | $5,310.46 |
| 6129493 | CATHETER, GUIDING | Supply/Implant | $11,808.00 |
| 6129500 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,270.66 |
| 6129507 | SUPPLY IMPLANT | Supply/Implant | $2,020.10 |
| 6129511 | STERILE SUPPLY | Supply/Implant | $240.01 |
| 6129521 | GENERAL SUPPLY | Supply/Implant | $793.22 |
| 6129550 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129557 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6129561 | SUPPLY IMPLANT | Supply/Implant | $6,483.97 |
| 6129566 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6129570 | SUPPLY IMPLANT | Supply/Implant | $2,035.20 |
| 6129580 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $526.59 |
| 6129582 | STERILE SUPPLY | Supply/Implant | $391.42 |
| 6129586 | STERILE SUPPLY | Supply/Implant | $555.39 |
| 6129667 | GENERAL SUPPLY | Supply/Implant | $4,288.00 |
| 6129718 | GENERAL SUPPLY | Supply/Implant | $482.69 |
| 6129730 | STERILE SUPPLY | Supply/Implant | $1,648.64 |
| 6129732 | STERILE SUPPLY | Supply/Implant | $262.40 |
| 6129794 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,209.09 |
| 6129833 | CATHETER, GUIDING | Supply/Implant | $3,840.00 |
| 6129838 | STERILE SUPPLY | Supply/Implant | $486.78 |
| 6129839 | STERILE SUPPLY | Supply/Implant | $595.46 |
| 6129840 | STERILE SUPPLY | Supply/Implant | $873.09 |
| 6129841 | STERILE SUPPLY | Supply/Implant | $169.60 |
| 6129846 | GENERAL SUPPLY | Supply/Implant | $960.00 |
| 6129857 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6129862 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129864 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129867 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129869 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6129870 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,840.00 |
| 6129871 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $15,360.00 |
| 6129873 | LEAD, CORONARY VENOUS | Supply/Implant | $76,800.00 |
| 6129877 | SUPPLY IMPLANT | Supply/Implant | $1,802.24 |
| 6129878 | SUPPLY IMPLANT | Supply/Implant | $1,043.20 |
| 6129893 | STERILE SUPPLY | Supply/Implant | $680.32 |
| 6129895 | SUPPLY IMPLANT | Supply/Implant | $4,544.77 |
| 6129942 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6129951 | CATH, DRAINAGE | Supply/Implant | $1,030.27 |
| 6129959 | SUPPLY IMPLANT | Supply/Implant | $350.59 |
| 6129961 | SUPPLY IMPLANT | Supply/Implant | $276.99 |
| 6129983 | CATHETER, GUIDING | Supply/Implant | $11,808.00 |
| 6130020 | CATHETER, GUIDING | Supply/Implant | $3,648.00 |
| 6130023 | GUIDE WIRE | Supply/Implant | $1,088.00 |
| 6130025 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6130030 | GENERAL SUPPLY | Supply/Implant | $358.40 |
| 6130031 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6130067 | SUPPLY IMPLANT | Supply/Implant | $2,421.12 |
| 6130070 | STERILE SUPPLY | Supply/Implant | $691.33 |
| 6130075 | CATHETER, GUIDING | Supply/Implant | $792.83 |
| 6130086 | GENERAL SUPPLY | Supply/Implant | $623.55 |
| 6130090 | SUPPLY IMPLANT | Supply/Implant | $305.28 |
| 6130100 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6130115 | STERILE SUPPLY | Supply/Implant | $172.80 |
| 6130138 | SUPPLY IMPLANT | Supply/Implant | $1,653.06 |
| 6130139 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,341.09 |
| 6130144 | SUPPLY IMPLANT | Supply/Implant | $1,012.99 |
| 6130149 | SUPPLY IMPLANT | Supply/Implant | $1,817.60 |
| 6130182 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $744.96 |
| 6130188 | SUPPLY IMPLANT | Supply/Implant | $145.02 |
| 6130220 | STERILE SUPPLY | Supply/Implant | $581.73 |
| 6130284 | STERILE SUPPLY | Supply/Implant | $2,350.98 |
| 6130292 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6130309 | SUPPLY IMPLANT | Supply/Implant | $270.75 |
| 6130327 | SUPPLY IMPLANT | Supply/Implant | $211.07 |
| 6130341 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,410.94 |
| 6130349 | STERILE SUPPLY | Supply/Implant | $565.38 |
| 6130373 | INTRO/SHEATH, NON-LASER | Supply/Implant | $526.08 |
| 6130378 | SUPPLY IMPLANT | Supply/Implant | $935.30 |
| 6130433 | CATHETER, GUIDING | Supply/Implant | $11,535.10 |
| 6130444 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6130447 | STERILE SUPPLY | Supply/Implant | $1,505.54 |
| 6130448 | GENERAL SUPPLY | Supply/Implant | $4,217.98 |
| 6130455 | STERILE SUPPLY | Supply/Implant | $624.00 |
| 6130459 | CATH, DRAINAGE | Supply/Implant | $232.19 |
| 6130460 | SUPPLY IMPLANT | Supply/Implant | $232.19 |
| 6130487 | GENERAL SUPPLY | Supply/Implant | $237.08 |
| 6130491 | SUPPLY IMPLANT | Supply/Implant | $17,792.00 |
| 6130499 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $37,071.49 |
| 6130502 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6130511 | SUPPLY IMPLANT | Supply/Implant | $1,182.34 |
| 6130571 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6130573 | GUIDE WIRE | Supply/Implant | $3,200.00 |
| 6130576 | GENERAL SUPPLY | Supply/Implant | $2,284.54 |
| 6130600 | SUPPLY IMPLANT | Supply/Implant | $2,016.00 |
| 6130601 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6130608 | CATHETER, GUIDING | Supply/Implant | $7,296.00 |
| 6130617 | GENERAL SUPPLY | Supply/Implant | $2,304.00 |
| 6130666 | SUPPLY IMPLANT | Supply/Implant | $764.67 |
| 6130699 | GENERAL SUPPLY | Supply/Implant | $422.53 |
| 6130760 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6130802 | GENERAL SUPPLY | Supply/Implant | $293.76 |
| 6130825 | SUPPLY IMPLANT | Supply/Implant | $1,036.80 |
| 6130826 | SUPPLY IMPLANT | Supply/Implant | $194.71 |
| 6130829 | GUIDE WIRE | Supply/Implant | $1,817.60 |
| 6130835 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6130851 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6130856 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $352.00 |
| 6130873 | SUPPLY IMPLANT | Supply/Implant | $43,276.80 |
| 6130882 | GENERAL SUPPLY | Supply/Implant | $13,888.00 |
| 6130886 | STERILE SUPPLY | Supply/Implant | $394.62 |
| 6130894 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130895 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130897 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130898 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130899 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130900 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130901 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130902 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130903 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130904 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6130905 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130907 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130908 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130909 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130910 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6130919 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,657.60 |
| 6130920 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6130923 | SUPPLY IMPLANT | Supply/Implant | $1,141.76 |
| 6130924 | BRACHYTX NON-STR YTTRIUM-90 | Supply/Implant | $178,500.00 |
| 6130930 | GUIDE WIRE | Supply/Implant | $1,968.00 |
| 6130941 | GUIDE WIRE | Supply/Implant | $1,344.00 |
| 6130949 | STERILE SUPPLY | Supply/Implant | $188.86 |
| 6130965 | STERILE SUPPLY | Supply/Implant | $827.90 |
| 6130987 | SUPPLY IMPLANT | Supply/Implant | $140.54 |
| 6130994 | STERILE SUPPLY | Supply/Implant | $1,240.32 |
| 6130997 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $1,802.24 |
| 6130998 | GRAFT, VASCULAR | Supply/Implant | $7,907.46 |
| 6131005 | SUPPLY IMPLANT | Supply/Implant | $190.21 |
| 6131011 | SUPPLY IMPLANT | Supply/Implant | $2,446.08 |
| 6131034 | STERILE SUPPLY | Supply/Implant | $194.56 |
| 6131046 | SUPPLY IMPLANT | Supply/Implant | $3,212.80 |
| 6131050 | STERILE SUPPLY | Supply/Implant | $1,079.42 |
| 6131052 | STERILE SUPPLY | Supply/Implant | $2,227.20 |
| 6131059 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6131060 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6131061 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6131062 | STERILE SUPPLY | Supply/Implant | $729.60 |
| 6131069 | STERILE SUPPLY | Supply/Implant | $1,272.58 |
| 6131070 | STERILE SUPPLY | Supply/Implant | $556.80 |
| 6131092 | SUPPLY IMPLANT | Supply/Implant | $266.28 |
| 6131096 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6131100 | STERILE SUPPLY | Supply/Implant | $242.43 |
| 6131103 | GENERAL SUPPLY | Supply/Implant | $1,849.22 |
| 6131104 | SUPPLY IMPLANT | Supply/Implant | $464.64 |
| 6131109 | SUPPLY IMPLANT | Supply/Implant | $1,210.11 |
| 6131111 | SUPPLY IMPLANT | Supply/Implant | $160.51 |
| 6131114 | MESH (IMPLANTABLE) | Supply/Implant | $2,913.02 |
| 6131115 | STERILE SUPPLY | Supply/Implant | $237.82 |
| 6131133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,472.00 |
| 6131143 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6131148 | SUPPLY IMPLANT | Supply/Implant | $2,219.52 |
| 6131153 | SUPPLY IMPLANT | Supply/Implant | $323.84 |
| 6131154 | SUPPLY IMPLANT | Supply/Implant | $559.87 |
| 6131176 | SYNTHETIC IMPLNT URINARY 1ML | Supply/Implant | $30,979.46 |
| 6131182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,003.84 |
| 6131193 | CATHETER, URETERAL | Supply/Implant | $156.93 |
| 6131195 | STERILE SUPPLY | Supply/Implant | $704.00 |
| 6131214 | GENERAL SUPPLY | Supply/Implant | $9,769.34 |
| 6131219 | GENERAL SUPPLY | Supply/Implant | $14,344.19 |
| 6131226 | STERILE SUPPLY | Supply/Implant | $850.18 |
| 6131238 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6131240 | SUPPLY IMPLANT | Supply/Implant | $394.24 |
| 6131248 | GENERAL SUPPLY | Supply/Implant | $2,547.20 |
| 6131249 | GENERAL SUPPLY | Supply/Implant | $3,161.60 |
| 6131250 | GENERAL SUPPLY | Supply/Implant | $2,537.86 |
| 6131251 | STERILE SUPPLY | Supply/Implant | $1,000.96 |
| 6131262 | STERILE SUPPLY | Supply/Implant | $129.15 |
| 6131273 | GENERAL SUPPLY | Supply/Implant | $2,022.40 |
| 6131283 | SUPPLY IMPLANT | Supply/Implant | $701.18 |
| 6131290 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,900.80 |
| 6131306 | SUPPLY IMPLANT | Supply/Implant | $600.06 |
| 6131311 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $201.47 |
| 6131321 | STERILE SUPPLY | Supply/Implant | $138.62 |
| 6131325 | STERILE SUPPLY | Supply/Implant | $201.60 |
| 6131334 | CATH, DRAINAGE | Supply/Implant | $1,202.56 |
| 6131358 | STERILE SUPPLY | Supply/Implant | $1,078.66 |
| 6131362 | STERILE SUPPLY | Supply/Implant | $336.00 |
| 6131373 | GENERAL SUPPLY | Supply/Implant | $18,086.40 |
| 6131375 | SUPPLY IMPLANT | Supply/Implant | $3,545.60 |
| 6131401 | INTERSPINOUS IMPLANT | Supply/Implant | $39,488.00 |
| 6131407 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6131410 | SUPPLY IMPLANT | Supply/Implant | $16,832.00 |
| 6131417 | SUPPLY IMPLANT | Supply/Implant | $194.56 |
| 6131425 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6131430 | SUPPLY IMPLANT | Supply/Implant | $829.57 |
| 6131431 | SUPPLY IMPLANT | Supply/Implant | $8,782.72 |
| 6131491 | SUPPLY IMPLANT | Supply/Implant | $39,488.00 |
| 6131532 | STERILE SUPPLY | Supply/Implant | $192.26 |
| 6131539 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6131543 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6131545 | SUPPLY IMPLANT | Supply/Implant | $169.68 |
| 6131569 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6131617 | SUPPLY IMPLANT | Supply/Implant | $2,549.76 |
| 6131620 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6131621 | SUPPLY IMPLANT | Supply/Implant | $19,955.71 |
| 6131633 | SUPPLY IMPLANT | Supply/Implant | $5,897.60 |
| 6131634 | SUPPLY IMPLANT | Supply/Implant | $3,832.06 |
| 6131668 | SUPPLY IMPLANT | Supply/Implant | $140.54 |
| 6131676 | STERILE SUPPLY | Supply/Implant | $1,370.24 |
| 6131682 | SUPPLY IMPLANT | Supply/Implant | $206.59 |
| 6131694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6131732 | SUPPLY IMPLANT | Supply/Implant | $884.99 |
| 6131756 | SUPPLY IMPLANT | Supply/Implant | $504.70 |
| 6131773 | STERILE SUPPLY | Supply/Implant | $826.88 |
| 6131791 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6131796 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,201.60 |
| 6131807 | GENERAL SUPPLY | Supply/Implant | $491.52 |
| 6131808 | SUPPLY IMPLANT | Supply/Implant | $2,617.22 |
| 6131835 | GUIDE WIRE | Supply/Implant | $2,647.04 |
| 6131841 | SUPPLY IMPLANT | Supply/Implant | $11,305.22 |
| 6131854 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6131856 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $11,596.80 |
| 6131877 | SUPPLY IMPLANT | Supply/Implant | $5,527.68 |
| 6131889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6131896 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6131936 | STERILE SUPPLY | Supply/Implant | $220.03 |
| 6131941 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6131952 | SUPPLY IMPLANT | Supply/Implant | $5,067.01 |
| 6131973 | SUPPLY IMPLANT | Supply/Implant | $5,345.28 |
| 6131982 | GENERAL SUPPLY | Supply/Implant | $17,587.20 |
| 6131983 | SUPPLY IMPLANT | Supply/Implant | $390.40 |
| 6131993 | SUPPLY IMPLANT | Supply/Implant | $1,056.00 |
| 6132001 | GRAFT, VASCULAR | Supply/Implant | $4,889.60 |
| 6132005 | SUPPLY IMPLANT | Supply/Implant | $1,821.31 |
| 6132007 | INTRO/SHEATH, NON-LASER | Supply/Implant | $2,163.20 |
| 6132009 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6132013 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6132023 | SUPPLY IMPLANT | Supply/Implant | $128.82 |
| 6132026 | SUPPLY IMPLANT | Supply/Implant | $2,265.60 |
| 6132032 | STERILE SUPPLY | Supply/Implant | $268.70 |
| 6132033 | SUPPLY IMPLANT | Supply/Implant | $1,599.87 |
| 6132034 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6132044 | SUPPLY IMPLANT | Supply/Implant | $7,000.70 |
| 6132046 | SUPPLY IMPLANT | Supply/Implant | $247.94 |
| 6132047 | SUPPLY IMPLANT | Supply/Implant | $140.54 |
| 6132058 | SUPPLY IMPLANT | Supply/Implant | $1,459.20 |
| 6132060 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6132061 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6132062 | SUPPLY IMPLANT | Supply/Implant | $44,800.00 |
| 6132071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,115.20 |
| 6132086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,344.00 |
| 6132099 | STERILE SUPPLY | Supply/Implant | $1,040.00 |
| 6132105 | GENERAL SUPPLY | Supply/Implant | $694.40 |
| 6132153 | SUPPLY IMPLANT | Supply/Implant | $1,599.87 |
| 6132161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,115.20 |
| 6132178 | GENERAL SUPPLY | Supply/Implant | $697.60 |
| 6132191 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6132211 | STERILE SUPPLY | Supply/Implant | $304.00 |
| 6132221 | SUPPLY IMPLANT | Supply/Implant | $1,620.22 |
| 6132238 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,086.40 |
| 6132252 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6132255 | GUIDE WIRE | Supply/Implant | $2,597.50 |
| 6132285 | SUPPLY IMPLANT | Supply/Implant | $1,804.80 |
| 6132298 | GENERAL SUPPLY | Supply/Implant | $348.36 |
| 6132306 | LOCM 200-299MG/ML IODINE,1ML | Supply/Implant | $219.26 |
| 6132318 | SUPPLY IMPLANT | Supply/Implant | $745.73 |
| 6132324 | GENERAL SUPPLY | Supply/Implant | $559.36 |
| 6132339 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $20,987.75 |
| 6132343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,398.40 |
| 6132348 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6132349 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6132351 | SUPPLY IMPLANT | Supply/Implant | $1,006.08 |
| 6132358 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6132359 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6132365 | MESH (IMPLANTABLE) | Supply/Implant | $2,412.03 |
| 6132384 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132385 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132397 | SUPPLY IMPLANT | Supply/Implant | $7,104.00 |
| 6132412 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6132435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $63,207.04 |
| 6132437 | STERILE SUPPLY | Supply/Implant | $6,041.60 |
| 6132443 | SUPPLY IMPLANT | Supply/Implant | $5,540.86 |
| 6132444 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6132455 | SUPPLY IMPLANT | Supply/Implant | $144.00 |
| 6132462 | SUPPLY IMPLANT | Supply/Implant | $155.26 |
| 6132464 | SUPPLY IMPLANT | Supply/Implant | $154.50 |
| 6132467 | SUPPLY IMPLANT | Supply/Implant | $574.08 |
| 6132471 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6132474 | SUPPLY IMPLANT | Supply/Implant | $1,519.23 |
| 6132476 | SUPPLY IMPLANT | Supply/Implant | $129.75 |
| 6132478 | STERILE SUPPLY | Supply/Implant | $285.57 |
| 6132508 | SUPPLY IMPLANT | Supply/Implant | $3,097.60 |
| 6132518 | SUPPLY IMPLANT | Supply/Implant | $642.30 |
| 6132533 | STERILE SUPPLY | Supply/Implant | $1,225.09 |
| 6132535 | SUPPLY IMPLANT | Supply/Implant | $9,049.60 |
| 6132548 | STERILE SUPPLY | Supply/Implant | $887.04 |
| 6132557 | GENERAL SUPPLY | Supply/Implant | $149.76 |
| 6132559 | SUPPLY IMPLANT | Supply/Implant | $2,060.80 |
| 6132562 | STERILE SUPPLY | Supply/Implant | $709.76 |
| 6132564 | STERILE SUPPLY | Supply/Implant | $737.92 |
| 6132570 | SUPPLY IMPLANT | Supply/Implant | $1,472.77 |
| 6132572 | SUPPLY IMPLANT | Supply/Implant | $1,254.40 |
| 6132586 | GENERAL SUPPLY | Supply/Implant | $919.04 |
| 6132599 | STERILE SUPPLY | Supply/Implant | $967.68 |
| 6132607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,886.08 |
| 6132609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,886.08 |
| 6132610 | SUPPLY IMPLANT | Supply/Implant | $4,556.80 |
| 6132611 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6132619 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,063.68 |
| 6132641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,401.73 |
| 6132648 | CATHETER, GUIDING | Supply/Implant | $1,648.38 |
| 6132693 | CATHETER, URETERAL | Supply/Implant | $167.17 |
| 6132708 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6132725 | SUPPLY IMPLANT | Supply/Implant | $2,007.04 |
| 6132729 | SUPPLY IMPLANT | Supply/Implant | $234.62 |
| 6132748 | CATHETER, GUIDING | Supply/Implant | $14,400.00 |
| 6132749 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,063.68 |
| 6132751 | GENERAL SUPPLY | Supply/Implant | $1,408.00 |
| 6132780 | SUPPLY IMPLANT | Supply/Implant | $354.30 |
| 6132783 | STERILE SUPPLY | Supply/Implant | $186.62 |
| 6132786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,063.68 |
| 6132802 | SUPPLY IMPLANT | Supply/Implant | $1,269.25 |
| 6132808 | SUPPLY IMPLANT | Supply/Implant | $9,351.30 |
| 6132811 | SUPPLY IMPLANT | Supply/Implant | $377.60 |
| 6132855 | STERILE SUPPLY | Supply/Implant | $332.93 |
| 6132859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,808.00 |
| 6132894 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6132895 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132900 | SUPPLY IMPLANT | Supply/Implant | $1,577.34 |
| 6132909 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6132911 | STERILE SUPPLY | Supply/Implant | $965.25 |
| 6132913 | SUPPLY IMPLANT | Supply/Implant | $1,560.83 |
| 6132917 | MESH (IMPLANTABLE) | Supply/Implant | $2,653.95 |
| 6132926 | SUPPLY IMPLANT | Supply/Implant | $1,539.84 |
| 6132935 | STERILE SUPPLY | Supply/Implant | $287.49 |
| 6132976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,121.60 |
| 6132988 | SUPPLY IMPLANT | Supply/Implant | $22,820.86 |
| 6132994 | SUPPLY IMPLANT | Supply/Implant | $183.04 |
| 6132999 | GUIDE WIRE | Supply/Implant | $659.20 |
| 6133000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,867.20 |
| 6133001 | SUPPLY IMPLANT | Supply/Implant | $6,899.20 |
| 6133006 | SUPPLY IMPLANT | Supply/Implant | $4,928.00 |
| 6133007 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6133014 | SUPPLY IMPLANT | Supply/Implant | $1,628.16 |
| 6133025 | SUPPLY IMPLANT | Supply/Implant | $802.82 |
| 6133052 | SUPPLY IMPLANT | Supply/Implant | $1,599.87 |
| 6133086 | STERILE SUPPLY | Supply/Implant | $549.25 |
| 6133092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,820.86 |
| 6133094 | SUPPLY IMPLANT | Supply/Implant | $2,119.94 |
| 6133128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,717.12 |
| 6133152 | GUIDE WIRE | Supply/Implant | $168.96 |
| 6133184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,600.00 |
| 6133206 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,820.86 |
| 6133225 | SUPPLY IMPLANT | Supply/Implant | $147.96 |
| 6133233 | CATHETER, URETERAL | Supply/Implant | $161.28 |
| 6133235 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6133269 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6133275 | SUPPLY IMPLANT | Supply/Implant | $434.30 |
| 6133277 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6133281 | SUPPLY IMPLANT | Supply/Implant | $354.30 |
| 6133285 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $5,131.52 |
| 6133309 | SUPPLY IMPLANT | Supply/Implant | $931.97 |
| 6133310 | GENERAL SUPPLY | Supply/Implant | $1,399.68 |
| 6133313 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $1,487.87 |
| 6133316 | SUPPLY IMPLANT | Supply/Implant | $169.86 |
| 6133332 | STERILE SUPPLY | Supply/Implant | $358.82 |
| 6133338 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6133359 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6133364 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6133375 | SUPPLY IMPLANT | Supply/Implant | $1,062.78 |
| 6133378 | INTRO/SHEATH, NON-LASER | Supply/Implant | $359.55 |
| 6133382 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $5,772.80 |
| 6133385 | GENERAL SUPPLY | Supply/Implant | $2,217.60 |
| 6133388 | SUPPLY IMPLANT | Supply/Implant | $696.83 |
| 6133393 | STERILE SUPPLY | Supply/Implant | $2,556.42 |
| 6133394 | STERILE SUPPLY | Supply/Implant | $465.54 |
| 6133395 | STERILE SUPPLY | Supply/Implant | $1,543.17 |
| 6133402 | SUPPLY IMPLANT | Supply/Implant | $202.37 |
| 6133407 | INTRO/SHEATH, NON-LASER | Supply/Implant | $141.06 |
| 6133430 | SUPPLY IMPLANT | Supply/Implant | $13,836.80 |
| 6133488 | SUPPLY IMPLANT | Supply/Implant | $24,239.49 |
| 6133495 | GENERAL SUPPLY | Supply/Implant | $2,112.00 |
| 6133520 | STERILE SUPPLY | Supply/Implant | $241.02 |
| 6133533 | STERILE SUPPLY | Supply/Implant | $3,008.00 |
| 6133534 | STERILE SUPPLY | Supply/Implant | $130.69 |
| 6133552 | SUPPLY IMPLANT | Supply/Implant | $36,169.22 |
| 6133563 | STERILE SUPPLY | Supply/Implant | $337.02 |
| 6133565 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6133567 | SUPPLY IMPLANT | Supply/Implant | $2,321.15 |
| 6133585 | SUPPLY IMPLANT | Supply/Implant | $8,491.39 |
| 6133586 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6133601 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6133608 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6133635 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6133655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6133685 | STERILE SUPPLY | Supply/Implant | $5,491.20 |
| 6133704 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,928.00 |
| 6133710 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6133715 | INTRO/SHEATH, NON-LASER | Supply/Implant | $619.26 |
| 6133720 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.76 |
| 6133729 | SUPPLY IMPLANT | Supply/Implant | $3,276.93 |
| 6133735 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6133768 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6133793 | SUPPLY IMPLANT | Supply/Implant | $819.20 |
| 6133797 | SUPPLY IMPLANT | Supply/Implant | $220.54 |
| 6133798 | STERILE SUPPLY | Supply/Implant | $2,056.45 |
| 6133802 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $157.31 |
| 6133834 | INTERSPINOUS IMPLANT | Supply/Implant | $28,985.86 |
| 6133855 | STERILE SUPPLY | Supply/Implant | $262.53 |
| 6133857 | STERILE SUPPLY | Supply/Implant | $257.41 |
| 6133858 | STERILE SUPPLY | Supply/Implant | $241.79 |
| 6133863 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6133865 | IMPL SYNTH VOCAL CORD | Supply/Implant | $8,000.00 |
| 6133881 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,693.44 |
| 6133883 | GENERAL SUPPLY | Supply/Implant | $16,832.00 |
| 6133896 | GENERAL SUPPLY | Supply/Implant | $5,693.44 |
| 6133903 | STERILE SUPPLY | Supply/Implant | $1,600.00 |
| 6133905 | GENERAL SUPPLY | Supply/Implant | $355.20 |
| 6133906 | STERILE SUPPLY | Supply/Implant | $4,672.00 |
| 6133927 | SUPPLY IMPLANT | Supply/Implant | $21,273.60 |
| 6133928 | SUPPLY IMPLANT | Supply/Implant | $21,273.60 |
| 6133929 | SUPPLY IMPLANT | Supply/Implant | $22,553.60 |
| 6133931 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6133940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,473.60 |
| 6133941 | SUPPLY IMPLANT | Supply/Implant | $210.43 |
| 6133942 | SUPPLY IMPLANT | Supply/Implant | $179.20 |
| 6134000 | MESH (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6134002 | GENERAL SUPPLY | Supply/Implant | $9,920.00 |
| 6134003 | GENERAL SUPPLY | Supply/Implant | $256.00 |
| 6134005 | GRAFT, VASCULAR | Supply/Implant | $5,299.20 |
| 6134009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,276.80 |
| 6134010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,283.20 |
| 6134013 | SUPPLY IMPLANT | Supply/Implant | $64,593.92 |
| 6134022 | INTERSPINOUS IMPLANT | Supply/Implant | $64,593.92 |
| 6134031 | SUPPLY IMPLANT | Supply/Implant | $45,836.80 |
| 6134034 | SUPPLY IMPLANT | Supply/Implant | $45,836.80 |
| 6134035 | SUPPLY IMPLANT | Supply/Implant | $45,836.80 |
| 6134047 | STERILE SUPPLY | Supply/Implant | $990.08 |
| 6134070 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $16,427.52 |
| 6134103 | SUPPLY IMPLANT | Supply/Implant | $2,280.83 |
| 6134106 | SUPPLY IMPLANT | Supply/Implant | $222.72 |
| 6134108 | STERILE SUPPLY | Supply/Implant | $238.34 |
| 6134116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,057.60 |
| 6134148 | PORT, INDWELLING, IMP | Supply/Implant | $9,483.26 |
| 6134152 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6134174 | SUPPLY IMPLANT | Supply/Implant | $468.10 |
| 6134182 | SUPPLY IMPLANT | Supply/Implant | $3,609.60 |
| 6134200 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134201 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134204 | SUPPLY IMPLANT | Supply/Implant | $5,693.44 |
| 6134231 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134249 | SUPPLY IMPLANT | Supply/Implant | $12,070.40 |
| 6134266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,134.40 |
| 6134288 | SUPPLY IMPLANT | Supply/Implant | $435.97 |
| 6134291 | PROSTHESIS, BREAST, IMP | Supply/Implant | $12,608.00 |
| 6134312 | SUPPLY IMPLANT | Supply/Implant | $8,103.94 |
| 6134379 | STERILE SUPPLY | Supply/Implant | $202.50 |
| 6134388 | SUPPLY IMPLANT | Supply/Implant | $8,514.05 |
| 6134391 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6134402 | GENERAL SUPPLY | Supply/Implant | $819.20 |
| 6134403 | STERILE SUPPLY | Supply/Implant | $537.60 |
| 6134404 | SUPPLY IMPLANT | Supply/Implant | $795.52 |
| 6134423 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6134435 | SUPPLY IMPLANT | Supply/Implant | $5,673.47 |
| 6134461 | STERILE SUPPLY | Supply/Implant | $513.02 |
| 6134462 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6134465 | SUPPLY IMPLANT | Supply/Implant | $1,004.80 |
| 6134473 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6134474 | GRAFT, VASCULAR | Supply/Implant | $13,782.78 |
| 6134489 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6134496 | INTERSPINOUS IMPLANT | Supply/Implant | $64,593.92 |
| 6134503 | ANTER CHAMBER INTRAOCUL LENS | Supply/Implant | $6,336.00 |
| 6134507 | STERILE SUPPLY | Supply/Implant | $874.62 |
| 6134508 | SUPPLY IMPLANT | Supply/Implant | $250.76 |
| 6134525 | STERILE SUPPLY | Supply/Implant | $771.84 |
| 6134546 | SUPPLY IMPLANT | Supply/Implant | $972.80 |
| 6134585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,376.00 |
| 6134587 | SUPPLY IMPLANT | Supply/Implant | $13,273.60 |
| 6134588 | SUPPLY IMPLANT | Supply/Implant | $17,612.80 |
| 6134590 | SUPPLY IMPLANT | Supply/Implant | $13,529.60 |
| 6134598 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6134608 | SUPPLY IMPLANT | Supply/Implant | $734.98 |
| 6134612 | SUPPLY IMPLANT | Supply/Implant | $28,480.00 |
| 6134626 | GENERAL SUPPLY | Supply/Implant | $908.80 |
| 6134634 | GENERAL SUPPLY | Supply/Implant | $2,880.00 |
| 6134637 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6134640 | SUPPLY IMPLANT | Supply/Implant | $2,627.97 |
| 6134643 | SUPPLY IMPLANT | Supply/Implant | $2,627.97 |
| 6134660 | GRAFT, VASCULAR | Supply/Implant | $6,273.54 |
| 6134661 | GRAFT, VASCULAR | Supply/Implant | $6,273.54 |
| 6134662 | SUPPLY IMPLANT | Supply/Implant | $6,273.54 |
| 6134667 | SUPPLY IMPLANT | Supply/Implant | $1,275.65 |
| 6134668 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6134672 | SUPPLY IMPLANT | Supply/Implant | $734.98 |
| 6134678 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,088.00 |
| 6134689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,160.00 |
| 6134696 | STERILE SUPPLY | Supply/Implant | $897.66 |
| 6134704 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $11,270.66 |
| 6134708 | STERILE SUPPLY | Supply/Implant | $274.82 |
| 6134710 | SUPPLY IMPLANT | Supply/Implant | $3,055.10 |
| 6134736 | SUPPLY IMPLANT | Supply/Implant | $8,720.64 |
| 6134762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6134802 | SUPPLY IMPLANT | Supply/Implant | $10,017.28 |
| 6134804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6134807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,580.80 |
| 6134809 | STERILE SUPPLY | Supply/Implant | $180.99 |
| 6134818 | STERILE SUPPLY | Supply/Implant | $263.30 |
| 6134825 | STERILE SUPPLY | Supply/Implant | $207.36 |
| 6134827 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6134846 | GRAFT, VASCULAR | Supply/Implant | $9,740.80 |
| 6134861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6134875 | RET DEV, INSERTABLE | Supply/Implant | $4,992.00 |
| 6134877 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6134908 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,472.00 |
| 6134926 | SUPPLY IMPLANT | Supply/Implant | $2,020.10 |
| 6134927 | SUPPLY IMPLANT | Supply/Implant | $2,020.10 |
| 6134932 | STERILE SUPPLY | Supply/Implant | $190.72 |
| 6134940 | INTRO/SHEATH, NON-LASER | Supply/Implant | $133.12 |
| 6134941 | SUPPLY IMPLANT | Supply/Implant | $1,574.40 |
| 6134942 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6134984 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6134985 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6134992 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $34,454.40 |
| 6135002 | SUPPLY IMPLANT | Supply/Implant | $1,369.47 |
| 6135003 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135005 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135006 | ADHESION BARRIER | Supply/Implant | $4,101.12 |
| 6135008 | STERILE SUPPLY | Supply/Implant | $176.90 |
| 6135011 | SUPPLY IMPLANT | Supply/Implant | $468.61 |
| 6135012 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135013 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135014 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135015 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135032 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135037 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135044 | SUPPLY IMPLANT | Supply/Implant | $231.53 |
| 6135060 | CATHETER, GUIDING | Supply/Implant | $11,535.10 |
| 6135063 | GENERAL SUPPLY | Supply/Implant | $166.16 |
| 6135065 | STERILE SUPPLY | Supply/Implant | $473.60 |
| 6135079 | GENERAL SUPPLY | Supply/Implant | $347.65 |
| 6135084 | GUIDE WIRE | Supply/Implant | $156.29 |
| 6135089 | STERILE SUPPLY | Supply/Implant | $533.22 |
| 6135094 | STERILE SUPPLY | Supply/Implant | $1,349.50 |
| 6135095 | SUPPLY IMPLANT | Supply/Implant | $233.96 |
| 6135107 | GENERAL SUPPLY | Supply/Implant | $193.79 |
| 6135152 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6135157 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6135177 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6135178 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6135187 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6135210 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135239 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $11,520.00 |
| 6135271 | GUIDE WIRE | Supply/Implant | $219.65 |
| 6135315 | SUPPLY IMPLANT | Supply/Implant | $1,424.64 |
| 6135324 | GENERAL SUPPLY | Supply/Implant | $2,873.34 |
| 6135327 | SUPPLY IMPLANT | Supply/Implant | $4,116.10 |
| 6135344 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135369 | SUPPLY IMPLANT | Supply/Implant | $1,246.72 |
| 6135399 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $2,954.50 |
| 6135401 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $26,816.00 |
| 6135420 | SUPPLY IMPLANT | Supply/Implant | $795.52 |
| 6135431 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135448 | GENERAL SUPPLY | Supply/Implant | $2,086.40 |
| 6135458 | SUPPLY IMPLANT | Supply/Implant | $1,288.70 |
| 6135462 | GENERAL SUPPLY | Supply/Implant | $2,170.11 |
| 6135474 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135475 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135476 | CATHETER, GUIDING | Supply/Implant | $11,187.20 |
| 6135488 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135504 | GENERAL SUPPLY | Supply/Implant | $1,313.02 |
| 6135532 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135535 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135536 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135560 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6135564 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6135565 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135569 | SUPPLY IMPLANT | Supply/Implant | $949.25 |
| 6135571 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135572 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135573 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135574 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $665.60 |
| 6135588 | STERILE SUPPLY | Supply/Implant | $3,046.40 |
| 6135604 | STERILE SUPPLY | Supply/Implant | $5,068.80 |
| 6135650 | GENERAL SUPPLY | Supply/Implant | $241.92 |
| 6135666 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135683 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135684 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6135693 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,344.00 |
| 6135695 | SUPPLY IMPLANT | Supply/Implant | $6,259.20 |
| 6135701 | INTRO/SHEATH, NON-LASER | Supply/Implant | $608.00 |
| 6135707 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $332.29 |
| 6135711 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6135737 | GENERAL SUPPLY | Supply/Implant | $2,014.46 |
| 6135756 | STERILE SUPPLY | Supply/Implant | $368.90 |
| 6135769 | GENERAL SUPPLY | Supply/Implant | $5,809.15 |
| 6135770 | SUPPLY IMPLANT | Supply/Implant | $528.51 |
| 6135819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6135826 | GUIDE WIRE | Supply/Implant | $309.38 |
| 6135836 | SUPPLY IMPLANT | Supply/Implant | $235.52 |
| 6135841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6135842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6135874 | GRAFT, VASCULAR | Supply/Implant | $5,633.79 |
| 6135911 | INTRO/SHEATH, NON-LASER | Supply/Implant | $332.29 |
| 6135924 | SUPPLY IMPLANT | Supply/Implant | $7,733.89 |
| 6135932 | SUPPLY IMPLANT | Supply/Implant | $1,028.35 |
| 6135960 | GENERAL SUPPLY | Supply/Implant | $806.40 |
| 6135979 | GENERAL SUPPLY | Supply/Implant | $146.94 |
| 6135981 | STERILE SUPPLY | Supply/Implant | $1,267.20 |
| 6135987 | GRAFT, VASCULAR | Supply/Implant | $5,913.60 |
| 6135990 | GENERAL SUPPLY | Supply/Implant | $1,076.48 |
| 6136004 | SUPPLY IMPLANT | Supply/Implant | $2,457.60 |
| 6136007 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6136051 | GENERAL SUPPLY | Supply/Implant | $974.59 |
| 6136052 | GENERAL SUPPLY | Supply/Implant | $995.33 |
| 6136054 | STERILE SUPPLY | Supply/Implant | $974.59 |
| 6136055 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,440.00 |
| 6136057 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6136078 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6136091 | INTRO/SHEATH, NON-LASER | Supply/Implant | $192.00 |
| 6136109 | SUPPLY IMPLANT | Supply/Implant | $151.81 |
| 6136113 | SUPPLY IMPLANT | Supply/Implant | $1,361.31 |
| 6136118 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6136130 | GENERAL SUPPLY | Supply/Implant | $348.42 |
| 6136132 | SUPPLY IMPLANT | Supply/Implant | $529.54 |
| 6136160 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136165 | STERILE SUPPLY | Supply/Implant | $484.22 |
| 6136179 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6136180 | GUIDE WIRE | Supply/Implant | $130.56 |
| 6136188 | STERILE SUPPLY | Supply/Implant | $797.06 |
| 6136192 | STERILE SUPPLY | Supply/Implant | $770.43 |
| 6136253 | GENERAL SUPPLY | Supply/Implant | $3,110.78 |
| 6136262 | GENERAL SUPPLY | Supply/Implant | $5,518.98 |
| 6136264 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,480.00 |
| 6136265 | GUIDE WIRE | Supply/Implant | $433.79 |
| 6136269 | SUPPLY IMPLANT | Supply/Implant | $17,792.00 |
| 6136272 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $6,105.60 |
| 6136277 | GENERAL SUPPLY | Supply/Implant | $166.66 |
| 6136285 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $836.35 |
| 6136288 | STERILE SUPPLY | Supply/Implant | $1,681.41 |
| 6136289 | GENERAL SUPPLY | Supply/Implant | $4,608.00 |
| 6136290 | STERILE SUPPLY | Supply/Implant | $985.60 |
| 6136294 | GENERAL SUPPLY | Supply/Implant | $146.94 |
| 6136307 | GENERAL SUPPLY | Supply/Implant | $4,045.18 |
| 6136317 | SUPPLY IMPLANT | Supply/Implant | $133.12 |
| 6136321 | STERILE SUPPLY | Supply/Implant | $284.42 |
| 6136326 | STERILE SUPPLY | Supply/Implant | $2,128.90 |
| 6136340 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $751.62 |
| 6136383 | SUPPLY IMPLANT | Supply/Implant | $186.37 |
| 6136397 | EPIFIX 1 SQ CM | Supply/Implant | $4,012.80 |
| 6136410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,907.20 |
| 6136414 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136418 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136420 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136421 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136424 | STERILE SUPPLY | Supply/Implant | $455.81 |
| 6136459 | CATH, DRAINAGE | Supply/Implant | $3,727.36 |
| 6136465 | STERILE SUPPLY | Supply/Implant | $2,232.06 |
| 6136474 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6136478 | SUPPLY IMPLANT | Supply/Implant | $342.40 |
| 6136490 | STERILE SUPPLY | Supply/Implant | $6,228.35 |
| 6136530 | CATHETER, GUIDING | Supply/Implant | $5,094.40 |
| 6136531 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $28,576.00 |
| 6136534 | AICD, DUAL CHAMBER | Supply/Implant | $586,045.50 |
| 6136589 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $836.35 |
| 6136590 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,280.00 |
| 6136591 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,280.00 |
| 6136592 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,280.00 |
| 6136594 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $836.35 |
| 6136605 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6136612 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136637 | SUPPLY IMPLANT | Supply/Implant | $31,270.40 |
| 6136642 | GENERAL SUPPLY | Supply/Implant | $511.87 |
| 6136657 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $28,160.00 |
| 6136661 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136662 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136671 | SUPPLY IMPLANT | Supply/Implant | $290.05 |
| 6136672 | SUPPLY IMPLANT | Supply/Implant | $290.05 |
| 6136673 | CATH, DRAINAGE | Supply/Implant | $848.90 |
| 6136689 | STERILE SUPPLY | Supply/Implant | $1,113.22 |
| 6136691 | STERILE SUPPLY | Supply/Implant | $422.40 |
| 6136695 | STERILE SUPPLY | Supply/Implant | $3,338.50 |
| 6136704 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6136712 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,600.00 |
| 6136718 | GENERAL SUPPLY | Supply/Implant | $148.48 |
| 6136730 | CATH, EP, 20 OR MORE ELEC | Supply/Implant | $3,264.00 |
| 6136734 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $12,300.80 |
| 6136735 | STERILE SUPPLY | Supply/Implant | $3,196.03 |
| 6136766 | SUPPLY IMPLANT | Supply/Implant | $13,081.60 |
| 6136773 | STERILE SUPPLY | Supply/Implant | $288.00 |
| 6136776 | CYTAL, PER SQUARE CENTIMETER | Supply/Implant | $24,480.00 |
| 6136777 | MATRISTEM MICROMATRIX 1 MG | Supply/Implant | $30,501.38 |
| 6136780 | SUPPLY IMPLANT | Supply/Implant | $18,304.00 |
| 6136820 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $41,664.00 |
| 6136825 | GUIDE WIRE | Supply/Implant | $8,704.00 |
| 6136844 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6136849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6136885 | SUPPLY IMPLANT | Supply/Implant | $3,256.58 |
| 6136891 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6136899 | GUIDE WIRE | Supply/Implant | $1,792.00 |
| 6136901 | CATHETER, GUIDING | Supply/Implant | $2,304.00 |
| 6136925 | STERILE SUPPLY | Supply/Implant | $169.22 |
| 6136926 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,240.00 |
| 6136932 | SUPPLY IMPLANT | Supply/Implant | $5,636.74 |
| 6136937 | SUPPLY IMPLANT | Supply/Implant | $1,502.98 |
| 6136957 | GENERAL SUPPLY | Supply/Implant | $22,544.64 |
| 6136960 | GENERAL SUPPLY | Supply/Implant | $22,857.73 |
| 6136962 | GENERAL SUPPLY | Supply/Implant | $5,875.20 |
| 6136972 | SUPPLY IMPLANT | Supply/Implant | $8,049.92 |
| 6137003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6137006 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6137013 | GENERAL SUPPLY | Supply/Implant | $601.60 |
| 6137028 | STERILE SUPPLY | Supply/Implant | $6,123.52 |
| 6137029 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,120.00 |
| 6137031 | CATH OCCLUSION | Supply/Implant | $640.00 |
| 6137034 | GUIDE WIRE | Supply/Implant | $4,160.00 |
| 6137038 | STERILE SUPPLY | Supply/Implant | $434.94 |
| 6137058 | GENERAL SUPPLY | Supply/Implant | $915.07 |
| 6137060 | STERILE SUPPLY | Supply/Implant | $129.28 |
| 6137062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6137072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6137077 | SUPPLY IMPLANT | Supply/Implant | $1,390.59 |
| 6137083 | STERILE SUPPLY | Supply/Implant | $355.20 |
| 6137086 | STRATTICE TM PER 1 SQ CM | Supply/Implant | $281,386.00 |
| 6137089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137125 | SUPPLY IMPLANT | Supply/Implant | $6,992.00 |
| 6137128 | STERILE SUPPLY | Supply/Implant | $532.38 |
| 6137132 | CRYOABLATION PROBE | Supply/Implant | $15,360.00 |
| 6137135 | GENERAL SUPPLY | Supply/Implant | $200.19 |
| 6137156 | SUPPLY IMPLANT | Supply/Implant | $864.00 |
| 6137175 | STERILE SUPPLY | Supply/Implant | $521.10 |
| 6137185 | SUPPLY IMPLANT | Supply/Implant | $1,181.57 |
| 6137186 | SUPPLY IMPLANT | Supply/Implant | $1,238.02 |
| 6137192 | GENERAL SUPPLY | Supply/Implant | $18,240.00 |
| 6137215 | STERILE SUPPLY | Supply/Implant | $6,528.00 |
| 6137241 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137280 | STERILE SUPPLY | Supply/Implant | $3,827.20 |
| 6137301 | STERILE SUPPLY | Supply/Implant | $851.33 |
| 6137317 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137321 | STERILE SUPPLY | Supply/Implant | $3,520.51 |
| 6137342 | SUPPLY IMPLANT | Supply/Implant | $862.85 |
| 6137343 | SUPPLY IMPLANT | Supply/Implant | $203.39 |
| 6137351 | CATHETER, GUIDING | Supply/Implant | $947.20 |
| 6137405 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6137410 | SUPPLY IMPLANT | Supply/Implant | $2,641.92 |
| 6137412 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6137418 | CYTAL, PER SQUARE CENTIMETER | Supply/Implant | $13,120.00 |
| 6137480 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137485 | GENERAL SUPPLY | Supply/Implant | $13,606.91 |
| 6137486 | SUPPLY IMPLANT | Supply/Implant | $8,279.04 |
| 6137494 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6137532 | GUIDE WIRE | Supply/Implant | $529.92 |
| 6137561 | INTRO/SHEATH, NON-LASER | Supply/Implant | $12,096.00 |
| 6137569 | SUPPLY IMPLANT | Supply/Implant | $1,916.80 |
| 6137590 | SUPPLY IMPLANT | Supply/Implant | $2,467.20 |
| 6137592 | GENERAL SUPPLY | Supply/Implant | $173.31 |
| 6137646 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,701.44 |
| 6137647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,679.68 |
| 6137653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,878.40 |
| 6137659 | LEAD, NEUROSTIMULATOR | Supply/Implant | $27,200.00 |
| 6137663 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6137697 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6137715 | SUPPLY IMPLANT | Supply/Implant | $12,480.00 |
| 6137716 | GENERAL SUPPLY | Supply/Implant | $476.80 |
| 6137752 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $6,400.00 |
| 6137809 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $11,520.00 |
| 6137810 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6137817 | GENERAL SUPPLY | Supply/Implant | $30,720.00 |
| 6137856 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137868 | SUPPLY IMPLANT | Supply/Implant | $3,184.00 |
| 6137892 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137903 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $30,080.00 |
| 6137904 | INTRO/SHEATH, NON-LASER | Supply/Implant | $761.60 |
| 6137905 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,945.60 |
| 6137906 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,945.60 |
| 6137909 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6137919 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6137928 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $1,152.00 |
| 6137930 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6137932 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $66,585.60 |
| 6137937 | PROSTHESIS, BREAST, IMP | Supply/Implant | $13,248.00 |
| 6137945 | SUPPLY IMPLANT | Supply/Implant | $282.62 |
| 6137955 | GENERAL SUPPLY | Supply/Implant | $22,857.73 |
| 6137960 | STERILE SUPPLY | Supply/Implant | $567.17 |
| 6137986 | GENERAL SUPPLY | Supply/Implant | $1,267.20 |
| 6138004 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6138011 | CLOSURE DEV, VASC | Supply/Implant | $2,852.86 |
| 6138012 | GENERAL SUPPLY | Supply/Implant | $1,113.86 |
| 6138015 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $1,242.88 |
| 6138019 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $761.60 |
| 6138066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,795.20 |
| 6138082 | STERILE SUPPLY | Supply/Implant | $188.80 |
| 6138085 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,683.97 |
| 6138101 | SUPPLY IMPLANT | Supply/Implant | $7,872.51 |
| 6138102 | GENERAL SUPPLY | Supply/Implant | $131.07 |
| 6138119 | GENERAL SUPPLY | Supply/Implant | $2,644.61 |
| 6138134 | SUPPLY IMPLANT | Supply/Implant | $203.01 |
| 6138176 | SUPPLY IMPLANT | Supply/Implant | $332.80 |
| 6138183 | SUPPLY IMPLANT | Supply/Implant | $280.45 |
| 6138241 | SUPPLY IMPLANT | Supply/Implant | $2,457.60 |
| 6138242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6138244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6138281 | SUPPLY IMPLANT | Supply/Implant | $293.76 |
| 6138283 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6138288 | GENERAL SUPPLY | Supply/Implant | $6,720.00 |
| 6138293 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138314 | SUPPLY IMPLANT | Supply/Implant | $530.69 |
| 6138315 | SUPPLY IMPLANT | Supply/Implant | $175.48 |
| 6138320 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6138332 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6138338 | GENERAL SUPPLY | Supply/Implant | $4,518.40 |
| 6138353 | GENERAL SUPPLY | Supply/Implant | $387.84 |
| 6138361 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $1,280.00 |
| 6138364 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6138365 | SUPPLY IMPLANT | Supply/Implant | $4,153.73 |
| 6138366 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6138378 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138380 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138381 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6138383 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6138386 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6138440 | SUPPLY IMPLANT | Supply/Implant | $2,628.61 |
| 6138469 | MESH (IMPLANTABLE) | Supply/Implant | $56,851.20 |
| 6138474 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6138489 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,984.00 |
| 6138492 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138495 | GUIDE WIRE | Supply/Implant | $1,920.00 |
| 6138500 | SUPPLY IMPLANT | Supply/Implant | $161.54 |
| 6138503 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $15,680.00 |
| 6138507 | UNCLASSIFIED BIOLOGICS | Supply/Implant | $12,729.60 |
| 6138514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,616.00 |
| 6138516 | SUPPLY IMPLANT | Supply/Implant | $1,455.62 |
| 6138517 | STERILE SUPPLY | Supply/Implant | $274.05 |
| 6138518 | SUPPLY IMPLANT | Supply/Implant | $30,758.40 |
| 6138519 | MESH (IMPLANTABLE) | Supply/Implant | $14,489.60 |
| 6138520 | MESH (IMPLANTABLE) | Supply/Implant | $26,530.56 |
| 6138524 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $607.23 |
| 6138526 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138527 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138528 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138529 | CERV FLEXIBLE NON-ADJUSTABLE | Supply/Implant | $550.40 |
| 6138539 | GENERAL SUPPLY | Supply/Implant | $2,304.00 |
| 6138542 | STERILE SUPPLY | Supply/Implant | $411.52 |
| 6138543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,083.20 |
| 6138545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138547 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,083.20 |
| 6138565 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138579 | STERILE SUPPLY | Supply/Implant | $1,253.38 |
| 6138584 | GENERAL SUPPLY | Supply/Implant | $7,888.77 |
| 6138590 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6138595 | GENERAL SUPPLY | Supply/Implant | $25,600.00 |
| 6138601 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6138602 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6138616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6138617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6138618 | SUPPLY IMPLANT | Supply/Implant | $8,051.20 |
| 6138619 | STERILE SUPPLY | Supply/Implant | $173.48 |
| 6138627 | CATHETER, GUIDING | Supply/Implant | $448.00 |
| 6138629 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6138632 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6138642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6138664 | SUPPLY IMPLANT | Supply/Implant | $1,203.20 |
| 6138679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6138686 | GENERAL SUPPLY | Supply/Implant | $242.56 |
| 6138703 | GUIDE WIRE | Supply/Implant | $2,754.43 |
| 6138709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $652.80 |
| 6138714 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6138758 | SUPPLY IMPLANT | Supply/Implant | $16,640.00 |
| 6138760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6138773 | STERILE SUPPLY | Supply/Implant | $4,928.00 |
| 6138818 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138819 | SUPPLY IMPLANT | Supply/Implant | $32,691.20 |
| 6138820 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138845 | WIRELESS PRESSURE SENSOR | Supply/Implant | $194,250.00 |
| 6138848 | CATHETER, GUIDING | Supply/Implant | $4,816.64 |
| 6138859 | SUPPLY IMPLANT | Supply/Implant | $1,945.60 |
| 6138864 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $33,920.00 |
| 6138884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,691.20 |
| 6138885 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138935 | SUPPLY IMPLANT | Supply/Implant | $45,798.40 |
| 6138936 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6138937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,982.40 |
| 6138938 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,915.20 |
| 6138939 | SUPPLY IMPLANT | Supply/Implant | $48,998.40 |
| 6138952 | GENERAL SUPPLY | Supply/Implant | $742.40 |
| 6138953 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6138954 | GENERAL SUPPLY | Supply/Implant | $1,792.00 |
| 6138969 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6138982 | STERILE SUPPLY | Supply/Implant | $621.70 |
| 6138983 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $2,784.00 |
| 6138995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,660.80 |
| 6139023 | SUPPLY IMPLANT | Supply/Implant | $2,954.50 |
| 6139024 | SUPPLY IMPLANT | Supply/Implant | $3,292.16 |
| 6139025 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6139026 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6139037 | SUPPLY IMPLANT | Supply/Implant | $4,111.36 |
| 6139046 | STERILE SUPPLY | Supply/Implant | $9,600.00 |
| 6139065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6139067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $889.34 |
| 6139077 | GENERAL SUPPLY | Supply/Implant | $9,145.22 |
| 6139092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,294.72 |
| 6139173 | GENERAL SUPPLY | Supply/Implant | $716.54 |
| 6139174 | GENERAL SUPPLY | Supply/Implant | $716.54 |
| 6139193 | SUPPLY IMPLANT | Supply/Implant | $1,671.17 |
| 6139204 | SUPPLY IMPLANT | Supply/Implant | $1,947.65 |
| 6139205 | GENERAL SUPPLY | Supply/Implant | $2,134.40 |
| 6139207 | GUIDE WIRE | Supply/Implant | $2,134.40 |
| 6139223 | SUPPLY IMPLANT | Supply/Implant | $10,569.60 |
| 6139240 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6139243 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6139252 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6139254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6139270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6139273 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6139312 | STERILE SUPPLY | Supply/Implant | $194.30 |
| 6139313 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6139315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,528.32 |
| 6139320 | STERILE SUPPLY | Supply/Implant | $215.01 |
| 6139323 | STERILE SUPPLY | Supply/Implant | $281.60 |
| 6139329 | SUPPLY IMPLANT | Supply/Implant | $1,363.71 |
| 6139332 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6139339 | STERILE SUPPLY | Supply/Implant | $222.46 |
| 6139351 | PORT, INDWELLING, IMP | Supply/Implant | $9,483.26 |
| 6139356 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6139358 | SUPPLY IMPLANT | Supply/Implant | $5,754.11 |
| 6139370 | SUPPLY IMPLANT | Supply/Implant | $1,357.95 |
| 6139417 | STERILE SUPPLY | Supply/Implant | $972.80 |
| 6139436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6139447 | GENERAL SUPPLY | Supply/Implant | $14,976.00 |
| 6139454 | STERILE SUPPLY | Supply/Implant | $588.80 |
| 6139469 | ALLODERM SKIN SUB | Supply/Implant | $113,599.50 |
| 6139473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,827.20 |
| 6139529 | SUPPLY IMPLANT | Supply/Implant | $193.54 |
| 6139602 | GENERAL SUPPLY | Supply/Implant | $1,326.34 |
| 6139604 | SUPPLY IMPLANT | Supply/Implant | $25,254.40 |
| 6139610 | SUPPLY IMPLANT | Supply/Implant | $666.24 |
| 6139620 | STERILE SUPPLY | Supply/Implant | $230.40 |
| 6139630 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139631 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139632 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139633 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6139645 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139689 | SUPPLY IMPLANT | Supply/Implant | $55,296.00 |
| 6139690 | SUPPLY IMPLANT | Supply/Implant | $55,296.00 |
| 6139694 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6139696 | GENERAL SUPPLY | Supply/Implant | $366.72 |
| 6139699 | SUPPLY IMPLANT | Supply/Implant | $4,413.82 |
| 6139715 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139716 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139717 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139718 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139723 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6139744 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6139752 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $16,427.52 |
| 6139754 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6139760 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139768 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6139770 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6139787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6139791 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139792 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139794 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,408.00 |
| 6139796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6139800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139801 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139809 | STERILE SUPPLY | Supply/Implant | $3,017.86 |
| 6139818 | GENERAL SUPPLY | Supply/Implant | $8,512.00 |
| 6139819 | GENERAL SUPPLY | Supply/Implant | $3,648.00 |
| 6139823 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139825 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139826 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6139828 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,299.20 |
| 6139831 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139833 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139837 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139838 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139839 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139840 | SUPPLY IMPLANT | Supply/Implant | $649.98 |
| 6139842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139844 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139851 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139853 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6139858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6139869 | SUPPLY IMPLANT | Supply/Implant | $739.20 |
| 6139877 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $16,427.52 |
| 6139886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6139887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139889 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139890 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139891 | SUPPLY IMPLANT | Supply/Implant | $23,078.40 |
| 6139893 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139896 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6139899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139908 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139922 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6139924 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139929 | MESH (IMPLANTABLE) | Supply/Implant | $25,920.00 |
| 6139931 | SUPPLY IMPLANT | Supply/Implant | $1,142.02 |
| 6139932 | SUPPLY IMPLANT | Supply/Implant | $841.93 |
| 6139933 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6139934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6139941 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139944 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139954 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6139968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6139972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6139984 | STERILE SUPPLY | Supply/Implant | $452.86 |
| 6140013 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6140022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6140027 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140029 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6140045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140086 | SUPPLY IMPLANT | Supply/Implant | $2,073.60 |
| 6140095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,280.77 |
| 6140105 | GUIDE WIRE | Supply/Implant | $616.96 |
| 6140107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6140117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6140118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140119 | GUIDE WIRE | Supply/Implant | $1,725.82 |
| 6140120 | SUPPLY IMPLANT | Supply/Implant | $2,520.96 |
| 6140126 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140150 | SUPPLY IMPLANT | Supply/Implant | $177.28 |
| 6140154 | GENERAL SUPPLY | Supply/Implant | $3,363.46 |
| 6140167 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6140170 | SUPPLY IMPLANT | Supply/Implant | $342.14 |
| 6140186 | GENERAL SUPPLY | Supply/Implant | $3,520.00 |
| 6140190 | SUPPLY IMPLANT | Supply/Implant | $46,933.38 |
| 6140206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6140210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140252 | SUPPLY IMPLANT | Supply/Implant | $7,303.30 |
| 6140255 | GENERAL SUPPLY | Supply/Implant | $640.00 |
| 6140259 | SUPPLY IMPLANT | Supply/Implant | $264.06 |
| 6140273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140281 | EPIFIX 1 SQ CM | Supply/Implant | $14,649.60 |
| 6140282 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6140283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6140306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,456.00 |
| 6140309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6140310 | SUPPLY IMPLANT | Supply/Implant | $2,520.96 |
| 6140312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140313 | SUPPLY IMPLANT | Supply/Implant | $4,460.16 |
| 6140314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6140329 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6140330 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6140336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6140349 | GENERAL SUPPLY | Supply/Implant | $6,336.00 |
| 6140354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,720.00 |
| 6140357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140374 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,072.00 |
| 6140377 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6140385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6140398 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,982.40 |
| 6140402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,982.40 |
| 6140403 | SUPPLY IMPLANT | Supply/Implant | $6,220.80 |
| 6140409 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6140422 | REP DEV, URINARY, W/O SLING | Supply/Implant | $6,589.44 |
| 6140427 | INTRO/SHEATH, NON-LASER | Supply/Implant | $276.86 |
| 6140428 | SUPPLY IMPLANT | Supply/Implant | $2,506.24 |
| 6140446 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6140471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,568.00 |
| 6140477 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6140479 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6140481 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6140488 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6140492 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6140495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,617.60 |
| 6140507 | SUPPLY IMPLANT | Supply/Implant | $147,000.00 |
| 6140508 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6140510 | SUPPLY IMPLANT | Supply/Implant | $5,561.60 |
| 6140532 | SUPPLY IMPLANT | Supply/Implant | $147.20 |
| 6140534 | SUPPLY IMPLANT | Supply/Implant | $1,296.00 |
| 6140540 | GENERAL SUPPLY | Supply/Implant | $2,624.00 |
| 6140549 | GENERAL SUPPLY | Supply/Implant | $5,532.80 |
| 6140551 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6140570 | STERILE SUPPLY | Supply/Implant | $444.80 |
| 6140578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,110.40 |
| 6140603 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140627 | EPIFIX 1 SQ CM | Supply/Implant | $39,059.20 |
| 6140635 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.10 |
| 6140648 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140678 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6140681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6140687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,134.08 |
| 6140706 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,480.00 |
| 6140712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6140715 | MESH (IMPLANTABLE) | Supply/Implant | $14,092.80 |
| 6140717 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140741 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6140742 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6140744 | STERILE SUPPLY | Supply/Implant | $453.12 |
| 6140745 | EPIFIX 1 SQ CM | Supply/Implant | $119,609.60 |
| 6140778 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,124.74 |
| 6140782 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140793 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140795 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6140797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6140801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6140812 | MESH (IMPLANTABLE) | Supply/Implant | $105,799.68 |
| 6140842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140843 | SUPPLY IMPLANT | Supply/Implant | $23,120.00 |
| 6140844 | SUPPLY IMPLANT | Supply/Implant | $28,124.80 |
| 6140853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,201.60 |
| 6140857 | SUPPLY IMPLANT | Supply/Implant | $2,309.12 |
| 6140862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.23 |
| 6140865 | STERILE SUPPLY | Supply/Implant | $376.32 |
| 6140870 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6140876 | SUPPLY IMPLANT | Supply/Implant | $110,162.05 |
| 6140882 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6140887 | SUPPLY IMPLANT | Supply/Implant | $1,497.09 |
| 6140890 | STERILE SUPPLY | Supply/Implant | $1,253.38 |
| 6140891 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,153.73 |
| 6140893 | SUPPLY IMPLANT | Supply/Implant | $3,513.60 |
| 6140913 | SUPPLY IMPLANT | Supply/Implant | $761.34 |
| 6140918 | SUPPLY IMPLANT | Supply/Implant | $2,175.36 |
| 6140920 | STERILE SUPPLY | Supply/Implant | $4,044.80 |
| 6140927 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6140929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6140943 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,121.60 |
| 6140952 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6140961 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6140964 | GUIDE WIRE | Supply/Implant | $2,265.60 |
| 6140967 | GENERAL SUPPLY | Supply/Implant | $24,960.00 |
| 6140977 | STERILE SUPPLY | Supply/Implant | $153.22 |
| 6141002 | STERILE SUPPLY | Supply/Implant | $313.60 |
| 6141015 | STERILE SUPPLY | Supply/Implant | $568.70 |
| 6141084 | MESH (IMPLANTABLE) | Supply/Implant | $2,833.92 |
| 6141100 | STERILE SUPPLY | Supply/Implant | $142.72 |
| 6141110 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6141115 | STERILE SUPPLY | Supply/Implant | $338.30 |
| 6141124 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6141125 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6141133 | STERILE SUPPLY | Supply/Implant | $1,024.38 |
| 6141138 | STERILE SUPPLY | Supply/Implant | $279.55 |
| 6141178 | SUPPLY IMPLANT | Supply/Implant | $14,515.20 |
| 6141200 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6141208 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6141230 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6141265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,083.20 |
| 6141266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6141269 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6141309 | GENERAL SUPPLY | Supply/Implant | $2,892.80 |
| 6141354 | GENERAL SUPPLY | Supply/Implant | $199.17 |
| 6141355 | GENERAL SUPPLY | Supply/Implant | $199.17 |
| 6141368 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,916.67 |
| 6141369 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,060.61 |
| 6141372 | GENERAL SUPPLY | Supply/Implant | $883.20 |
| 6141396 | STERILE SUPPLY | Supply/Implant | $2,300.80 |
| 6141397 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $3,097.60 |
| 6141419 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6141423 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141425 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141426 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6141429 | SUPPLY IMPLANT | Supply/Implant | $2,421.76 |
| 6141469 | SUPPLY IMPLANT | Supply/Implant | $1,824.38 |
| 6141475 | SUPPLY IMPLANT | Supply/Implant | $5,430.40 |
| 6141476 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6141478 | SUPPLY IMPLANT | Supply/Implant | $1,909.89 |
| 6141483 | STERILE SUPPLY | Supply/Implant | $8,326.02 |
| 6141484 | SUPPLY IMPLANT | Supply/Implant | $3,437.06 |
| 6141490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6141493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,144.90 |
| 6141509 | STERILE SUPPLY | Supply/Implant | $389.12 |
| 6141526 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141527 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141528 | SUPPLY IMPLANT | Supply/Implant | $37,580.80 |
| 6141529 | SUPPLY IMPLANT | Supply/Implant | $40,217.60 |
| 6141550 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6141562 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6141563 | SUPPLY IMPLANT | Supply/Implant | $5,561.22 |
| 6141567 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,728.00 |
| 6141572 | SUPPLY IMPLANT | Supply/Implant | $17,498.88 |
| 6141573 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6141576 | SUPPLY IMPLANT | Supply/Implant | $5,135.36 |
| 6141580 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6141583 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6141592 | GENERAL SUPPLY | Supply/Implant | $20,416.00 |
| 6141594 | SUPPLY IMPLANT | Supply/Implant | $3,712.00 |
| 6141595 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6141599 | GENERAL SUPPLY | Supply/Implant | $322.69 |
| 6141617 | STERILE SUPPLY | Supply/Implant | $2,560.00 |
| 6141633 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6141635 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6141650 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6141652 | LEAD, NEUROSTIM TEST KIT | Supply/Implant | $20,864.00 |
| 6141669 | SUPPLY IMPLANT | Supply/Implant | $559.36 |
| 6141676 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6141677 | SUPPLY IMPLANT | Supply/Implant | $8,593.92 |
| 6141680 | SUPPLY IMPLANT | Supply/Implant | $4,009.50 |
| 6141690 | SUPPLY IMPLANT | Supply/Implant | $4,160.00 |
| 6141702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6141733 | VENA CAVA FILTER | Supply/Implant | $15,616.00 |
| 6141735 | SUPPLY IMPLANT | Supply/Implant | $8,512.00 |
| 6141742 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,344.00 |
| 6141743 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,344.00 |
| 6141745 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6141759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,488.32 |
| 6141760 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6141784 | SUPPLY IMPLANT | Supply/Implant | $33,044.61 |
| 6141795 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6141808 | SUPPLY IMPLANT | Supply/Implant | $300.80 |
| 6141818 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6141840 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6141849 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,127.81 |
| 6141885 | SUPPLY IMPLANT | Supply/Implant | $2,949.12 |
| 6141896 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6141910 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6141927 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6141945 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6141950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,684.48 |
| 6141999 | SUPPLY IMPLANT | Supply/Implant | $164.86 |
| 6142025 | SUPPLY IMPLANT | Supply/Implant | $1,971.84 |
| 6142085 | STERILE SUPPLY | Supply/Implant | $2,347.52 |
| 6142099 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $168.45 |
| 6142107 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6142108 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6142109 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6142110 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6142116 | STERILE SUPPLY | Supply/Implant | $591.36 |
| 6142118 | STERILE SUPPLY | Supply/Implant | $663.30 |
| 6142130 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6142137 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142138 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142140 | SUPPLY IMPLANT | Supply/Implant | $2,918.40 |
| 6142144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6142148 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6142170 | STERILE SUPPLY | Supply/Implant | $753.28 |
| 6142173 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6142180 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,566.40 |
| 6142181 | STERILE SUPPLY | Supply/Implant | $327.12 |
| 6142196 | SUPPLY IMPLANT | Supply/Implant | $1,573.50 |
| 6142200 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6142201 | PORT, INDWELLING, IMP | Supply/Implant | $3,136.00 |
| 6142254 | SUPPLY IMPLANT | Supply/Implant | $353.02 |
| 6142257 | SUPPLY IMPLANT | Supply/Implant | $353.02 |
| 6142269 | STERILE SUPPLY | Supply/Implant | $577.41 |
| 6142277 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6142279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,423.10 |
| 6142281 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6142292 | SUPPLY IMPLANT | Supply/Implant | $15,200.64 |
| 6142320 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $3,648.00 |
| 6142347 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $20,416.00 |
| 6142357 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6142373 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6142374 | CATHETER, GUIDING | Supply/Implant | $1,920.00 |
| 6142376 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,438.40 |
| 6142378 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,898.75 |
| 6142379 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,438.40 |
| 6142380 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,454.66 |
| 6142381 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6142382 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,880.64 |
| 6142388 | STERILE SUPPLY | Supply/Implant | $245.76 |
| 6142395 | GENERAL SUPPLY | Supply/Implant | $2,508.80 |
| 6142396 | INTRO/SHEATH, NON-LASER | Supply/Implant | $564.48 |
| 6142407 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6142449 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6142454 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6142461 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142462 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142464 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6142504 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142513 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,528.00 |
| 6142518 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $52,646.40 |
| 6142526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6142538 | SUPPLY IMPLANT | Supply/Implant | $252.80 |
| 6142544 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6142546 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6142557 | STERILE SUPPLY | Supply/Implant | $354.82 |
| 6142558 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6142562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,779.52 |
| 6142565 | GENERAL SUPPLY | Supply/Implant | $5,491.20 |
| 6142567 | GENERAL SUPPLY | Supply/Implant | $1,664.00 |
| 6142588 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,900.80 |
| 6142601 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,880.00 |
| 6142637 | INTERSPINOUS IMPLANT | Supply/Implant | $45,619.20 |
| 6142642 | MESH (IMPLANTABLE) | Supply/Implant | $14,092.80 |
| 6142643 | SUPPLY IMPLANT | Supply/Implant | $2,540.16 |
| 6142646 | SUPPLY IMPLANT | Supply/Implant | $2,257.28 |
| 6142647 | SUPPLY IMPLANT | Supply/Implant | $1,758.21 |
| 6142648 | SUPPLY IMPLANT | Supply/Implant | $1,716.86 |
| 6142649 | SUPPLY IMPLANT | Supply/Implant | $1,593.34 |
| 6142650 | SUPPLY IMPLANT | Supply/Implant | $688.64 |
| 6142657 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,001.60 |
| 6142662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6142667 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6142700 | GENERAL SUPPLY | Supply/Implant | $2,403.20 |
| 6142701 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6142722 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6142753 | INTERSPINOUS IMPLANT | Supply/Implant | $29,376.00 |
| 6142779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,012.16 |
| 6142786 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,889.60 |
| 6142792 | SUPPLY IMPLANT | Supply/Implant | $10,925.95 |
| 6142795 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,816.00 |
| 6142817 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,880.00 |
| 6142820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6142826 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6142838 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $24,960.00 |
| 6142839 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6142840 | SUPPLY IMPLANT | Supply/Implant | $3,904.00 |
| 6142842 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6142843 | GENERAL SUPPLY | Supply/Implant | $1,408.00 |
| 6142853 | CATHETER, GUIDING | Supply/Implant | $7,840.00 |
| 6142854 | CATHETER, GUIDING | Supply/Implant | $8,467.20 |
| 6142877 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,622.72 |
| 6142894 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6142897 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6142898 | STERILE SUPPLY | Supply/Implant | $1,216.00 |
| 6142900 | STERILE SUPPLY | Supply/Implant | $460.80 |
| 6142903 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142906 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142908 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142909 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142919 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142922 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6142924 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6142926 | SUPPLY IMPLANT | Supply/Implant | $2,067.20 |
| 6142929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,888.32 |
| 6142930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,832.64 |
| 6142934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,363.46 |
| 6142982 | SUPPLY IMPLANT | Supply/Implant | $1,363.33 |
| 6142991 | GRAFT, VASCULAR | Supply/Implant | $34,611.20 |
| 6142992 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6142995 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,392.00 |
| 6143024 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6143030 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6143043 | GENERAL SUPPLY | Supply/Implant | $243.20 |
| 6143063 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $10,176.00 |
| 6143072 | LEAD, NEUROSTIMULATOR | Supply/Implant | $41,600.00 |
| 6143074 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,800.00 |
| 6143085 | GUIDE WIRE | Supply/Implant | $703.23 |
| 6143086 | SUPPLY IMPLANT | Supply/Implant | $2,213.89 |
| 6143130 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6143152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6143153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6143160 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6143173 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6143183 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6143196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,512.70 |
| 6143242 | GENERAL SUPPLY | Supply/Implant | $288.00 |
| 6143390 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6143394 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6143412 | PROSTHETIC IMPLANT NOS | Supply/Implant | $32,000.00 |
| 6143419 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,421.95 |
| 6143421 | SUPPLY IMPLANT | Supply/Implant | $2,577.54 |
| 6143424 | STERILE SUPPLY | Supply/Implant | $1,585.02 |
| 6143440 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,800.00 |
| 6143444 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $3,059.20 |
| 6143446 | INTRO/SHEATH, NON-LASER | Supply/Implant | $960.00 |
| 6143452 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6143457 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6143458 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6143459 | GUIDE WIRE | Supply/Implant | $1,920.00 |
| 6143466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,296.00 |
| 6143512 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $73,395.20 |
| 6143514 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,499.20 |
| 6143546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $45,798.40 |
| 6143565 | GENERAL SUPPLY | Supply/Implant | $3,187.20 |
| 6143597 | GENERAL SUPPLY | Supply/Implant | $472.32 |
| 6143603 | SUPPLY IMPLANT | Supply/Implant | $4,556.54 |
| 6143610 | SUPPLY IMPLANT | Supply/Implant | $131.16 |
| 6143617 | ALLODERM SKIN SUB | Supply/Implant | $117,001.50 |
| 6143632 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6143663 | SUPPLY IMPLANT | Supply/Implant | $663.68 |
| 6143677 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $20,864.00 |
| 6143694 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6143695 | SUPPLY IMPLANT | Supply/Implant | $1,828.86 |
| 6143714 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $22,976.00 |
| 6143732 | SUPPLY IMPLANT | Supply/Implant | $193.79 |
| 6143733 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6143779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6143812 | GENERAL SUPPLY | Supply/Implant | $10,112.00 |
| 6143816 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $96,640.00 |
| 6143819 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $96,640.00 |
| 6143821 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6143825 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $654.08 |
| 6143826 | SUPPLY IMPLANT | Supply/Implant | $349.82 |
| 6143827 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6143829 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6143841 | STERILE SUPPLY | Supply/Implant | $1,075.20 |
| 6143842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6143849 | SUPPLY IMPLANT | Supply/Implant | $194.71 |
| 6143850 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $563.20 |
| 6143869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6143873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,496.00 |
| 6143875 | SUPPLY IMPLANT | Supply/Implant | $16,597.38 |
| 6143926 | GENERAL SUPPLY | Supply/Implant | $574.85 |
| 6143927 | STERILE SUPPLY | Supply/Implant | $436.48 |
| 6143928 | GENERAL SUPPLY | Supply/Implant | $442.88 |
| 6143966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6143979 | SUPPLY IMPLANT | Supply/Implant | $3,648.00 |
| 6143982 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $7,351.04 |
| 6143983 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $9,079.04 |
| 6143987 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6143989 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6143991 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6143993 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6143995 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6144009 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144010 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144011 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144026 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $35,520.00 |
| 6144035 | INTERSPINOUS IMPLANT | Supply/Implant | $56,467.20 |
| 6144069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,941.50 |
| 6144088 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6144089 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6144091 | SUPPLY IMPLANT | Supply/Implant | $41,600.00 |
| 6144103 | SUPPLY IMPLANT | Supply/Implant | $2,854.40 |
| 6144134 | STERILE SUPPLY | Supply/Implant | $428.16 |
| 6144138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,256.00 |
| 6144160 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6144178 | CRYOABLATION PROBE | Supply/Implant | $51,200.00 |
| 6144187 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $22,976.00 |
| 6144189 | SUPPLY IMPLANT | Supply/Implant | $7,251.20 |
| 6144190 | SUPPLY IMPLANT | Supply/Implant | $28,609.28 |
| 6144191 | SUPPLY IMPLANT | Supply/Implant | $51,681.28 |
| 6144192 | SUPPLY IMPLANT | Supply/Implant | $63,678.72 |
| 6144194 | SUPPLY IMPLANT | Supply/Implant | $146.94 |
| 6144214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6144216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,665.60 |
| 6144219 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6144257 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144259 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144279 | INTRO/SHEATH, NON-LASER | Supply/Implant | $8,640.00 |
| 6144287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,693.44 |
| 6144291 | GENERAL SUPPLY | Supply/Implant | $546.30 |
| 6144292 | STERILE SUPPLY | Supply/Implant | $470.91 |
| 6144306 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $22,976.00 |
| 6144312 | SUPPLY IMPLANT | Supply/Implant | $2,291.20 |
| 6144332 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6144343 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6144344 | PURAPLY 1 SQ CM | Supply/Implant | $9,600.00 |
| 6144345 | PURAPLY 1 SQ CM | Supply/Implant | $12,160.00 |
| 6144346 | PURAPLY 1 SQ CM | Supply/Implant | $40,960.00 |
| 6144347 | PURAPLY 1 SQ CM | Supply/Implant | $85,760.00 |
| 6144361 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144411 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144412 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144414 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144419 | SUPPLY IMPLANT | Supply/Implant | $1,625.60 |
| 6144420 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6144422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6144423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6144430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,267.20 |
| 6144442 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6144455 | SUPPLY IMPLANT | Supply/Implant | $5,337.60 |
| 6144482 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6144506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6144514 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,475.52 |
| 6144519 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,280.00 |
| 6144532 | GENERAL SUPPLY | Supply/Implant | $66,649.60 |
| 6144536 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6144538 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $19,136.00 |
| 6144557 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144558 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,846.78 |
| 6144592 | GENERAL SUPPLY | Supply/Implant | $376.70 |
| 6144609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $758.40 |
| 6144623 | STERILE SUPPLY | Supply/Implant | $135.17 |
| 6144631 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6144652 | STERILE SUPPLY | Supply/Implant | $473.60 |
| 6144668 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144676 | CRYOABLATION PROBE | Supply/Implant | $15,360.00 |
| 6144689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6144691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,268.80 |
| 6144698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,469.44 |
| 6144705 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,709.57 |
| 6144713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6144719 | SUPPLY IMPLANT | Supply/Implant | $169.47 |
| 6144734 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6144771 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,140.80 |
| 6144783 | PURAPLY AM 1 SQ CM | Supply/Implant | $167,475.00 |
| 6144817 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6144820 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6144832 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,459.20 |
| 6144834 | STERILE SUPPLY | Supply/Implant | $5,120.00 |
| 6144835 | SUPPLY IMPLANT | Supply/Implant | $8,064.00 |
| 6144836 | STERILE SUPPLY | Supply/Implant | $7,680.00 |
| 6144837 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6144840 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6144847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6144864 | GENERAL SUPPLY | Supply/Implant | $2,368.00 |
| 6144865 | SUPPLY IMPLANT | Supply/Implant | $8,240.00 |
| 6144866 | SUPPLY IMPLANT | Supply/Implant | $34,331.14 |
| 6144867 | SUPPLY IMPLANT | Supply/Implant | $62,017.54 |
| 6144868 | SUPPLY IMPLANT | Supply/Implant | $76,414.46 |
| 6144896 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6144898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,243.90 |
| 6144905 | SUPPLY IMPLANT | Supply/Implant | $9,106.94 |
| 6144916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $585.60 |
| 6144917 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6144918 | STERILE SUPPLY | Supply/Implant | $960.00 |
| 6144925 | SUPPLY IMPLANT | Supply/Implant | $9,567.74 |
| 6144948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6144952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,005.95 |
| 6144953 | SUPPLY IMPLANT | Supply/Implant | $2,675.20 |
| 6144957 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6144986 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6144987 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6145020 | INTERSPINOUS IMPLANT | Supply/Implant | $63,769.60 |
| 6145023 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $113,600.00 |
| 6145024 | STERILE SUPPLY | Supply/Implant | $9,344.00 |
| 6145027 | CATHETER, GUIDING | Supply/Implant | $8,899.20 |
| 6145028 | INTRO/SHEATH, NON-LASER | Supply/Implant | $336.00 |
| 6145029 | INTRO/SHEATH, NON-LASER | Supply/Implant | $276.86 |
| 6145030 | INTRO/SHEATH, NON-LASER | Supply/Implant | $335.36 |
| 6145038 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6145058 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6145059 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6145063 | STERILE SUPPLY | Supply/Implant | $486.40 |
| 6145064 | STERILE SUPPLY | Supply/Implant | $486.40 |
| 6145065 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $416,242.50 |
| 6145069 | STERILE SUPPLY | Supply/Implant | $964.99 |
| 6145082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6145083 | GENERAL SUPPLY | Supply/Implant | $225.66 |
| 6145084 | GENERAL SUPPLY | Supply/Implant | $225.66 |
| 6145100 | STERILE SUPPLY | Supply/Implant | $2,070.53 |
| 6145105 | GUIDE WIRE | Supply/Implant | $3,520.00 |
| 6145110 | GENERAL SUPPLY | Supply/Implant | $2,880.00 |
| 6145111 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $11,200.00 |
| 6145125 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $19,136.00 |
| 6145126 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $18,240.00 |
| 6145127 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $19,136.00 |
| 6145130 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,824.00 |
| 6145132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,240.00 |
| 6145154 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145156 | INTERSPINOUS IMPLANT | Supply/Implant | $88,652.80 |
| 6145157 | INTERSPINOUS IMPLANT | Supply/Implant | $88,652.80 |
| 6145163 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6145166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6145168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145192 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6145194 | GENERAL SUPPLY | Supply/Implant | $5,120.00 |
| 6145199 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,830.40 |
| 6145200 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,881.60 |
| 6145203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6145224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145225 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145228 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145277 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145278 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145285 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145296 | INTRO/SHEATH, NON-LASER | Supply/Implant | $359.55 |
| 6145312 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6145327 | GUIDE WIRE | Supply/Implant | $4,352.00 |
| 6145329 | CATHETER, GUIDING | Supply/Implant | $5,632.00 |
| 6145330 | SUPPLY IMPLANT | Supply/Implant | $76,800.00 |
| 6145340 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6145349 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6145351 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6145365 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6145373 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,126.40 |
| 6145391 | SUPPLY IMPLANT | Supply/Implant | $1,868.80 |
| 6145396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,828.80 |
| 6145410 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6145438 | SUPPLY IMPLANT | Supply/Implant | $3,161.60 |
| 6145488 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6145492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145495 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,688.00 |
| 6145498 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6145506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145509 | STERILE SUPPLY | Supply/Implant | $2,137.60 |
| 6145521 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6145523 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6145528 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,828.80 |
| 6145539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6145547 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6145585 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6145596 | PURAPLY 1 SQ CM | Supply/Implant | $5,760.00 |
| 6145597 | SUPPLY IMPLANT | Supply/Implant | $8,430.98 |
| 6145598 | SUPPLY IMPLANT | Supply/Implant | $16,362.62 |
| 6145599 | SUPPLY IMPLANT | Supply/Implant | $16,793.60 |
| 6145600 | GENERAL SUPPLY | Supply/Implant | $1,280.00 |
| 6145603 | GENERAL SUPPLY | Supply/Implant | $192.00 |
| 6145604 | STERILE SUPPLY | Supply/Implant | $4,710.40 |
| 6145605 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145618 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145619 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6145620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145639 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6145657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $857.60 |
| 6145663 | SUPPLY IMPLANT | Supply/Implant | $30,400.00 |
| 6145664 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6145667 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6145720 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6145734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6145735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6145737 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,920.00 |
| 6145743 | SUPPLY IMPLANT | Supply/Implant | $17,792.00 |
| 6145747 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,684.48 |
| 6145760 | MESH (IMPLANTABLE) | Supply/Implant | $122,880.00 |
| 6145764 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6145784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6145785 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6145794 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6145809 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6145818 | STERILE SUPPLY | Supply/Implant | $4,160.00 |
| 6145824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,051.20 |
| 6145856 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,536.00 |
| 6145865 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6145869 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145872 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6145886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6145887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6145893 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6145894 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6145895 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6145897 | SUPPLY IMPLANT | Supply/Implant | $3,648.00 |
| 6145904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6145907 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6145920 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6145921 | SUPPLY IMPLANT | Supply/Implant | $5,639.04 |
| 6145926 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $17,305.60 |
| 6145937 | STERILE SUPPLY | Supply/Implant | $172.80 |
| 6145965 | GENERAL SUPPLY | Supply/Implant | $6,701.70 |
| 6145974 | GENERAL SUPPLY | Supply/Implant | $30,323.20 |
| 6145989 | SUPPLY IMPLANT | Supply/Implant | $2,915.87 |
| 6145991 | SUPPLY IMPLANT | Supply/Implant | $285.06 |
| 6145995 | GENERAL SUPPLY | Supply/Implant | $228.22 |
| 6146004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6146016 | STERILE SUPPLY | Supply/Implant | $259.97 |
| 6146017 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6146020 | NUSHIELD 1 SQUARE CM | Supply/Implant | $17,920.00 |
| 6146021 | NUSHIELD 1 SQUARE CM | Supply/Implant | $5,056.00 |
| 6146022 | NUSHIELD 1 SQUARE CM | Supply/Implant | $10,176.00 |
| 6146024 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $2,016.90 |
| 6146048 | SUPPLY IMPLANT | Supply/Implant | $16,256.00 |
| 6146054 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,465.60 |
| 6146065 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6146071 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $126,796.80 |
| 6146080 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6146081 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $125,321.60 |
| 6146084 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $127,692.80 |
| 6146146 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6146172 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6146176 | PROSTHESIS, BREAST, IMP | Supply/Implant | $15,360.00 |
| 6146181 | STERILE SUPPLY | Supply/Implant | $190.04 |
| 6146198 | STERILE SUPPLY | Supply/Implant | $2,038.02 |
| 6146204 | CATHETER, GUIDING | Supply/Implant | $3,712.00 |
| 6146212 | SUPPLY IMPLANT | Supply/Implant | $1,198.59 |
| 6146218 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,800.83 |
| 6146220 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,800.83 |
| 6146222 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,230.72 |
| 6146233 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6146236 | ALLODERM SKIN SUB | Supply/Implant | $58,828.80 |
| 6146240 | SUPPLY IMPLANT | Supply/Implant | $5,939.20 |
| 6146256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $328.32 |
| 6146265 | MESH (IMPLANTABLE) | Supply/Implant | $27,648.00 |
| 6146266 | MESH (IMPLANTABLE) | Supply/Implant | $13,824.00 |
| 6146267 | MESH (IMPLANTABLE) | Supply/Implant | $7,680.00 |
| 6146268 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6146270 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6146271 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6146303 | STERILE SUPPLY | Supply/Implant | $329.86 |
| 6146304 | SUPPLY IMPLANT | Supply/Implant | $3,061.76 |
| 6146306 | SUPPLY IMPLANT | Supply/Implant | $3,061.76 |
| 6146324 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6146339 | GENERAL SUPPLY | Supply/Implant | $1,127.17 |
| 6146350 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6146355 | MESH (IMPLANTABLE) | Supply/Implant | $91,238.40 |
| 6146372 | GENERAL SUPPLY | Supply/Implant | $30,505.86 |
| 6146424 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6146425 | STERILE SUPPLY | Supply/Implant | $1,041.66 |
| 6146435 | SUPPLY IMPLANT | Supply/Implant | $7,459.58 |
| 6146437 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6146445 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6146446 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6146447 | GUIDE WIRE | Supply/Implant | $1,727.74 |
| 6146451 | STERILE SUPPLY | Supply/Implant | $1,580.54 |
| 6146460 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6146523 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6146527 | SUPPLY IMPLANT | Supply/Implant | $1,702.40 |
| 6146541 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6146559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6146561 | SUPPLY IMPLANT | Supply/Implant | $63,769.60 |
| 6146565 | GENERAL SUPPLY | Supply/Implant | $3,776.00 |
| 6146573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,049.60 |
| 6146574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6146599 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6146600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6146611 | SUPPLY IMPLANT | Supply/Implant | $88,652.80 |
| 6146651 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,473.02 |
| 6146652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,473.02 |
| 6146658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $308.48 |
| 6146671 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6146682 | SUPPLY IMPLANT | Supply/Implant | $17,344.00 |
| 6146687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,888.32 |
| 6146715 | SUPPLY IMPLANT | Supply/Implant | $1,638.40 |
| 6146718 | STERILE SUPPLY | Supply/Implant | $884.48 |
| 6146719 | STERILE SUPPLY | Supply/Implant | $480.26 |
| 6146721 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $544.00 |
| 6146762 | SUPPLY IMPLANT | Supply/Implant | $4,755.20 |
| 6146777 | GENERAL SUPPLY | Supply/Implant | $368.77 |
| 6146787 | STERILE SUPPLY | Supply/Implant | $1,304.45 |
| 6146790 | STERILE SUPPLY | Supply/Implant | $385.66 |
| 6146800 | STERILE SUPPLY | Supply/Implant | $236.80 |
| 6146803 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6146804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,416.00 |
| 6146805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,416.00 |
| 6146810 | MESH (IMPLANTABLE) | Supply/Implant | $11,895.42 |
| 6146811 | SUPPLY IMPLANT | Supply/Implant | $327.68 |
| 6146840 | SUPPLY IMPLANT | Supply/Implant | $551.55 |
| 6146890 | STERILE SUPPLY | Supply/Implant | $6,284.29 |
| 6146956 | STERILE SUPPLY | Supply/Implant | $1,375.23 |
| 6147042 | SUPPLY IMPLANT | Supply/Implant | $435.97 |
| 6147106 | STERILE SUPPLY | Supply/Implant | $405.50 |
| 6147110 | SUPPLY IMPLANT | Supply/Implant | $185.60 |
| 6147122 | STERILE SUPPLY | Supply/Implant | $405.50 |
| 6147135 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $212.19 |
| 6147144 | SUPPLY IMPLANT | Supply/Implant | $531.71 |
| 6147147 | STERILE SUPPLY | Supply/Implant | $733.57 |
| 6147157 | SUPPLY IMPLANT | Supply/Implant | $3,519.23 |
| 6147168 | SUPPLY IMPLANT | Supply/Implant | $3,481.60 |
| 6147176 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6147178 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,954.50 |
| 6147179 | REP DEV, URINARY, W/SLING | Supply/Implant | $18,700.80 |
| 6147180 | STERILE SUPPLY | Supply/Implant | $1,701.63 |
| 6147181 | SUPPLY IMPLANT | Supply/Implant | $566.66 |
| 6147182 | SUPPLY IMPLANT | Supply/Implant | $1,146.37 |
| 6147183 | STERILE SUPPLY | Supply/Implant | $528.64 |
| 6147185 | SUPPLY IMPLANT | Supply/Implant | $551.68 |
| 6147190 | SUPPLY IMPLANT | Supply/Implant | $181.76 |
| 6147206 | SUPPLY IMPLANT | Supply/Implant | $1,900.42 |
| 6147224 | STERILE SUPPLY | Supply/Implant | $9,344.00 |
| 6147236 | GENERAL SUPPLY | Supply/Implant | $192.26 |
| 6147254 | STERILE SUPPLY | Supply/Implant | $140.80 |
| 6147266 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6147268 | SUPPLY IMPLANT | Supply/Implant | $2,873.60 |
| 6147304 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6147309 | GENERAL SUPPLY | Supply/Implant | $1,945.60 |
| 6147364 | SUPPLY IMPLANT | Supply/Implant | $448.00 |
| 6147378 | STERILE SUPPLY | Supply/Implant | $8,745.22 |
| 6147379 | GENERAL SUPPLY | Supply/Implant | $666.37 |
| 6147384 | GENERAL SUPPLY | Supply/Implant | $415.74 |
| 6147396 | GENERAL SUPPLY | Supply/Implant | $434.43 |
| 6147403 | SUPPLY IMPLANT | Supply/Implant | $406.91 |
| 6147404 | SUPPLY IMPLANT | Supply/Implant | $1,146.37 |
| 6147425 | SUPPLY IMPLANT | Supply/Implant | $3,929.60 |
| 6147459 | STERILE SUPPLY | Supply/Implant | $191.23 |
| 6147463 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6147473 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,235.26 |
| 6147486 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147488 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147490 | GUIDE WIRE | Supply/Implant | $1,856.00 |
| 6147512 | STERILE SUPPLY | Supply/Implant | $280.45 |
| 6147519 | STERILE SUPPLY | Supply/Implant | $317.88 |
| 6147525 | SUPPLY IMPLANT | Supply/Implant | $2,439.17 |
| 6147530 | CATHETER, URETERAL | Supply/Implant | $190.09 |
| 6147531 | GENERAL SUPPLY | Supply/Implant | $533.76 |
| 6147539 | SUPPLY IMPLANT | Supply/Implant | $139.65 |
| 6147547 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147578 | SUPPLY IMPLANT | Supply/Implant | $4,827.26 |
| 6147640 | STERILE SUPPLY | Supply/Implant | $1,089.79 |
| 6147645 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,571.07 |
| 6147646 | GENERAL SUPPLY | Supply/Implant | $362.30 |
| 6147652 | STERILE SUPPLY | Supply/Implant | $257.45 |
| 6147654 | STERILE SUPPLY | Supply/Implant | $196.22 |
| 6147657 | SUPPLY IMPLANT | Supply/Implant | $4,494.44 |
| 6147672 | SUPPLY IMPLANT | Supply/Implant | $2,450.41 |
| 6147678 | STERILE SUPPLY | Supply/Implant | $360.55 |
| 6147690 | STERILE SUPPLY | Supply/Implant | $183.14 |
| 6147691 | STERILE SUPPLY | Supply/Implant | $188.44 |
| 6147694 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6147704 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147739 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147740 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147747 | SUPPLY IMPLANT | Supply/Implant | $570.88 |
| 6147766 | SUPPLY IMPLANT | Supply/Implant | $869.12 |
| 6147768 | GENERAL SUPPLY | Supply/Implant | $165.56 |
| 6147769 | SUPPLY IMPLANT | Supply/Implant | $869.12 |
| 6147770 | SUPPLY IMPLANT | Supply/Implant | $869.12 |
| 6147772 | SUPPLY IMPLANT | Supply/Implant | $237.82 |
| 6147782 | STERILE SUPPLY | Supply/Implant | $323.46 |
| 6147783 | CATHETER, URETERAL | Supply/Implant | $143.49 |
| 6147784 | STERILE SUPPLY | Supply/Implant | $1,979.90 |
| 6147793 | SUPPLY IMPLANT | Supply/Implant | $555.65 |
| 6147820 | GENERAL SUPPLY | Supply/Implant | $1,110.53 |
| 6147843 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147848 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $4,736.00 |
| 6147850 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6147861 | CATHETER, GUIDING | Supply/Implant | $1,062.40 |
| 6147864 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6147866 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147877 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147881 | STERILE SUPPLY | Supply/Implant | $762.88 |
| 6147904 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147917 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6147942 | GENERAL SUPPLY | Supply/Implant | $2,752.00 |
| 6147983 | STERILE SUPPLY | Supply/Implant | $1,728.00 |
| 6147991 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6147992 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6147994 | GUIDE WIRE | Supply/Implant | $251.78 |
| 6148004 | GAUZE <=16 IN NO W/SAL W/O B | Supply/Implant | $4,615.68 |
| 6148042 | STERILE SUPPLY | Supply/Implant | $138.71 |
| 6148045 | SUPPLY IMPLANT | Supply/Implant | $2,585.60 |
| 6148054 | CATHETER, GUIDING | Supply/Implant | $204.67 |
| 6148062 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6148109 | GENERAL SUPPLY | Supply/Implant | $252.01 |
| 6148112 | SUPPLY IMPLANT | Supply/Implant | $4,330.88 |
| 6148113 | GENERAL SUPPLY | Supply/Implant | $291.72 |
| 6148130 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6148132 | STERILE SUPPLY | Supply/Implant | $1,792.00 |
| 6148134 | GENERAL SUPPLY | Supply/Implant | $334.46 |
| 6148149 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6148157 | GUIDE WIRE | Supply/Implant | $928.00 |
| 6148158 | CATH, DRAINAGE | Supply/Implant | $2,150.40 |
| 6148166 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,536.00 |
| 6148169 | GENERAL SUPPLY | Supply/Implant | $204.29 |
| 6148170 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6148179 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $343.73 |
| 6148188 | SUPPLY IMPLANT | Supply/Implant | $974.72 |
| 6148191 | GUIDE WIRE | Supply/Implant | $1,216.77 |
| 6148192 | STERILE SUPPLY | Supply/Implant | $327.17 |
| 6148194 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6148204 | SUPPLY IMPLANT | Supply/Implant | $3,461.12 |
| 6148225 | GENERAL SUPPLY | Supply/Implant | $184.58 |
| 6148254 | GENERAL SUPPLY | Supply/Implant | $600.70 |
| 6148276 | SUPPLY IMPLANT | Supply/Implant | $4,352.00 |
| 6148286 | SUPPLY IMPLANT | Supply/Implant | $4,079.74 |
| 6148293 | STERILE SUPPLY | Supply/Implant | $238.31 |
| 6148299 | STERILE SUPPLY | Supply/Implant | $129.02 |
| 6148300 | STERILE SUPPLY | Supply/Implant | $139.39 |
| 6148307 | STERILE SUPPLY | Supply/Implant | $160.77 |
| 6148313 | SUPPLY IMPLANT | Supply/Implant | $259.97 |
| 6148326 | STERILE SUPPLY | Supply/Implant | $270.82 |
| 6148328 | SUPPLY IMPLANT | Supply/Implant | $142.59 |
| 6148342 | STERILE SUPPLY | Supply/Implant | $260.22 |
| 6148344 | STERILE SUPPLY | Supply/Implant | $134.78 |
| 6148350 | SUPPLY IMPLANT | Supply/Implant | $4,537.60 |
| 6148355 | STERILE SUPPLY | Supply/Implant | $1,597.31 |
| 6148363 | STERILE SUPPLY | Supply/Implant | $383.74 |
| 6148369 | GENERAL SUPPLY | Supply/Implant | $440.70 |
| 6148374 | STERILE SUPPLY | Supply/Implant | $440.06 |
| 6148378 | SUPPLY IMPLANT | Supply/Implant | $327.81 |
| 6148379 | STERILE SUPPLY | Supply/Implant | $498.09 |
| 6148380 | STERILE SUPPLY | Supply/Implant | $235.20 |
| 6148382 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,109.50 |
| 6148386 | STERILE SUPPLY | Supply/Implant | $1,346.51 |
| 6148390 | SUPPLY IMPLANT | Supply/Implant | $987.01 |
| 6148398 | STERILE SUPPLY | Supply/Implant | $196.22 |
| 6148421 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $1,571.07 |
| 6148422 | SUPPLY IMPLANT | Supply/Implant | $1,853.57 |
| 6148424 | SUPPLY IMPLANT | Supply/Implant | $239.36 |
| 6148442 | STERILE SUPPLY | Supply/Implant | $1,092.61 |
| 6148453 | SUPPLY IMPLANT | Supply/Implant | $1,820.29 |
| 6148454 | SUPPLY IMPLANT | Supply/Implant | $2,343.04 |
| 6148455 | SUPPLY IMPLANT | Supply/Implant | $2,094.72 |
| 6148462 | SUPPLY IMPLANT | Supply/Implant | $4,430.46 |
| 6148463 | RET DEV, INSERTABLE | Supply/Implant | $4,405.50 |
| 6148466 | SUPPLY IMPLANT | Supply/Implant | $777.22 |
| 6148467 | SUPPLY IMPLANT | Supply/Implant | $1,761.92 |
| 6148470 | STERILE SUPPLY | Supply/Implant | $749.18 |
| 6148474 | STERILE SUPPLY | Supply/Implant | $159.49 |
| 6148492 | SUPPLY IMPLANT | Supply/Implant | $3,450.75 |
| 6148504 | SUPPLY IMPLANT | Supply/Implant | $2,537.57 |
| 6148506 | GENERAL SUPPLY | Supply/Implant | $368.77 |
| 6148511 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $489.98 |
| 6148515 | SUPPLY IMPLANT | Supply/Implant | $698.75 |
| 6148531 | GENERAL SUPPLY | Supply/Implant | $3,200.64 |
| 6148536 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $489.98 |
| 6148543 | STERILE SUPPLY | Supply/Implant | $218.75 |
| 6148548 | STERILE SUPPLY | Supply/Implant | $157.67 |
| 6148552 | GENERAL SUPPLY | Supply/Implant | $681.47 |
| 6148554 | SUPPLY IMPLANT | Supply/Implant | $1,324.42 |
| 6148579 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,486.40 |
| 6148589 | STERILE SUPPLY | Supply/Implant | $285.06 |
| 6148592 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $534.40 |
| 6148593 | GENERAL SUPPLY | Supply/Implant | $145.51 |
| 6148607 | STERILE SUPPLY | Supply/Implant | $207.36 |
| 6148618 | STERILE SUPPLY | Supply/Implant | $194.62 |
| 6148634 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,785.47 |
| 6148658 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,331.52 |
| 6148661 | GENERAL SUPPLY | Supply/Implant | $520.40 |
| 6148693 | SUPPLY IMPLANT | Supply/Implant | $601.60 |
| 6148697 | INTRO/SHEATH, NON-LASER | Supply/Implant | $611.97 |
| 6148709 | STERILE SUPPLY | Supply/Implant | $203.52 |
| 6148718 | STERILE SUPPLY | Supply/Implant | $193.15 |
| 6148723 | SUPPLY IMPLANT | Supply/Implant | $3,525.12 |
| 6148725 | GENERAL SUPPLY | Supply/Implant | $2,380.80 |
| 6148728 | STERILE SUPPLY | Supply/Implant | $303.62 |
| 6148734 | STERILE SUPPLY | Supply/Implant | $303.10 |
| 6148737 | STERILE SUPPLY | Supply/Implant | $711.68 |
| 6148738 | STERILE SUPPLY | Supply/Implant | $985.60 |
| 6148742 | STERILE SUPPLY | Supply/Implant | $699.01 |
| 6148743 | STERILE SUPPLY | Supply/Implant | $698.88 |
| 6148798 | GENERAL SUPPLY | Supply/Implant | $292.86 |
| 6148799 | STERILE SUPPLY | Supply/Implant | $228.01 |
| 6148801 | SUPPLY IMPLANT | Supply/Implant | $264.83 |
| 6148898 | SUPPLY IMPLANT | Supply/Implant | $253.18 |
| 6148899 | SUPPLY IMPLANT | Supply/Implant | $253.18 |
| 6148906 | GENERAL SUPPLY | Supply/Implant | $177.98 |
| 6148907 | SUPPLY IMPLANT | Supply/Implant | $950.40 |
| 6148914 | STERILE SUPPLY | Supply/Implant | $185.98 |
| 6148939 | GENERAL SUPPLY | Supply/Implant | $605.18 |
| 6148972 | GENERAL SUPPLY | Supply/Implant | $6,613.38 |
| 6148992 | SUPPLY IMPLANT | Supply/Implant | $1,066.11 |
| 6148993 | GENERAL SUPPLY | Supply/Implant | $145.87 |
| 6148994 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $489.98 |
| 6148995 | GUIDE WIRE | Supply/Implant | $209.02 |
| 6149007 | SUPPLY IMPLANT | Supply/Implant | $438.91 |
| 6149018 | GENERAL SUPPLY | Supply/Implant | $192.13 |
| 6149033 | SUPPLY IMPLANT | Supply/Implant | $11,212.20 |
| 6149084 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $145.41 |
| 6149085 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $145.41 |
| 6149110 | STERILE SUPPLY | Supply/Implant | $330.75 |
| 6149113 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6149117 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6149120 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6149141 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $178.30 |
| 6149154 | INTRO/SHEATH, NON-LASER | Supply/Implant | $698.37 |
| 6149163 | GENERAL SUPPLY | Supply/Implant | $174.46 |
| 6149209 | MESH (IMPLANTABLE) | Supply/Implant | $1,496.45 |
| 6149215 | STERILE SUPPLY | Supply/Implant | $155.40 |
| 6149226 | SUPPLY IMPLANT | Supply/Implant | $627.84 |
| 6149243 | SUPPLY IMPLANT | Supply/Implant | $2,779.07 |
| 6149260 | STERILE SUPPLY | Supply/Implant | $785.02 |
| 6149263 | STERILE SUPPLY | Supply/Implant | $541.82 |
| 6149267 | STERILE SUPPLY | Supply/Implant | $135.04 |
| 6149272 | STERILE SUPPLY | Supply/Implant | $310.40 |
| 6149300 | STERILE SUPPLY | Supply/Implant | $234.50 |
| 6149356 | GENERAL SUPPLY | Supply/Implant | $140.80 |
| 6149397 | GENERAL SUPPLY | Supply/Implant | $504.83 |
| 6149502 | STERILE SUPPLY | Supply/Implant | $1,816.32 |
| 6149539 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6149577 | STERILE SUPPLY | Supply/Implant | $131.20 |
| 6149655 | SUPPLY IMPLANT | Supply/Implant | $2,301.44 |
| 6149674 | STERILE SUPPLY | Supply/Implant | $268.80 |
| 6149774 | SUPPLY IMPLANT | Supply/Implant | $2,581.50 |
| 6149776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6149777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6149792 | GENERAL SUPPLY | Supply/Implant | $128.51 |
| 6149804 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $704.00 |
| 6149818 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,088.00 |
| 6149823 | CATHETER, URETERAL | Supply/Implant | $3,274.75 |
| 6149848 | SUPPLY IMPLANT | Supply/Implant | $649.47 |
| 6149866 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6149877 | STERILE SUPPLY | Supply/Implant | $2,067.20 |
| 6149878 | GENERAL SUPPLY | Supply/Implant | $2,146.18 |
| 6149881 | SUPPLY IMPLANT | Supply/Implant | $5,298.43 |
| 6149884 | GUIDE WIRE | Supply/Implant | $151.68 |
| 6149885 | GENERAL SUPPLY | Supply/Implant | $313.60 |
| 6149889 | GENERAL SUPPLY | Supply/Implant | $313.60 |
| 6149914 | CATHETER, URETERAL | Supply/Implant | $29,239.30 |
| 6149923 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6149930 | SUPPLY IMPLANT | Supply/Implant | $5,995.01 |
| 6149931 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $464.00 |
| 6149936 | SUPPLY IMPLANT | Supply/Implant | $7,967.23 |
| 6149939 | STERILE SUPPLY | Supply/Implant | $780.10 |
| 6149945 | SUPPLY IMPLANT | Supply/Implant | $1,082.88 |
| 6149948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6149959 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6149960 | SUPPLY IMPLANT | Supply/Implant | $499.20 |
| 6149961 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6149964 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,028.80 |
| 6149966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,212.80 |
| 6149967 | OCULAR IMPLANT | Supply/Implant | $174.08 |
| 6149969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,536.64 |
| 6149973 | GENERAL SUPPLY | Supply/Implant | $21,177.60 |
| 6149974 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $114,673.13 |
| 6149975 | STERILE SUPPLY | Supply/Implant | $358.17 |
| 6149976 | STERILE SUPPLY | Supply/Implant | $198.66 |
| 6149977 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149978 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149979 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6149981 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6149991 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6149992 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6149993 | CATHETER, GUIDING | Supply/Implant | $35,200.00 |
| 6149994 | CATHETER, GUIDING | Supply/Implant | $36,288.00 |
| 6149995 | STERILE SUPPLY | Supply/Implant | $8,938.37 |
| 6149996 | STERILE SUPPLY | Supply/Implant | $8,938.37 |
| 6149997 | SUPPLY IMPLANT | Supply/Implant | $9,011.20 |
| 6150000 | STERILE SUPPLY | Supply/Implant | $537.60 |
| 6150011 | SUPPLY IMPLANT | Supply/Implant | $491.65 |
| 6150015 | SUPPLY IMPLANT | Supply/Implant | $93,719.30 |
| 6150016 | SUPPLY IMPLANT | Supply/Implant | $30,789.12 |
| 6150022 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6150023 | SUPPLY IMPLANT | Supply/Implant | $8,435.20 |
| 6150025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6150036 | GUIDE WIRE | Supply/Implant | $2,112.00 |
| 6150041 | CATH, EP, DIAG/ABL, 3D/VECT | Supply/Implant | $35,840.00 |
| 6150042 | GUIDE WIRE | Supply/Implant | $542.85 |
| 6150047 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6150048 | SUPPLY IMPLANT | Supply/Implant | $544.38 |
| 6150053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6150054 | GENERAL SUPPLY | Supply/Implant | $525.70 |
| 6150057 | SUPPLY IMPLANT | Supply/Implant | $484.99 |
| 6150059 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6150061 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6150067 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6150069 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $896.00 |
| 6150075 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6150076 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6150077 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6150080 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $202,000.00 |
| 6150088 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150092 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6150093 | CATHETER, GUIDING | Supply/Implant | $648.32 |
| 6150097 | SUPPLY IMPLANT | Supply/Implant | $464.59 |
| 6150099 | GENERAL SUPPLY | Supply/Implant | $157.70 |
| 6150109 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6150114 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6150115 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6150116 | SUPPLY IMPLANT | Supply/Implant | $21,696.00 |
| 6150117 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6150118 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6150122 | STERILE SUPPLY | Supply/Implant | $276.35 |
| 6150123 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6150124 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6150125 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6150126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6150127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150129 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6150131 | SUPPLY IMPLANT | Supply/Implant | $309.91 |
| 6150139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,648.00 |
| 6150140 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,242.88 |
| 6150148 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6150152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6150154 | SUPPLY IMPLANT | Supply/Implant | $188,227.62 |
| 6150155 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6150157 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6150158 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6150159 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6150160 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6150162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6150164 | SUPPLY IMPLANT | Supply/Implant | $1,078.27 |
| 6150165 | STERILE SUPPLY | Supply/Implant | $413.70 |
| 6150167 | SUPPLY IMPLANT | Supply/Implant | $221.95 |
| 6150179 | INTRO/SHEATH, NON-LASER | Supply/Implant | $356.53 |
| 6150180 | INTRO/SHEATH, NON-LASER | Supply/Implant | $356.53 |
| 6150182 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6150191 | INTRO/SHEATH, NON-LASER | Supply/Implant | $600.06 |
| 6150195 | SUPPLY IMPLANT | Supply/Implant | $151.81 |
| 6150196 | CATHETER, GUIDING | Supply/Implant | $836.35 |
| 6150198 | AICD, DUAL CHAMBER | Supply/Implant | $182,070.00 |
| 6150200 | AICD, DUAL CHAMBER | Supply/Implant | $178,342.50 |
| 6150201 | AICD, DUAL CHAMBER | Supply/Implant | $187,267.50 |
| 6150202 | AICD, SINGLE CHAMBER | Supply/Implant | $171,675.00 |
| 6150204 | AICD, SINGLE CHAMBER | Supply/Implant | $166,792.50 |
| 6150205 | AICD, SINGLE CHAMBER | Supply/Implant | $173,827.50 |
| 6150206 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $92,800.00 |
| 6150208 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $92,800.00 |
| 6150209 | GUIDE WIRE | Supply/Implant | $12,736.00 |
| 6150210 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6150212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.22 |
| 6150217 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6150218 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6150221 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6150229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6150231 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6150233 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $106,752.00 |
| 6150236 | GENERAL SUPPLY | Supply/Implant | $1,446.40 |
| 6150245 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6150246 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6150248 | SUPPLY IMPLANT | Supply/Implant | $329.34 |
| 6150250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6150253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6150255 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6150256 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6150257 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6150258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6150261 | STERILE SUPPLY | Supply/Implant | $6,293.76 |
| 6150268 | SUPPLY IMPLANT | Supply/Implant | $60,496.00 |
| 6150271 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $42,560.00 |
| 6150274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,209.60 |
| 6150275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,497.60 |
| 6150281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,560.00 |
| 6150282 | SUPPLY IMPLANT | Supply/Implant | $3,187.07 |
| 6150290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $33,904.64 |
| 6150293 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6150294 | GENERAL SUPPLY | Supply/Implant | $146.20 |
| 6150294 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $46,912.00 |
| 6150295 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6150296 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $46,912.00 |
| 6150297 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $46,912.00 |
| 6150297 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,128.00 |
| 6150302 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $46,912.00 |
| 6150303 | LEAD, AICD, ENDO DUAL COIL | Supply/Implant | $46,912.00 |
| 6150305 | STERILE SUPPLY | Supply/Implant | $512.00 |
| 6150310 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $50,777.60 |
| 6150314 | SUPPLY IMPLANT | Supply/Implant | $676.61 |
| 6150317 | SUPPLY IMPLANT | Supply/Implant | $8,768.00 |
| 6150329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,514.56 |
| 6150330 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6150334 | SUPPLY IMPLANT | Supply/Implant | $11,068.54 |
| 6150335 | SUPPLY IMPLANT | Supply/Implant | $12,583.68 |
| 6150336 | SUPPLY IMPLANT | Supply/Implant | $11,798.91 |
| 6150337 | SUPPLY IMPLANT | Supply/Implant | $13,697.28 |
| 6150339 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6150342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6150343 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150344 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6150345 | ALLODERM SKIN SUB | Supply/Implant | $52,620.80 |
| 6150349 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $231,593.00 |
| 6150354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6150358 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150359 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150361 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150364 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150365 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150366 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150367 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150368 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150369 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150370 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150371 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150374 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150375 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150376 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150377 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150378 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150379 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150380 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150381 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150382 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150383 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150384 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150385 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150386 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150387 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150388 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150389 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150390 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150391 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150392 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150393 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150394 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150395 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150396 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150397 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150398 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150399 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150400 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150401 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150402 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150403 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150404 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,480.00 |
| 6150405 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6150407 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $7,040.00 |
| 6150419 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6150426 | SUPPLY IMPLANT | Supply/Implant | $1,222.78 |
| 6150430 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6150435 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6150449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,544.00 |
| 6150450 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6150453 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150454 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150455 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150456 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150457 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150458 | GENERAL SUPPLY | Supply/Implant | $164.99 |
| 6150459 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6150461 | SUPPLY IMPLANT | Supply/Implant | $1,077.41 |
| 6150463 | GENERAL SUPPLY | Supply/Implant | $375.17 |
| 6150466 | SUPPLY IMPLANT | Supply/Implant | $4,856.32 |
| 6150468 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6150470 | STERILE SUPPLY | Supply/Implant | $8,000.00 |
| 6150471 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6150475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6150476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6150477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6150478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6150479 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $186.37 |
| 6150487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6150488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6150489 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6150490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6150491 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6150493 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6150496 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6150498 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6150499 | SUPPLY IMPLANT | Supply/Implant | $2,409.98 |
| 6150506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6150509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6150510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6150511 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6150512 | SUPPLY IMPLANT | Supply/Implant | $2,841.60 |
| 6150513 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6150514 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6150515 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $12,800.00 |
| 6150518 | SUPPLY IMPLANT | Supply/Implant | $222.21 |
| 6150520 | GUIDE WIRE | Supply/Implant | $19,576.45 |
| 6150522 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6150526 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6150530 | SUPPLY IMPLANT | Supply/Implant | $3,383.55 |
| 6150531 | GENERAL SUPPLY | Supply/Implant | $479.00 |
| 6150533 | GENERAL SUPPLY | Supply/Implant | $832.00 |
| 6150534 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6150535 | SUPPLY IMPLANT | Supply/Implant | $1,520.64 |
| 6150536 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6150537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6150538 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6150539 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6150540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6150541 | STERILE SUPPLY | Supply/Implant | $1,664.00 |
| 6150544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6150546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6150547 | STERILE SUPPLY | Supply/Implant | $3,840.00 |
| 6150548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6150549 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6150550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6150553 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6150557 | SUPPLY IMPLANT | Supply/Implant | $52,531.20 |
| 6150558 | STERILE SUPPLY | Supply/Implant | $3,136.00 |
| 6150560 | GENERAL SUPPLY | Supply/Implant | $2,432.00 |
| 6150562 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6150567 | SUPPLY IMPLANT | Supply/Implant | $159.10 |
| 6150568 | CATHETER, GUIDING | Supply/Implant | $3,712.00 |
| 6150570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6150571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6150572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,348.80 |
| 6150573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6150574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6150577 | COCHLEAR DEVICE | Supply/Implant | $169,441.44 |
| 6150578 | COCHLEAR DEVICE | Supply/Implant | $169,441.44 |
| 6150581 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6150582 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6150583 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $35,776.00 |
| 6150584 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6150592 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150593 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150594 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150595 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150597 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6150599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6150600 | SUPPLY IMPLANT | Supply/Implant | $1,049.60 |
| 6150601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6150602 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $23,040.00 |
| 6150603 | O&P SUPPLY/ACCESSORY/SERVICE | Supply/Implant | $320.00 |
| 6150605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,419.20 |
| 6150610 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6150611 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6150612 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6150613 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6150616 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6150617 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,376.00 |
| 6150618 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150619 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150620 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,056.00 |
| 6150621 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $25,536.00 |
| 6150622 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $29,376.00 |
| 6150623 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150624 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,216.00 |
| 6150625 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $37,056.00 |
| 6150626 | SUPPLY IMPLANT | Supply/Implant | $9,197.06 |
| 6150632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6150636 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6150637 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6150638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,640.00 |
| 6150641 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6150642 | STERILE SUPPLY | Supply/Implant | $5,312.00 |
| 6150644 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6150646 | SUPPLY IMPLANT | Supply/Implant | $8,000.00 |
| 6150648 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150649 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150650 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150651 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150653 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6150654 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6150656 | SUPPLY IMPLANT | Supply/Implant | $2,270.85 |
| 6150663 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6150664 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6150667 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6150668 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6150671 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6150672 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6150676 | STERILE SUPPLY | Supply/Implant | $153.60 |
| 6150677 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6150678 | STERILE SUPPLY | Supply/Implant | $427.14 |
| 6150681 | SUPPLY IMPLANT | Supply/Implant | $4,257.79 |
| 6150682 | SUPPLY IMPLANT | Supply/Implant | $1,680.00 |
| 6150684 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6150685 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6150686 | CATHETER, GUIDING | Supply/Implant | $334.08 |
| 6150690 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $30,208.00 |
| 6150705 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $31,616.00 |
| 6150706 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $28,736.00 |
| 6150707 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $31,616.00 |
| 6150708 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $28,736.00 |
| 6150709 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $31,616.00 |
| 6150710 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,220.80 |
| 6150719 | CATHETER, GUIDING | Supply/Implant | $4,089.60 |
| 6150720 | CATHETER, GUIDING | Supply/Implant | $4,089.60 |
| 6150731 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6150740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,672.00 |
| 6150744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6150748 | SUPPLY IMPLANT | Supply/Implant | $5,952.00 |
| 6150754 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6150763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,584.00 |
| 6150771 | SUPPLY IMPLANT | Supply/Implant | $6,838.53 |
| 6150772 | SUPPLY IMPLANT | Supply/Implant | $2,381.57 |
| 6150773 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6150776 | STERILE SUPPLY | Supply/Implant | $1,280.00 |
| 6150781 | SUPPLY IMPLANT | Supply/Implant | $28,096.00 |
| 6150782 | SKIN SUBSTITUTE, NOS | Supply/Implant | $28,096.00 |
| 6150783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6150784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6150785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,960.00 |
| 6150787 | SUPPLY IMPLANT | Supply/Implant | $7,620.10 |
| 6150788 | STERILE SUPPLY | Supply/Implant | $575.10 |
| 6150796 | SUPPLY IMPLANT | Supply/Implant | $763.11 |
| 6150800 | INTRO/SHEATH, NON-LASER | Supply/Implant | $332.72 |
| 6150823 | GUIDE WIRE | Supply/Implant | $4,646.40 |
| 6150824 | GUIDE WIRE | Supply/Implant | $4,646.40 |
| 6150826 | SUPPLY IMPLANT | Supply/Implant | $1,083.65 |
| 6150827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6150842 | STERILE SUPPLY | Supply/Implant | $167.04 |
| 6150945 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151035 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151037 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151039 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6151071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6151073 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6151084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151092 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151103 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151104 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151107 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151108 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151109 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151113 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151115 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,056.00 |
| 6151168 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $832.00 |
| 6151169 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $832.00 |
| 6151172 | INTRO/SHEATH, NON-LASER | Supply/Implant | $934.40 |
| 6151174 | CATH OCCLUSION | Supply/Implant | $20,032.00 |
| 6151175 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $20,032.00 |
| 6151176 | CATH OCCLUSION | Supply/Implant | $20,032.00 |
| 6151179 | WRIST COCK-UP NON-MOLDED | Supply/Implant | $282.62 |
| 6151186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151193 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151296 | GENERAL SUPPLY | Supply/Implant | $167.30 |
| 6151302 | GENERAL SUPPLY | Supply/Implant | $293.25 |
| 6151337 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6151350 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6151357 | GENERAL SUPPLY | Supply/Implant | $432.38 |
| 6151413 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151414 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,698.88 |
| 6151415 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $14,627.20 |
| 6151416 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $14,627.20 |
| 6151427 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6151431 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $59,888.00 |
| 6151433 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6151435 | SUPPLY IMPLANT | Supply/Implant | $124,950.00 |
| 6151436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151438 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151439 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151442 | SUPPLY IMPLANT | Supply/Implant | $9,894.40 |
| 6151443 | SUPPLY IMPLANT | Supply/Implant | $9,894.40 |
| 6151444 | GENERAL SUPPLY | Supply/Implant | $332.80 |
| 6151481 | SUPPLY IMPLANT | Supply/Implant | $3,808.00 |
| 6151488 | SUPPLY IMPLANT | Supply/Implant | $11,776.00 |
| 6151506 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6151509 | GUIDE WIRE | Supply/Implant | $1,885.31 |
| 6151520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6151521 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6151522 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6151523 | SUPPLY IMPLANT | Supply/Implant | $38,580.48 |
| 6151528 | ALLODERM SKIN SUB | Supply/Implant | $127,603.20 |
| 6151535 | SUPPLY IMPLANT | Supply/Implant | $21,056.00 |
| 6151537 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6151538 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $14,976.00 |
| 6151540 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6151541 | GENERAL SUPPLY | Supply/Implant | $914.43 |
| 6151542 | GENERAL SUPPLY | Supply/Implant | $220.42 |
| 6151543 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6151544 | GENERAL SUPPLY | Supply/Implant | $1,471.49 |
| 6151546 | GENERAL SUPPLY | Supply/Implant | $185.60 |
| 6151546 | GENERAL SUPPLY | Supply/Implant | $231.74 |
| 6151547 | STERILE SUPPLY | Supply/Implant | $198.39 |
| 6151548 | GENERAL SUPPLY | Supply/Implant | $225.28 |
| 6151551 | SUPPLY IMPLANT | Supply/Implant | $168.96 |
| 6151552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,529.60 |
| 6151565 | SUPPLY IMPLANT | Supply/Implant | $1,322.88 |
| 6151566 | SUPPLY IMPLANT | Supply/Implant | $1,322.88 |
| 6151570 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6151573 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6151580 | SUPPLY IMPLANT | Supply/Implant | $1,640.58 |
| 6151582 | SUPPLY IMPLANT | Supply/Implant | $1,576.96 |
| 6151588 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6151589 | GUIDE WIRE | Supply/Implant | $217.60 |
| 6151590 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6151592 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6151599 | STERILE SUPPLY | Supply/Implant | $133.12 |
| 6151600 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6151602 | SUPPLY IMPLANT | Supply/Implant | $1,517.18 |
| 6151606 | SUPPLY IMPLANT | Supply/Implant | $3,808.00 |
| 6151610 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6151611 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6151618 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6151620 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6151623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,765.12 |
| 6151624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,027.52 |
| 6151632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,987.20 |
| 6151633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $204.80 |
| 6151634 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6151638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,238.40 |
| 6151644 | INTRO/SHEATH, NON-LASER | Supply/Implant | $409.60 |
| 6151659 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,560.00 |
| 6151660 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6151661 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6151662 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6151679 | GENERAL SUPPLY | Supply/Implant | $912.51 |
| 6151680 | GENERAL SUPPLY | Supply/Implant | $171.26 |
| 6151685 | STERILE SUPPLY | Supply/Implant | $132.71 |
| 6151695 | STERILE SUPPLY | Supply/Implant | $2,688.00 |
| 6151700 | STERILE SUPPLY | Supply/Implant | $719.36 |
| 6151746 | SUPPLY IMPLANT | Supply/Implant | $1,257.22 |
| 6151749 | SUPPLY IMPLANT | Supply/Implant | $2,992.77 |
| 6151754 | SUPPLY IMPLANT | Supply/Implant | $260.99 |
| 6151760 | CATH, DRAINAGE | Supply/Implant | $2,899.97 |
| 6151761 | CATH, DRAINAGE | Supply/Implant | $2,262.27 |
| 6151762 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6151764 | SUPPLY IMPLANT | Supply/Implant | $60,945.92 |
| 6151787 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6151788 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6151789 | GUIDE WIRE | Supply/Implant | $1,728.00 |
| 6151791 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6151792 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6151797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6151798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6151799 | SUPPLY IMPLANT | Supply/Implant | $48,320.00 |
| 6151800 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6151810 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6151811 | SUPPLY IMPLANT | Supply/Implant | $6,208.00 |
| 6151812 | SUPPLY IMPLANT | Supply/Implant | $493.72 |
| 6151816 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6151817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6151818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,633.60 |
| 6151819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6151820 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6151822 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6151823 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6151826 | SUPPLY IMPLANT | Supply/Implant | $294.40 |
| 6151833 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6151834 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6151835 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6151836 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6151837 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6151841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,536.00 |
| 6151846 | SUPPLY IMPLANT | Supply/Implant | $1,347.71 |
| 6151850 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $208,868.00 |
| 6151851 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $206,898.50 |
| 6151852 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $206,898.50 |
| 6151853 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $221,644.50 |
| 6151854 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $223,664.50 |
| 6151855 | GENERAL SUPPLY | Supply/Implant | $168.70 |
| 6151856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6151863 | STERILE SUPPLY | Supply/Implant | $3,742.72 |
| 6151865 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151866 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151867 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151879 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151901 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6151913 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $7,680.00 |
| 6151935 | GENERAL SUPPLY | Supply/Implant | $3,115.26 |
| 6151937 | GENERAL SUPPLY | Supply/Implant | $2,580.35 |
| 6151940 | STERILE SUPPLY | Supply/Implant | $162.69 |
| 6151941 | STERILE SUPPLY | Supply/Implant | $481.02 |
| 6151942 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6151954 | CATH, DRAINAGE | Supply/Implant | $1,027.20 |
| 6151955 | STERILE SUPPLY | Supply/Implant | $386.30 |
| 6151987 | STERILE SUPPLY | Supply/Implant | $215.17 |
| 6151994 | SUPPLY IMPLANT | Supply/Implant | $158.52 |
| 6151995 | SUPPLY IMPLANT | Supply/Implant | $499.97 |
| 6151998 | SUPPLY IMPLANT | Supply/Implant | $688.00 |
| 6151999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $684.80 |
| 6152012 | GENERAL SUPPLY | Supply/Implant | $608.26 |
| 6152013 | SUPPLY IMPLANT | Supply/Implant | $511.10 |
| 6152028 | SUPPLY IMPLANT | Supply/Implant | $832.00 |
| 6152038 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6152047 | CLOSURE DEV, VASC | Supply/Implant | $2,931.20 |
| 6152080 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,595.52 |
| 6152100 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6152105 | SUPPLY IMPLANT | Supply/Implant | $3,144.32 |
| 6152114 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6152126 | STERILE SUPPLY | Supply/Implant | $721.54 |
| 6152128 | GENERAL SUPPLY | Supply/Implant | $2,284.54 |
| 6152148 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6152150 | STERILE SUPPLY | Supply/Implant | $710.91 |
| 6152158 | INTRO/SHEATH, NON-LASER | Supply/Implant | $352.77 |
| 6152164 | STERILE SUPPLY | Supply/Implant | $30,707.20 |
| 6152169 | INTRO/SHEATH, NON-LASER | Supply/Implant | $768.00 |
| 6152172 | SUPPLY IMPLANT | Supply/Implant | $567.42 |
| 6152173 | SUPPLY IMPLANT | Supply/Implant | $633.60 |
| 6152174 | CATH, DRAINAGE | Supply/Implant | $507.78 |
| 6152177 | SUPPLY IMPLANT | Supply/Implant | $561.02 |
| 6152188 | SUPPLY IMPLANT | Supply/Implant | $22,592.00 |
| 6152193 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6152200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6152218 | SUPPLY IMPLANT | Supply/Implant | $597.38 |
| 6152219 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6152222 | STERILE SUPPLY | Supply/Implant | $587.52 |
| 6152250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $913.92 |
| 6152254 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,993.60 |
| 6152271 | STERILE SUPPLY | Supply/Implant | $976.78 |
| 6152279 | STERILE SUPPLY | Supply/Implant | $144.00 |
| 6152280 | SUPPLY IMPLANT | Supply/Implant | $4,582.40 |
| 6152283 | SUPPLY IMPLANT | Supply/Implant | $371.33 |
| 6152305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6152313 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152324 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6152328 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152331 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152333 | GUIDE WIRE | Supply/Implant | $379.14 |
| 6152334 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.23 |
| 6152335 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.10 |
| 6152344 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6152345 | SUPPLY IMPLANT | Supply/Implant | $282.24 |
| 6152347 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.10 |
| 6152350 | GUIDE WIRE | Supply/Implant | $371.58 |
| 6152385 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $38,336.00 |
| 6152402 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,711.10 |
| 6152419 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $678.40 |
| 6152421 | STERILE SUPPLY | Supply/Implant | $323.85 |
| 6152433 | SUPPLY IMPLANT | Supply/Implant | $326.40 |
| 6152442 | STERILE SUPPLY | Supply/Implant | $131.20 |
| 6152446 | SUPPLY IMPLANT | Supply/Implant | $2,372.22 |
| 6152458 | STERILE SUPPLY | Supply/Implant | $974.59 |
| 6152460 | SUPPLY IMPLANT | Supply/Implant | $289.66 |
| 6152461 | CATH, DRAINAGE | Supply/Implant | $320.00 |
| 6152468 | SUPPLY IMPLANT | Supply/Implant | $1,633.05 |
| 6152469 | SUPPLY IMPLANT | Supply/Implant | $543.23 |
| 6152474 | GUIDE WIRE | Supply/Implant | $345.60 |
| 6152478 | STERILE SUPPLY | Supply/Implant | $826.62 |
| 6152497 | SUPPLY IMPLANT | Supply/Implant | $9,401.73 |
| 6152500 | SUPPLY IMPLANT | Supply/Implant | $2,414.05 |
| 6152506 | SEPTAL DEFECT IMP SYS | Supply/Implant | $82,419.20 |
| 6152516 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,064.00 |
| 6152521 | SUPPLY IMPLANT | Supply/Implant | $614.40 |
| 6152529 | GENERAL SUPPLY | Supply/Implant | $5,977.98 |
| 6152534 | STERILE SUPPLY | Supply/Implant | $2,100.86 |
| 6152538 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,323.65 |
| 6152545 | SUPPLY IMPLANT | Supply/Implant | $7,667.33 |
| 6152551 | SUPPLY IMPLANT | Supply/Implant | $1,689.60 |
| 6152560 | STERILE SUPPLY | Supply/Implant | $270.46 |
| 6152612 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6152620 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,201.60 |
| 6152627 | SUPPLY IMPLANT | Supply/Implant | $3,179.52 |
| 6152629 | GUIDE WIRE | Supply/Implant | $379.14 |
| 6152657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,380.80 |
| 6152661 | STERILE SUPPLY | Supply/Implant | $1,121.41 |
| 6152672 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6152682 | SUPPLY IMPLANT | Supply/Implant | $2,284.93 |
| 6152685 | STERILE SUPPLY | Supply/Implant | $388.19 |
| 6152694 | SUPPLY IMPLANT | Supply/Implant | $62,112.64 |
| 6152701 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $34,201.60 |
| 6152709 | SUPPLY IMPLANT | Supply/Implant | $127,680.00 |
| 6152722 | GUIDE WIRE | Supply/Implant | $7,680.00 |
| 6152726 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,208.00 |
| 6152735 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $21,056.00 |
| 6152739 | STERILE SUPPLY | Supply/Implant | $38,400.00 |
| 6152743 | GUIDE WIRE | Supply/Implant | $2,988.16 |
| 6152744 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6152745 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6152746 | SUPPLY IMPLANT | Supply/Implant | $35,110.40 |
| 6152759 | SUPPLY IMPLANT | Supply/Implant | $507.78 |
| 6152774 | GUIDE WIRE | Supply/Implant | $407.68 |
| 6152775 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6152778 | GENERAL SUPPLY | Supply/Implant | $422.40 |
| 6152780 | GENERAL SUPPLY | Supply/Implant | $473.60 |
| 6152785 | STERILE SUPPLY | Supply/Implant | $300.80 |
| 6152788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $89,651.20 |
| 6152799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6152800 | SUPPLY IMPLANT | Supply/Implant | $535.04 |
| 6152803 | STERILE SUPPLY | Supply/Implant | $320.00 |
| 6152809 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6152811 | SUPPLY IMPLANT | Supply/Implant | $280.96 |
| 6152814 | SUPPLY IMPLANT | Supply/Implant | $252.80 |
| 6152817 | GENERAL SUPPLY | Supply/Implant | $4,330.88 |
| 6152822 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6152827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $61,004.80 |
| 6152831 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6152836 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,868.03 |
| 6152858 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6152861 | SUPPLY IMPLANT | Supply/Implant | $285.44 |
| 6152862 | GENERAL SUPPLY | Supply/Implant | $512.00 |
| 6152902 | SUPPLY IMPLANT | Supply/Implant | $1,407.10 |
| 6152904 | GENERAL SUPPLY | Supply/Implant | $2,534.40 |
| 6152934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,993.60 |
| 6152936 | STERILE SUPPLY | Supply/Implant | $1,830.78 |
| 6152946 | GENERAL SUPPLY | Supply/Implant | $460.80 |
| 6152947 | GENERAL SUPPLY | Supply/Implant | $395.64 |
| 6152948 | GENERAL SUPPLY | Supply/Implant | $251.70 |
| 6152949 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152950 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152953 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152958 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6152971 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153009 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153010 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153011 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153012 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153013 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153020 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153022 | CATHETER, GUIDING | Supply/Implant | $645.63 |
| 6153060 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $448.00 |
| 6153071 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6153073 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6153081 | STERILE SUPPLY | Supply/Implant | $7,616.00 |
| 6153082 | STERILE SUPPLY | Supply/Implant | $3,776.00 |
| 6153083 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6153085 | SUPPLY IMPLANT | Supply/Implant | $427,500.00 |
| 6153093 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,636.80 |
| 6153094 | SUPPLY IMPLANT | Supply/Implant | $1,322.88 |
| 6153098 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6153099 | SUPPLY IMPLANT | Supply/Implant | $791.04 |
| 6153100 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6153101 | SUPPLY IMPLANT | Supply/Implant | $791.04 |
| 6153110 | SUPPLY IMPLANT | Supply/Implant | $2,170.88 |
| 6153111 | CATHETER, GUIDING | Supply/Implant | $648.96 |
| 6153113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6153118 | SUPPLY IMPLANT | Supply/Implant | $63,360.00 |
| 6153119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,083.20 |
| 6153121 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6153122 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6153124 | INTRO/SHEATH, NON-LASER | Supply/Implant | $979.20 |
| 6153125 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6153136 | SUPPLY IMPLANT | Supply/Implant | $176.64 |
| 6153137 | SUPPLY IMPLANT | Supply/Implant | $3,456.00 |
| 6153138 | STERILE SUPPLY | Supply/Implant | $139.52 |
| 6153143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,200.00 |
| 6153145 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6153146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6153149 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6153150 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153156 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153157 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153180 | SUPPLY IMPLANT | Supply/Implant | $1,605.76 |
| 6153181 | SUPPLY IMPLANT | Supply/Implant | $268.19 |
| 6153183 | SUPPLY IMPLANT | Supply/Implant | $1,640.58 |
| 6153186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6153187 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,916.80 |
| 6153190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,952.64 |
| 6153191 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,706.05 |
| 6153192 | STERILE SUPPLY | Supply/Implant | $6,375.81 |
| 6153193 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $17,210.62 |
| 6153194 | INTERPHALANGEAL JOINT REPL | Supply/Implant | $17,210.62 |
| 6153196 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6153203 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6153213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6153218 | SUPPLY IMPLANT | Supply/Implant | $20,697.60 |
| 6153223 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6153224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6153225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6153226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6153227 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6153228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6153230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6153231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6153238 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6153245 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,368.00 |
| 6153263 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6153264 | SUPPLY IMPLANT | Supply/Implant | $4,812.80 |
| 6153270 | STERILE SUPPLY | Supply/Implant | $137.34 |
| 6153272 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6153274 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6153277 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $33,817.60 |
| 6153283 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6153288 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $2,444.80 |
| 6153289 | ALLODERM SKIN SUB | Supply/Implant | $117,001.50 |
| 6153291 | SUPPLY IMPLANT | Supply/Implant | $1,640.58 |
| 6153294 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6153296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153297 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6153302 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $11,456.00 |
| 6153303 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6153304 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6153306 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6153307 | SUPPLY IMPLANT | Supply/Implant | $5,875.20 |
| 6153308 | GENERAL SUPPLY | Supply/Implant | $15,296.00 |
| 6153310 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6153312 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6153313 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6153314 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6153315 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153322 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153323 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153324 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153325 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153326 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153327 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153328 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153329 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6153331 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153332 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153333 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153334 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153336 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153337 | GUIDE WIRE | Supply/Implant | $1,280.00 |
| 6153352 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6153355 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6153359 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6153361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153362 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6153363 | SUPPLY IMPLANT | Supply/Implant | $115,919.48 |
| 6153364 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,443.84 |
| 6153368 | AMNIOTIC MEMBRANE | Supply/Implant | $37,760.00 |
| 6153369 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6153370 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153371 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153373 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6153375 | GENERAL SUPPLY | Supply/Implant | $3,200.00 |
| 6153376 | SUPPLY IMPLANT | Supply/Implant | $174.72 |
| 6153377 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6153379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6153387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153414 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153457 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153460 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153462 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153463 | SUPPLY IMPLANT | Supply/Implant | $22,528.00 |
| 6153472 | SUPPLY IMPLANT | Supply/Implant | $1,107.33 |
| 6153473 | CATHETER, GUIDING | Supply/Implant | $3,890.18 |
| 6153476 | CATHETER, GUIDING | Supply/Implant | $3,890.18 |
| 6153509 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6153510 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6153511 | SUPPLY IMPLANT | Supply/Implant | $13,849.60 |
| 6153512 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6153517 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6153521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,262.40 |
| 6153523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6153526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6153529 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $105,000.00 |
| 6153530 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $70,400.00 |
| 6153531 | INTRO/SHEATH, NON-LASER | Supply/Implant | $19,200.00 |
| 6153532 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6153535 | SUPPLY IMPLANT | Supply/Implant | $4,544.00 |
| 6153538 | PT PRGRM FOR IMPLT NEUROSTIM | Supply/Implant | $15,232.00 |
| 6153539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,446.40 |
| 6153541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6153547 | GENERAL SUPPLY | Supply/Implant | $6,462.72 |
| 6153548 | SUPPLY IMPLANT | Supply/Implant | $5,534.72 |
| 6153549 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6153551 | GENERAL SUPPLY | Supply/Implant | $585.86 |
| 6153552 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6153553 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6153557 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6153585 | STERILE SUPPLY | Supply/Implant | $3,303.42 |
| 6153586 | STERILE SUPPLY | Supply/Implant | $2,696.32 |
| 6153587 | STERILE SUPPLY | Supply/Implant | $3,251.97 |
| 6153588 | STERILE SUPPLY | Supply/Implant | $3,646.72 |
| 6153596 | STERILE SUPPLY | Supply/Implant | $3,667.20 |
| 6153598 | STERILE SUPPLY | Supply/Implant | $321.41 |
| 6153611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153616 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6153617 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153618 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153621 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6153622 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6153623 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6153624 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6153626 | CATHETER, GUIDING | Supply/Implant | $12,608.00 |
| 6153628 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6153631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6153632 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6153633 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6153634 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6153638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,584.00 |
| 6153643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6153644 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6153651 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6153652 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6153653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6153655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,070.40 |
| 6153662 | STERILE SUPPLY | Supply/Implant | $362.50 |
| 6153663 | SUPPLY IMPLANT | Supply/Implant | $57,536.00 |
| 6153664 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6153678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,920.00 |
| 6153682 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6153688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6153690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,845.76 |
| 6153691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,350.08 |
| 6153693 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153694 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6153695 | SUPPLY IMPLANT | Supply/Implant | $115,689.00 |
| 6153725 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6153732 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6153733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6153734 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6153735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6153738 | GENERAL SUPPLY | Supply/Implant | $2,187.39 |
| 6153739 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153740 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6153746 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $64,278.40 |
| 6153751 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $204,750.00 |
| 6153757 | SUPPLY IMPLANT | Supply/Implant | $6,097.92 |
| 6153758 | STERILE SUPPLY | Supply/Implant | $640.00 |
| 6153767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6153772 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,738.24 |
| 6153776 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6153777 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6153782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6153787 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6153788 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $48,000.00 |
| 6153799 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6153800 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6153801 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6153802 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6153805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6153806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6153807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6153808 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6153809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6153810 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6153811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,760.00 |
| 6153813 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153814 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153816 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6153820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6153821 | SUPPLY IMPLANT | Supply/Implant | $5,004.80 |
| 6153824 | SUPPLY IMPLANT | Supply/Implant | $15,360.00 |
| 6153831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153832 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153834 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6153836 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6153839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,952.00 |
| 6153840 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6153843 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6153844 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6153847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6153848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6153851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6153854 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,081.22 |
| 6153855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,201.15 |
| 6153856 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6153899 | SUPPLY IMPLANT | Supply/Implant | $291.97 |
| 6153900 | SUPPLY IMPLANT | Supply/Implant | $4,705.41 |
| 6153908 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6153909 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6153910 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6153911 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6153912 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6153915 | PORT, INDWELLING, IMP | Supply/Implant | $4,160.00 |
| 6153917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6153920 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6153925 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6153926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153929 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6153931 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6153933 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $11,072.00 |
| 6153934 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $11,072.00 |
| 6153935 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $11,072.00 |
| 6153937 | SUPPLY IMPLANT | Supply/Implant | $15,040.00 |
| 6153938 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6153940 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6153943 | LOCM 300-399MG/ML IODINE,1ML | Supply/Implant | $512.56 |
| 6153957 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $434.53 |
| 6153959 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6153960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6153961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6153963 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6153968 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6153969 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6153970 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6153971 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6153972 | GENERAL SUPPLY | Supply/Implant | $268.80 |
| 6153977 | STERILE SUPPLY | Supply/Implant | $2,918.40 |
| 6153979 | SUPPLY IMPLANT | Supply/Implant | $4,428.29 |
| 6153981 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $471.04 |
| 6153984 | SUPPLY IMPLANT | Supply/Implant | $8,232.32 |
| 6153985 | AMNIOTIC MEMBRANE | Supply/Implant | $28,096.00 |
| 6153988 | SUPPLY IMPLANT | Supply/Implant | $119,969.33 |
| 6153992 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6153993 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6153995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6153996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $32,952.32 |
| 6153997 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6153999 | STERILE SUPPLY | Supply/Implant | $407.73 |
| 6154000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6154003 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6154005 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6154006 | STERILE SUPPLY | Supply/Implant | $8,640.00 |
| 6154007 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6154008 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6154009 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6154010 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6154011 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6154013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,416.00 |
| 6154019 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,790.40 |
| 6154028 | SUPPLY IMPLANT | Supply/Implant | $1,396.99 |
| 6154031 | SUPPLY IMPLANT | Supply/Implant | $6,387.20 |
| 6154033 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6154036 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6154038 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154042 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6154043 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6154044 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6154050 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6154056 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154057 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154058 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154059 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154060 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154061 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154062 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154063 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154064 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154065 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154066 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154067 | SUPPLY IMPLANT | Supply/Implant | $1,292.80 |
| 6154068 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154069 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6154070 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154071 | SUPPLY IMPLANT | Supply/Implant | $6,464.00 |
| 6154072 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154073 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154075 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6154076 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154077 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154078 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154079 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154080 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154081 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154082 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6154083 | SUPPLY IMPLANT | Supply/Implant | $2,292.48 |
| 6154084 | SUPPLY IMPLANT | Supply/Implant | $1,433.60 |
| 6154085 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6154089 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6154095 | SUPPLY IMPLANT | Supply/Implant | $45,696.00 |
| 6154098 | SUPPLY IMPLANT | Supply/Implant | $206.59 |
| 6154099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6154100 | SUPPLY IMPLANT | Supply/Implant | $300.80 |
| 6154105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,017.22 |
| 6154106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,145.86 |
| 6154109 | STERILE SUPPLY | Supply/Implant | $407.04 |
| 6154110 | CATHETER, GUIDING | Supply/Implant | $3,520.00 |
| 6154129 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6154130 | SUPPLY IMPLANT | Supply/Implant | $4,986.88 |
| 6154132 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,124.74 |
| 6154135 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $7,898.75 |
| 6154141 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6154142 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,371.39 |
| 6154145 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,371.39 |
| 6154146 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $4,670.72 |
| 6154188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6154189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6154190 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6154191 | SUPPLY IMPLANT | Supply/Implant | $4,986.88 |
| 6154193 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6154201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154205 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,196.80 |
| 6154216 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6154219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6154220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,541.38 |
| 6154221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6154223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6154224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6154237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6154246 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6154247 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6154248 | CATHETER, GUIDING | Supply/Implant | $3,890.18 |
| 6154249 | CATHETER, GUIDING | Supply/Implant | $5,005.18 |
| 6154260 | STERILE SUPPLY | Supply/Implant | $18,700.80 |
| 6154264 | SUPPLY IMPLANT | Supply/Implant | $4,096.00 |
| 6154265 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6154266 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6154267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6154268 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6154271 | CATHETER, GUIDING | Supply/Implant | $5,632.00 |
| 6154272 | GENERAL SUPPLY | Supply/Implant | $896.00 |
| 6154275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,736.00 |
| 6154287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6154292 | STERILE SUPPLY | Supply/Implant | $363.26 |
| 6154293 | SUPPLY IMPLANT | Supply/Implant | $29,376.00 |
| 6154298 | GENERAL SUPPLY | Supply/Implant | $975.36 |
| 6154299 | GENERAL SUPPLY | Supply/Implant | $975.36 |
| 6154303 | CATHETER, GUIDING | Supply/Implant | $46,912.00 |
| 6154316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6154317 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6154318 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6154319 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6154324 | SUPPLY IMPLANT | Supply/Implant | $54,758.40 |
| 6154325 | SUPPLY IMPLANT | Supply/Implant | $5,196.80 |
| 6154326 | SUPPLY IMPLANT | Supply/Implant | $5,196.80 |
| 6154327 | SUPPLY IMPLANT | Supply/Implant | $3,148.80 |
| 6154328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6154329 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6154330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6154331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6154334 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $480.00 |
| 6154338 | SUPPLY IMPLANT | Supply/Implant | $1,382.40 |
| 6154341 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6154349 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6154350 | CATHETER, GUIDING | Supply/Implant | $4,864.00 |
| 6154355 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6154356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6154359 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6154360 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6154367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6154373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6154374 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6154378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6154379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6154380 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6154387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6154388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6154389 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6154390 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6154391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6154395 | MESH (IMPLANTABLE) | Supply/Implant | $29,358.98 |
| 6154398 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6154404 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $59,584.00 |
| 6154405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,017.60 |
| 6154408 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6154410 | SUPPLY IMPLANT | Supply/Implant | $3,231.36 |
| 6154411 | STERILE SUPPLY | Supply/Implant | $3,394.56 |
| 6154412 | GUIDE WIRE | Supply/Implant | $4,659.20 |
| 6154420 | SUPPLY IMPLANT | Supply/Implant | $57,600.00 |
| 6154422 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6154426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6154429 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $183,750.00 |
| 6154430 | SUPPLY IMPLANT | Supply/Implant | $1,215.62 |
| 6154431 | SUPPLY IMPLANT | Supply/Implant | $3,655.81 |
| 6154432 | SUPPLY IMPLANT | Supply/Implant | $3,525.38 |
| 6154433 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $3,230.72 |
| 6154435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6154436 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6154438 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6154439 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6154450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6154451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6154499 | SUPPLY IMPLANT | Supply/Implant | $1,217.41 |
| 6154504 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6154532 | SUPPLY IMPLANT | Supply/Implant | $1,032.70 |
| 6154539 | SUPPLY IMPLANT | Supply/Implant | $887.81 |
| 6154592 | SUPPLY IMPLANT | Supply/Implant | $3,650.56 |
| 6154631 | SUPPLY IMPLANT | Supply/Implant | $2,593.92 |
| 6154635 | STERILE SUPPLY | Supply/Implant | $1,500.67 |
| 6154736 | SUPPLY IMPLANT | Supply/Implant | $6,547.71 |
| 6154739 | SUPPLY IMPLANT | Supply/Implant | $1,828.48 |
| 6154741 | SUPPLY IMPLANT | Supply/Implant | $34,469.38 |
| 6154758 | SUPPLY IMPLANT | Supply/Implant | $28,546.56 |
| 6154771 | STERILE SUPPLY | Supply/Implant | $10,562.18 |
| 6154789 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6154797 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6154799 | STERILE SUPPLY | Supply/Implant | $351.10 |
| 6154800 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154801 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6154810 | STERILE SUPPLY | Supply/Implant | $313.47 |
| 6154813 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154819 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154833 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154852 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6154856 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154867 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154868 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154871 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154883 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154887 | STERILE SUPPLY | Supply/Implant | $269.44 |
| 6154890 | STERILE SUPPLY | Supply/Implant | $261.63 |
| 6154894 | STERILE SUPPLY | Supply/Implant | $274.69 |
| 6154898 | STERILE SUPPLY | Supply/Implant | $318.21 |
| 6154980 | SUPPLY IMPLANT | Supply/Implant | $1,856.00 |
| 6154981 | SUPPLY IMPLANT | Supply/Implant | $151.55 |
| 6155016 | SUPPLY IMPLANT | Supply/Implant | $3,851.52 |
| 6155036 | SUPPLY IMPLANT | Supply/Implant | $12,057.60 |
| 6155064 | SUPPLY IMPLANT | Supply/Implant | $125,798.40 |
| 6155086 | SUPPLY IMPLANT | Supply/Implant | $486.40 |
| 6155098 | SUPPLY IMPLANT | Supply/Implant | $8,147.20 |
| 6155102 | SUPPLY IMPLANT | Supply/Implant | $6,353.66 |
| 6155129 | SUPPLY IMPLANT | Supply/Implant | $694.78 |
| 6155145 | SUPPLY IMPLANT | Supply/Implant | $252.54 |
| 6155147 | SUPPLY IMPLANT | Supply/Implant | $403.97 |
| 6155159 | SUPPLY IMPLANT | Supply/Implant | $188.67 |
| 6155177 | SUPPLY IMPLANT | Supply/Implant | $420.74 |
| 6155179 | SUPPLY IMPLANT | Supply/Implant | $348.54 |
| 6155188 | SUPPLY IMPLANT | Supply/Implant | $425.60 |
| 6155191 | SUPPLY IMPLANT | Supply/Implant | $373.12 |
| 6155194 | SUPPLY IMPLANT | Supply/Implant | $1,098.88 |
| 6155198 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6155200 | GENERAL SUPPLY | Supply/Implant | $198.27 |
| 6155203 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6155204 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6155205 | STERILE SUPPLY | Supply/Implant | $319.23 |
| 6155206 | STERILE SUPPLY | Supply/Implant | $414.34 |
| 6155208 | SUPPLY IMPLANT | Supply/Implant | $204.80 |
| 6155211 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6155215 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6155216 | GUIDE WIRE | Supply/Implant | $12,160.00 |
| 6155217 | CATHETER, GUIDING | Supply/Implant | $8,960.00 |
| 6155218 | CATHETER, GUIDING | Supply/Implant | $8,960.00 |
| 6155219 | CATHETER, GUIDING | Supply/Implant | $10,880.00 |
| 6155235 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6155236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6155239 | CATH, DRAINAGE | Supply/Implant | $1,027.20 |
| 6155241 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6155242 | CATHETER, GUIDING | Supply/Implant | $4,352.00 |
| 6155244 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6155245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6155249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6155256 | SUPPLY IMPLANT | Supply/Implant | $1,086.59 |
| 6155259 | STERILE SUPPLY | Supply/Implant | $410.62 |
| 6155260 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6155261 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6155262 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6155263 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6155264 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6155267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6155268 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6155272 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6155273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6155280 | STERILE SUPPLY | Supply/Implant | $346.62 |
| 6155287 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $960.00 |
| 6155288 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155289 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155290 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155291 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155292 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155293 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $960.00 |
| 6155294 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6155295 | SUPPLY IMPLANT | Supply/Implant | $9,920.00 |
| 6155300 | CATHETER, URETERAL | Supply/Implant | $334.98 |
| 6155304 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6155305 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,774.40 |
| 6155310 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6155312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6155315 | SUPPLY IMPLANT | Supply/Implant | $1,037.70 |
| 6155316 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6155317 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6155322 | SUPPLY IMPLANT | Supply/Implant | $2,201.60 |
| 6155325 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,104.96 |
| 6155329 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6155331 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6155333 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6155334 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6155335 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6155344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6155345 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6155352 | OCULAR IMP AQUEOUS DRAIN | Supply/Implant | $29,120.00 |
| 6155355 | PORT, INDWELLING, IMP | Supply/Implant | $1,984.00 |
| 6155356 | PORT, INDWELLING, IMP | Supply/Implant | $1,664.00 |
| 6155362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6155364 | STERILE SUPPLY | Supply/Implant | $407.73 |
| 6155368 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6155369 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $716.80 |
| 6155371 | STERILE SUPPLY | Supply/Implant | $426.27 |
| 6155372 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6155385 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6155389 | SUPPLY IMPLANT | Supply/Implant | $465.92 |
| 6155395 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6155403 | INTRO/SHEATH, NON-LASER | Supply/Implant | $931.46 |
| 6155408 | SUPPLY IMPLANT | Supply/Implant | $1,361.41 |
| 6155410 | SUPPLY IMPLANT | Supply/Implant | $739.84 |
| 6155411 | SUPPLY IMPLANT | Supply/Implant | $384.64 |
| 6155412 | SUPPLY IMPLANT | Supply/Implant | $252.54 |
| 6155414 | STERILE SUPPLY | Supply/Implant | $1,925.89 |
| 6155415 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6155416 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6155417 | SUPPLY IMPLANT | Supply/Implant | $5,901.31 |
| 6155418 | SUPPLY IMPLANT | Supply/Implant | $10,624.00 |
| 6155422 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6155425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,539.20 |
| 6155428 | STERILE SUPPLY | Supply/Implant | $337.41 |
| 6155429 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6155434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6155435 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6155436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6155437 | SUPPLY IMPLANT | Supply/Implant | $1,759.94 |
| 6155440 | STERILE SUPPLY | Supply/Implant | $448.00 |
| 6155445 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6155447 | STERILE SUPPLY | Supply/Implant | $1,834.11 |
| 6155454 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,428.22 |
| 6155455 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,428.22 |
| 6155456 | STERILE SUPPLY | Supply/Implant | $352.64 |
| 6155457 | CATHETER, GUIDING | Supply/Implant | $15,360.00 |
| 6155458 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155459 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155460 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155461 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155462 | SUPPLY IMPLANT | Supply/Implant | $680.70 |
| 6155463 | SUPPLY IMPLANT | Supply/Implant | $4,180.35 |
| 6155468 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6155469 | CATH, EP, OTHR THAN COOL-TIP | Supply/Implant | $63,360.00 |
| 6155473 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6155475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6155476 | GENERAL SUPPLY | Supply/Implant | $3,372.54 |
| 6155482 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6155485 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6155486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6155490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,579.20 |
| 6155492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6155493 | GUIDE WIRE | Supply/Implant | $1,520.64 |
| 6155494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6155495 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6155497 | LEAD, NEUROSTIMULATOR | Supply/Implant | $103,680.00 |
| 6155498 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6155500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,135.87 |
| 6155502 | STERILE SUPPLY | Supply/Implant | $625.66 |
| 6155503 | STERILE SUPPLY | Supply/Implant | $206.08 |
| 6155504 | SUPPLY IMPLANT | Supply/Implant | $5,621.76 |
| 6155505 | SUPPLY IMPLANT | Supply/Implant | $6,046.72 |
| 6155532 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155533 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155534 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155535 | SUPPLY IMPLANT | Supply/Implant | $5,322.24 |
| 6155538 | PMKR, OTHER THAN SING/DUAL | Supply/Implant | $100,480.00 |
| 6155544 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,872.00 |
| 6155545 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6155549 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6155550 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6155551 | GENERAL SUPPLY | Supply/Implant | $217.60 |
| 6155552 | SUPPLY IMPLANT | Supply/Implant | $3,257.47 |
| 6155553 | STERILE SUPPLY | Supply/Implant | $320.29 |
| 6155554 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6155557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6155559 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,120.00 |
| 6155560 | SUPPLY IMPLANT | Supply/Implant | $1,473.92 |
| 6155561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6155562 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6155564 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6155575 | TRANS ANGIOPLASTY CATH | Supply/Implant | $20,480.00 |
| 6155578 | SUPPLY IMPLANT | Supply/Implant | $704.00 |
| 6155579 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $332,562.70 |
| 6155602 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6155603 | SUPPLY IMPLANT | Supply/Implant | $1,947.52 |
| 6155604 | SUPPLY IMPLANT | Supply/Implant | $1,947.52 |
| 6155605 | SUPPLY IMPLANT | Supply/Implant | $1,947.52 |
| 6155606 | SUPPLY IMPLANT | Supply/Implant | $1,664.00 |
| 6155608 | STERILE SUPPLY | Supply/Implant | $130.42 |
| 6155611 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6155612 | SUPPLY IMPLANT | Supply/Implant | $2,322.43 |
| 6155616 | SUPPLY IMPLANT | Supply/Implant | $5,990.40 |
| 6155617 | SUPPLY IMPLANT | Supply/Implant | $2,647.81 |
| 6155619 | SUPPLY IMPLANT | Supply/Implant | $133.89 |
| 6155624 | SUPPLY IMPLANT | Supply/Implant | $15,355.78 |
| 6155627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,078.40 |
| 6155628 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.00 |
| 6155629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,440.13 |
| 6155636 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6155637 | STERILE SUPPLY | Supply/Implant | $403.20 |
| 6155638 | STERILE SUPPLY | Supply/Implant | $376.58 |
| 6155639 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6155640 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6155641 | SUPPLY IMPLANT | Supply/Implant | $4,544.00 |
| 6155654 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6155672 | SUPPLY IMPLANT | Supply/Implant | $1,241.98 |
| 6155676 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,800.00 |
| 6155677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6155678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $67,200.00 |
| 6155679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,041.60 |
| 6155680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,080.00 |
| 6155681 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,760.00 |
| 6155682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,800.00 |
| 6155683 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $67,200.00 |
| 6155686 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6155689 | SUPPLY IMPLANT | Supply/Implant | $19,788.80 |
| 6155708 | SUPPLY IMPLANT | Supply/Implant | $20,044.80 |
| 6155719 | SUPPLY IMPLANT | Supply/Implant | $20,044.80 |
| 6155743 | SUPPLY IMPLANT | Supply/Implant | $21,248.00 |
| 6155754 | SUPPLY IMPLANT | Supply/Implant | $20,044.80 |
| 6155771 | SUPPLY IMPLANT | Supply/Implant | $5,068.80 |
| 6155772 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6155913 | MESH (IMPLANTABLE) | Supply/Implant | $8,848.13 |
| 6155914 | MESH (IMPLANTABLE) | Supply/Implant | $8,848.13 |
| 6155949 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6155958 | STERILE SUPPLY | Supply/Implant | $217.79 |
| 6155961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6155965 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,084.48 |
| 6155967 | STERILE SUPPLY | Supply/Implant | $468.48 |
| 6155968 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $312.06 |
| 6155969 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155970 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155971 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155973 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6155977 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6155979 | SUPPLY IMPLANT | Supply/Implant | $33,267.20 |
| 6155980 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6155982 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,920.00 |
| 6155983 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,920.00 |
| 6155986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6155987 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6155988 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6155989 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6155990 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6155991 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6155993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6155995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,883.20 |
| 6155996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6156000 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6156001 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6156003 | ALLODERM SKIN SUB | Supply/Implant | $69,132.80 |
| 6156004 | SUPPLY IMPLANT | Supply/Implant | $2,872.32 |
| 6156005 | SUPPLY IMPLANT | Supply/Implant | $3,427.20 |
| 6156007 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6156008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6156009 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $601.60 |
| 6156012 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6156018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6156019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6156027 | SUPPLY IMPLANT | Supply/Implant | $790.27 |
| 6156034 | SUPPLY IMPLANT | Supply/Implant | $410.88 |
| 6156040 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6156041 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6156042 | SUPPLY IMPLANT | Supply/Implant | $2,611.20 |
| 6156043 | LEAD, CORONARY VENOUS | Supply/Implant | $47,424.00 |
| 6156044 | SUPPLY IMPLANT | Supply/Implant | $7,072.00 |
| 6156045 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6156046 | SUPPLY IMPLANT | Supply/Implant | $41,186.82 |
| 6156047 | SUPPLY IMPLANT | Supply/Implant | $7,833.60 |
| 6156048 | SUPPLY IMPLANT | Supply/Implant | $2,383.36 |
| 6156049 | OCULAR IMP AQUEOUS DRAIN | Supply/Implant | $24,320.00 |
| 6156050 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6156053 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6156054 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156055 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156056 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156057 | SUPPLY IMPLANT | Supply/Implant | $2,944.00 |
| 6156060 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6156061 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6156062 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6156063 | STERILE SUPPLY | Supply/Implant | $393.73 |
| 6156064 | STERILE SUPPLY | Supply/Implant | $317.06 |
| 6156071 | STERILE SUPPLY | Supply/Implant | $313.60 |
| 6156072 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156073 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156074 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156075 | STERILE SUPPLY | Supply/Implant | $311.68 |
| 6156076 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156077 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156078 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156079 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156080 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156081 | SUPPLY IMPLANT | Supply/Implant | $639.87 |
| 6156082 | CATH, HEMODIALYSIS,LONG-TERM | Supply/Implant | $6,387.20 |
| 6156087 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156088 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156089 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156090 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156091 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156092 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156093 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156094 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156095 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156096 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156097 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156098 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156100 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156101 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156102 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156106 | SUPPLY IMPLANT | Supply/Implant | $892.42 |
| 6156109 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6156111 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $521.73 |
| 6156118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6156119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6156120 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156122 | GENERATOR NEURO RECHG BAT SY | Supply/Implant | $222,200.00 |
| 6156123 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $8,256.00 |
| 6156124 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,560.00 |
| 6156126 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6156138 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6156140 | SUPPLY IMPLANT | Supply/Implant | $26,307.07 |
| 6156141 | STERILE SUPPLY | Supply/Implant | $969.60 |
| 6156142 | SUPPLY IMPLANT | Supply/Implant | $5,312.00 |
| 6156145 | SUPPLY IMPLANT | Supply/Implant | $962.69 |
| 6156146 | SUPPLY IMPLANT | Supply/Implant | $962.69 |
| 6156149 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,320.00 |
| 6156152 | GENERAL SUPPLY | Supply/Implant | $2,250.24 |
| 6156158 | GUIDE WIRE | Supply/Implant | $1,664.00 |
| 6156159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6156164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6156165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6156166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,824.00 |
| 6156168 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6156173 | CATH, TRANS ATHEREC,ROTATION | Supply/Implant | $48,576.00 |
| 6156179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6156180 | SUPPLY IMPLANT | Supply/Implant | $30,182.40 |
| 6156182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6156185 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,529.41 |
| 6156190 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6156191 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156192 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156193 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156194 | SUPPLY IMPLANT | Supply/Implant | $507.39 |
| 6156197 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156198 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156199 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156200 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156201 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156203 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156204 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156205 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156206 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156207 | CATH, DRAINAGE | Supply/Implant | $998.40 |
| 6156208 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156209 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156210 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6156211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6156221 | SUPPLY IMPLANT | Supply/Implant | $14,807.32 |
| 6156222 | SUPPLY IMPLANT | Supply/Implant | $16,283.03 |
| 6156223 | CATH, DRAINAGE | Supply/Implant | $6,720.00 |
| 6156224 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156236 | STERILE SUPPLY | Supply/Implant | $488.32 |
| 6156240 | SUPPLY IMPLANT | Supply/Implant | $858.62 |
| 6156245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,920.00 |
| 6156246 | SUPPLY IMPLANT | Supply/Implant | $24,969.60 |
| 6156247 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6156256 | STERILE SUPPLY | Supply/Implant | $12,787.20 |
| 6156258 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6156259 | SUPPLY IMPLANT | Supply/Implant | $921.60 |
| 6156261 | STERILE SUPPLY | Supply/Implant | $329.34 |
| 6156262 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6156268 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6156271 | SUPPLY IMPLANT | Supply/Implant | $491.52 |
| 6156273 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6156292 | ALLODERM SKIN SUB | Supply/Implant | $127,603.20 |
| 6156294 | SUPPLY IMPLANT | Supply/Implant | $31,910.40 |
| 6156296 | ARTHROFLEX PER 1 SQ CM | Supply/Implant | $49,280.00 |
| 6156297 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $5,428.22 |
| 6156301 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,499.20 |
| 6156302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6156305 | GUIDE WIRE | Supply/Implant | $3,246.08 |
| 6156308 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,990.40 |
| 6156326 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156327 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156331 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6156332 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6156333 | STERILE SUPPLY | Supply/Implant | $371.20 |
| 6156335 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6156339 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156340 | GENERAL SUPPLY | Supply/Implant | $133.12 |
| 6156341 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6156345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156346 | SUPPLY IMPLANT | Supply/Implant | $35,942.40 |
| 6156347 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6156348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6156349 | ADAPT/EXT, PACING/NEURO LEAD | Supply/Implant | $12,800.00 |
| 6156350 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6156353 | SUPPLY IMPLANT | Supply/Implant | $15,936.00 |
| 6156355 | SUPPLY IMPLANT | Supply/Implant | $3,525.38 |
| 6156363 | SUPPLY IMPLANT | Supply/Implant | $19,187.20 |
| 6156366 | SUPPLY IMPLANT | Supply/Implant | $2,803.20 |
| 6156367 | SUPPLY IMPLANT | Supply/Implant | $140.80 |
| 6156368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6156370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6156371 | GENERAL SUPPLY | Supply/Implant | $3,520.00 |
| 6156372 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156373 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $86,976.00 |
| 6156375 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,640.00 |
| 6156376 | STERILE SUPPLY | Supply/Implant | $4,672.00 |
| 6156379 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6156389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6156391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6156392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6156393 | SUPPLY IMPLANT | Supply/Implant | $94,656.00 |
| 6156395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,560.00 |
| 6156398 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6156399 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6156405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156408 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6156413 | SUPPLY IMPLANT | Supply/Implant | $1,364.74 |
| 6156415 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6156416 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6156417 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6156418 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156423 | SUPPLY IMPLANT | Supply/Implant | $4,089.34 |
| 6156424 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $247.05 |
| 6156425 | PROSTHESIS, BREAST, IMP | Supply/Implant | $8,960.00 |
| 6156427 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156429 | STERILE SUPPLY | Supply/Implant | $7,186.18 |
| 6156435 | STERILE SUPPLY | Supply/Implant | $8,028.16 |
| 6156438 | INTERSPINOUS IMPLANT | Supply/Implant | $21,760.00 |
| 6156439 | SUPPLY IMPLANT | Supply/Implant | $4,482.56 |
| 6156440 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6156441 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6156452 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6156453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6156456 | AICD, DUAL CHAMBER | Supply/Implant | $167,128.50 |
| 6156457 | AICD, SINGLE CHAMBER | Supply/Implant | $172,504.50 |
| 6156458 | AICD, SINGLE CHAMBER | Supply/Implant | $167,128.50 |
| 6156459 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $40,153.60 |
| 6156460 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $40,153.60 |
| 6156461 | SUPPLY IMPLANT | Supply/Implant | $3,928.32 |
| 6156464 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $207,900.00 |
| 6156469 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $928.00 |
| 6156470 | TISSUE MARKER, IMPLANTABLE | Supply/Implant | $1,152.00 |
| 6156478 | GENERAL SUPPLY | Supply/Implant | $192.00 |
| 6156482 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,080.00 |
| 6156483 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $19,840.00 |
| 6156484 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $17,280.00 |
| 6156490 | SUPPLY IMPLANT | Supply/Implant | $8,443.90 |
| 6156491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6156492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6156493 | SUPPLY IMPLANT | Supply/Implant | $1,447.68 |
| 6156498 | SUPPLY IMPLANT | Supply/Implant | $79,296.00 |
| 6156511 | SUPPLY IMPLANT | Supply/Implant | $14,714.88 |
| 6156512 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6156513 | SUPPLY IMPLANT | Supply/Implant | $3,832.06 |
| 6156514 | SUPPLY IMPLANT | Supply/Implant | $5,051.29 |
| 6156515 | SUPPLY IMPLANT | Supply/Implant | $8,491.39 |
| 6156516 | SUPPLY IMPLANT | Supply/Implant | $5,573.25 |
| 6156517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6156534 | GUIDE WIRE | Supply/Implant | $6,400.00 |
| 6156535 | SUPPLY IMPLANT | Supply/Implant | $3,891.20 |
| 6156537 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6156539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6156540 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6156541 | GUIDE WIRE | Supply/Implant | $3,246.08 |
| 6156546 | FDA INVESTIGATIONAL DEVICE | Supply/Implant | $303,000.00 |
| 6156549 | RET DEV, INSERTABLE | Supply/Implant | $1,408.00 |
| 6156551 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6156553 | SUPPLY IMPLANT | Supply/Implant | $858.24 |
| 6156554 | SUPPLY IMPLANT | Supply/Implant | $17,136.00 |
| 6156556 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6156574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6156575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $620.16 |
| 6156578 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6156581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6156583 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,753.60 |
| 6156584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6156587 | SUPPLY IMPLANT | Supply/Implant | $6,049.66 |
| 6156589 | GUIDE WIRE | Supply/Implant | $186.11 |
| 6156594 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6156619 | GUIDE WIRE | Supply/Implant | $172.80 |
| 6156623 | AICD, SINGLE CHAMBER | Supply/Implant | $154,531.13 |
| 6156624 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,593.22 |
| 6156627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,676.80 |
| 6156629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6156630 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6156631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6156632 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6156633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6156634 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6156636 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6156638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6156639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6156641 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6156642 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $100,787.20 |
| 6156643 | SUPPLY IMPLANT | Supply/Implant | $13,798.40 |
| 6156647 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6156648 | STERILE SUPPLY | Supply/Implant | $625.79 |
| 6156654 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156657 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156658 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156660 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156661 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156662 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156663 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156664 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156665 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156666 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156667 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156668 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156669 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156670 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156672 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156673 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156674 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156676 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156678 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156679 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156681 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156682 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156683 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156685 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156686 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156687 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $10,880.00 |
| 6156691 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156692 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156693 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6156698 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6156699 | CATHETER, URETERAL | Supply/Implant | $162.56 |
| 6156700 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $36,480.00 |
| 6156701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6156702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6156709 | SUPPLY IMPLANT | Supply/Implant | $171.52 |
| 6156713 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6156715 | INTRO/SHEATH, NON-LASER | Supply/Implant | $384.00 |
| 6156717 | SUPPLY IMPLANT | Supply/Implant | $3,949.44 |
| 6156720 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,378.94 |
| 6156730 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6156731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156733 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $109,568.00 |
| 6156734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156735 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156736 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156738 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6156739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6156741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6156742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6156748 | SUPPLY IMPLANT | Supply/Implant | $435.20 |
| 6156751 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6156753 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6156754 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6156761 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6156768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,428.48 |
| 6156800 | SUPPLY IMPLANT | Supply/Implant | $20,849.92 |
| 6156810 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156811 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156825 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156828 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156830 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156833 | SUPPLY IMPLANT | Supply/Implant | $23,188.48 |
| 6156901 | SUPPLY IMPLANT | Supply/Implant | $27,086.08 |
| 6156903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,912.00 |
| 6156904 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,912.00 |
| 6156906 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,792.00 |
| 6156909 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,184.00 |
| 6156912 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,125.31 |
| 6156913 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6156914 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6156917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,360.00 |
| 6156967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6156969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6156973 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6156974 | SUPPLY IMPLANT | Supply/Implant | $23,296.00 |
| 6156975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6156976 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6156977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6156978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6156979 | STERILE SUPPLY | Supply/Implant | $535.30 |
| 6156982 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156983 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6156985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6156987 | INTRO/SHEATH, NON-LASER | Supply/Implant | $7,603.20 |
| 6156989 | GENERAL SUPPLY | Supply/Implant | $166.40 |
| 6156991 | STERILE SUPPLY | Supply/Implant | $1,611.90 |
| 6156992 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6156994 | MESH (IMPLANTABLE) | Supply/Implant | $13,824.00 |
| 6157001 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6157006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6157008 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157009 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6157015 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6157016 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6157017 | SUPPLY IMPLANT | Supply/Implant | $6,815.10 |
| 6157018 | SUPPLY IMPLANT | Supply/Implant | $7,261.31 |
| 6157019 | SUPPLY IMPLANT | Supply/Implant | $41,817.60 |
| 6157020 | SUPPLY IMPLANT | Supply/Implant | $5,196.80 |
| 6157023 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157024 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157029 | SUPPLY IMPLANT | Supply/Implant | $13,440.00 |
| 6157030 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6157031 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6157039 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6157043 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6157045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6157046 | SUPPLY IMPLANT | Supply/Implant | $2,022.40 |
| 6157052 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $15,360.00 |
| 6157054 | SUPPLY IMPLANT | Supply/Implant | $5,683.20 |
| 6157057 | GUIDE WIRE | Supply/Implant | $7,142.40 |
| 6157058 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,228.80 |
| 6157060 | GUIDE WIRE | Supply/Implant | $9,280.00 |
| 6157061 | GUIDE WIRE | Supply/Implant | $9,280.00 |
| 6157065 | SUPPLY IMPLANT | Supply/Implant | $1,423.36 |
| 6157066 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6157069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6157071 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6157080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6157081 | CATH, INTRAVAS ULTRASOUND | Supply/Implant | $9,280.00 |
| 6157083 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $24,960.00 |
| 6157090 | GUIDE WIRE | Supply/Implant | $3,520.00 |
| 6157091 | GUIDE WIRE | Supply/Implant | $3,520.00 |
| 6157094 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157095 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157096 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157097 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157098 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157099 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157100 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157101 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157102 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157105 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $20,416.00 |
| 6157119 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6157140 | GENERAL SUPPLY | Supply/Implant | $244.48 |
| 6157141 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6157143 | SUPPLY IMPLANT | Supply/Implant | $254.08 |
| 6157144 | SUPPLY IMPLANT | Supply/Implant | $4,289.92 |
| 6157148 | GENERAL SUPPLY | Supply/Implant | $371.20 |
| 6157151 | STERILE SUPPLY | Supply/Implant | $1,472.00 |
| 6157153 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6157158 | SUPPLY IMPLANT | Supply/Implant | $6,280.83 |
| 6157160 | SUPPLY IMPLANT | Supply/Implant | $6,280.83 |
| 6157168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157172 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6157174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6157175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6157176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,177.60 |
| 6157178 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6157181 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6157182 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6157193 | STERILE SUPPLY | Supply/Implant | $318.85 |
| 6157199 | CATHETER, GUIDING | Supply/Implant | $1,774.08 |
| 6157200 | STERILE SUPPLY | Supply/Implant | $411.14 |
| 6157202 | STERILE SUPPLY | Supply/Implant | $238.98 |
| 6157203 | STERILE SUPPLY | Supply/Implant | $4,702.21 |
| 6157204 | STERILE SUPPLY | Supply/Implant | $354.94 |
| 6157218 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $92,096.00 |
| 6157222 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6157224 | GENERAL SUPPLY | Supply/Implant | $1,459.20 |
| 6157225 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6157226 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6157227 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $21,324.80 |
| 6157228 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $30,720.00 |
| 6157253 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6157258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6157259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6157265 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157266 | SUPPLY IMPLANT | Supply/Implant | $5,043.97 |
| 6157267 | SUPPLY IMPLANT | Supply/Implant | $5,043.97 |
| 6157273 | SUPPLY IMPLANT | Supply/Implant | $252,500.00 |
| 6157275 | SUPPLY IMPLANT | Supply/Implant | $165.38 |
| 6157276 | SUPPLY IMPLANT | Supply/Implant | $20,936.19 |
| 6157278 | CATH, THROMBECTOMY/EMBOLECT | Supply/Implant | $105,000.00 |
| 6157279 | SUPPLY IMPLANT | Supply/Implant | $1,186.56 |
| 6157283 | GENERAL SUPPLY | Supply/Implant | $1,702.40 |
| 6157284 | SUPPLY IMPLANT | Supply/Implant | $2,831.23 |
| 6157285 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6157287 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6157289 | SUPPLY IMPLANT | Supply/Implant | $303.36 |
| 6157292 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6157294 | CATHETER, GUIDING | Supply/Implant | $537.60 |
| 6157297 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $85,440.00 |
| 6157298 | SUPPLY IMPLANT | Supply/Implant | $33,088.00 |
| 6157299 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,400.00 |
| 6157301 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6157302 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6157304 | SUPPLY IMPLANT | Supply/Implant | $3,363.84 |
| 6157305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6157306 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6157310 | STERILE SUPPLY | Supply/Implant | $308.99 |
| 6157311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6157315 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6157316 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6157324 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6157325 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6157327 | SUPPLY IMPLANT | Supply/Implant | $32,320.00 |
| 6157328 | SUPPLY IMPLANT | Supply/Implant | $31,616.00 |
| 6157335 | GUIDE WIRE | Supply/Implant | $6,080.00 |
| 6157347 | SUPPLY IMPLANT | Supply/Implant | $254.34 |
| 6157349 | GENERAL SUPPLY | Supply/Implant | $808.45 |
| 6157350 | GENERAL SUPPLY | Supply/Implant | $808.45 |
| 6157352 | STERILE SUPPLY | Supply/Implant | $459.52 |
| 6157362 | LOCM 200-299MG/ML IODINE,1ML | Supply/Implant | $2,768.90 |
| 6157364 | GAUZE <=16 IN NO W/SAL W/O B | Supply/Implant | $158.98 |
| 6157367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157369 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157374 | GUIDE WIRE | Supply/Implant | $281.60 |
| 6157378 | SUPPLY IMPLANT | Supply/Implant | $7,488.00 |
| 6157379 | SUPPLY IMPLANT | Supply/Implant | $7,142.40 |
| 6157380 | SUPPLY IMPLANT | Supply/Implant | $7,488.00 |
| 6157382 | SUPPLY IMPLANT | Supply/Implant | $7,142.40 |
| 6157384 | SUPPLY IMPLANT | Supply/Implant | $7,142.40 |
| 6157386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,680.00 |
| 6157387 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,080.00 |
| 6157389 | SUPPLY IMPLANT | Supply/Implant | $2,324.48 |
| 6157397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6157402 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157403 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6157406 | SUPPLY IMPLANT | Supply/Implant | $62,016.00 |
| 6157413 | STERILE SUPPLY | Supply/Implant | $6,387.20 |
| 6157416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6157426 | STERILE SUPPLY | Supply/Implant | $19,136.00 |
| 6157429 | SUPPLY IMPLANT | Supply/Implant | $22,771.20 |
| 6157431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6157432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6157433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6157434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,368.00 |
| 6157437 | SUPPLY IMPLANT | Supply/Implant | $1,755.52 |
| 6157438 | SUPPLY IMPLANT | Supply/Implant | $1,729.66 |
| 6157440 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6157441 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6157443 | SUPPLY IMPLANT | Supply/Implant | $1,876.74 |
| 6157446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157447 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6157452 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,560.00 |
| 6157453 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $18,560.00 |
| 6157459 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6157460 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6157462 | SUPPLY IMPLANT | Supply/Implant | $1,729.66 |
| 6157464 | STERILE SUPPLY | Supply/Implant | $394.24 |
| 6157475 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6157477 | GENERAL SUPPLY | Supply/Implant | $21,760.00 |
| 6157478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6157479 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6157482 | SUPPLY IMPLANT | Supply/Implant | $5,333.89 |
| 6157489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157493 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157494 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157495 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6157501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6157502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157503 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6157505 | GENERAL SUPPLY | Supply/Implant | $23,360.00 |
| 6157506 | GENERAL SUPPLY | Supply/Implant | $973.44 |
| 6157508 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,492.80 |
| 6157509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6157510 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6157513 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6157517 | SUPPLY IMPLANT | Supply/Implant | $212.74 |
| 6157518 | SUPPLY IMPLANT | Supply/Implant | $1,923.84 |
| 6157520 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6157527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6157529 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $11,456.00 |
| 6157533 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $141,750.00 |
| 6157534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6157539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6157540 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6157541 | STERILE SUPPLY | Supply/Implant | $347.28 |
| 6157544 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6157546 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6157547 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6157551 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6157552 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6157553 | GUIDE WIRE | Supply/Implant | $6,364.80 |
| 6157554 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6157556 | SUPPLY IMPLANT | Supply/Implant | $208.90 |
| 6157561 | GENERAL SUPPLY | Supply/Implant | $239.87 |
| 6157567 | SUPPLY IMPLANT | Supply/Implant | $4,106.62 |
| 6157569 | SUPPLY IMPLANT | Supply/Implant | $13,096.96 |
| 6157570 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6157571 | SUPPLY IMPLANT | Supply/Implant | $2,713.60 |
| 6157594 | STERILE SUPPLY | Supply/Implant | $422.39 |
| 6157596 | SUPPLY IMPLANT | Supply/Implant | $354.30 |
| 6157597 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157604 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6157605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6157606 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157615 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6157626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6157634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,742.40 |
| 6157635 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,352.00 |
| 6157639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,750.40 |
| 6157640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,536.00 |
| 6157641 | SUPPLY IMPLANT | Supply/Implant | $4,544.81 |
| 6157642 | GUIDE WIRE | Supply/Implant | $192.00 |
| 6157643 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6157644 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6157648 | STERILE SUPPLY | Supply/Implant | $212.12 |
| 6157649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6157653 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6157656 | GENERAL SUPPLY | Supply/Implant | $429.18 |
| 6157659 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6157660 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6157665 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6157666 | FOAM DRSG <=16 SQ IN W/O BDR | Supply/Implant | $2,931.46 |
| 6157667 | STERILE SUPPLY | Supply/Implant | $2,931.46 |
| 6157673 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6157674 | CATHETER, GUIDING | Supply/Implant | $2,368.00 |
| 6157679 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6157680 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6157682 | SUPPLY IMPLANT | Supply/Implant | $179.47 |
| 6157683 | STERILE SUPPLY | Supply/Implant | $391.81 |
| 6157686 | SUPPLY IMPLANT | Supply/Implant | $1,121.28 |
| 6157688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6157689 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6157700 | SUPPLY IMPLANT | Supply/Implant | $2,066.05 |
| 6157701 | SUPPLY IMPLANT | Supply/Implant | $2,107.74 |
| 6157704 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6157705 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157713 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6157714 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6157719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6157723 | SUPPLY IMPLANT | Supply/Implant | $16,793.60 |
| 6157727 | SUPPLY IMPLANT | Supply/Implant | $3,313.66 |
| 6157728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,800.96 |
| 6157730 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6157734 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6157735 | SUPPLY IMPLANT | Supply/Implant | $89,600.00 |
| 6157736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6157738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6157739 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6157740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6157742 | GENERAL SUPPLY | Supply/Implant | $19,626.88 |
| 6157743 | STERILE SUPPLY | Supply/Implant | $379.52 |
| 6157744 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,240.00 |
| 6157750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6157751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6157753 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6157755 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6157756 | SUPPLY IMPLANT | Supply/Implant | $4,508.42 |
| 6157758 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6157759 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6157760 | SUPPLY IMPLANT | Supply/Implant | $5,749.38 |
| 6157761 | SUPPLY IMPLANT | Supply/Implant | $6,652.80 |
| 6157762 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6157764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,928.00 |
| 6157774 | SUPPLY IMPLANT | Supply/Implant | $787.71 |
| 6157775 | STERILE SUPPLY | Supply/Implant | $416.63 |
| 6157782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6157792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6157793 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6157796 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6157797 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6157812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6157824 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157825 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157826 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6157828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6157831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,784.00 |
| 6157834 | SUPPLY IMPLANT | Supply/Implant | $226.94 |
| 6157835 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6157838 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157839 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157840 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157841 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157842 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6157845 | INTERSPINOUS IMPLANT | Supply/Implant | $60,800.00 |
| 6157847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6157850 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,785.60 |
| 6157856 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6157857 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6157860 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6157863 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157864 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157865 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6157866 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157876 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157883 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157884 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157886 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157888 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157891 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157892 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157895 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157896 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157897 | SUPPLY IMPLANT | Supply/Implant | $156,975.00 |
| 6157899 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6157900 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6157902 | LEAD, NEUROSTIMULATOR | Supply/Implant | $35,840.00 |
| 6157903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6157904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6157908 | SUPPLY IMPLANT | Supply/Implant | $3,046.40 |
| 6157909 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,112.00 |
| 6157913 | CATHETER, GUIDING | Supply/Implant | $4,796.03 |
| 6157915 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6157916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6157917 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6157933 | SUPPLY IMPLANT | Supply/Implant | $1,484.80 |
| 6157934 | STERILE SUPPLY | Supply/Implant | $318.72 |
| 6157935 | STERILE SUPPLY | Supply/Implant | $256.00 |
| 6157936 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6157939 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $1,733.38 |
| 6157940 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6157944 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6157945 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6157946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6157947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6157949 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $5,977.60 |
| 6157950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6157952 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6157954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6157961 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6157964 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,360.00 |
| 6157967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6157968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6157970 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,126.72 |
| 6157972 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6157974 | SUPPLY IMPLANT | Supply/Implant | $40,691.20 |
| 6157976 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6157977 | GUIDE WIRE | Supply/Implant | $1,209.60 |
| 6157980 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6157986 | SUPPLY IMPLANT | Supply/Implant | $1,627.52 |
| 6157995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,928.70 |
| 6158003 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6158004 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6158005 | GENERATOR, NEURO NON-RECHARG | Supply/Implant | $179,550.00 |
| 6158006 | LEAD, NEUROSTIMULATOR | Supply/Implant | $24,960.00 |
| 6158007 | LEAD, NEUROSTIMULATOR | Supply/Implant | $43,200.00 |
| 6158008 | GENERAL SUPPLY | Supply/Implant | $17,920.00 |
| 6158010 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6158011 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158013 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6158014 | SUPPLY IMPLANT | Supply/Implant | $118,387.50 |
| 6158015 | LEAD, NEUROSTIMULATOR | Supply/Implant | $7,040.00 |
| 6158017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6158018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6158019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6158020 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6158023 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6158024 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6158025 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6158029 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6158032 | MESH (IMPLANTABLE) | Supply/Implant | $14,592.00 |
| 6158033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6158038 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6158042 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $24,640.00 |
| 6158044 | GENERAL SUPPLY | Supply/Implant | $189.06 |
| 6158049 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6158050 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6158052 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158053 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6158054 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6158055 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6158062 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6158063 | SUPPLY IMPLANT | Supply/Implant | $17,920.00 |
| 6158065 | SUPPLY IMPLANT | Supply/Implant | $49,190.40 |
| 6158067 | STERILE SUPPLY | Supply/Implant | $796.80 |
| 6158069 | GENERAL SUPPLY | Supply/Implant | $249.60 |
| 6158070 | GENERAL SUPPLY | Supply/Implant | $160.00 |
| 6158078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6158079 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6158093 | STERILE SUPPLY | Supply/Implant | $190.87 |
| 6158094 | STERILE SUPPLY | Supply/Implant | $280.01 |
| 6158098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6158100 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158101 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158102 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158103 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158104 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158105 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158106 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158107 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6158109 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $11,038.72 |
| 6158110 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $13,760.00 |
| 6158111 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $16,934.40 |
| 6158112 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $36,126.72 |
| 6158115 | GRAFIX CORE | Supply/Implant | $16,934.40 |
| 6158116 | GRAFIX CORE | Supply/Implant | $36,126.72 |
| 6158118 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $6,336.00 |
| 6158119 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $13,760.00 |
| 6158121 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $16,934.40 |
| 6158122 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $36,126.72 |
| 6158123 | GRAFIX STRAVIX PRIME PL SQCM | Supply/Implant | $106,624.00 |
| 6158129 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158142 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6158143 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6158147 | SUPPLY IMPLANT | Supply/Implant | $3,763.20 |
| 6158155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,097.60 |
| 6158158 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158160 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158181 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158183 | SUPPLY IMPLANT | Supply/Implant | $209,947.50 |
| 6158186 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158196 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158198 | SUPPLY IMPLANT | Supply/Implant | $209,947.50 |
| 6158201 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158210 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158222 | SUPPLY IMPLANT | Supply/Implant | $217,099.50 |
| 6158224 | SUPPLY IMPLANT | Supply/Implant | $194,197.50 |
| 6158244 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158245 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,936.00 |
| 6158247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6158253 | SUPPLY IMPLANT | Supply/Implant | $23,795.20 |
| 6158258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6158260 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.00 |
| 6158261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,283.20 |
| 6158262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $460.80 |
| 6158274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158276 | CATHETER, GUIDING | Supply/Implant | $611.71 |
| 6158278 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6158279 | SUPPLY IMPLANT | Supply/Implant | $28,160.00 |
| 6158282 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6158286 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,312.00 |
| 6158288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6158290 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6158295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,848.32 |
| 6158297 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6158303 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6158315 | SUPPLY IMPLANT | Supply/Implant | $392.58 |
| 6158316 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6158319 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6158320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6158321 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6158322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6158323 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6158324 | SUPPLY IMPLANT | Supply/Implant | $1,932.80 |
| 6158325 | SUPPLY IMPLANT | Supply/Implant | $4,812.80 |
| 6158330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6158333 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,433.60 |
| 6158336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6158337 | SUPPLY IMPLANT | Supply/Implant | $83,200.00 |
| 6158343 | SUPPLY IMPLANT | Supply/Implant | $896.00 |
| 6158346 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6158348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,056.00 |
| 6158351 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,000.00 |
| 6158357 | CATHETER, GUIDING | Supply/Implant | $440.32 |
| 6158360 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6158361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6158362 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6158364 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6158367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6158368 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6158370 | SUPPLY IMPLANT | Supply/Implant | $1,809.79 |
| 6158376 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6158380 | SEPTAL DEFECT IMP SYS | Supply/Implant | $131,040.00 |
| 6158383 | SEPTAL DEFECT IMP SYS | Supply/Implant | $131,040.00 |
| 6158386 | GUIDE WIRE | Supply/Implant | $14,105.60 |
| 6158388 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $2,112.00 |
| 6158390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6158391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,710.40 |
| 6158393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6158395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6158396 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6158397 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6158398 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6158399 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6158402 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158409 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158415 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158420 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158434 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158453 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158468 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158474 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,880.00 |
| 6158492 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6158494 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6158495 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6158496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6158497 | GRAFTJACKET SKIN SUB | Supply/Implant | $38,643.20 |
| 6158500 | CATHETER, GUIDING | Supply/Implant | $672.00 |
| 6158503 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6158504 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6158505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6158508 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158509 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158514 | STERILE SUPPLY | Supply/Implant | $4,948.22 |
| 6158527 | SUPPLY IMPLANT | Supply/Implant | $1,956.26 |
| 6158531 | SUPPLY IMPLANT | Supply/Implant | $5,192.58 |
| 6158543 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158544 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158546 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6158569 | SUPPLY IMPLANT | Supply/Implant | $14,259.20 |
| 6158575 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $2,222.72 |
| 6158579 | SUPPLY IMPLANT | Supply/Implant | $731.78 |
| 6158588 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6158589 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6158590 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6158591 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6158595 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6158596 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6158598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6158616 | GENERAL SUPPLY | Supply/Implant | $1,600.00 |
| 6158617 | GENERAL SUPPLY | Supply/Implant | $1,600.00 |
| 6158632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,120.00 |
| 6158633 | SUPPLY IMPLANT | Supply/Implant | $2,099.20 |
| 6158634 | LEAD, PMKR, TRANSVENOUS VDD | Supply/Implant | $6,515.20 |
| 6158636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,528.00 |
| 6158641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6158643 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6158645 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6158647 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6158650 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,200.00 |
| 6158651 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6158654 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $18,432.00 |
| 6158660 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6158672 | STERILE SUPPLY | Supply/Implant | $419.97 |
| 6158686 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158687 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158688 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158690 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,438.40 |
| 6158700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158703 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6158710 | GENERAL SUPPLY | Supply/Implant | $796.80 |
| 6158711 | GENERAL SUPPLY | Supply/Implant | $796.80 |
| 6158712 | GENERAL SUPPLY | Supply/Implant | $796.80 |
| 6158718 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6158719 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158722 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6158727 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6158728 | PROSTHETIC IMPLANT NOS | Supply/Implant | $2,547.20 |
| 6158730 | STERILE SUPPLY | Supply/Implant | $41,792.00 |
| 6158731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $101,376.00 |
| 6158732 | SUPPLY IMPLANT | Supply/Implant | $17,136.00 |
| 6158733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6158736 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6158737 | STENT, NON-COR, TEM W/O DEL | Supply/Implant | $960.00 |
| 6158739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6158740 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6158760 | SUPPLY IMPLANT | Supply/Implant | $32,780.80 |
| 6158768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6158770 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6158771 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,326.40 |
| 6158783 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158784 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158788 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158790 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158793 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158794 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158795 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158796 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $38,400.00 |
| 6158800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6158809 | SUPPLY IMPLANT | Supply/Implant | $3,123.20 |
| 6158810 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6158811 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6158813 | GENERAL SUPPLY | Supply/Implant | $160.00 |
| 6158818 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6158819 | CATHETER, GUIDING | Supply/Implant | $7,168.00 |
| 6158820 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,648.00 |
| 6158821 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,136.00 |
| 6158824 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,219.20 |
| 6158825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158827 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158828 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,929.60 |
| 6158835 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,059.20 |
| 6158836 | CATHETER, GUIDING | Supply/Implant | $11,558.40 |
| 6158837 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158838 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6158841 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6158842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,693.12 |
| 6158843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,693.12 |
| 6158844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6158848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158849 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6158865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,541.38 |
| 6158868 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158871 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158872 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158873 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $29,440.00 |
| 6158878 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6158879 | SUPPLY IMPLANT | Supply/Implant | $7,099.78 |
| 6158880 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6158882 | PROBE, ROBOTIC, WATER-JET | Supply/Implant | $3,200.00 |
| 6158891 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6158893 | SUPPLY IMPLANT | Supply/Implant | $3,735.55 |
| 6158901 | COCHLEAR DEVICE | Supply/Implant | $148,785.00 |
| 6158902 | COCHLEAR DEVICE | Supply/Implant | $148,785.00 |
| 6158903 | COCHLEAR DEVICE | Supply/Implant | $148,785.00 |
| 6158907 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158908 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158909 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158911 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158913 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158915 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158916 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6158919 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6158923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,833.60 |
| 6158928 | SUPPLY IMPLANT | Supply/Implant | $4,851.20 |
| 6158933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6158937 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158938 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158939 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6158940 | REP DEV, URINARY, W/SLING | Supply/Implant | $80,678.40 |
| 6158953 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6158960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6158961 | GENERAL SUPPLY | Supply/Implant | $2,547.20 |
| 6158966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6158967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,372.80 |
| 6158968 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6158973 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6158975 | STERILE SUPPLY | Supply/Implant | $178.94 |
| 6158978 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6158980 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6158981 | INTERSPINOUS IMPLANT | Supply/Implant | $6,400.00 |
| 6158983 | INTERSPINOUS IMPLANT | Supply/Implant | $57,600.00 |
| 6158986 | SUPPLY IMPLANT | Supply/Implant | $21,593.60 |
| 6158987 | INTERSPINOUS IMPLANT | Supply/Implant | $63,769.60 |
| 6158988 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,706.69 |
| 6158990 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6158992 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6158993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6158994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6158995 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6158996 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6158997 | SUPPLY IMPLANT | Supply/Implant | $1,254.91 |
| 6159004 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6159005 | SUPPLY IMPLANT | Supply/Implant | $1,216.00 |
| 6159009 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6159013 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6159014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6159015 | SUPPLY IMPLANT | Supply/Implant | $2,144.00 |
| 6159018 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,272.32 |
| 6159019 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6159035 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6159042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6159047 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159048 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6159057 | STERILE SUPPLY | Supply/Implant | $1,254.40 |
| 6159060 | SUPPLY IMPLANT | Supply/Implant | $63,936.00 |
| 6159061 | SUPPLY IMPLANT | Supply/Implant | $793.60 |
| 6159065 | CATHETER, GUIDING | Supply/Implant | $665.60 |
| 6159069 | SUPPLY IMPLANT | Supply/Implant | $4,851.20 |
| 6159073 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,118.40 |
| 6159074 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6159076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6159078 | GENERAL SUPPLY | Supply/Implant | $304.00 |
| 6159079 | SUPPLY IMPLANT | Supply/Implant | $3,584.00 |
| 6159082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,740.80 |
| 6159083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,163.20 |
| 6159084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6159087 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6159088 | SUPPLY IMPLANT | Supply/Implant | $1,747.33 |
| 6159093 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6159097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6159102 | SUPPLY IMPLANT | Supply/Implant | $14,016.00 |
| 6159105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6159106 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6159109 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159110 | SUPPLY IMPLANT | Supply/Implant | $570.24 |
| 6159111 | SUPPLY IMPLANT | Supply/Implant | $570.24 |
| 6159112 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159113 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159115 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159116 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159119 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6159129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,849.60 |
| 6159132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6159142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6159143 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159144 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159145 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159146 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159147 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159148 | STERILE SUPPLY | Supply/Implant | $392.61 |
| 6159150 | LEAD, CORONARY VENOUS | Supply/Implant | $42,432.00 |
| 6159151 | CATHETER, GUIDING | Supply/Implant | $5,056.00 |
| 6159153 | SUPPLY IMPLANT | Supply/Implant | $10,892.80 |
| 6159154 | SUPPLY IMPLANT | Supply/Implant | $10,892.80 |
| 6159155 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6159159 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6159163 | GENERAL SUPPLY | Supply/Implant | $598.66 |
| 6159165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,147.20 |
| 6159169 | SUPPLY IMPLANT | Supply/Implant | $3,893.76 |
| 6159171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6159185 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6159189 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6159194 | GUIDE WIRE | Supply/Implant | $1,336.06 |
| 6159196 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159197 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159200 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6159202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6159203 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6159206 | GENERAL SUPPLY | Supply/Implant | $178.18 |
| 6159207 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6159210 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6159211 | SUPPLY IMPLANT | Supply/Implant | $35,200.00 |
| 6159214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6159219 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,734.40 |
| 6159222 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6159224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,438.40 |
| 6159229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6159230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,508.80 |
| 6159237 | SUPPLY IMPLANT | Supply/Implant | $13,096.96 |
| 6159238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,792.00 |
| 6159239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,152.00 |
| 6159242 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6159247 | SUPPLY IMPLANT | Supply/Implant | $13,632.00 |
| 6159248 | SUPPLY IMPLANT | Supply/Implant | $12,736.00 |
| 6159249 | INTRO/SHEATH, NON-LASER | Supply/Implant | $6,336.00 |
| 6159250 | SUPPLY IMPLANT | Supply/Implant | $514.56 |
| 6159257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,048.00 |
| 6159258 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6159259 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $5,059.20 |
| 6159261 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6159263 | SUPPLY IMPLANT | Supply/Implant | $76,416.00 |
| 6159264 | SUPPLY IMPLANT | Supply/Implant | $76,416.00 |
| 6159265 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6159268 | GENERAL SUPPLY | Supply/Implant | $808.45 |
| 6159269 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6159270 | SUPPLY IMPLANT | Supply/Implant | $2,452.35 |
| 6159275 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,816.00 |
| 6159291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6159292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,896.00 |
| 6159296 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6159297 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6159298 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6159305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,753.60 |
| 6159312 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6159313 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6159314 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6159315 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,873.92 |
| 6159316 | SUPPLY IMPLANT | Supply/Implant | $4,992.00 |
| 6159317 | SUPPLY IMPLANT | Supply/Implant | $5,696.00 |
| 6159318 | GENERAL SUPPLY | Supply/Implant | $2,560.00 |
| 6159320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6159321 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6159322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6159323 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6159326 | SUPPLY IMPLANT | Supply/Implant | $6,018.05 |
| 6159327 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6159359 | SUPPLY IMPLANT | Supply/Implant | $18,560.00 |
| 6159362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6159363 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6159365 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6159379 | SUPPLY IMPLANT | Supply/Implant | $55,040.00 |
| 6159390 | SUPPLY IMPLANT | Supply/Implant | $806.40 |
| 6159392 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6159394 | SUPPLY IMPLANT | Supply/Implant | $1,792.00 |
| 6159398 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6159401 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159402 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159404 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159406 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159407 | SUPPLY IMPLANT | Supply/Implant | $83,660.80 |
| 6159411 | SUPPLY IMPLANT | Supply/Implant | $641.56 |
| 6159429 | SUPPLY IMPLANT | Supply/Implant | $19,200.00 |
| 6159430 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6159431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,638.40 |
| 6159432 | SUPPLY IMPLANT | Supply/Implant | $3,823.10 |
| 6159435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6159438 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159439 | SUPPLY IMPLANT | Supply/Implant | $1,690.24 |
| 6159445 | AMNIOTIC MEMBRANE | Supply/Implant | $23,040.00 |
| 6159446 | AMNIOTIC MEMBRANE | Supply/Implant | $40,960.00 |
| 6159447 | AMNIOTIC MEMBRANE | Supply/Implant | $53,120.00 |
| 6159458 | SUPPLY IMPLANT | Supply/Implant | $21,273.60 |
| 6159461 | SUPPLY IMPLANT | Supply/Implant | $698.24 |
| 6159463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,401.60 |
| 6159464 | INTRO/SHEATH, NON-LASER | Supply/Implant | $692.86 |
| 6159469 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6159475 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6159494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6159495 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6159498 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159499 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159500 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159500 | GENERAL SUPPLY | Supply/Implant | $4,648.45 |
| 6159501 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6159502 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159502 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159503 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159503 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159504 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6159505 | STERILE SUPPLY | Supply/Implant | $409.60 |
| 6159506 | STERILE SUPPLY | Supply/Implant | $338.30 |
| 6159506 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6159509 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159511 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159512 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159513 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,600.00 |
| 6159514 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6159515 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6159516 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6159518 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6159520 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6159524 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6159525 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $131,617.50 |
| 6159531 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6159532 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6159533 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6159534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6159537 | STERILE SUPPLY | Supply/Implant | $414.34 |
| 6159539 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6159540 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159541 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159542 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6159544 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6159547 | SUPPLY IMPLANT | Supply/Implant | $2,484.10 |
| 6159552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6159557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,248.00 |
| 6159565 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6159572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6159574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,763.20 |
| 6159575 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6159580 | GENERAL SUPPLY | Supply/Implant | $24,835.20 |
| 6159582 | SUPPLY IMPLANT | Supply/Implant | $151.83 |
| 6159583 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6159584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6159585 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6159586 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6159587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6159590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $720.64 |
| 6159592 | SUPPLY IMPLANT | Supply/Implant | $537.47 |
| 6159599 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159601 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159602 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159603 | STERILE SUPPLY | Supply/Implant | $216.96 |
| 6159610 | CLOSURE DEV, VASC | Supply/Implant | $3,072.00 |
| 6159611 | GENERAL SUPPLY | Supply/Implant | $2,035.20 |
| 6159612 | RET DEV, INSERTABLE | Supply/Implant | $4,608.00 |
| 6159614 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6159617 | STERILE SUPPLY | Supply/Implant | $214.27 |
| 6159623 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,265.60 |
| 6159624 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6159626 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6159634 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6159635 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $2,009.60 |
| 6159636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,014.40 |
| 6159649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,800.00 |
| 6159665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6159666 | SUPPLY IMPLANT | Supply/Implant | $31,948.80 |
| 6159667 | GENERAL SUPPLY | Supply/Implant | $6,515.20 |
| 6159669 | SUPPLY IMPLANT | Supply/Implant | $25,527.04 |
| 6159670 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6159671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6159672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6159674 | STERILE SUPPLY | Supply/Implant | $9,600.00 |
| 6159675 | GENERAL SUPPLY | Supply/Implant | $301.79 |
| 6159676 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6159677 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6159678 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6159680 | GUIDE WIRE | Supply/Implant | $8,640.00 |
| 6159682 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6159707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159715 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $256.00 |
| 6159719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6159720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6159721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6159723 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6159726 | EMBOLIZATION PROTECT SYST | Supply/Implant | $17,856.00 |
| 6159731 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159732 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159734 | SUPPLY IMPLANT | Supply/Implant | $25,472.00 |
| 6159738 | SUPPLY IMPLANT | Supply/Implant | $5,312.00 |
| 6159747 | SUPPLY IMPLANT | Supply/Implant | $16,640.00 |
| 6159749 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6159750 | CATHETER, GUIDING | Supply/Implant | $31,936.00 |
| 6159752 | GENERAL SUPPLY | Supply/Implant | $272.00 |
| 6159753 | GENERAL SUPPLY | Supply/Implant | $272.00 |
| 6159757 | SUPPLY IMPLANT | Supply/Implant | $17,136.00 |
| 6159761 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6159762 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6159763 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6159770 | SUPPLY IMPLANT | Supply/Implant | $21,888.00 |
| 6159784 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6159785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6159786 | SUPPLY IMPLANT | Supply/Implant | $11,648.00 |
| 6159787 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6159791 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $34,560.00 |
| 6159797 | STERILE SUPPLY | Supply/Implant | $3,863.42 |
| 6159800 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6159801 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6159803 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6159804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,494.40 |
| 6159806 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6159821 | GENERAL SUPPLY | Supply/Implant | $719.49 |
| 6159822 | GENERAL SUPPLY | Supply/Implant | $692.86 |
| 6159824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6159826 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6159827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6159829 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6159835 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6159836 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6159837 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6159840 | STERILE SUPPLY | Supply/Implant | $3,403.71 |
| 6159843 | SUPPLY IMPLANT | Supply/Implant | $17,971.20 |
| 6159844 | SUPPLY IMPLANT | Supply/Implant | $18,585.60 |
| 6159846 | SUPPLY IMPLANT | Supply/Implant | $21,350.40 |
| 6159847 | SUPPLY IMPLANT | Supply/Implant | $25,856.00 |
| 6159850 | STERILE SUPPLY | Supply/Implant | $10,816.00 |
| 6159852 | GUIDE WIRE | Supply/Implant | $2,048.00 |
| 6159853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,672.00 |
| 6159857 | SUPPLY IMPLANT | Supply/Implant | $452.10 |
| 6159859 | SUPPLY IMPLANT | Supply/Implant | $416.00 |
| 6159861 | STERILE SUPPLY | Supply/Implant | $1,885.13 |
| 6159862 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6159870 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,521.60 |
| 6159871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,521.60 |
| 6159872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,008.00 |
| 6159878 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6159885 | SUPPLY IMPLANT | Supply/Implant | $1,464.32 |
| 6159891 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6159892 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6159895 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6159896 | STERILE SUPPLY | Supply/Implant | $8,320.00 |
| 6159897 | SUPPLY IMPLANT | Supply/Implant | $10,816.00 |
| 6159898 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,492.80 |
| 6159900 | GENERAL SUPPLY | Supply/Implant | $1,000.96 |
| 6159901 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159902 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6159903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $96,908.80 |
| 6159904 | AQUEOUS SHUNT IMPLANT | Supply/Implant | $10,265.60 |
| 6159905 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6159911 | SUPPLY IMPLANT | Supply/Implant | $3,712.00 |
| 6159913 | PROSTHETIC IMPLANT NOS | Supply/Implant | $37,964.80 |
| 6159918 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6159919 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,366.40 |
| 6159920 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6159927 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6159928 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,784.64 |
| 6159929 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6159947 | SUPPLY IMPLANT | Supply/Implant | $13,058.18 |
| 6159948 | STERILE SUPPLY | Supply/Implant | $435.20 |
| 6159949 | STERILE SUPPLY | Supply/Implant | $435.20 |
| 6159950 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6159951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6159957 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $32,640.00 |
| 6159969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.00 |
| 6159970 | SUPPLY IMPLANT | Supply/Implant | $531,487.00 |
| 6159977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6159978 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6159981 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6159982 | SUPPLY IMPLANT | Supply/Implant | $36,633.60 |
| 6159985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $384.00 |
| 6159988 | SUPPLY IMPLANT | Supply/Implant | $238.08 |
| 6159992 | CATH, DRAINAGE | Supply/Implant | $1,028.35 |
| 6159994 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6159995 | INTRO/SHEATH, NON-LASER | Supply/Implant | $751.62 |
| 6159996 | INTRO/SHEATH, NON-LASER | Supply/Implant | $751.62 |
| 6160000 | INTRO/SHEATH, NON-LASER | Supply/Implant | $751.62 |
| 6160003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6160005 | STERILE SUPPLY | Supply/Implant | $190.89 |
| 6160006 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6160007 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6160009 | SUPPLY IMPLANT | Supply/Implant | $5,145.60 |
| 6160010 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6160012 | SUPPLY IMPLANT | Supply/Implant | $1,894.40 |
| 6160013 | GENERAL SUPPLY | Supply/Implant | $179.20 |
| 6160018 | GENERAL SUPPLY | Supply/Implant | $128.00 |
| 6160020 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6160021 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,316.16 |
| 6160022 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,956.80 |
| 6160023 | GUIDE WIRE | Supply/Implant | $583.68 |
| 6160024 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,664.00 |
| 6160025 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,664.00 |
| 6160026 | GASTRO/JEJUNO TUBE LOW-PRO | Supply/Implant | $1,088.00 |
| 6160027 | SUPPLY IMPLANT | Supply/Implant | $10,304.00 |
| 6160033 | GRAFT, VASCULAR | Supply/Implant | $6,515.20 |
| 6160040 | REP DEV, URINARY, W/SLING | Supply/Implant | $23,143.68 |
| 6160044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6160045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,080.00 |
| 6160047 | GUIDE WIRE | Supply/Implant | $1,088.00 |
| 6160051 | SUPPLY IMPLANT | Supply/Implant | $2,444.80 |
| 6160052 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $8,140.80 |
| 6160053 | GENERAL SUPPLY | Supply/Implant | $921.60 |
| 6160055 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6160059 | INTRO/SHEATH, NON-LASER | Supply/Implant | $929.28 |
| 6160061 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6160071 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6160073 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160075 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160076 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160077 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6160081 | CATHETER, GUIDING | Supply/Implant | $139.14 |
| 6160082 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6160083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6160084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,516.80 |
| 6160085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,312.00 |
| 6160088 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6160089 | INTRO/SHEATH, NON-LASER | Supply/Implant | $360.06 |
| 6160090 | SUPPLY IMPLANT | Supply/Implant | $42,240.00 |
| 6160091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $112,640.00 |
| 6160092 | SUPPLY IMPLANT | Supply/Implant | $76,847.87 |
| 6160093 | SUPPLY IMPLANT | Supply/Implant | $693.96 |
| 6160099 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $34,560.00 |
| 6160100 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6160102 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6160109 | SUPPLY IMPLANT | Supply/Implant | $8,966.40 |
| 6160110 | SUPPLY IMPLANT | Supply/Implant | $8,915.20 |
| 6160111 | SUPPLY IMPLANT | Supply/Implant | $8,915.20 |
| 6160112 | SUPPLY IMPLANT | Supply/Implant | $3,808.00 |
| 6160114 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6160115 | SUPPLY IMPLANT | Supply/Implant | $3,539.20 |
| 6160116 | SUPPLY IMPLANT | Supply/Implant | $2,009.60 |
| 6160117 | SUPPLY IMPLANT | Supply/Implant | $2,009.60 |
| 6160126 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6160128 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6160130 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6160132 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160143 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,296.00 |
| 6160152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6160153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6160154 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,889.60 |
| 6160156 | SUPPLY IMPLANT | Supply/Implant | $5,094.40 |
| 6160157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6160158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6160171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6160172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6160180 | SUPPLY IMPLANT | Supply/Implant | $320.51 |
| 6160183 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160184 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6160185 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6160186 | SUPPLY IMPLANT | Supply/Implant | $985.60 |
| 6160188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6160191 | GUIDE WIRE | Supply/Implant | $1,067.78 |
| 6160192 | CATH, DRAINAGE | Supply/Implant | $1,126.40 |
| 6160194 | SUPPLY IMPLANT | Supply/Implant | $5,888.00 |
| 6160204 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160205 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160206 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160207 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160208 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $752.00 |
| 6160209 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6160210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6160213 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6160219 | MESH (IMPLANTABLE) | Supply/Implant | $2,066.12 |
| 6160233 | AMNIOTIC MEMBRANE | Supply/Implant | $45,440.00 |
| 6160243 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6160252 | SUPPLY IMPLANT | Supply/Implant | $32,588.80 |
| 6160253 | SUPPLY IMPLANT | Supply/Implant | $32,780.80 |
| 6160254 | SUPPLY IMPLANT | Supply/Implant | $32,588.80 |
| 6160265 | SUPPLY IMPLANT | Supply/Implant | $35,302.40 |
| 6160267 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6160269 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6160270 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6160278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160280 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160283 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160286 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6160290 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160291 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6160292 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160294 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6160295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160297 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160312 | SUPPLY IMPLANT | Supply/Implant | $6,528.00 |
| 6160323 | SUPPLY IMPLANT | Supply/Implant | $27,253.12 |
| 6160325 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6160327 | CATHETER, GUIDING | Supply/Implant | $2,168.96 |
| 6160334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $573.44 |
| 6160335 | STERILE SUPPLY | Supply/Implant | $21,120.00 |
| 6160336 | STERILE SUPPLY | Supply/Implant | $14,080.00 |
| 6160337 | STERILE SUPPLY | Supply/Implant | $24,320.00 |
| 6160338 | STERILE SUPPLY | Supply/Implant | $14,080.00 |
| 6160340 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6160341 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160343 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6160344 | GENERAL SUPPLY | Supply/Implant | $763.39 |
| 6160345 | STERILE SUPPLY | Supply/Implant | $2,958.98 |
| 6160346 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $120,697.50 |
| 6160347 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $120,697.50 |
| 6160348 | PROSTHESIS, PENILE, NON-INF | Supply/Implant | $120,697.50 |
| 6160349 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6160350 | GUIDE WIRE | Supply/Implant | $10,880.00 |
| 6160351 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160354 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6160355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6160356 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6160361 | SUPPLY IMPLANT | Supply/Implant | $1,774.72 |
| 6160362 | SUPPLY IMPLANT | Supply/Implant | $2,120.32 |
| 6160367 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160368 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160369 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160370 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160371 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160373 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160374 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160375 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160376 | GRAFTJACKET SKIN SUB | Supply/Implant | $38,643.20 |
| 6160380 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6160384 | SUPPLY IMPLANT | Supply/Implant | $2,518.27 |
| 6160385 | SUPPLY IMPLANT | Supply/Implant | $61,804.16 |
| 6160386 | SUPPLY IMPLANT | Supply/Implant | $21,124.74 |
| 6160387 | SUPPLY IMPLANT | Supply/Implant | $21,307.90 |
| 6160388 | SUPPLY IMPLANT | Supply/Implant | $108,065.79 |
| 6160393 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6160394 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6160397 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160398 | GENERAL SUPPLY | Supply/Implant | $1,144.64 |
| 6160400 | GENERAL SUPPLY | Supply/Implant | $1,254.40 |
| 6160406 | STERILE SUPPLY | Supply/Implant | $1,109.27 |
| 6160407 | SUPPLY IMPLANT | Supply/Implant | $11,084.80 |
| 6160411 | GENERAL SUPPLY | Supply/Implant | $1,103.23 |
| 6160416 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6160423 | SUPPLY IMPLANT | Supply/Implant | $3,973.12 |
| 6160424 | SUPPLY IMPLANT | Supply/Implant | $3,071.23 |
| 6160427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,210.11 |
| 6160429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6160430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6160431 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160434 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160435 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160436 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160437 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160438 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6160439 | STERILE SUPPLY | Supply/Implant | $1,881.60 |
| 6160440 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6160442 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160443 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160444 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160445 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6160446 | SUPPLY IMPLANT | Supply/Implant | $5,222.40 |
| 6160447 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6160448 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6160449 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $604.16 |
| 6160450 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6160451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $394.24 |
| 6160454 | GUIDE WIRE | Supply/Implant | $1,228.80 |
| 6160456 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6160457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6160458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,004.80 |
| 6160459 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160460 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160462 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,833.60 |
| 6160463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160467 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160468 | SUPPLY IMPLANT | Supply/Implant | $31,969.28 |
| 6160470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $779.52 |
| 6160471 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6160472 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6160473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,438.40 |
| 6160474 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6160475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,631.68 |
| 6160476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,631.68 |
| 6160477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6160478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6160479 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6160480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160485 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,696.00 |
| 6160486 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160487 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6160488 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6160489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6160490 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,876.48 |
| 6160493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,317.44 |
| 6160494 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,080.00 |
| 6160497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6160498 | SUPPLY IMPLANT | Supply/Implant | $419.33 |
| 6160499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,224.00 |
| 6160500 | GRAFT, VASCULAR | Supply/Implant | $70,387.20 |
| 6160501 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6160502 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,736.00 |
| 6160503 | GRAFT, VASCULAR | Supply/Implant | $51,187.20 |
| 6160504 | SUPPLY IMPLANT | Supply/Implant | $7,667.20 |
| 6160505 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6160506 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6160508 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,579.20 |
| 6160509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,579.20 |
| 6160510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,971.20 |
| 6160511 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,200.00 |
| 6160512 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6160513 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,676.48 |
| 6160514 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6160515 | SUPPLY IMPLANT | Supply/Implant | $7,040.00 |
| 6160516 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,388.35 |
| 6160517 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160526 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6160527 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6160530 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,008.00 |
| 6160534 | SUPPLY IMPLANT | Supply/Implant | $5,107.20 |
| 6160535 | GUIDE WIRE | Supply/Implant | $912.38 |
| 6160536 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6160537 | INTRO/SHEATH, NON-LASER | Supply/Implant | $927.36 |
| 6160541 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6160542 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $28,816.13 |
| 6160543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160544 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6160545 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6160546 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6160547 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6160549 | GENERAL SUPPLY | Supply/Implant | $172.80 |
| 6160550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6160552 | STERILE SUPPLY | Supply/Implant | $243.58 |
| 6160553 | STERILE SUPPLY | Supply/Implant | $132.48 |
| 6160554 | STERILE SUPPLY | Supply/Implant | $145.15 |
| 6160555 | STERILE SUPPLY | Supply/Implant | $132.48 |
| 6160556 | STERILE SUPPLY | Supply/Implant | $356.20 |
| 6160558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160560 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6160561 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6160562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $529.02 |
| 6160563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6160564 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,352.26 |
| 6160565 | SUPPLY IMPLANT | Supply/Implant | $149.12 |
| 6160567 | SUPPLY IMPLANT | Supply/Implant | $746.62 |
| 6160568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6160569 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,758.40 |
| 6160570 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,686.40 |
| 6160576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $376.32 |
| 6160577 | SUPPLY IMPLANT | Supply/Implant | $20,416.00 |
| 6160578 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160579 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160580 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6160582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6160585 | MESH (IMPLANTABLE) | Supply/Implant | $11,493.12 |
| 6160587 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,219.20 |
| 6160588 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6160589 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6160590 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6160591 | SUPPLY IMPLANT | Supply/Implant | $7,360.00 |
| 6160592 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,912.00 |
| 6160593 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6160594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $704.00 |
| 6160595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6160596 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,520.00 |
| 6160597 | CATHETER, GUIDING | Supply/Implant | $1,774.08 |
| 6160598 | SUPPLY IMPLANT | Supply/Implant | $5,568.00 |
| 6160599 | SUPPLY IMPLANT | Supply/Implant | $9,049.60 |
| 6160601 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160602 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160604 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160608 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160611 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6160612 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160613 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160615 | SUPPLY IMPLANT | Supply/Implant | $1,088.00 |
| 6160617 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160619 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160620 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160621 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160622 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160623 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160624 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160625 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160631 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160634 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6160635 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6160636 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160637 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160639 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6160640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,520.00 |
| 6160645 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160647 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160648 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160649 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160653 | SUPPLY IMPLANT | Supply/Implant | $1,472.00 |
| 6160659 | SUPPLY IMPLANT | Supply/Implant | $550.40 |
| 6160662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6160663 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6160666 | GENERAL SUPPLY | Supply/Implant | $2,204.16 |
| 6160684 | INTERSPINOUS IMPLANT | Supply/Implant | $44,800.00 |
| 6160685 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6160686 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160687 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6160689 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,328.00 |
| 6160690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,810.24 |
| 6160691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160692 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $837.12 |
| 6160695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6160696 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6160697 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,420.80 |
| 6160698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,155.39 |
| 6160700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160702 | SUPPLY IMPLANT | Supply/Implant | $742.40 |
| 6160703 | SUPPLY IMPLANT | Supply/Implant | $2,624.00 |
| 6160704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6160705 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6160706 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6160708 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6160709 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6160710 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6160715 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6160719 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $30,156.80 |
| 6160720 | SUPPLY IMPLANT | Supply/Implant | $4,851.20 |
| 6160726 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,032.00 |
| 6160730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,259.20 |
| 6160731 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6160732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,528.00 |
| 6160733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,847.94 |
| 6160734 | SUPPLY IMPLANT | Supply/Implant | $2,437.12 |
| 6160735 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6160736 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6160737 | GENERAL SUPPLY | Supply/Implant | $3,993.60 |
| 6160738 | GENERAL SUPPLY | Supply/Implant | $1,938.05 |
| 6160739 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6160740 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6160741 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6160742 | SUPPLY IMPLANT | Supply/Implant | $159.62 |
| 6160745 | SUPPLY IMPLANT | Supply/Implant | $159.62 |
| 6160750 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6160754 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6160755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6160756 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6160757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6160758 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6160759 | PROSTHETIC IMPLANT NOS | Supply/Implant | $7,424.00 |
| 6160760 | SUPPLY IMPLANT | Supply/Implant | $4,339.20 |
| 6160767 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6160778 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $168,262.50 |
| 6160779 | SUPPLY IMPLANT | Supply/Implant | $2,406.40 |
| 6160780 | SUPPLY IMPLANT | Supply/Implant | $2,406.40 |
| 6160781 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $202,000.00 |
| 6160782 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $23,795.20 |
| 6160783 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6160784 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6160785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6160786 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6160787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6160788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6160789 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6160790 | SUPPLY IMPLANT | Supply/Implant | $2,144.00 |
| 6160791 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6160792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6160793 | SUPPLY IMPLANT | Supply/Implant | $320.00 |
| 6160794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6160795 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6160796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $640.00 |
| 6160797 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,000.00 |
| 6160798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,640.00 |
| 6160799 | SUPPLY IMPLANT | Supply/Implant | $4,800.00 |
| 6160800 | GENERAL SUPPLY | Supply/Implant | $1,088.00 |
| 6160801 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6160802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6160803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,827.20 |
| 6160805 | SUPPLY IMPLANT | Supply/Implant | $1,498.88 |
| 6160810 | INTRO/SHEATH, FIXED,NON-PEEL | Supply/Implant | $358.91 |
| 6160811 | GUIDE WIRE | Supply/Implant | $2,432.00 |
| 6160812 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6160817 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $71,360.00 |
| 6160821 | SUPPLY IMPLANT | Supply/Implant | $152.96 |
| 6160822 | STERILE SUPPLY | Supply/Implant | $2,240.00 |
| 6160824 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6160825 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6160826 | SUPPLY IMPLANT | Supply/Implant | $394.60 |
| 6160829 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6160830 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6160831 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6160832 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6160833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6160834 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6160838 | GENERAL SUPPLY | Supply/Implant | $1,127.68 |
| 6160841 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6160842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6160843 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6160844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6160845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6160846 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6160847 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,508.80 |
| 6160848 | SUPPLY IMPLANT | Supply/Implant | $229.89 |
| 6160849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,742.40 |
| 6160851 | INTERSPINOUS IMPLANT | Supply/Implant | $67,200.00 |
| 6160860 | SUPPLY IMPLANT | Supply/Implant | $29,632.00 |
| 6160863 | SUPPLY IMPLANT | Supply/Implant | $301.06 |
| 6160864 | INTRO/SHEATH, NON-LASER | Supply/Implant | $929.28 |
| 6160866 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6160874 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6160875 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6160879 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $13,440.00 |
| 6160880 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $13,440.00 |
| 6160881 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $13,440.00 |
| 6160886 | GENERAL SUPPLY | Supply/Implant | $607.82 |
| 6160888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,750.40 |
| 6160891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6160892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,456.00 |
| 6160894 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6160895 | INTERSPINOUS IMPLANT | Supply/Implant | $98,137.60 |
| 6160896 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6160897 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6160898 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6160899 | SUPPLY IMPLANT | Supply/Implant | $23,636.86 |
| 6160909 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160912 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160916 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160918 | GRAFT, VASCULAR | Supply/Implant | $166,342.89 |
| 6160930 | SUPPLY IMPLANT | Supply/Implant | $17,856.00 |
| 6160931 | GRAFT, VASCULAR | Supply/Implant | $73,920.00 |
| 6160986 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6160987 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6160988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,600.00 |
| 6160997 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6160998 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6160999 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6161000 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6161002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,166.34 |
| 6161012 | SUPPLY IMPLANT | Supply/Implant | $226.66 |
| 6161014 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6161018 | SUPPLY IMPLANT | Supply/Implant | $92,096.00 |
| 6161019 | GENERAL SUPPLY | Supply/Implant | $233.73 |
| 6161023 | SUPPLY IMPLANT | Supply/Implant | $54,445.82 |
| 6161028 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6161029 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6161030 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6161031 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,201.28 |
| 6161032 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6161033 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,230.21 |
| 6161034 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6161035 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161038 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6161039 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6161040 | SUPPLY IMPLANT | Supply/Implant | $6,485.12 |
| 6161041 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,251.26 |
| 6161042 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6161043 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161044 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161045 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161046 | SUPPLY IMPLANT | Supply/Implant | $41,600.00 |
| 6161047 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6161048 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161049 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6161050 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6161051 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $98,176.00 |
| 6161052 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6161053 | SUPPLY IMPLANT | Supply/Implant | $5,632.00 |
| 6161060 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6161061 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6161062 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6161063 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6161064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161065 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,231.81 |
| 6161066 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,297.09 |
| 6161067 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,297.09 |
| 6161068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,430.02 |
| 6161069 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,459.20 |
| 6161071 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161072 | PROSTHETIC IMPLANT NOS | Supply/Implant | $4,310.78 |
| 6161073 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161074 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161075 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161078 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6161079 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,128.00 |
| 6161080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $63,219.20 |
| 6161081 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,198.08 |
| 6161082 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,506.24 |
| 6161083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6161084 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6161085 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,734.40 |
| 6161086 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6161087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6161088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6161089 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6161091 | SUPPLY IMPLANT | Supply/Implant | $22,720.00 |
| 6161092 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6161093 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6161094 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6161095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161098 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161100 | SUPPLY IMPLANT | Supply/Implant | $20,428.80 |
| 6161102 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6161103 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6161104 | SUPPLY IMPLANT | Supply/Implant | $183,750.00 |
| 6161105 | STERILE SUPPLY | Supply/Implant | $6,400.00 |
| 6161106 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6161107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6161111 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6161113 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6161114 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $35,200.00 |
| 6161115 | STERILE SUPPLY | Supply/Implant | $736.00 |
| 6161116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $118,080.00 |
| 6161117 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161118 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161119 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,736.00 |
| 6161121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $44,736.00 |
| 6161122 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6161123 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6161125 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6161126 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6161127 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $135,240.00 |
| 6161128 | GRAFT, VASCULAR | Supply/Implant | $43,888.00 |
| 6161129 | SUPPLY IMPLANT | Supply/Implant | $1,251.84 |
| 6161130 | SUPPLY IMPLANT | Supply/Implant | $691.20 |
| 6161131 | SUPPLY IMPLANT | Supply/Implant | $11,699.20 |
| 6161132 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6161134 | SUPPLY IMPLANT | Supply/Implant | $4,518.40 |
| 6161136 | GENERAL SUPPLY | Supply/Implant | $459.26 |
| 6161137 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6161141 | STERILE SUPPLY | Supply/Implant | $244.74 |
| 6161153 | STERILE SUPPLY | Supply/Implant | $146.94 |
| 6161154 | STERILE SUPPLY | Supply/Implant | $237.31 |
| 6161156 | GENERAL SUPPLY | Supply/Implant | $395.52 |
| 6161157 | GUIDE WIRE | Supply/Implant | $2,380.80 |
| 6161158 | SUPPLY IMPLANT | Supply/Implant | $31,910.40 |
| 6161159 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6161162 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6161163 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161165 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161166 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,689.60 |
| 6161167 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6161168 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6161169 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6161170 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6161171 | SUPPLY IMPLANT | Supply/Implant | $9,216.00 |
| 6161172 | SUPPLY IMPLANT | Supply/Implant | $16,640.00 |
| 6161173 | SUPPLY IMPLANT | Supply/Implant | $21,954.56 |
| 6161178 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6161179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6161180 | SUPPLY IMPLANT | Supply/Implant | $644.35 |
| 6161182 | INTERSPINOUS IMPLANT | Supply/Implant | $60,480.00 |
| 6161183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,643.20 |
| 6161184 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6161185 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $672.00 |
| 6161186 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,536.00 |
| 6161187 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6161188 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6161189 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $6,630.40 |
| 6161190 | STERILE SUPPLY | Supply/Implant | $238.08 |
| 6161202 | SUPPLY IMPLANT | Supply/Implant | $28,544.00 |
| 6161210 | SUPPLY IMPLANT | Supply/Implant | $1,360.00 |
| 6161211 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161212 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6161213 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6161217 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6161223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161224 | SUPPLY IMPLANT | Supply/Implant | $4,488.58 |
| 6161225 | SUPPLY IMPLANT | Supply/Implant | $1,670.40 |
| 6161226 | SUPPLY IMPLANT | Supply/Implant | $1,414.27 |
| 6161227 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6161228 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,536.64 |
| 6161229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161231 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161232 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6161236 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6161237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161238 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6161239 | PROSTHESIS, PENILE, INFLATAB | Supply/Implant | $103,833.60 |
| 6161240 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6161241 | SUPPLY IMPLANT | Supply/Implant | $15,705.60 |
| 6161242 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6161243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,170.56 |
| 6161244 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $17,280.00 |
| 6161245 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161246 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161247 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6161248 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $51,136.00 |
| 6161249 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,439.74 |
| 6161250 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6161251 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6161255 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6161259 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6161260 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6161261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6161262 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6161263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $985.60 |
| 6161265 | SUPPLY IMPLANT | Supply/Implant | $640.00 |
| 6161266 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6161275 | SUPPLY IMPLANT | Supply/Implant | $20,121.60 |
| 6161276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6161279 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6161292 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $10,880.00 |
| 6161293 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161294 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161295 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6161296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161297 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161298 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6161299 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6161302 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6161304 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161305 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161306 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161307 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6161309 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6161310 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6161311 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,412.80 |
| 6161313 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $3,840.00 |
| 6161314 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $4,864.00 |
| 6161317 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161318 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161319 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6161320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6161321 | SUPPLY IMPLANT | Supply/Implant | $35,840.00 |
| 6161325 | SUPPLY IMPLANT | Supply/Implant | $76,847.87 |
| 6161326 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6161327 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6161328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6161331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161332 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161334 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161336 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161340 | STERILE SUPPLY | Supply/Implant | $31,290.88 |
| 6161341 | STERILE SUPPLY | Supply/Implant | $5,371.10 |
| 6161344 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161346 | STERILE SUPPLY | Supply/Implant | $5,599.58 |
| 6161347 | SUPPLY IMPLANT | Supply/Implant | $5,599.58 |
| 6161348 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6161349 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6161351 | SUPPLY IMPLANT | Supply/Implant | $250.32 |
| 6161352 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6161353 | SUPPLY IMPLANT | Supply/Implant | $8,512.00 |
| 6161354 | CATH EP COOL-TIP | Supply/Implant | $36,480.00 |
| 6161356 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6161357 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6161358 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6161359 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6161361 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161362 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161366 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6161373 | SUPPLY IMPLANT | Supply/Implant | $57,600.00 |
| 6161374 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6161375 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6161376 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6161377 | SUPPLY IMPLANT | Supply/Implant | $57,600.00 |
| 6161378 | SUPPLY IMPLANT | Supply/Implant | $12,787.20 |
| 6161379 | CORNEAL TISSUE PROCESSING | Supply/Implant | $53,760.00 |
| 6161380 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161382 | SUPPLY IMPLANT | Supply/Implant | $692.22 |
| 6161383 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6161384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6161392 | MESH (IMPLANTABLE) | Supply/Implant | $27,860.35 |
| 6161403 | SUPPLY IMPLANT | Supply/Implant | $5,030.40 |
| 6161404 | SUPPLY IMPLANT | Supply/Implant | $4,044.80 |
| 6161405 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,507.20 |
| 6161406 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,507.20 |
| 6161407 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,965.76 |
| 6161409 | STERILE SUPPLY | Supply/Implant | $793.60 |
| 6161410 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6161411 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161412 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161413 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6161414 | SUPPLY IMPLANT | Supply/Implant | $2,564.22 |
| 6161415 | SUPPLY IMPLANT | Supply/Implant | $43,626.88 |
| 6161417 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161418 | INTRO/SHEATH, NON-LASER | Supply/Implant | $664.45 |
| 6161420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6161421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6161423 | GUIDE WIRE | Supply/Implant | $1,856.00 |
| 6161424 | SUPPLY IMPLANT | Supply/Implant | $4,399.10 |
| 6161425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6161426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161430 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161431 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161432 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,360.00 |
| 6161433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,010.56 |
| 6161434 | SUPPLY IMPLANT | Supply/Implant | $10,777.60 |
| 6161435 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,492.48 |
| 6161436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,416.00 |
| 6161438 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,992.00 |
| 6161440 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161442 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161452 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,198.40 |
| 6161453 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,958.59 |
| 6161454 | STERILE SUPPLY | Supply/Implant | $6,543.36 |
| 6161456 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6161457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,411.52 |
| 6161459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $110,668.80 |
| 6161460 | SUPPLY IMPLANT | Supply/Implant | $3,745.28 |
| 6161461 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6161462 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6161463 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,608.00 |
| 6161464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6161465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6161466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6161469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161470 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161480 | SUPPLY IMPLANT | Supply/Implant | $24,499.20 |
| 6161481 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6161482 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6161483 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161485 | GUIDE WIRE | Supply/Implant | $136.58 |
| 6161486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6161487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,100.80 |
| 6161488 | SUPPLY IMPLANT | Supply/Implant | $3,644.80 |
| 6161489 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,400.00 |
| 6161490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6161494 | GENERAL SUPPLY | Supply/Implant | $240.64 |
| 6161495 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6161497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,292.80 |
| 6161499 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,227.20 |
| 6161500 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6161501 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $20,108.80 |
| 6161502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6161503 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6161513 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161514 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161515 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161516 | SUPPLY IMPLANT | Supply/Implant | $2,828.80 |
| 6161528 | LEAD, AICD, ENDO SINGLE COIL | Supply/Implant | $36,307.20 |
| 6161531 | SUPPLY IMPLANT | Supply/Implant | $128.00 |
| 6161533 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6161534 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6161535 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6161536 | SUPPLY IMPLANT | Supply/Implant | $12,864.00 |
| 6161537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161538 | GUIDE WIRE | Supply/Implant | $960.00 |
| 6161539 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,400.00 |
| 6161540 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,800.00 |
| 6161541 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,752.00 |
| 6161543 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6161545 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161546 | SUPPLY IMPLANT | Supply/Implant | $268.80 |
| 6161547 | SUPPLY IMPLANT | Supply/Implant | $2,176.00 |
| 6161548 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,848.00 |
| 6161549 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6161550 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6161555 | SUPPLY IMPLANT | Supply/Implant | $353,500.00 |
| 6161556 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6161557 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6161558 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,017.86 |
| 6161559 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6161560 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6161561 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,737.60 |
| 6161565 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,630.40 |
| 6161566 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6161567 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6161568 | GENERAL SUPPLY | Supply/Implant | $642.43 |
| 6161569 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161570 | SUPPLY IMPLANT | Supply/Implant | $1,984.00 |
| 6161571 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $40,960.00 |
| 6161572 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $40,960.00 |
| 6161575 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6161586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6161587 | SUPPLY IMPLANT | Supply/Implant | $60,160.00 |
| 6161588 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6161589 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6161591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6161592 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6161593 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6161594 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6161601 | SUPPLY IMPLANT | Supply/Implant | $1,939.20 |
| 6161602 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $76,992.00 |
| 6161603 | STERILE SUPPLY | Supply/Implant | $1,676.83 |
| 6161604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6161605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6161606 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161607 | SUPPLY IMPLANT | Supply/Implant | $38,400.00 |
| 6161608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161610 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6161612 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161613 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161614 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161615 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161616 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161617 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161618 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161619 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161620 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161621 | SUPPLY IMPLANT | Supply/Implant | $14,694.40 |
| 6161623 | SUPPLY IMPLANT | Supply/Implant | $14,528.00 |
| 6161624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161626 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,120.00 |
| 6161627 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,120.00 |
| 6161632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,000.32 |
| 6161636 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,017.86 |
| 6161638 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,017.86 |
| 6161653 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6161654 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,432.00 |
| 6161655 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6161656 | SUPPLY IMPLANT | Supply/Implant | $186.24 |
| 6161657 | SUPPLY IMPLANT | Supply/Implant | $2,368.00 |
| 6161658 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6161659 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6161660 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,321.15 |
| 6161663 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,780.80 |
| 6161664 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $127,526.40 |
| 6161665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6161666 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6161667 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,078.72 |
| 6161668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,440.64 |
| 6161670 | SUPPLY IMPLANT | Supply/Implant | $2,752.00 |
| 6161671 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161672 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161673 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6161674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6161676 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161677 | SUPPLY IMPLANT | Supply/Implant | $3,220.74 |
| 6161692 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6161694 | SUPPLY IMPLANT | Supply/Implant | $22,515.20 |
| 6161695 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161696 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6161697 | SUPPLY IMPLANT | Supply/Implant | $6,336.00 |
| 6161698 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,238.40 |
| 6161699 | SUPPLY IMPLANT | Supply/Implant | $69,504.00 |
| 6161700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6161701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6161702 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6161706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161709 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6161710 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6161711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161712 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161713 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6161714 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161715 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6161716 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6161718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,521.60 |
| 6161719 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,190.40 |
| 6161720 | SUPPLY IMPLANT | Supply/Implant | $118,976.00 |
| 6161721 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6161723 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6161724 | STERILE SUPPLY | Supply/Implant | $2,150.40 |
| 6161727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6161728 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,411.52 |
| 6161729 | SUPPLY IMPLANT | Supply/Implant | $197,925.00 |
| 6161731 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,589.44 |
| 6161732 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,420.80 |
| 6161733 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $985.60 |
| 6161734 | GENERAL SUPPLY | Supply/Implant | $832.00 |
| 6161735 | SUPPLY IMPLANT | Supply/Implant | $10,585.60 |
| 6161736 | GEN, NEURO, NON-HF RECHG BAT | Supply/Implant | $267,650.00 |
| 6161737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161738 | SUPPLY IMPLANT | Supply/Implant | $6,937.60 |
| 6161739 | SUPPLY IMPLANT | Supply/Implant | $6,937.60 |
| 6161742 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6161743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,355.52 |
| 6161746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6161747 | SUPPLY IMPLANT | Supply/Implant | $41,600.00 |
| 6161748 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6161749 | SUPPLY IMPLANT | Supply/Implant | $3,968.00 |
| 6161750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6161751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6161752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6161753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,096.00 |
| 6161754 | SUPPLY IMPLANT | Supply/Implant | $1,098.88 |
| 6161755 | STERILE SUPPLY | Supply/Implant | $59,456.00 |
| 6161756 | GEN, NEURO, NON-HF RECHG BAT | Supply/Implant | $12,800.00 |
| 6161757 | PATIENT PROGR, NEUROSTIM | Supply/Implant | $12,800.00 |
| 6161760 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6161761 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6161762 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6161764 | SUPPLY IMPLANT | Supply/Implant | $3,010.56 |
| 6161766 | SUPPLY IMPLANT | Supply/Implant | $19,578.88 |
| 6161767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,317.76 |
| 6161771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6161772 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,643.20 |
| 6161774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6161775 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,240.00 |
| 6161781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6161782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6161785 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,400.00 |
| 6161786 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,400.00 |
| 6161787 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6161790 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6161796 | GRAFT, VASCULAR | Supply/Implant | $24,808.96 |
| 6161801 | INTERSPINOUS IMPLANT | Supply/Implant | $49,920.00 |
| 6161802 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6161803 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6161805 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6161806 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6161807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6161809 | CATHETER, GUIDING | Supply/Implant | $14,310.40 |
| 6161810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,233.60 |
| 6161813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,267.20 |
| 6161814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,611.52 |
| 6161815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6161816 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,611.52 |
| 6161817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6161818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6161819 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161820 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161822 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6161824 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,809.60 |
| 6161825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $564.22 |
| 6161826 | SUPPLY IMPLANT | Supply/Implant | $2,149.89 |
| 6161828 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6161829 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,259.20 |
| 6161831 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6161832 | SUPPLY IMPLANT | Supply/Implant | $8,678.40 |
| 6161835 | SUPPLY IMPLANT | Supply/Implant | $13,096.96 |
| 6161847 | SUPPLY IMPLANT | Supply/Implant | $1,781.76 |
| 6161850 | SUPPLY IMPLANT | Supply/Implant | $4,216.32 |
| 6161853 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161854 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161855 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161856 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6161859 | SUPPLY IMPLANT | Supply/Implant | $25,344.00 |
| 6161861 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6161862 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6161865 | SUPPLY IMPLANT | Supply/Implant | $753.59 |
| 6161866 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $88,464.64 |
| 6161867 | GENERAL SUPPLY | Supply/Implant | $176.58 |
| 6161870 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161871 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6161876 | SUPPLY IMPLANT | Supply/Implant | $6,379.52 |
| 6161878 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6161879 | SUPPLY IMPLANT | Supply/Implant | $9,740.80 |
| 6161882 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $15,360.00 |
| 6161884 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6161886 | GUIDE WIRE | Supply/Implant | $1,365.76 |
| 6161887 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161888 | GRAFT, VASCULAR | Supply/Implant | $77,824.00 |
| 6161890 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6161891 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6161892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6161900 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6161901 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6161902 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6161903 | GUIDE WIRE | Supply/Implant | $2,291.20 |
| 6161904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,139.20 |
| 6161905 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,132.80 |
| 6161906 | SUPPLY IMPLANT | Supply/Implant | $82,214.40 |
| 6161907 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161908 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161909 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161910 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161911 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161913 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161914 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161915 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161917 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161918 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161920 | INTRO/SHEATH, NON-LASER | Supply/Implant | $873.60 |
| 6161921 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6161922 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6161923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6161924 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161930 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6161931 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6161932 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6161933 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6161934 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,603.20 |
| 6161935 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,520.00 |
| 6161936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6161937 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,072.00 |
| 6161939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6161940 | SUPPLY IMPLANT | Supply/Implant | $2,383.36 |
| 6161941 | GUIDE WIRE | Supply/Implant | $1,925.12 |
| 6161942 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161943 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6161944 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6161945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6161946 | SUPPLY IMPLANT | Supply/Implant | $26,880.00 |
| 6161947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6161948 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6161949 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6161950 | AUD OSSEO DEV INT/EXT COMP | Supply/Implant | $40,668.29 |
| 6161953 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6161954 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6161955 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6161956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,184.00 |
| 6161957 | GENERAL SUPPLY | Supply/Implant | $4,672.00 |
| 6161960 | CATHETER, GUIDING | Supply/Implant | $320.00 |
| 6161963 | SUPPLY IMPLANT | Supply/Implant | $3,939.42 |
| 6161968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,831.36 |
| 6161969 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,456.64 |
| 6161970 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161971 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161974 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161975 | SUPPLY IMPLANT | Supply/Implant | $25,024.00 |
| 6161980 | SUPPLY IMPLANT | Supply/Implant | $627.20 |
| 6161981 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6161982 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6161983 | SUPPLY IMPLANT | Supply/Implant | $11,870.08 |
| 6161984 | SUPPLY IMPLANT | Supply/Implant | $19,136.00 |
| 6161985 | SUPPLY IMPLANT | Supply/Implant | $6,310.40 |
| 6161986 | SUPPLY IMPLANT | Supply/Implant | $11,200.00 |
| 6161987 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6161988 | CATH, INTRA ECHOCARDIOGRAPHY | Supply/Implant | $23,680.00 |
| 6161990 | GENERAL SUPPLY | Supply/Implant | $972.80 |
| 6161991 | GENERAL SUPPLY | Supply/Implant | $972.80 |
| 6161992 | SUPPLY IMPLANT | Supply/Implant | $2,472.70 |
| 6161995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,056.00 |
| 6161996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,964.80 |
| 6161997 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6161998 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6161999 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6162000 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $50,150.40 |
| 6162001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,320.00 |
| 6162003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,387.20 |
| 6162005 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6162006 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6162007 | SUPPLY IMPLANT | Supply/Implant | $28,800.00 |
| 6162008 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6162009 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6162010 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6162011 | SUPPLY IMPLANT | Supply/Implant | $32,000.00 |
| 6162012 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6162013 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6162014 | GUIDE WIRE | Supply/Implant | $576.00 |
| 6162015 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6162017 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162020 | GENERAL SUPPLY | Supply/Implant | $793.60 |
| 6162022 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6162023 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6162024 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6162025 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6162026 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6162027 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6162029 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,937.60 |
| 6162034 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162035 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162037 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162039 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162040 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,709.44 |
| 6162041 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6162042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162043 | MESH (IMPLANTABLE) | Supply/Implant | $66,496.00 |
| 6162044 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6162045 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6162046 | SUPPLY IMPLANT | Supply/Implant | $55,949.44 |
| 6162047 | SUPPLY IMPLANT | Supply/Implant | $73,728.00 |
| 6162048 | SUPPLY IMPLANT | Supply/Implant | $7,052.80 |
| 6162049 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6162051 | GUIDE WIRE | Supply/Implant | $1,937.86 |
| 6162055 | SUPPLY IMPLANT | Supply/Implant | $450.56 |
| 6162058 | SUPPLY IMPLANT | Supply/Implant | $31,215.49 |
| 6162060 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,523.20 |
| 6162061 | SUPPLY IMPLANT | Supply/Implant | $1,923.84 |
| 6162062 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,643.20 |
| 6162063 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6162064 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6162067 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6162068 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162069 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162071 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6162072 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6162073 | SUPPLY IMPLANT | Supply/Implant | $1,024.00 |
| 6162074 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6162075 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6162076 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6162077 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6162078 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162079 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162080 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162081 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162082 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162083 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162084 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6162085 | SUPPLY IMPLANT | Supply/Implant | $64,000.00 |
| 6162086 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6162087 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6162088 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162092 | SUPPLY IMPLANT | Supply/Implant | $25,872.00 |
| 6162094 | SUPPLY IMPLANT | Supply/Implant | $1,657.60 |
| 6162095 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,040.00 |
| 6162096 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6162097 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6162098 | GRAFT, VASCULAR | Supply/Implant | $188,475.00 |
| 6162102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $832.00 |
| 6162103 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162104 | INTERSPINOUS IMPLANT | Supply/Implant | $134,400.00 |
| 6162105 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6162107 | SUPPLY IMPLANT | Supply/Implant | $2,585.60 |
| 6162109 | SUPPLY IMPLANT | Supply/Implant | $2,363.14 |
| 6162111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6162112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,195.20 |
| 6162113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6162114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6162115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,392.00 |
| 6162116 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,059.20 |
| 6162117 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162118 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6162119 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $39,590.40 |
| 6162121 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,928.64 |
| 6162122 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,400.00 |
| 6162125 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6162126 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6162129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,784.00 |
| 6162130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,784.00 |
| 6162131 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6162132 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6162133 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6162134 | SUPPLY IMPLANT | Supply/Implant | $25,049.60 |
| 6162135 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6162136 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6162137 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6162139 | SUPPLY IMPLANT | Supply/Implant | $3,326.46 |
| 6162140 | STERILE SUPPLY | Supply/Implant | $832.00 |
| 6162144 | STERILE SUPPLY | Supply/Implant | $3,609.60 |
| 6162145 | STERILE SUPPLY | Supply/Implant | $4,480.00 |
| 6162146 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6162147 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6162148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6162149 | INTERSPINOUS IMPLANT | Supply/Implant | $60,480.00 |
| 6162150 | INTERSPINOUS IMPLANT | Supply/Implant | $60,480.00 |
| 6162151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6162152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162154 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6162155 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6162156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6162157 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162158 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162159 | SUPPLY IMPLANT | Supply/Implant | $9,920.00 |
| 6162160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6162161 | STERILE SUPPLY | Supply/Implant | $896.00 |
| 6162163 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162164 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162165 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162166 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,371.20 |
| 6162168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,366.40 |
| 6162169 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6162170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $550.40 |
| 6162172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6162173 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6162174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6162178 | ALLODERM SKIN SUB | Supply/Implant | $65,369.60 |
| 6162179 | ALLODERM SKIN SUB | Supply/Implant | $37,465.60 |
| 6162180 | ALLODERM SKIN SUB | Supply/Implant | $37,465.60 |
| 6162185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,242.88 |
| 6162186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,858.56 |
| 6162187 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6162188 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $266.37 |
| 6162189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6162190 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6162191 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,419.20 |
| 6162192 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,248.00 |
| 6162220 | SUPPLY IMPLANT | Supply/Implant | $146,947.50 |
| 6162221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,560.00 |
| 6162222 | SUPPLY IMPLANT | Supply/Implant | $8,320.00 |
| 6162223 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,520.00 |
| 6162224 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,960.00 |
| 6162225 | SUPPLY IMPLANT | Supply/Implant | $1,003.52 |
| 6162226 | SUPPLY IMPLANT | Supply/Implant | $1,003.52 |
| 6162227 | STERILE SUPPLY | Supply/Implant | $912.26 |
| 6162228 | SUPPLY IMPLANT | Supply/Implant | $2,547.20 |
| 6162240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,768.00 |
| 6162241 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6162242 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6162243 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,720.00 |
| 6162245 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6162250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6162251 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162252 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162255 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162256 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6162257 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6162258 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,638.40 |
| 6162259 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,118.40 |
| 6162260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6162263 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162264 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,989.12 |
| 6162265 | SUPPLY IMPLANT | Supply/Implant | $2,150.40 |
| 6162271 | SUPPLY IMPLANT | Supply/Implant | $19,578.88 |
| 6162272 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,666.56 |
| 6162275 | SUPPLY IMPLANT | Supply/Implant | $2,543.04 |
| 6162276 | SUPPLY IMPLANT | Supply/Implant | $2,543.04 |
| 6162277 | SUPPLY IMPLANT | Supply/Implant | $1,875.52 |
| 6162278 | SUPPLY IMPLANT | Supply/Implant | $1,875.52 |
| 6162280 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,311.81 |
| 6162287 | MESH (IMPLANTABLE) | Supply/Implant | $22,272.51 |
| 6162288 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6162289 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $326.40 |
| 6162290 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6162291 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162292 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6162293 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,664.00 |
| 6162294 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6162295 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6162298 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162299 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162300 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162301 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162302 | SUPPLY IMPLANT | Supply/Implant | $3,113.98 |
| 6162303 | SUPPLY IMPLANT | Supply/Implant | $2,311.81 |
| 6162305 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6162306 | SUPPLY IMPLANT | Supply/Implant | $3,826.56 |
| 6162307 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6162309 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6162312 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6162313 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162314 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6162315 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,492.16 |
| 6162316 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,163.52 |
| 6162317 | PROSTHESIS, BREAST, IMP | Supply/Implant | $21,056.00 |
| 6162318 | PROSTHESIS, BREAST, IMP | Supply/Implant | $21,056.00 |
| 6162319 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6162320 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6162321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6162322 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6162323 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162324 | SUPPLY IMPLANT | Supply/Implant | $466.94 |
| 6162327 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162333 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6162334 | GENERAL SUPPLY | Supply/Implant | $1,088.00 |
| 6162335 | SUPPLY IMPLANT | Supply/Implant | $7,667.20 |
| 6162337 | SUPPLY IMPLANT | Supply/Implant | $5,145.60 |
| 6162342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6162344 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162345 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162346 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162348 | GUIDE WIRE | Supply/Implant | $1,365.76 |
| 6162355 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6162356 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6162358 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $501.12 |
| 6162359 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $501.12 |
| 6162360 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $501.12 |
| 6162361 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,352.00 |
| 6162364 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162366 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162367 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162373 | SUPPLY IMPLANT | Supply/Implant | $1,152.00 |
| 6162374 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,662.72 |
| 6162379 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $4,217.09 |
| 6162387 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6162388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,944.00 |
| 6162389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,944.00 |
| 6162390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162395 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6162416 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6162417 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162418 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6162419 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,980.61 |
| 6162420 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6162422 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $86,976.00 |
| 6162427 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162428 | SUPPLY IMPLANT | Supply/Implant | $20,646.40 |
| 6162429 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162430 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162431 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6162432 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6162433 | CATH EP 19 OR FEW ELECTRODES | Supply/Implant | $19,200.00 |
| 6162434 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $5,760.00 |
| 6162435 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6162438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,305.34 |
| 6162440 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162441 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,670.40 |
| 6162442 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6162443 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6162444 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162445 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162447 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6162450 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6162451 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6162455 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $386.43 |
| 6162458 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6162460 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6162461 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6162462 | SUPPLY IMPLANT | Supply/Implant | $4,902.40 |
| 6162463 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6162464 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6162465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6162466 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6162467 | SUPPLY IMPLANT | Supply/Implant | $1,745.28 |
| 6162468 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6162469 | SUPPLY IMPLANT | Supply/Implant | $1,766.40 |
| 6162470 | SUPPLY IMPLANT | Supply/Implant | $844.80 |
| 6162471 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6162472 | SUPPLY IMPLANT | Supply/Implant | $1,228.80 |
| 6162473 | SUPPLY IMPLANT | Supply/Implant | $2,995.20 |
| 6162474 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $8,896.00 |
| 6162475 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,805.44 |
| 6162476 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,961.60 |
| 6162477 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,235.20 |
| 6162478 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162479 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162480 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6162481 | SUPPLY IMPLANT | Supply/Implant | $8,384.00 |
| 6162482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6162483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6162484 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6162485 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,380.80 |
| 6162486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6162487 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6162488 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6162489 | NEURAWRAP NERVE PROTECTOR,CM | Supply/Implant | $25,123.20 |
| 6162490 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,760.00 |
| 6162491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6162492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6162493 | SUPPLY IMPLANT | Supply/Implant | $131,160.75 |
| 6162494 | SUPPLY IMPLANT | Supply/Implant | $10,137.60 |
| 6162495 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6162496 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6162497 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6162500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,331.20 |
| 6162501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,331.20 |
| 6162502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,227.20 |
| 6162503 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6162504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162506 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162507 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162508 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162509 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162515 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162516 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162518 | RET DEV, INSERTABLE | Supply/Implant | $21,696.00 |
| 6162528 | SUPPLY IMPLANT | Supply/Implant | $4,710.40 |
| 6162529 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6162531 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6162532 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6162533 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6162534 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6162535 | SUPPLY IMPLANT | Supply/Implant | $2,016.00 |
| 6162536 | SUPPLY IMPLANT | Supply/Implant | $30,080.00 |
| 6162537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6162560 | SUPPLY IMPLANT | Supply/Implant | $6,272.00 |
| 6162580 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6162581 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6162582 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $26,508.80 |
| 6162584 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6162588 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162589 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162594 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,178.11 |
| 6162598 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162599 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162600 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162601 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162602 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6162603 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6162604 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6162605 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162606 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6162607 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,022.40 |
| 6162608 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6162609 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6162610 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162611 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6162612 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6162615 | SUPPLY IMPLANT | Supply/Implant | $70,400.00 |
| 6162616 | INTRO/SHEATH, NON-LASER | Supply/Implant | $4,902.40 |
| 6162617 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162618 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162621 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162630 | SUPPLY IMPLANT | Supply/Implant | $14,400.00 |
| 6162632 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162633 | SUPPLY IMPLANT | Supply/Implant | $173.18 |
| 6162641 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6162642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,598.40 |
| 6162643 | SUPPLY IMPLANT | Supply/Implant | $6,464.00 |
| 6162644 | SUPPLY IMPLANT | Supply/Implant | $6,464.00 |
| 6162645 | SUPPLY IMPLANT | Supply/Implant | $3,404.80 |
| 6162646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $205,380.00 |
| 6162647 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,339.20 |
| 6162662 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162663 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162669 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162671 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162672 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162675 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162677 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162684 | SUPPLY IMPLANT | Supply/Implant | $4,896.00 |
| 6162706 | SUPPLY IMPLANT | Supply/Implant | $1,128.96 |
| 6162709 | SUPPLY IMPLANT | Supply/Implant | $1,290.24 |
| 6162714 | SUPPLY IMPLANT | Supply/Implant | $36,864.00 |
| 6162717 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,546.24 |
| 6162718 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6162719 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6162720 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,480.00 |
| 6162721 | GENERAL SUPPLY | Supply/Implant | $1,254.91 |
| 6162722 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6162723 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6162724 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6162726 | CATH, TRANSLUMIN NON-LASER | Supply/Implant | $1,216.00 |
| 6162734 | STERILE SUPPLY | Supply/Implant | $597.80 |
| 6162736 | STERILE SUPPLY | Supply/Implant | $931.71 |
| 6162737 | STERILE SUPPLY | Supply/Implant | $931.71 |
| 6162738 | STERILE SUPPLY | Supply/Implant | $1,026.05 |
| 6162739 | STERILE SUPPLY | Supply/Implant | $575.87 |
| 6162742 | STERILE SUPPLY | Supply/Implant | $653.31 |
| 6162743 | STERILE SUPPLY | Supply/Implant | $312.90 |
| 6162745 | STERILE SUPPLY | Supply/Implant | $1,636.86 |
| 6162747 | STERILE SUPPLY | Supply/Implant | $1,454.08 |
| 6162748 | STERILE SUPPLY | Supply/Implant | $1,164.54 |
| 6162749 | STERILE SUPPLY | Supply/Implant | $1,912.32 |
| 6162750 | STERILE SUPPLY | Supply/Implant | $5,521.41 |
| 6162751 | STERILE SUPPLY | Supply/Implant | $4,252.16 |
| 6162753 | SUPPLY IMPLANT | Supply/Implant | $1,078.14 |
| 6162754 | SUPPLY IMPLANT | Supply/Implant | $985.73 |
| 6162756 | STERILE SUPPLY | Supply/Implant | $1,840.00 |
| 6162757 | STERILE SUPPLY | Supply/Implant | $835.84 |
| 6162758 | STERILE SUPPLY | Supply/Implant | $2,409.34 |
| 6162759 | STERILE SUPPLY | Supply/Implant | $2,771.33 |
| 6162762 | STERILE SUPPLY | Supply/Implant | $1,238.27 |
| 6162763 | STERILE SUPPLY | Supply/Implant | $2,205.31 |
| 6162764 | STERILE SUPPLY | Supply/Implant | $3,672.70 |
| 6162765 | STERILE SUPPLY | Supply/Implant | $1,977.73 |
| 6162766 | STERILE SUPPLY | Supply/Implant | $1,344.51 |
| 6162767 | SUPPLY IMPLANT | Supply/Implant | $1,069.44 |
| 6162768 | SUPPLY IMPLANT | Supply/Implant | $1,562.37 |
| 6162769 | SUPPLY IMPLANT | Supply/Implant | $3,241.47 |
| 6162770 | SUPPLY IMPLANT | Supply/Implant | $4,024.83 |
| 6162771 | SUPPLY IMPLANT | Supply/Implant | $2,359.94 |
| 6162772 | SUPPLY IMPLANT | Supply/Implant | $2,457.60 |
| 6162773 | STERILE SUPPLY | Supply/Implant | $1,274.50 |
| 6162775 | SUPPLY IMPLANT | Supply/Implant | $1,329.54 |
| 6162776 | SUPPLY IMPLANT | Supply/Implant | $874.11 |
| 6162777 | SUPPLY IMPLANT | Supply/Implant | $1,390.34 |
| 6162779 | SUPPLY IMPLANT | Supply/Implant | $1,257.69 |
| 6162780 | STERILE SUPPLY | Supply/Implant | $567.04 |
| 6162781 | STERILE SUPPLY | Supply/Implant | $513.79 |
| 6162782 | STERILE SUPPLY | Supply/Implant | $457.86 |
| 6162784 | STERILE SUPPLY | Supply/Implant | $552.00 |
| 6162789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6162796 | SUPPLY IMPLANT | Supply/Implant | $5,440.00 |
| 6162809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,012.35 |
| 6162810 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6162811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,003.84 |
| 6162812 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6162813 | SUPPLY IMPLANT | Supply/Implant | $47,766.40 |
| 6162814 | STERILE SUPPLY | Supply/Implant | $396.80 |
| 6162815 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6162816 | ALGINATE DRSG >16 <=48 SQ IN | Supply/Implant | $285.70 |
| 6162817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6162818 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6162819 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6162820 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6162821 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6162828 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6162832 | STERILE SUPPLY | Supply/Implant | $576.00 |
| 6162838 | GENERAL SUPPLY | Supply/Implant | $1,216.00 |
| 6162839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6162840 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6162842 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6162843 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6162844 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6162845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6162846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6162847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6162848 | SUPPLY IMPLANT | Supply/Implant | $1,726.59 |
| 6162849 | SUPPLY IMPLANT | Supply/Implant | $34,048.00 |
| 6162850 | SUPPLY IMPLANT | Supply/Implant | $15,680.00 |
| 6162851 | SUPPLY IMPLANT | Supply/Implant | $23,040.00 |
| 6162856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6162861 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6162862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6162865 | SUPPLY IMPLANT | Supply/Implant | $2,304.00 |
| 6162871 | GUIDE WIRE | Supply/Implant | $819.20 |
| 6162872 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,152.00 |
| 6162873 | SUPPLY IMPLANT | Supply/Implant | $6,049.66 |
| 6162874 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6162875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6162876 | SUPPLY IMPLANT | Supply/Implant | $358.40 |
| 6162879 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162880 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162881 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162882 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162883 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $484.74 |
| 6162887 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $2,862.08 |
| 6162888 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,595.20 |
| 6162889 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6162890 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,177.60 |
| 6162891 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162893 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162894 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,673.60 |
| 6162895 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6162896 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162901 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,235.26 |
| 6162902 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6162903 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,298.88 |
| 6162904 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6162905 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,280.00 |
| 6162907 | MESH (IMPLANTABLE) | Supply/Implant | $110,162.05 |
| 6162908 | MESH (IMPLANTABLE) | Supply/Implant | $126,416.90 |
| 6162910 | MESH (IMPLANTABLE) | Supply/Implant | $109,730.78 |
| 6162911 | SUPPLY IMPLANT | Supply/Implant | $17,248.00 |
| 6162912 | SUPPLY IMPLANT | Supply/Implant | $115,080.32 |
| 6162913 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6162914 | SUPPLY IMPLANT | Supply/Implant | $4,147.20 |
| 6162915 | SUPPLY IMPLANT | Supply/Implant | $4,147.20 |
| 6162916 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $512.00 |
| 6162920 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6162922 | SUPPLY IMPLANT | Supply/Implant | $4,399.10 |
| 6162924 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6162927 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,072.00 |
| 6162930 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,356.48 |
| 6162932 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6162933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,251.20 |
| 6162934 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,251.20 |
| 6162935 | SUPPLY IMPLANT | Supply/Implant | $6,016.00 |
| 6162939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,638.40 |
| 6162940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162941 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162942 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6162943 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6162944 | SUPPLY IMPLANT | Supply/Implant | $10,649.60 |
| 6162945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162946 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6162947 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6162948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6162949 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $99,673.60 |
| 6162950 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $76,864.00 |
| 6162951 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,944.00 |
| 6162952 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6162954 | SUPPLY IMPLANT | Supply/Implant | $3,340.80 |
| 6162955 | SUPPLY IMPLANT | Supply/Implant | $3,225.60 |
| 6162956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,772.16 |
| 6162966 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,481.60 |
| 6162967 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,880.00 |
| 6162968 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6162970 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6162971 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,392.00 |
| 6162972 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,392.00 |
| 6162973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6162974 | SUPPLY IMPLANT | Supply/Implant | $2,612.48 |
| 6162975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6162976 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6162977 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6162980 | SUPPLY IMPLANT | Supply/Implant | $15,557.12 |
| 6162984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,702.40 |
| 6162985 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6162987 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6162989 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162990 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6162994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,515.20 |
| 6162995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6162997 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163000 | SUPPLY IMPLANT | Supply/Implant | $7,296.00 |
| 6163002 | STERILE SUPPLY | Supply/Implant | $226.05 |
| 6163003 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,968.00 |
| 6163005 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6163008 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,632.00 |
| 6163019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6163032 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6163036 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,561.60 |
| 6163078 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6163079 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6163080 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6163081 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6163082 | SUPPLY IMPLANT | Supply/Implant | $386.43 |
| 6163083 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6163087 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6163088 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6163090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,815.36 |
| 6163091 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163092 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163093 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163094 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163097 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6163098 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $53,849.60 |
| 6163100 | INTERSPINOUS IMPLANT | Supply/Implant | $17,600.00 |
| 6163101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,568.32 |
| 6163102 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,888.00 |
| 6163103 | GENERAL SUPPLY | Supply/Implant | $314.37 |
| 6163104 | GENERAL SUPPLY | Supply/Implant | $400.04 |
| 6163105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,120.00 |
| 6163106 | GUIDE WIRE | Supply/Implant | $1,925.12 |
| 6163107 | SUPPLY IMPLANT | Supply/Implant | $2,383.36 |
| 6163108 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6163109 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6163111 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6163113 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,920.00 |
| 6163114 | STERILE SUPPLY | Supply/Implant | $621.39 |
| 6163116 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6163117 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,716.48 |
| 6163126 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6163128 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6163130 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,568.00 |
| 6163131 | STENT, NON-COAT/COV W/O DEL | Supply/Implant | $13,568.00 |
| 6163133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,294.40 |
| 6163134 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6163135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,712.00 |
| 6163136 | INTERSPINOUS IMPLANT | Supply/Implant | $46,080.00 |
| 6163137 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,276.80 |
| 6163139 | SUPPLY IMPLANT | Supply/Implant | $37,849.60 |
| 6163142 | SUPPLY IMPLANT | Supply/Implant | $2,612.48 |
| 6163143 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6163147 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163148 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163149 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163150 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6163151 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6163152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6163153 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,833.60 |
| 6163155 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6163156 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,228.48 |
| 6163157 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $183,750.00 |
| 6163159 | SUPPLY IMPLANT | Supply/Implant | $7,667.20 |
| 6163160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6163161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6163162 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,606.08 |
| 6163163 | SUPPLY IMPLANT | Supply/Implant | $2,435.58 |
| 6163164 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6163167 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,412.99 |
| 6163168 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,317.38 |
| 6163172 | SUPPLY IMPLANT | Supply/Implant | $8,502.40 |
| 6163173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163174 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163175 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163178 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6163179 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,030.40 |
| 6163180 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,395.20 |
| 6163182 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163183 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6163184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6163185 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6163186 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,768.00 |
| 6163187 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6163192 | PMKR, SINGLE, RATE-RESP | Supply/Implant | $128,625.00 |
| 6163195 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6163196 | SUPPLY IMPLANT | Supply/Implant | $11,520.00 |
| 6163197 | SUPPLY IMPLANT | Supply/Implant | $6,784.00 |
| 6163198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6163199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,788.80 |
| 6163200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,788.80 |
| 6163201 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6163202 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,863.68 |
| 6163205 | SUPPLY IMPLANT | Supply/Implant | $24,576.00 |
| 6163206 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163207 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,200.00 |
| 6163209 | SUPPLY IMPLANT | Supply/Implant | $41,894.40 |
| 6163210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,934.40 |
| 6163211 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,854.40 |
| 6163215 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163217 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6163218 | INTERSPINOUS IMPLANT | Supply/Implant | $29,376.00 |
| 6163219 | SUPPLY IMPLANT | Supply/Implant | $27,200.00 |
| 6163220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163221 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163222 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163223 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163224 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163225 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6163226 | SUPPLY IMPLANT | Supply/Implant | $39,936.00 |
| 6163227 | SUPPLY IMPLANT | Supply/Implant | $5,171.20 |
| 6163228 | SUPPLY IMPLANT | Supply/Implant | $6,963.20 |
| 6163229 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,203.20 |
| 6163230 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,392.00 |
| 6163231 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6163232 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6163233 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6163234 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6163235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6163236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6163237 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $27,520.00 |
| 6163238 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6163239 | SUPPLY IMPLANT | Supply/Implant | $15,872.00 |
| 6163240 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6163241 | SUPPLY IMPLANT | Supply/Implant | $2,419.20 |
| 6163242 | BRACHYTHERAPY NEEDLE | Supply/Implant | $151.30 |
| 6163243 | BRACHYTHERAPY NEEDLE | Supply/Implant | $151.30 |
| 6163244 | BRACHYTHERAPY NEEDLE | Supply/Implant | $169.68 |
| 6163245 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6163246 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6163248 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6163250 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6163262 | GUIDE WIRE | Supply/Implant | $1,856.00 |
| 6163263 | SUPPLY IMPLANT | Supply/Implant | $5,365.76 |
| 6163264 | SUPPLY IMPLANT | Supply/Implant | $1,751.04 |
| 6163265 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163267 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163268 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6163269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,280.00 |
| 6163270 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163271 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163272 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163273 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,408.00 |
| 6163276 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6163277 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163278 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163279 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163280 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163282 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163283 | SUPPLY IMPLANT | Supply/Implant | $166.40 |
| 6163284 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,896.00 |
| 6163285 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6163286 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6163287 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163288 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6163289 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163290 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163291 | SUPPLY IMPLANT | Supply/Implant | $4,787.20 |
| 6163292 | OCULAR IMPLANT | Supply/Implant | $8,256.00 |
| 6163293 | INTERSPINOUS IMPLANT | Supply/Implant | $57,600.00 |
| 6163296 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $40,908.80 |
| 6163300 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6163302 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,049.28 |
| 6163303 | SUPPLY IMPLANT | Supply/Implant | $1,704.52 |
| 6163304 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,160.00 |
| 6163305 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,851.84 |
| 6163306 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6163307 | SUPPLY IMPLANT | Supply/Implant | $5,799.04 |
| 6163308 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6163309 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,451.46 |
| 6163310 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6163312 | SUPPLY IMPLANT | Supply/Implant | $6,466.82 |
| 6163313 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6163314 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6163315 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,780.74 |
| 6163318 | SUPPLY IMPLANT | Supply/Implant | $1,523.20 |
| 6163319 | STERILE SUPPLY | Supply/Implant | $2,368.00 |
| 6163320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,720.00 |
| 6163321 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,595.20 |
| 6163322 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,408.00 |
| 6163325 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6163326 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163327 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6163328 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163330 | SUPPLY IMPLANT | Supply/Implant | $1,231.36 |
| 6163332 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6163333 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $11,456.00 |
| 6163334 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,480.00 |
| 6163335 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6163336 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6163337 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $74,313.60 |
| 6163338 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163339 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,280.00 |
| 6163340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,720.00 |
| 6163342 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163343 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163344 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6163349 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $10,579.20 |
| 6163350 | SUPPLY IMPLANT | Supply/Implant | $1,389.57 |
| 6163351 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,503.36 |
| 6163352 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6163353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,397.76 |
| 6163354 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6163355 | SUPPLY IMPLANT | Supply/Implant | $2,867.20 |
| 6163356 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6163357 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6163358 | SUPPLY IMPLANT | Supply/Implant | $20,838.40 |
| 6163359 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6163360 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $57,122.56 |
| 6163361 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,766.40 |
| 6163362 | GENERAL SUPPLY | Supply/Implant | $328.64 |
| 6163364 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6163365 | SUPPLY IMPLANT | Supply/Implant | $1,754.88 |
| 6163366 | SUPPLY IMPLANT | Supply/Implant | $7,513.60 |
| 6163367 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,624.00 |
| 6163368 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,624.00 |
| 6163370 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,164.80 |
| 6163371 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,800.00 |
| 6163372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,752.00 |
| 6163373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,083.20 |
| 6163374 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,536.00 |
| 6163375 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,649.60 |
| 6163376 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163377 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163378 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163379 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6163380 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6163381 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6163382 | SUPPLY IMPLANT | Supply/Implant | $2,262.40 |
| 6163383 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,948.80 |
| 6163384 | SUPPLY IMPLANT | Supply/Implant | $15,805.44 |
| 6163385 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $60,800.00 |
| 6163386 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,752.00 |
| 6163387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,425.41 |
| 6163388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6163389 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6163390 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6163391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6163392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6163393 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163394 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163395 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6163396 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6163397 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,440.00 |
| 6163398 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6163403 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,595.20 |
| 6163404 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,954.56 |
| 6163416 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6163417 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163419 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6163420 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6163425 | SUPPLY IMPLANT | Supply/Implant | $32,640.00 |
| 6163426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,083.20 |
| 6163427 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,094.72 |
| 6163428 | SUPPLY IMPLANT | Supply/Implant | $60,487.68 |
| 6163429 | SUPPLY IMPLANT | Supply/Implant | $49,497.60 |
| 6163431 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163432 | SUPPLY IMPLANT | Supply/Implant | $36,774.40 |
| 6163433 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6163436 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163437 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163438 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6163439 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163441 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,347.20 |
| 6163444 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163445 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163446 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163447 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6163448 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6163455 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6163456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,899.20 |
| 6163457 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6163458 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6163459 | PROSTHETIC IMPLANT NOS | Supply/Implant | $28,096.00 |
| 6163460 | SUPPLY IMPLANT | Supply/Implant | $7,820.80 |
| 6163464 | STERILE SUPPLY | Supply/Implant | $6,272.00 |
| 6163465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,635.20 |
| 6163466 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6163467 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6163468 | SUPPLY IMPLANT | Supply/Implant | $47,040.00 |
| 6163469 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,280.00 |
| 6163470 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,720.00 |
| 6163471 | SUPPLY IMPLANT | Supply/Implant | $5,616.00 |
| 6163472 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,992.00 |
| 6163473 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163474 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163475 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6163478 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,864.00 |
| 6163481 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6163482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,392.00 |
| 6163483 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,520.00 |
| 6163484 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,520.00 |
| 6163486 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6163487 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6163488 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6163489 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,960.00 |
| 6163490 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $64,166.40 |
| 6163491 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6163492 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6163493 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,589.44 |
| 6163495 | SUPPLY IMPLANT | Supply/Implant | $5,184.00 |
| 6163496 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6163497 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6163499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6163500 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6163501 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6163502 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6163503 | SUPPLY IMPLANT | Supply/Implant | $24,960.00 |
| 6163504 | SUPPLY IMPLANT | Supply/Implant | $4,928.00 |
| 6163506 | GENERAL SUPPLY | Supply/Implant | $6,272.00 |
| 6163507 | GENERAL SUPPLY | Supply/Implant | $6,272.00 |
| 6163508 | GENERAL SUPPLY | Supply/Implant | $6,400.00 |
| 6163509 | GENERAL SUPPLY | Supply/Implant | $6,400.00 |
| 6163510 | GENERAL SUPPLY | Supply/Implant | $7,040.00 |
| 6163512 | SUPPLY IMPLANT | Supply/Implant | $2,543.04 |
| 6163514 | SUPPLY IMPLANT | Supply/Implant | $2,316.80 |
| 6163515 | SUPPLY IMPLANT | Supply/Implant | $3,072.00 |
| 6163516 | STERILE SUPPLY | Supply/Implant | $550.40 |
| 6163517 | STERILE SUPPLY | Supply/Implant | $4,006.40 |
| 6163518 | STERILE SUPPLY | Supply/Implant | $27,916.80 |
| 6163519 | STERILE SUPPLY | Supply/Implant | $2,944.00 |
| 6163520 | STERILE SUPPLY | Supply/Implant | $1,408.00 |
| 6163521 | STERILE SUPPLY | Supply/Implant | $384.00 |
| 6163522 | STERILE SUPPLY | Supply/Implant | $1,382.40 |
| 6163523 | STERILE SUPPLY | Supply/Implant | $908.80 |
| 6163524 | STERILE SUPPLY | Supply/Implant | $3,648.00 |
| 6163525 | STERILE SUPPLY | Supply/Implant | $93,388.80 |
| 6163526 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163527 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,250.43 |
| 6163530 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,288.00 |
| 6163585 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6163586 | GENERAL SUPPLY | Supply/Implant | $285.25 |
| 6163588 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6163589 | SUPPLY IMPLANT | Supply/Implant | $13,145.60 |
| 6163592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6163593 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6163595 | SUPPLY IMPLANT | Supply/Implant | $31,936.00 |
| 6163596 | SUPPLY IMPLANT | Supply/Implant | $19,619.84 |
| 6163597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6163599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6163600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $573.44 |
| 6163603 | SUPPLY IMPLANT | Supply/Implant | $1,003.52 |
| 6163604 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6163605 | SUPPLY IMPLANT | Supply/Implant | $2,257.92 |
| 6163607 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,547.20 |
| 6163608 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6163613 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,211.39 |
| 6163614 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,725.70 |
| 6163615 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6163616 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6163618 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6163620 | STERILE SUPPLY | Supply/Implant | $134.53 |
| 6163621 | SUPPLY IMPLANT | Supply/Implant | $6,823.68 |
| 6163623 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6163624 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6163625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,430.40 |
| 6163626 | STERILE SUPPLY | Supply/Implant | $4,697.60 |
| 6163627 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6163628 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6163629 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6163630 | SUPPLY IMPLANT | Supply/Implant | $1,715.20 |
| 6163633 | SUPPLY IMPLANT | Supply/Implant | $581.76 |
| 6163634 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6163635 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6163636 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6163637 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6163638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6163639 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6163640 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6163641 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6163642 | SUPPLY IMPLANT | Supply/Implant | $125,685.00 |
| 6163643 | SUPPLY IMPLANT | Supply/Implant | $10,764.80 |
| 6163644 | SUPPLY IMPLANT | Supply/Implant | $2,688.00 |
| 6163645 | SUPPLY IMPLANT | Supply/Implant | $5,888.00 |
| 6163646 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6163647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6163648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6163649 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6163651 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6163652 | SUPPLY IMPLANT | Supply/Implant | $645.12 |
| 6163653 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6163654 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6163656 | SUPPLY IMPLANT | Supply/Implant | $20,787.20 |
| 6163660 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6163678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,659.33 |
| 6163679 | STERILE SUPPLY | Supply/Implant | $1,152.00 |
| 6163684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163686 | GENERAL SUPPLY | Supply/Implant | $2,432.00 |
| 6163687 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6163688 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $761.60 |
| 6163690 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,055.10 |
| 6163692 | SUPPLY IMPLANT | Supply/Implant | $243.20 |
| 6163693 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,978.24 |
| 6163694 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,843.20 |
| 6163695 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,311.62 |
| 6163696 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163697 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6163698 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6163699 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6163700 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6163701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6163702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6163704 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6163707 | CATHETER, GUIDING | Supply/Implant | $21,760.00 |
| 6163709 | BRACHYTHERAPY NEEDLE | Supply/Implant | $211.20 |
| 6163710 | STERILE SUPPLY | Supply/Implant | $134.53 |
| 6163711 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163712 | SUPPLY IMPLANT | Supply/Implant | $10,180.74 |
| 6163714 | STERILE SUPPLY | Supply/Implant | $504.32 |
| 6163716 | STERILE SUPPLY | Supply/Implant | $1,408.00 |
| 6163717 | STERILE SUPPLY | Supply/Implant | $768.00 |
| 6163720 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6163721 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6163722 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6163723 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,778.88 |
| 6163724 | STERILE SUPPLY | Supply/Implant | $422.40 |
| 6163727 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6163728 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6163729 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6163730 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163732 | SUPPLY IMPLANT | Supply/Implant | $1,344.00 |
| 6163733 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6163734 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6163737 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6163738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6163742 | SUPPLY IMPLANT | Supply/Implant | $20,070.40 |
| 6163743 | STENT, NON-COR, TEM W/DEL SY | Supply/Implant | $2,547.20 |
| 6163744 | STERILE SUPPLY | Supply/Implant | $598.02 |
| 6163746 | SUPPLY IMPLANT | Supply/Implant | $3,010.94 |
| 6163747 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6163750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6163751 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6163752 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,216.00 |
| 6163753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6163754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6163755 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,188.80 |
| 6163756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6163757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $28,672.00 |
| 6163762 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $84,128.00 |
| 6163763 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $63,219.20 |
| 6163764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,198.08 |
| 6163765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $46,506.24 |
| 6163766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6163767 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,084.80 |
| 6163768 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $37,734.40 |
| 6163769 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6163770 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6163771 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,488.00 |
| 6163773 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,880.00 |
| 6163774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6163775 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6163776 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163777 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6163778 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6163779 | GENERAL SUPPLY | Supply/Implant | $247.19 |
| 6163780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6163781 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6163782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6163783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6163784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6163785 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6163786 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163787 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6163788 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6163789 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6163790 | GENERAL SUPPLY | Supply/Implant | $259.84 |
| 6163793 | SUPPLY IMPLANT | Supply/Implant | $328,250.00 |
| 6163794 | SUPPLY IMPLANT | Supply/Implant | $396.80 |
| 6163795 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6163796 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,161.60 |
| 6163797 | SUPPLY IMPLANT | Supply/Implant | $13,948.54 |
| 6163798 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6163799 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6163807 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6163808 | GUIDE WIRE | Supply/Implant | $311.30 |
| 6163809 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163810 | AMNIOTIC MEMBRANE | Supply/Implant | $13,824.00 |
| 6163817 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,728.00 |
| 6163818 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,392.00 |
| 6163819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,392.00 |
| 6163820 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,728.00 |
| 6163821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6163822 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $37,760.00 |
| 6163823 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6163825 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163826 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163827 | INTERSPINOUS IMPLANT | Supply/Implant | $27,200.00 |
| 6163828 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6163829 | INTRO/SHEATH, NON-LASER | Supply/Implant | $1,280.00 |
| 6163831 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $564.22 |
| 6163832 | SUPPLY IMPLANT | Supply/Implant | $66,688.00 |
| 6163833 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,648.00 |
| 6163834 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6163835 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6163848 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6163850 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6163852 | SUPPLY IMPLANT | Supply/Implant | $30,881.28 |
| 6163853 | SUPPLY IMPLANT | Supply/Implant | $2,363.14 |
| 6163857 | PROSTHESIS, BREAST, IMP | Supply/Implant | $14,016.00 |
| 6163859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163862 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6163864 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6163865 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6163868 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6163869 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6163870 | SUPPLY IMPLANT | Supply/Implant | $5,145.60 |
| 6163871 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6163872 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,504.00 |
| 6163875 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $972.80 |
| 6163876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $665.60 |
| 6163878 | SUPPLY IMPLANT | Supply/Implant | $4,019.20 |
| 6163879 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6163880 | SUPPLY IMPLANT | Supply/Implant | $15,557.12 |
| 6163881 | GENERAL SUPPLY | Supply/Implant | $640.00 |
| 6163882 | GUIDE WIRE | Supply/Implant | $256.00 |
| 6163883 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6163886 | SUPPLY IMPLANT | Supply/Implant | $3,392.00 |
| 6163887 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6163890 | GRAFT, VASCULAR | Supply/Implant | $162,750.00 |
| 6163891 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6163901 | SUPPLY IMPLANT | Supply/Implant | $60,800.00 |
| 6163902 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6163903 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6163904 | CATH, DRAINAGE | Supply/Implant | $512.00 |
| 6163905 | SUPPLY IMPLANT | Supply/Implant | $69,184.00 |
| 6163906 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6163907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,776.00 |
| 6163908 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6163910 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6163911 | SUPPLY IMPLANT | Supply/Implant | $94,707.20 |
| 6163912 | GENERAL SUPPLY | Supply/Implant | $1,242.88 |
| 6163913 | GENERAL SUPPLY | Supply/Implant | $1,242.88 |
| 6163914 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,124.42 |
| 6163915 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6163916 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6163917 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6163918 | SUPPLY IMPLANT | Supply/Implant | $2,393.60 |
| 6163919 | SUPPLY IMPLANT | Supply/Implant | $1,536.00 |
| 6163920 | SUPPLY IMPLANT | Supply/Implant | $256.00 |
| 6163921 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,004.80 |
| 6163922 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,126.40 |
| 6163923 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163924 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163925 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163926 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6163927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6163931 | GENERAL SUPPLY | Supply/Implant | $11,970.56 |
| 6163932 | GENERAL SUPPLY | Supply/Implant | $18,833.92 |
| 6163933 | GENERAL SUPPLY | Supply/Implant | $94,169.60 |
| 6163934 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6163935 | SUPPLY IMPLANT | Supply/Implant | $21,760.00 |
| 6163936 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6163937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,500.10 |
| 6163938 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6163939 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,600.00 |
| 6163940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,806.72 |
| 6163941 | GENERAL SUPPLY | Supply/Implant | $4,881.79 |
| 6163942 | GENERAL SUPPLY | Supply/Implant | $6,170.75 |
| 6163943 | SUPPLY IMPLANT | Supply/Implant | $54,400.00 |
| 6163945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $742.40 |
| 6163946 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6163947 | GENERAL SUPPLY | Supply/Implant | $36,111.87 |
| 6163948 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6163949 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6163951 | GENERAL SUPPLY | Supply/Implant | $147.20 |
| 6163952 | GENERAL SUPPLY | Supply/Implant | $7,680.00 |
| 6163953 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6163954 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,572.29 |
| 6163956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,160.00 |
| 6163957 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6163958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6163959 | SUPPLY IMPLANT | Supply/Implant | $38,336.00 |
| 6163960 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6163961 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6163962 | SUPPLY IMPLANT | Supply/Implant | $460.80 |
| 6163963 | SUPPLY IMPLANT | Supply/Implant | $3,840.00 |
| 6163964 | SUPPLY IMPLANT | Supply/Implant | $8,832.00 |
| 6163965 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6163966 | SUPPLY IMPLANT | Supply/Implant | $17,331.20 |
| 6163968 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6163969 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6163970 | SUPPLY IMPLANT | Supply/Implant | $23,142.40 |
| 6163972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,939.20 |
| 6163973 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,398.40 |
| 6163975 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,671.42 |
| 6163977 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,589.44 |
| 6163978 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6163979 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6163980 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $624.00 |
| 6163981 | GENERAL SUPPLY | Supply/Implant | $28,795.52 |
| 6163982 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163983 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6163984 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,787.20 |
| 6163985 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6163986 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6163987 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6163988 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,928.64 |
| 6163989 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6163990 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6163993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6163994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163995 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163996 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163997 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,959.68 |
| 6163998 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,136.00 |
| 6163999 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6164000 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6164001 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164002 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164003 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164004 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164005 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $21,056.00 |
| 6164006 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,880.00 |
| 6164008 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6164010 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6164014 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164015 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6164016 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6164017 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,804.80 |
| 6164018 | SUPPLY IMPLANT | Supply/Implant | $25,510.40 |
| 6164019 | SUPPLY IMPLANT | Supply/Implant | $22,080.00 |
| 6164020 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,864.00 |
| 6164021 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $217.60 |
| 6164022 | SUPPLY IMPLANT | Supply/Implant | $4,860.67 |
| 6164026 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,092.80 |
| 6164027 | SUPPLY IMPLANT | Supply/Implant | $13,414.40 |
| 6164028 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6164029 | SUPPLY IMPLANT | Supply/Implant | $5,248.00 |
| 6164032 | SUPPLY IMPLANT | Supply/Implant | $2,816.00 |
| 6164039 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6164040 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6164041 | SUPPLY IMPLANT | Supply/Implant | $9,600.00 |
| 6164042 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,040.00 |
| 6164043 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164044 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164045 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164046 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,752.00 |
| 6164049 | SUPPLY IMPLANT | Supply/Implant | $537.60 |
| 6164050 | STERILE SUPPLY | Supply/Implant | $6,927.36 |
| 6164052 | SUPPLY IMPLANT | Supply/Implant | $5,037.44 |
| 6164056 | GENERAL SUPPLY | Supply/Implant | $742.40 |
| 6164066 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $576.00 |
| 6164067 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6164068 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6164070 | CATH OCCLUSION | Supply/Implant | $2,560.00 |
| 6164079 | SUPPLY IMPLANT | Supply/Implant | $1,449.98 |
| 6164082 | SUPPLY IMPLANT | Supply/Implant | $716.80 |
| 6164084 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,851.84 |
| 6164087 | GENERAL SUPPLY | Supply/Implant | $320.00 |
| 6164089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6164102 | GENERAL SUPPLY | Supply/Implant | $2,016.00 |
| 6164103 | SUPPLY IMPLANT | Supply/Implant | $1,178.11 |
| 6164104 | SUPPLY IMPLANT | Supply/Implant | $1,178.11 |
| 6164105 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6164107 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,096.00 |
| 6164115 | SUPPLY IMPLANT | Supply/Implant | $44,064.00 |
| 6164121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,007.04 |
| 6164127 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6164128 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6164129 | SUPPLY IMPLANT | Supply/Implant | $674.05 |
| 6164142 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164144 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164153 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6164156 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6164157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6164158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6164159 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,536.00 |
| 6164161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,736.45 |
| 6164162 | GRAFT, VASCULAR | Supply/Implant | $72,947.20 |
| 6164163 | SUPPLY IMPLANT | Supply/Implant | $832.90 |
| 6164165 | CATHETER, GUIDING | Supply/Implant | $7,168.00 |
| 6164168 | SUPPLY IMPLANT | Supply/Implant | $1,454.21 |
| 6164185 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6164186 | SUPPLY IMPLANT | Supply/Implant | $3,269.58 |
| 6164189 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6164194 | STERILE SUPPLY | Supply/Implant | $24,487.68 |
| 6164200 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164204 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164205 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6164208 | SUPPLY IMPLANT | Supply/Implant | $33,454.08 |
| 6164218 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6164220 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164221 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,376.00 |
| 6164235 | MESH (IMPLANTABLE) | Supply/Implant | $3,402.24 |
| 6164240 | GASTRO/JEJUNO TUBE, STD | Supply/Implant | $1,662.72 |
| 6164244 | MESH (IMPLANTABLE) | Supply/Implant | $16,410.88 |
| 6164246 | MESH (IMPLANTABLE) | Supply/Implant | $3,095.04 |
| 6164248 | MESH (IMPLANTABLE) | Supply/Implant | $3,095.04 |
| 6164249 | MESH (IMPLANTABLE) | Supply/Implant | $3,402.24 |
| 6164260 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,806.72 |
| 6164261 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,894.72 |
| 6164262 | GENERAL SUPPLY | Supply/Implant | $573.31 |
| 6164274 | SUPPLY IMPLANT | Supply/Implant | $5,037.57 |
| 6164276 | CATHETER, GUIDING | Supply/Implant | $147.20 |
| 6164279 | STERILE SUPPLY | Supply/Implant | $141.06 |
| 6164282 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6164283 | GENERAL SUPPLY | Supply/Implant | $215.42 |
| 6164289 | STERILE SUPPLY | Supply/Implant | $647.55 |
| 6164292 | STERILE SUPPLY | Supply/Implant | $229.89 |
| 6164294 | CATH, DRAINAGE | Supply/Implant | $764.67 |
| 6164295 | INTRO/SHEATH, NON-LASER | Supply/Implant | $320.00 |
| 6164297 | SUPPLY IMPLANT | Supply/Implant | $64,998.40 |
| 6164300 | GENERAL SUPPLY | Supply/Implant | $1,536.00 |
| 6164307 | SUPPLY IMPLANT | Supply/Implant | $2,311.81 |
| 6164311 | SUPPLY IMPLANT | Supply/Implant | $2,227.20 |
| 6164312 | SUPPLY IMPLANT | Supply/Implant | $2,240.00 |
| 6164326 | SUPPLY IMPLANT | Supply/Implant | $19,494.40 |
| 6164327 | STERILE SUPPLY | Supply/Implant | $1,523.20 |
| 6164329 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,168.00 |
| 6164330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6164331 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,760.00 |
| 6164332 | GUIDE WIRE | Supply/Implant | $7,508.86 |
| 6164336 | GENERAL SUPPLY | Supply/Implant | $6,696.32 |
| 6164338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6164339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6164348 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $356,752.20 |
| 6164359 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6164363 | GENERAL SUPPLY | Supply/Implant | $549.76 |
| 6164364 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164366 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164368 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164369 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164372 | CERV COL THERMPLAS FOAM 2 PI | Supply/Implant | $200.96 |
| 6164376 | GENERAL SUPPLY | Supply/Implant | $10,944.00 |
| 6164377 | SUPPLY IMPLANT | Supply/Implant | $6,720.00 |
| 6164380 | STERILE SUPPLY | Supply/Implant | $1,241.60 |
| 6164389 | SUPPLY IMPLANT | Supply/Implant | $4,864.00 |
| 6164390 | SUPPLY IMPLANT | Supply/Implant | $3,136.00 |
| 6164393 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,051.20 |
| 6164394 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6164395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6164397 | SUPPLY IMPLANT | Supply/Implant | $7,907.46 |
| 6164433 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $241.92 |
| 6164435 | GUIDE WIRE | Supply/Implant | $4,160.00 |
| 6164436 | CORNEAL TISSUE PROCESSING | Supply/Implant | $53,760.00 |
| 6164438 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6164448 | SUPPLY IMPLANT | Supply/Implant | $8,182.14 |
| 6164449 | SUPPLY IMPLANT | Supply/Implant | $18,726.40 |
| 6164464 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6164465 | SUPPLY IMPLANT | Supply/Implant | $1,510.40 |
| 6164466 | INTERSPINOUS IMPLANT | Supply/Implant | $8,960.00 |
| 6164474 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $201,663.00 |
| 6164475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6164479 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6164480 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,622.40 |
| 6164481 | SUPPLY IMPLANT | Supply/Implant | $3,800.83 |
| 6164482 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6164483 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,432.64 |
| 6164485 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $1,779.20 |
| 6164487 | SUPPLY IMPLANT | Supply/Implant | $8,691.20 |
| 6164491 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164497 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6164498 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164499 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6164510 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164511 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,480.00 |
| 6164512 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6164513 | BREAST PROSTHESIS SILICONE/E | Supply/Implant | $13,324.80 |
| 6164519 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6164520 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6164522 | SUPPLY IMPLANT | Supply/Implant | $4,352.00 |
| 6164523 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,842.88 |
| 6164524 | SUPPLY IMPLANT | Supply/Implant | $2,858.62 |
| 6164525 | STERILE SUPPLY | Supply/Implant | $4,173.82 |
| 6164526 | GENERAL SUPPLY | Supply/Implant | $131.20 |
| 6164527 | STERILE SUPPLY | Supply/Implant | $254.26 |
| 6164534 | STERILE SUPPLY | Supply/Implant | $976.90 |
| 6164535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6164536 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164538 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6164541 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6164542 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6164543 | LEAD, PMKR, OTHER THAN TRANS | Supply/Implant | $7,168.00 |
| 6164548 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6164560 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6164561 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6164562 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $12,800.00 |
| 6164564 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6164565 | SUPPLY IMPLANT | Supply/Implant | $4,217.09 |
| 6164566 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6164567 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6164568 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6164569 | SUPPLY IMPLANT | Supply/Implant | $24,384.00 |
| 6164570 | SUPPLY IMPLANT | Supply/Implant | $24,384.00 |
| 6164571 | SUPPLY IMPLANT | Supply/Implant | $2,483.20 |
| 6164572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6164573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6164574 | SUPPLY IMPLANT | Supply/Implant | $27,611.52 |
| 6164576 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6164577 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6164580 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6164582 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6164587 | SUPPLY IMPLANT | Supply/Implant | $16,000.00 |
| 6164588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,787.20 |
| 6164589 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,787.20 |
| 6164590 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6164591 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6164592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6164593 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,486.40 |
| 6164594 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6164595 | GRAFT, VASCULAR | Supply/Implant | $118,572.83 |
| 6164599 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $2,168.96 |
| 6164601 | SUPPLY IMPLANT | Supply/Implant | $48,640.00 |
| 6164602 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6164606 | SUPPLY IMPLANT | Supply/Implant | $28,096.00 |
| 6164607 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6164608 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6164609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $687.85 |
| 6164616 | SUPPLY IMPLANT | Supply/Implant | $12,800.00 |
| 6164620 | SUPPLY IMPLANT | Supply/Implant | $768.00 |
| 6164621 | SUPPLY IMPLANT | Supply/Implant | $9,984.00 |
| 6164623 | STERILE SUPPLY | Supply/Implant | $437.76 |
| 6164627 | INTERSPINOUS IMPLANT | Supply/Implant | $1,536.00 |
| 6164628 | SUPPLY IMPLANT | Supply/Implant | $7,171.20 |
| 6164629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,817.60 |
| 6164631 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,481.60 |
| 6164633 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6164634 | INTERSPINOUS IMPLANT | Supply/Implant | $43,584.00 |
| 6164635 | INTERSPINOUS IMPLANT | Supply/Implant | $43,584.00 |
| 6164643 | PROSTHETIC IMPLANT NOS | Supply/Implant | $17,510.91 |
| 6164654 | GENERAL SUPPLY | Supply/Implant | $172.54 |
| 6164655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $155,347.50 |
| 6164661 | SUPPLY IMPLANT | Supply/Implant | $1,224.83 |
| 6164662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,928.64 |
| 6164663 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6164664 | SUPPLY IMPLANT | Supply/Implant | $3,686.40 |
| 6164665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,931.07 |
| 6164666 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6164667 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164668 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164669 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.32 |
| 6164674 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,059.58 |
| 6164675 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $78,663.94 |
| 6164677 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,124.74 |
| 6164678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $62,685.18 |
| 6164679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,307.90 |
| 6164680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $108,065.92 |
| 6164685 | SUPPLY IMPLANT | Supply/Implant | $3,328.00 |
| 6164686 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,560.00 |
| 6164687 | SUPPLY IMPLANT | Supply/Implant | $11,200.00 |
| 6164698 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6164699 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,225.75 |
| 6164700 | INTERSPINOUS IMPLANT | Supply/Implant | $84,128.00 |
| 6164701 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,432.64 |
| 6164702 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,176.00 |
| 6164703 | CONN TISS, NON-HUMAN | Supply/Implant | $19,200.00 |
| 6164706 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6164707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $30,720.00 |
| 6164709 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6164711 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,921.60 |
| 6164712 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6164713 | STERILE SUPPLY | Supply/Implant | $208.81 |
| 6164715 | STERILE SUPPLY | Supply/Implant | $29,248.00 |
| 6164717 | SUPPLY IMPLANT | Supply/Implant | $13,056.00 |
| 6164718 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $30,518.40 |
| 6164719 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6164721 | SUPPLY IMPLANT | Supply/Implant | $384.00 |
| 6164723 | GENERAL SUPPLY | Supply/Implant | $341.34 |
| 6164724 | SUPPLY IMPLANT | Supply/Implant | $418.14 |
| 6164725 | SUPPLY IMPLANT | Supply/Implant | $7,155.20 |
| 6164727 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,492.80 |
| 6164731 | SUPPLY IMPLANT | Supply/Implant | $47,360.00 |
| 6164733 | SUPPLY IMPLANT | Supply/Implant | $88,391.04 |
| 6164734 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,145.60 |
| 6164735 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,936.00 |
| 6164736 | SUPPLY IMPLANT | Supply/Implant | $431.10 |
| 6164743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,512.00 |
| 6164744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6164745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6164746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,470.40 |
| 6164751 | SUPPLY IMPLANT | Supply/Implant | $2,133.34 |
| 6164753 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6164754 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,940.80 |
| 6164755 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6164756 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,542.72 |
| 6164757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6164758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6164762 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,779.52 |
| 6164763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,851.84 |
| 6164764 | SUPPLY IMPLANT | Supply/Implant | $310.91 |
| 6164765 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6164766 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6164767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,145.60 |
| 6164768 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164769 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6164770 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6164771 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6164772 | INTERSPINOUS IMPLANT | Supply/Implant | $11,520.00 |
| 6164773 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.13 |
| 6164774 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6164779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,920.00 |
| 6164781 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $14,016.00 |
| 6164784 | INTERSPINOUS IMPLANT | Supply/Implant | $12,800.00 |
| 6164786 | COCHLEAR DEVICE | Supply/Implant | $239,875.00 |
| 6164787 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164788 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164789 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164790 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164791 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6164793 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164794 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6164795 | SUPPLY IMPLANT | Supply/Implant | $3,264.00 |
| 6164796 | SUPPLY IMPLANT | Supply/Implant | $9,920.00 |
| 6164804 | SUPPLY IMPLANT | Supply/Implant | $20,480.00 |
| 6164805 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6164806 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6164807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6164808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6164809 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,265.92 |
| 6164811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164812 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6164813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,584.00 |
| 6164814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,584.00 |
| 6164815 | GUIDE WIRE | Supply/Implant | $2,496.00 |
| 6164816 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164819 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $720.00 |
| 6164821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164837 | GENERAL SUPPLY | Supply/Implant | $31,744.00 |
| 6164839 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164840 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164841 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6164844 | SUPPLY IMPLANT | Supply/Implant | $32,473.60 |
| 6164845 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6164847 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6164848 | SUPPLY IMPLANT | Supply/Implant | $12,710.40 |
| 6164849 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6164850 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6164853 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $432.00 |
| 6164854 | SUPPLY IMPLANT | Supply/Implant | $82,174.46 |
| 6164855 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164857 | SUPPLY IMPLANT | Supply/Implant | $7,680.00 |
| 6164861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,088.00 |
| 6164863 | SUPPLY IMPLANT | Supply/Implant | $28,108.80 |
| 6164865 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,441.60 |
| 6164866 | GENERAL SUPPLY | Supply/Implant | $7,265.28 |
| 6164867 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164868 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164871 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6164873 | STERILE SUPPLY | Supply/Implant | $217.60 |
| 6164874 | SUPPLY IMPLANT | Supply/Implant | $4,416.00 |
| 6164875 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6164876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6164877 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6164878 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $38,336.00 |
| 6164879 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6164880 | SUPPLY IMPLANT | Supply/Implant | $9,676.80 |
| 6164881 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164882 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6164883 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6164884 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $98,176.00 |
| 6164885 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,529.60 |
| 6164886 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,499.20 |
| 6164887 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6164888 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6164889 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6164890 | GENERAL SUPPLY | Supply/Implant | $260.35 |
| 6164891 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $106,393.60 |
| 6164892 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164895 | GENERAL SUPPLY | Supply/Implant | $1,920.00 |
| 6164897 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6164898 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,284.03 |
| 6164899 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,254.78 |
| 6164900 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $5,233.15 |
| 6164903 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6164906 | SUPPLY IMPLANT | Supply/Implant | $69,184.00 |
| 6164907 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $573.44 |
| 6164911 | SUPPLY IMPLANT | Supply/Implant | $3,520.00 |
| 6164931 | SUPPLY IMPLANT | Supply/Implant | $6,400.00 |
| 6164933 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,408.00 |
| 6164941 | SUPPLY IMPLANT | Supply/Implant | $2,880.00 |
| 6164943 | SUPPLY IMPLANT | Supply/Implant | $9,817.60 |
| 6164944 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,694.40 |
| 6164945 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,694.40 |
| 6164947 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $83,443.20 |
| 6164948 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $88,537.60 |
| 6164952 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6164953 | SUPPLY IMPLANT | Supply/Implant | $4,032.00 |
| 6164954 | INTERSPINOUS IMPLANT | Supply/Implant | $30,400.00 |
| 6164955 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6164956 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164957 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164958 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164959 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164960 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,094.40 |
| 6164962 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,611.20 |
| 6164963 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $40,473.60 |
| 6164964 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6164966 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6164967 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,984.00 |
| 6164968 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164969 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6164970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6164972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,817.60 |
| 6164973 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6164974 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6164975 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6164976 | INTERSPINOUS IMPLANT | Supply/Implant | $29,376.00 |
| 6164977 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6164978 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6164979 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6164980 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6164985 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6164988 | STERILE SUPPLY | Supply/Implant | $334.23 |
| 6164989 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,868.16 |
| 6164992 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,103.04 |
| 6164993 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $452.48 |
| 6164994 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,886.08 |
| 6164995 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,640.00 |
| 6164996 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6164997 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,369.60 |
| 6164998 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $17,323.52 |
| 6165000 | INTERSPINOUS IMPLANT | Supply/Implant | $38,400.00 |
| 6165003 | SUPPLY IMPLANT | Supply/Implant | $5,884.54 |
| 6165004 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165005 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165006 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6165008 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165009 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $11,520.00 |
| 6165010 | GENERAL SUPPLY | Supply/Implant | $163.84 |
| 6165011 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6165012 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6165014 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $147,525.00 |
| 6165015 | GENERAL SUPPLY | Supply/Implant | $783.36 |
| 6165016 | STERILE SUPPLY | Supply/Implant | $204.80 |
| 6165018 | SUPPLY IMPLANT | Supply/Implant | $151,725.00 |
| 6165031 | SUPPLY IMPLANT | Supply/Implant | $138,075.00 |
| 6165032 | SUPPLY IMPLANT | Supply/Implant | $138,075.00 |
| 6165046 | GENERAL SUPPLY | Supply/Implant | $186.33 |
| 6165049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165050 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,531.20 |
| 6165051 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6165056 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165057 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165058 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $79,321.60 |
| 6165059 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,219.20 |
| 6165060 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6165061 | SUPPLY IMPLANT | Supply/Implant | $2,112.00 |
| 6165064 | GENERAL SUPPLY | Supply/Implant | $1,068.26 |
| 6165069 | SUPPLY IMPLANT | Supply/Implant | $409.60 |
| 6165079 | GENERAL SUPPLY | Supply/Implant | $196.15 |
| 6165080 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165081 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165082 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165083 | SUPPLY IMPLANT | Supply/Implant | $148.48 |
| 6165085 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6165088 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $46,604.80 |
| 6165089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165090 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165093 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165094 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6165098 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165099 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,888.00 |
| 6165100 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,985.60 |
| 6165101 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165102 | SUPPLY IMPLANT | Supply/Implant | $9,203.20 |
| 6165104 | SUPPLY IMPLANT | Supply/Implant | $3,200.00 |
| 6165105 | SUPPLY IMPLANT | Supply/Implant | $6,144.00 |
| 6165106 | GENERAL SUPPLY | Supply/Implant | $12,800.00 |
| 6165107 | SUPPLY IMPLANT | Supply/Implant | $78,668.80 |
| 6165108 | SUPPLY IMPLANT | Supply/Implant | $22,873.60 |
| 6165109 | SUPPLY IMPLANT | Supply/Implant | $21,120.00 |
| 6165110 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,360.00 |
| 6165111 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6165112 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6165113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6165114 | SUPPLY IMPLANT | Supply/Implant | $307.42 |
| 6165118 | SUPPLY IMPLANT | Supply/Implant | $4,224.00 |
| 6165119 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165120 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165121 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,840.00 |
| 6165122 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6165124 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,865.60 |
| 6165125 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $793.60 |
| 6165128 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $793.60 |
| 6165134 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6165135 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6165136 | SUPPLY IMPLANT | Supply/Implant | $303,000.00 |
| 6165137 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6165138 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165139 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6165140 | SUPPLY IMPLANT | Supply/Implant | $14,080.00 |
| 6165142 | SUPPLY IMPLANT | Supply/Implant | $95,744.00 |
| 6165148 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165151 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6165152 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6165153 | STERILE SUPPLY | Supply/Implant | $1,121.41 |
| 6165154 | STERILE SUPPLY | Supply/Implant | $1,121.41 |
| 6165155 | PROSTHESIS, BREAST, IMP | Supply/Implant | $11,328.00 |
| 6165156 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $12,608.00 |
| 6165157 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6165158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,400.00 |
| 6165159 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $16,640.00 |
| 6165162 | SUPPLY IMPLANT | Supply/Implant | $6,845.18 |
| 6165168 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6165176 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,894.72 |
| 6165177 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,894.72 |
| 6165178 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6165182 | SUPPLY IMPLANT | Supply/Implant | $2,329.60 |
| 6165183 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,725.70 |
| 6165184 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,542.91 |
| 6165190 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,476.80 |
| 6165196 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $33,454.08 |
| 6165209 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,600.00 |
| 6165213 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6165214 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,680.00 |
| 6165215 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6165216 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,478.40 |
| 6165217 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165269 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165274 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $475,000.00 |
| 6165276 | SUPPLY IMPLANT | Supply/Implant | $1,740.80 |
| 6165282 | GRAFIX CORE | Supply/Implant | $27,584.00 |
| 6165287 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6165288 | SUPPLY IMPLANT | Supply/Implant | $13,696.00 |
| 6165296 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,052.80 |
| 6165309 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,907.20 |
| 6165315 | EVENT RECORDER CARDIAC | Supply/Implant | $53,760.00 |
| 6165316 | SUPPLY IMPLANT | Supply/Implant | $1,408.00 |
| 6165317 | SUPPLY IMPLANT | Supply/Implant | $1,728.00 |
| 6165318 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6165319 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6165320 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6165321 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,800.00 |
| 6165323 | SUPPLY IMPLANT | Supply/Implant | $11,942.40 |
| 6165324 | SUPPLY IMPLANT | Supply/Implant | $5,209.60 |
| 6165325 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6165330 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6165334 | SUPPLY IMPLANT | Supply/Implant | $3,540.48 |
| 6165338 | SUPPLY IMPLANT | Supply/Implant | $18,880.00 |
| 6165339 | GUIDE WIRE | Supply/Implant | $3,010.62 |
| 6165340 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6165341 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $16,640.00 |
| 6165342 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,383.81 |
| 6165344 | INTRO/SHEATH, NON-LASER | Supply/Implant | $3,264.00 |
| 6165348 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,473.60 |
| 6165349 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $2,176.00 |
| 6165350 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165351 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165352 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165355 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6165356 | SUPPLY IMPLANT | Supply/Implant | $8,051.20 |
| 6165357 | SUPPLY IMPLANT | Supply/Implant | $11,481.60 |
| 6165358 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6165361 | SUPPLY IMPLANT | Supply/Implant | $2,496.00 |
| 6165362 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6165363 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,497.60 |
| 6165364 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $18,432.00 |
| 6165365 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6165366 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6165367 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $27,366.40 |
| 6165373 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6165380 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $5,884.54 |
| 6165381 | SUPPLY IMPLANT | Supply/Implant | $1,772.80 |
| 6165382 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6165383 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $26,662.40 |
| 6165384 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6165385 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,049.60 |
| 6165386 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,366.40 |
| 6165387 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,406.40 |
| 6165388 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $9,920.00 |
| 6165389 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6165390 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6165391 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165392 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165393 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165394 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6165395 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $48,869.63 |
| 6165398 | GENERAL SUPPLY | Supply/Implant | $179.55 |
| 6165422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $192.51 |
| 6165423 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,408.00 |
| 6165424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6165425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6165427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,385.92 |
| 6165428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,395.20 |
| 6165429 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $291.84 |
| 6165430 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $24,627.84 |
| 6165431 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $201,663.00 |
| 6165432 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6165433 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,569.60 |
| 6165434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6165438 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $18,150.40 |
| 6165439 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $18,150.40 |
| 6165440 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $18,150.40 |
| 6165441 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165442 | SUPPLY IMPLANT | Supply/Implant | $153.60 |
| 6165443 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6165444 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165445 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165446 | SUPPLY IMPLANT | Supply/Implant | $1,600.00 |
| 6165447 | STERILE SUPPLY | Supply/Implant | $1,698.30 |
| 6165448 | GUIDE WIRE | Supply/Implant | $780.80 |
| 6165449 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6165450 | SUPPLY IMPLANT | Supply/Implant | $10,240.00 |
| 6165451 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6165452 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $6,720.00 |
| 6165453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,840.00 |
| 6165455 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6165456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $69,854.72 |
| 6165457 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6165458 | STERILE SUPPLY | Supply/Implant | $4,608.00 |
| 6165460 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165463 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6165464 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,227.20 |
| 6165465 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,227.20 |
| 6165466 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6165467 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165469 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,944.00 |
| 6165470 | SUPPLY IMPLANT | Supply/Implant | $2,662.40 |
| 6165472 | SUPPLY IMPLANT | Supply/Implant | $42,240.00 |
| 6165473 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,513.28 |
| 6165474 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,513.28 |
| 6165475 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,513.28 |
| 6165476 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $11,667.84 |
| 6165477 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,335.10 |
| 6165478 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,467.78 |
| 6165479 | SUPPLY IMPLANT | Supply/Implant | $1,280.00 |
| 6165480 | CATHETER, GUIDING | Supply/Implant | $87,680.00 |
| 6165482 | CATHETER, GUIDING | Supply/Implant | $87,680.00 |
| 6165483 | CATHETER, GUIDING | Supply/Implant | $74,880.00 |
| 6165484 | CATHETER, GUIDING | Supply/Implant | $25,536.00 |
| 6165485 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,745.60 |
| 6165486 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6165487 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165488 | STERILE SUPPLY | Supply/Implant | $1,587.84 |
| 6165489 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6165498 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6165499 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,303.32 |
| 6165500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165501 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165502 | GUIDE WIRE | Supply/Implant | $640.00 |
| 6165507 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165518 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165550 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6165551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6165552 | SUPPLY IMPLANT | Supply/Implant | $25,536.00 |
| 6165553 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,120.00 |
| 6165555 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $7,321.60 |
| 6165557 | SUPPLY IMPLANT | Supply/Implant | $10,560.00 |
| 6165559 | SKIN SUBSTITUTE, NOS | Supply/Implant | $13,824.00 |
| 6165560 | SKIN SUBSTITUTE, NOS | Supply/Implant | $16,576.00 |
| 6165561 | SKIN SUBSTITUTE, NOS | Supply/Implant | $44,736.00 |
| 6165563 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6165564 | SUPPLY IMPLANT | Supply/Implant | $6,080.00 |
| 6165568 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6165570 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,928.00 |
| 6165572 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165573 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165574 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6165575 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165576 | SUPPLY IMPLANT | Supply/Implant | $7,168.00 |
| 6165577 | SUPPLY IMPLANT | Supply/Implant | $3,776.00 |
| 6165581 | SUPPLY IMPLANT | Supply/Implant | $5,427.20 |
| 6165582 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,294.08 |
| 6165583 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,520.00 |
| 6165584 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $2,099.20 |
| 6165586 | SUPPLY IMPLANT | Supply/Implant | $73,216.00 |
| 6165587 | SUPPLY IMPLANT | Supply/Implant | $53,107.20 |
| 6165588 | SUPPLY IMPLANT | Supply/Implant | $42,240.00 |
| 6165591 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,281.60 |
| 6165592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,043.52 |
| 6165593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $43,806.72 |
| 6165594 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6165607 | SUPPLY IMPLANT | Supply/Implant | $107,584.00 |
| 6165608 | SUPPLY IMPLANT | Supply/Implant | $205,380.00 |
| 6165609 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6165616 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $448.00 |
| 6165617 | SUPPLY IMPLANT | Supply/Implant | $1,747.20 |
| 6165619 | CATHETER, GUIDING | Supply/Implant | $11,456.00 |
| 6165625 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $1,472.00 |
| 6165629 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,562.75 |
| 6165630 | CONN TISS, HUMAN(INC FASCIA) | Supply/Implant | $2,833.92 |
| 6165632 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,283.20 |
| 6165633 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,041.60 |
| 6165638 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,630.40 |
| 6165639 | INTERSPINOUS IMPLANT | Supply/Implant | $25,600.00 |
| 6165640 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,232.00 |
| 6165641 | PROSTHESIS, BREAST, IMP | Supply/Implant | $10,240.00 |
| 6165642 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6165645 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165646 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6165647 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6165648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $34,816.00 |
| 6165649 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,736.00 |
| 6165654 | STERILE SUPPLY | Supply/Implant | $6,076.16 |
| 6165655 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,910.40 |
| 6165656 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,910.40 |
| 6165657 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,910.40 |
| 6165658 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $7,616.00 |
| 6165659 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165660 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $105,356.80 |
| 6165661 | SUPPLY IMPLANT | Supply/Implant | $8,121.60 |
| 6165662 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6165663 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6165664 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6165665 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $707.20 |
| 6165666 | INTRO/SHEATH,FIXED,PEEL-AWAY | Supply/Implant | $11,511.42 |
| 6165667 | SUPPLY IMPLANT | Supply/Implant | $12,160.00 |
| 6165668 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165669 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165670 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165671 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6165672 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $715.14 |
| 6165673 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6165674 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6165675 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6165676 | INTERSPINOUS IMPLANT | Supply/Implant | $60,160.00 |
| 6165677 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165678 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,637.44 |
| 6165679 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6165680 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,912.00 |
| 6165683 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6165684 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,569.60 |
| 6165685 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6165687 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,141.95 |
| 6165689 | SUPPLY IMPLANT | Supply/Implant | $28,713.60 |
| 6165691 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,176.00 |
| 6165692 | SUPPLY IMPLANT | Supply/Implant | $20,480.00 |
| 6165693 | SUPPLY IMPLANT | Supply/Implant | $6,566.40 |
| 6165698 | GENERAL SUPPLY | Supply/Implant | $169.08 |
| 6165700 | PMKR, DUAL, RATE-RESP | Supply/Implant | $58,880.00 |
| 6165701 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,737.60 |
| 6165702 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6165703 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6165704 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6165705 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6165706 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165707 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6165708 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,816.00 |
| 6165720 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,694.40 |
| 6165723 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6165724 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $83,443.20 |
| 6165725 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $88,537.60 |
| 6165726 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6165727 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6165728 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6165729 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6165730 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6165731 | SUPPLY IMPLANT | Supply/Implant | $7,328.51 |
| 6165734 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6165742 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6165743 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6165744 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165746 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165751 | EVENT RECORDER CARDIAC | Supply/Implant | $63,936.00 |
| 6165754 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $3,200.00 |
| 6165755 | GENERAL SUPPLY | Supply/Implant | $250.79 |
| 6165756 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,630.40 |
| 6165757 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165762 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6165763 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,864.32 |
| 6165764 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,600.00 |
| 6165765 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6165766 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $646.40 |
| 6165767 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,409.28 |
| 6165768 | GENERAL SUPPLY | Supply/Implant | $9,587.20 |
| 6165769 | SUPPLY IMPLANT | Supply/Implant | $1,376.00 |
| 6165770 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,640.00 |
| 6165771 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,640.00 |
| 6165772 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,000.00 |
| 6165773 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,000.00 |
| 6165774 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $32,000.00 |
| 6165777 | INTERSPINOUS IMPLANT | Supply/Implant | $96,000.00 |
| 6165778 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6165779 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,249.60 |
| 6165780 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,920.00 |
| 6165781 | SUPPLY IMPLANT | Supply/Implant | $3,161.60 |
| 6165782 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,576.00 |
| 6165783 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $972.80 |
| 6165784 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,576.00 |
| 6165786 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $499.20 |
| 6165787 | STERILE SUPPLY | Supply/Implant | $7,296.00 |
| 6165789 | INTRO/SHEATH,STRBLE,NON-PEEL | Supply/Implant | $4,480.00 |
| 6165790 | SUPPLY IMPLANT | Supply/Implant | $797.44 |
| 6165792 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,616.00 |
| 6165794 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,062.40 |
| 6165795 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,630.40 |
| 6165796 | SUPPLY IMPLANT | Supply/Implant | $1,741.57 |
| 6165798 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165799 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165800 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165801 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6165802 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $672.00 |
| 6165803 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6165804 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $768.00 |
| 6165805 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,976.00 |
| 6165810 | SUPPLY IMPLANT | Supply/Implant | $13,056.00 |
| 6165811 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,572.80 |
| 6165812 | STERILE SUPPLY | Supply/Implant | $614.40 |
| 6165817 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165818 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,988.80 |
| 6165819 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165820 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165821 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165822 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,662.40 |
| 6165823 | SUPPLY IMPLANT | Supply/Implant | $8,985.60 |
| 6165825 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6165826 | INTERSPINOUS IMPLANT | Supply/Implant | $70,400.00 |
| 6165827 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $21,120.00 |
| 6165828 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,340.80 |
| 6165831 | SUPPLY IMPLANT | Supply/Implant | $3,468.80 |
| 6165833 | INTERSPINOUS IMPLANT | Supply/Implant | $16,896.00 |
| 6165834 | SUPPLY IMPLANT | Supply/Implant | $13,312.00 |
| 6165835 | OCULAR IMPLANT | Supply/Implant | $192.00 |
| 6165836 | SUPPLY IMPLANT | Supply/Implant | $8,448.00 |
| 6165837 | GENERAL SUPPLY | Supply/Implant | $19,840.00 |
| 6165842 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6165843 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,640.00 |
| 6165845 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6165846 | SUPPLY IMPLANT | Supply/Implant | $205,380.00 |
| 6165847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6165848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,404.80 |
| 6165849 | SUPPLY IMPLANT | Supply/Implant | $8,793.60 |
| 6165850 | SUPPLY IMPLANT | Supply/Implant | $3,404.80 |
| 6165851 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $44,160.00 |
| 6165852 | SUPPLY IMPLANT | Supply/Implant | $1,168.00 |
| 6165853 | SUPPLY IMPLANT | Supply/Implant | $1,952.00 |
| 6165854 | SUPPLY IMPLANT | Supply/Implant | $1,968.00 |
| 6165855 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6165856 | GENERAL SUPPLY | Supply/Implant | $21,056.00 |
| 6165857 | GENERAL SUPPLY | Supply/Implant | $14,016.00 |
| 6165858 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $63,193.60 |
| 6165859 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6165860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6165861 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,664.00 |
| 6165862 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,328.00 |
| 6165863 | SUPPLY IMPLANT | Supply/Implant | $2,521.60 |
| 6165864 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6165865 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6165866 | SUPPLY IMPLANT | Supply/Implant | $5,037.57 |
| 6165867 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6165868 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $3,143.68 |
| 6165869 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,075.20 |
| 6165870 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,539.20 |
| 6165872 | SUPPLY IMPLANT | Supply/Implant | $21,984.00 |
| 6165873 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,680.00 |
| 6165874 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6165875 | INTERSPINOUS IMPLANT | Supply/Implant | $72,960.00 |
| 6165876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6165878 | SUPPLY IMPLANT | Supply/Implant | $80,629.76 |
| 6165879 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,496.00 |
| 6165884 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,276.80 |
| 6165893 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6165894 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6165897 | GENERAL SUPPLY | Supply/Implant | $310.40 |
| 6165899 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6165904 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6165905 | SUPPLY IMPLANT | Supply/Implant | $22,400.00 |
| 6165927 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,496.00 |
| 6165928 | SUPPLY IMPLANT | Supply/Implant | $1,920.00 |
| 6165929 | INTERSPINOUS IMPLANT | Supply/Implant | $115,200.00 |
| 6165930 | INTERSPINOUS IMPLANT | Supply/Implant | $72,576.00 |
| 6165937 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6165938 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,264.00 |
| 6165939 | INTERSPINOUS IMPLANT | Supply/Implant | $27,520.00 |
| 6165940 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,328.83 |
| 6165941 | GENERAL SUPPLY | Supply/Implant | $15,104.00 |
| 6165944 | SUPPLY IMPLANT | Supply/Implant | $208,868.00 |
| 6165950 | STERILE SUPPLY | Supply/Implant | $5,436.38 |
| 6165953 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6165954 | GENERAL SUPPLY | Supply/Implant | $9,600.00 |
| 6165955 | INTERSPINOUS IMPLANT | Supply/Implant | $37,760.00 |
| 6165956 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6165960 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,984.00 |
| 6165961 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,294.40 |
| 6165962 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,918.40 |
| 6165967 | GENERAL SUPPLY | Supply/Implant | $819.88 |
| 6165968 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6165969 | SUPPLY IMPLANT | Supply/Implant | $4,642.56 |
| 6165970 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6165971 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6165972 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6165973 | SUPPLY IMPLANT | Supply/Implant | $13,798.40 |
| 6165974 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6165975 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $39,680.00 |
| 6165977 | STENT, NON-COA/NON-COV W/DEL | Supply/Implant | $27,058.82 |
| 6165987 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6165990 | GENERAL SUPPLY | Supply/Implant | $196.26 |
| 6165991 | GENERAL SUPPLY | Supply/Implant | $217.60 |
| 6165994 | GENERAL SUPPLY | Supply/Implant | $10,419.20 |
| 6165995 | SUPPLY IMPLANT | Supply/Implant | $44,736.00 |
| 6165997 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6166011 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $2,432.00 |
| 6166013 | SUPPLY IMPLANT | Supply/Implant | $30,297.60 |
| 6166014 | EVENT RECORDER CARDIAC | Supply/Implant | $53,760.00 |
| 6166015 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166019 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,411.52 |
| 6166026 | EXTERNAL RECHARG SYS INTERN | Supply/Implant | $35,225.60 |
| 6166028 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166037 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6166046 | SUPPLY IMPLANT | Supply/Implant | $9,792.00 |
| 6166047 | SUPPLY IMPLANT | Supply/Implant | $9,792.00 |
| 6166048 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,350.40 |
| 6166049 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166050 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166051 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166052 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6166053 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $41,600.00 |
| 6166054 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $54,400.00 |
| 6166055 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,200.00 |
| 6166056 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166060 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6166061 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166064 | INTERSPINOUS IMPLANT | Supply/Implant | $9,600.00 |
| 6166070 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $7,616.00 |
| 6166089 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,643.20 |
| 6166090 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $67,200.00 |
| 6166091 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,227.20 |
| 6166092 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,235.20 |
| 6166093 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6166094 | SUPPLY IMPLANT | Supply/Implant | $38,928.64 |
| 6166095 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $16,000.00 |
| 6166096 | STERILE SUPPLY | Supply/Implant | $1,536.00 |
| 6166097 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $25,104.00 |
| 6166098 | SUPPLY IMPLANT | Supply/Implant | $36,569.60 |
| 6166099 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $35,368.96 |
| 6166101 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,048.32 |
| 6166102 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,784.00 |
| 6166103 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6166104 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166108 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $87,744.00 |
| 6166109 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,057.60 |
| 6166111 | SUPPLY IMPLANT | Supply/Implant | $412.16 |
| 6166112 | SUPPLY IMPLANT | Supply/Implant | $4,828.16 |
| 6166113 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,060.80 |
| 6166114 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,475.84 |
| 6166115 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,118.72 |
| 6166116 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6166117 | CATH, TRANSLUMIN ANGIO LASER | Supply/Implant | $35,776.00 |
| 6166120 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,632.00 |
| 6166122 | STERILE SUPPLY | Supply/Implant | $1,088.00 |
| 6166123 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,200.00 |
| 6166127 | SUPPLY IMPLANT | Supply/Implant | $2,795.52 |
| 6166129 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6166130 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,000.00 |
| 6166131 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $50,849.92 |
| 6166132 | SUPPLY IMPLANT | Supply/Implant | $247,071.25 |
| 6166133 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6166134 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6166135 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6166136 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166139 | SUPPLY IMPLANT | Supply/Implant | $4,480.00 |
| 6166140 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166141 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $56,141.95 |
| 6166142 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $49,536.00 |
| 6166145 | SUPPLY IMPLANT | Supply/Implant | $4,659.20 |
| 6166146 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6166147 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6166152 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166153 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6166154 | INTERSPINOUS IMPLANT | Supply/Implant | $123,900.00 |
| 6166158 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,083.20 |
| 6166159 | INTERSPINOUS IMPLANT | Supply/Implant | $51,200.00 |
| 6166160 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,936.00 |
| 6166161 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,936.00 |
| 6166165 | SUPPLY IMPLANT | Supply/Implant | $4,120.70 |
| 6166166 | SUPPLY IMPLANT | Supply/Implant | $4,120.70 |
| 6166168 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6166169 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6166170 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6166171 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,592.00 |
| 6166172 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6166173 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $15,360.00 |
| 6166190 | SUPPLY IMPLANT | Supply/Implant | $7,076.48 |
| 6166192 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,510.40 |
| 6166195 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166196 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166197 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166198 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166199 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,120.70 |
| 6166201 | SUPPLY IMPLANT | Supply/Implant | $4,849.92 |
| 6166203 | IMPLANT BREAST SILICONE/EQ | Supply/Implant | $8,960.00 |
| 6166207 | MESH (IMPLANTABLE) | Supply/Implant | $183,750.00 |
| 6166208 | SUPPLY IMPLANT | Supply/Implant | $6,038.40 |
| 6166210 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6166217 | CATHETER, GUIDING | Supply/Implant | $5,440.00 |
| 6166219 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6166220 | GENERAL SUPPLY | Supply/Implant | $3,840.00 |
| 6166221 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $10,560.00 |
| 6166222 | SUPPLY IMPLANT | Supply/Implant | $2,048.00 |
| 6166223 | GENERAL SUPPLY | Supply/Implant | $19,840.00 |
| 6166224 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166225 | AICD, OTHER THAN SING/DUAL | Supply/Implant | $202,000.00 |
| 6166226 | AICD, SINGLE CHAMBER | Supply/Implant | $154,531.13 |
| 6166233 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,663.49 |
| 6166234 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6166235 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,663.49 |
| 6166236 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,246.08 |
| 6166237 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,600.00 |
| 6166238 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6166239 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $58,240.00 |
| 6166240 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,503.36 |
| 6166241 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $55,503.36 |
| 6166242 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6166243 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,102.08 |
| 6166244 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6166246 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,628.80 |
| 6166247 | SUPPLY IMPLANT | Supply/Implant | $960.00 |
| 6166248 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,622.40 |
| 6166250 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,905.60 |
| 6166251 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,360.00 |
| 6166252 | INTERSPINOUS IMPLANT | Supply/Implant | $64,000.00 |
| 6166269 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6166270 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,832.00 |
| 6166271 | GENERAL SUPPLY | Supply/Implant | $20,915.20 |
| 6166281 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166283 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,201.28 |
| 6166287 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,049.92 |
| 6166288 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,480.00 |
| 6166289 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,400.00 |
| 6166292 | SUPPLY IMPLANT | Supply/Implant | $5,120.00 |
| 6166293 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6166327 | GENERAL SUPPLY | Supply/Implant | $323.94 |
| 6166328 | SUPPLY IMPLANT | Supply/Implant | $209,241.70 |
| 6166329 | INTERSPINOUS IMPLANT | Supply/Implant | $35,840.00 |
| 6166330 | INTERSPINOUS IMPLANT | Supply/Implant | $32,640.00 |
| 6166333 | STERILE SUPPLY | Supply/Implant | $427.14 |
| 6166335 | SUPPLY IMPLANT | Supply/Implant | $6,912.00 |
| 6166336 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166337 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166338 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166339 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166340 | SUPPLY IMPLANT | Supply/Implant | $512.00 |
| 6166341 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6166342 | SUPPLY IMPLANT | Supply/Implant | $69,120.00 |
| 6166346 | SUPPLY IMPLANT | Supply/Implant | $4,608.00 |
| 6166347 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166350 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,912.00 |
| 6166351 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $45,772.80 |
| 6166352 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $75,507.20 |
| 6166353 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,484.80 |
| 6166354 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,484.80 |
| 6166355 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,200.00 |
| 6166356 | GENERAL SUPPLY | Supply/Implant | $3,782.40 |
| 6166357 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6166359 | GENERAL SUPPLY | Supply/Implant | $2,515.20 |
| 6166360 | GENERAL SUPPLY | Supply/Implant | $551.94 |
| 6166361 | GENERAL SUPPLY | Supply/Implant | $1,718.40 |
| 6166362 | GENERAL SUPPLY | Supply/Implant | $1,075.20 |
| 6166363 | GENERAL SUPPLY | Supply/Implant | $1,075.20 |
| 6166364 | GENERAL SUPPLY | Supply/Implant | $3,542.40 |
| 6166365 | GENERAL SUPPLY | Supply/Implant | $3,657.60 |
| 6166366 | GENERAL SUPPLY | Supply/Implant | $9,004.80 |
| 6166367 | GENERAL SUPPLY | Supply/Implant | $22,185.60 |
| 6166368 | GENERAL SUPPLY | Supply/Implant | $26,102.40 |
| 6166369 | GENERAL SUPPLY | Supply/Implant | $21,302.40 |
| 6166370 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,153.60 |
| 6166371 | SUPPLY IMPLANT | Supply/Implant | $25,600.00 |
| 6166372 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $72,153.60 |
| 6166394 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $7,616.00 |
| 6166396 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6166397 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6166398 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,144.26 |
| 6166399 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,353.60 |
| 6166400 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,904.00 |
| 6166401 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $36,608.00 |
| 6166402 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $107,353.60 |
| 6166403 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,200.00 |
| 6166410 | SUPPLY IMPLANT | Supply/Implant | $4,304.77 |
| 6166411 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,150.40 |
| 6166412 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6166413 | SUPPLY IMPLANT | Supply/Implant | $2,560.00 |
| 6166414 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166416 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6166417 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6166418 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,231.36 |
| 6166419 | SUPPLY IMPLANT | Supply/Implant | $195,108.06 |
| 6166420 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $2,887.30 |
| 6166421 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166422 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166423 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $29,673.60 |
| 6166424 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.20 |
| 6166425 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.20 |
| 6166426 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,531.20 |
| 6166427 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,928.64 |
| 6166428 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,403.20 |
| 6166429 | SUPPLY IMPLANT | Supply/Implant | $62,112.64 |
| 6166430 | SUPPLY IMPLANT | Supply/Implant | $2,597.25 |
| 6166431 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $33,744.00 |
| 6166432 | STERILE SUPPLY | Supply/Implant | $2,969.60 |
| 6166434 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,656.00 |
| 6166435 | SUPPLY IMPLANT | Supply/Implant | $43,806.72 |
| 6166436 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,962.24 |
| 6166437 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $13,312.00 |
| 6166438 | SUPPLY IMPLANT | Supply/Implant | $44,876.80 |
| 6166439 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6166440 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $203,464.50 |
| 6166441 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $12,160.00 |
| 6166442 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6166443 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,098.24 |
| 6166452 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166453 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166454 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,880.00 |
| 6166456 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,772.80 |
| 6166457 | GENERAL SUPPLY | Supply/Implant | $7,315.20 |
| 6166458 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6166459 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,800.00 |
| 6166460 | SUPPLY IMPLANT | Supply/Implant | $38,297.60 |
| 6166461 | MESH (IMPLANTABLE) | Supply/Implant | $66,594.94 |
| 6166465 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6166466 | GENERAL SUPPLY | Supply/Implant | $330.88 |
| 6166467 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $25,098.24 |
| 6166494 | SUPPLY IMPLANT | Supply/Implant | $11,622.40 |
| 6166495 | GENERAL SUPPLY | Supply/Implant | $15,994.88 |
| 6166496 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $24,690.94 |
| 6166497 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $31,055.36 |
| 6166498 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $17,280.00 |
| 6166500 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,984.00 |
| 6166501 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6166502 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6166503 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $23,120.00 |
| 6166504 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6166505 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,256.00 |
| 6166508 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,416.00 |
| 6166509 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,039.81 |
| 6166510 | SUPPLY IMPLANT | Supply/Implant | $10,880.00 |
| 6166511 | STERILE SUPPLY | Supply/Implant | $1,894.40 |
| 6166513 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166517 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,208.00 |
| 6166518 | SUPPLY IMPLANT | Supply/Implant | $184.58 |
| 6166521 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,416.00 |
| 6166522 | STERILE SUPPLY | Supply/Implant | $3,200.00 |
| 6166524 | STERILE SUPPLY | Supply/Implant | $24,960.00 |
| 6166525 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $8,960.00 |
| 6166526 | PRESBYOPIA-CORRECT FUNCTION | Supply/Implant | $12,736.00 |
| 6166527 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6166529 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,984.00 |
| 6166533 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,600.00 |
| 6166534 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6166535 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,143.68 |
| 6166536 | STERILE SUPPLY | Supply/Implant | $11,489.28 |
| 6166537 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $4,608.00 |
| 6166539 | CATH, BAL DIL, NON-VASCULAR | Supply/Implant | $22,976.00 |
| 6166542 | GENERAL SUPPLY | Supply/Implant | $54,400.00 |
| 6166543 | GENERAL SUPPLY | Supply/Implant | $768.00 |
| 6166544 | SUPPLY IMPLANT | Supply/Implant | $35,776.00 |
| 6166546 | KO IMMOBILIZER CANVAS LONGIT | Supply/Implant | $672.38 |
| 6166550 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,532.80 |
| 6166551 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $12,313.60 |
| 6166552 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $16,204.80 |
| 6166553 | UNSPEC MAXILLOFACIAL PROSTH | Supply/Implant | $24,153.60 |
| 6166561 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,880.00 |
| 6166562 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6166563 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,249.60 |
| 6166566 | SUPPLY IMPLANT | Supply/Implant | $427,500.00 |
| 6166569 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6166571 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $10,099.20 |
| 6166575 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6166576 | SUPPLY IMPLANT | Supply/Implant | $15,846.40 |
| 6166577 | INTERSPINOUS IMPLANT | Supply/Implant | $84,128.00 |
| 6166578 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $35,302.40 |
| 6166580 | SUPPLY IMPLANT | Supply/Implant | $576.00 |
| 6166581 | SUPPLY IMPLANT | Supply/Implant | $2,137.60 |
| 6166582 | SUPPLY IMPLANT | Supply/Implant | $4,672.00 |
| 6166583 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,200.00 |
| 6166584 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,371.84 |
| 6166585 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,921.60 |
| 6166586 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $6,873.60 |
| 6166587 | INTERSPINOUS IMPLANT | Supply/Implant | $54,400.00 |
| 6166588 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,321.60 |
| 6166592 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6166593 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6166594 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,726.08 |
| 6166595 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6166597 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,331.20 |
| 6166598 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $20,704.00 |
| 6166599 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,254.72 |
| 6166600 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,254.72 |
| 6166601 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,254.72 |
| 6166602 | IMPLANT/INSERT DEVICE, NOC | Supply/Implant | $10,560.00 |
| 6166603 | CATH, DRAINAGE | Supply/Implant | $1,516.80 |
| 6166604 | GUIDE WIRE | Supply/Implant | $1,600.00 |
| 6166616 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6166617 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6166619 | SUPPLY IMPLANT | Supply/Implant | $178,500.00 |
| 6166621 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $11,532.80 |
| 6166622 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $20,480.00 |
| 6166623 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $26,662.40 |
| 6166625 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,976.32 |
| 6166628 | SUPPLY IMPLANT | Supply/Implant | $2,432.00 |
| 6166629 | INTERSPINOUS IMPLANT | Supply/Implant | $57,600.00 |
| 6166634 | INTERSPINOUS IMPLANT | Supply/Implant | $62,112.64 |
| 6166642 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $36,774.40 |
| 6166643 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $21,984.00 |
| 6166647 | SUPPLY IMPLANT | Supply/Implant | $8,960.00 |
| 6166648 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,536.00 |
| 6166649 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6166650 | INTERSPINOUS IMPLANT | Supply/Implant | $53,516.80 |
| 6166651 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $7,168.00 |
| 6166652 | CATH, INF, PER/CENT/MIDLINE | Supply/Implant | $535.04 |
| 6166653 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,708.80 |
| 6166655 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $43,130.88 |
| 6166656 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $47,923.20 |
| 6166658 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,241.60 |
| 6166659 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166662 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $17,280.00 |
| 6166663 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6166664 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $1,920.00 |
| 6166665 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $23,040.00 |
| 6166666 | SUPPLY IMPLANT | Supply/Implant | $5,760.00 |
| 6166669 | SUPPLY IMPLANT | Supply/Implant | $37,760.00 |
| 6166674 | SUPPLY IMPLANT | Supply/Implant | $192.00 |
| 6166675 | POST CHMBR INTRAOCULAR LENS | Supply/Implant | $12,736.00 |
| 6166678 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,784.00 |
| 6166679 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166680 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $22,400.00 |
| 6166681 | SUPPLY IMPLANT | Supply/Implant | $162,750.00 |
| 6166682 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,501.89 |
| 6166705 | GENERAL SUPPLY | Supply/Implant | $4,915.20 |
| 6166706 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,436.80 |
| 6166707 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $6,298.88 |
| 6166708 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $38,912.00 |
| 6166709 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $8,960.00 |
| 6166710 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $576.00 |
| 6166727 | SUPPLY IMPLANT | Supply/Implant | $7,206.40 |
| 6166728 | SUPPLY IMPLANT | Supply/Implant | $780.80 |
| 6166730 | SUPPLY IMPLANT | Supply/Implant | $17,280.00 |
| 6166731 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6166732 | INTERSPINOUS IMPLANT | Supply/Implant | $32,000.00 |
| 6166736 | AICD, DUAL CHAMBER | Supply/Implant | $158,602.50 |
| 6166738 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $31,910.40 |
| 6166739 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $32,460.80 |
| 6166740 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,584.00 |
| 6166745 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6166750 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $14,400.00 |
| 6166751 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $15,923.20 |
| 6166752 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6166753 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $38,928.64 |
| 6166754 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6166755 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6166756 | SUPPLY IMPLANT | Supply/Implant | $51,200.00 |
| 6166757 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $400.77 |
| 6166758 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $19,968.51 |
| 6166759 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,914.43 |
| 6166780 | SUPPLY IMPLANT | Supply/Implant | $60,160.00 |
| 6166781 | SUPPLY IMPLANT | Supply/Implant | $60,160.00 |
| 6166786 | AICD, SINGLE CHAMBER | Supply/Implant | $154,531.13 |
| 6166799 | ASTIGMATISM-CORRECT FUNCTION | Supply/Implant | $6,336.00 |
| 6166801 | SUPPLY IMPLANT | Supply/Implant | $24,320.00 |
| 6166807 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $14,080.00 |
| 6166808 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $13,144.58 |
| 6166809 | INTERSPINOUS IMPLANT | Supply/Implant | $12,160.00 |
| 6166811 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6166813 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $4,864.00 |
| 6166814 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $9,241.60 |
| 6166815 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6166816 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $29,959.68 |
| 6166841 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $19,724.80 |
| 6166842 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $5,798.40 |
| 6166843 | STENT, COATED/COV W/DEL SYS | Supply/Implant | $44,876.80 |
| 6166846 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,163.52 |
| 6166847 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6166848 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $18,726.40 |
| 6166849 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6166850 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,214.40 |
| 6166851 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6166852 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $1,139.20 |
| 6166856 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $97,351.68 |
| 6166857 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $22,454.40 |
| 6166858 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6166859 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $10,230.78 |
| 6166860 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $2,252.80 |
| 6166866 | ORTH/DEVIC/DRUG BN/BN,TIS/BN | Supply/Implant | $12,236.80 |
| 6166871 | JOINT DEVICE (IMPLANTABLE) | Supply/Implant | $12,697.60 |
| 6166876 | ANCHOR/SCREW BN/BN,TIS/BN | Supply/Implant | $3,328.00 |
| 6166992 | SUPPLY IMPLANT | Supply/Implant | $12,840.96 |
| 6999901 | EXTERNAL COCHLEAR PROCESSOR | Supply/Implant | $132,870.15 |
| 6999902 | EXTERNAL COCHLEAR MAGNET | Supply/Implant | $26,226.30 |
| 6999910 | PROLACTA HMF 10ML 93901-10 | Supply/Implant | $73.24 |
| 6999911 | PROLACTA HMF 20ML 93901-20 | Supply/Implant | $73.24 |
| 6999912 | PROLACTA HMF 30ML 93901-30 | Supply/Implant | $73.24 |
| 6999913 | PROLACTA HMF 40ML 93901-40 | Supply/Implant | $73.24 |
| 6999915 | PROLACTA RTF 26 100ML 95026-100 | Supply/Implant | $20.92 |
| 6999917 | MILK DONOR 50ML NY MILK BANK | Supply/Implant | $2.52 |
| 6999918 | MILK DONOR 100ML NY MILK BANK | Supply/Implant | $1.70 |
| 6999920 | MILK DONOR 60ML NY MILK BANK | Supply/Implant | $2.52 |
| 6999921 | MILK DONOR 120ML NY MILK BANK | Supply/Implant | $1.89 |
| 2025960 | HC TELEHEALTH FACILITY FEE | Telemedicine | $84.58 |
| 2026539 | HC HH TELEHEALTH FACILITY FEE | Telemedicine | $174.90 |
| 2026579 | HC HH TELEMONITORING/HOME SNTI PER MNTH | Telemedicine | $420.00 |
| 2026807 | HC HCPRO PHONE CALL 5-10MIN | Telemedicine | $20.44 |
| 2026808 | HC HCPRO PHONE CALL 11-20MIN | Telemedicine | $40.37 |
| 2026809 | HC HCPRO PHONE CALL 21-30MIN | Telemedicine | $58.30 |
| 2026815 | HC INPT/TELE FOLLOW UP 15 MIN | Telemedicine | $47.35 |
| 2026816 | HC INPT/TELE FOLLOW UP 25 MIN | Telemedicine | $87.16 |
| 2026933 | HC FHC TELE SBH HCPRO PHONE CALL 5-10MIN | Telemedicine | $19.29 |
| 2025437 | HC PRE ARRIV TRAUMA RESPONS W/ CC | Trauma Response - Level I | $7,511.03 |
| 2026977 | HC PRE ARRIV TRAUMA RESPONS W/O CC | Trauma Response - Level I | $7,511.03 |
| MS-DRG | Description | Average Charges |
|---|---|---|
| MS001 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC | $2,257,244 |
| MS002 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC | $1,474,938 |
| MS003 | ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH NECK W MAJ O.R. | $1,557,354 |
| MS004 | TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH NECK W/O MAJ O.R. | $742,629 |
| MS005 | LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT | $1,383,670 |
| MS006 | LIVER TRANSPLANT W/O MCC | $1,021,471 |
| MS007 | LUNG TRANSPLANT | $1,378,765 |
| MS008 | SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT | $1,005,607 |
| MS010 | PANCREAS TRANSPLANT | $740,971 |
| MS011 | TRACHEOSTOMY FOR FACE, MOUTH NECK DIAGNOSES OR LARYNGECTOMY W MCC | $634,928 |
| MS012 | TRACHEOSTOMY FOR FACE, MOUTH NECK DIAGNOSES OR LARYNGECTOMY W CC | $426,523 |
| MS013 | TRACHEOSTOMY FOR FACE, MOUTH NECK DIAGNOSES OR LARYNGECTOMY W/O CC/MCC | $210,193 |
| MS014 | ALLOGENEIC BONE MARROW TRANSPLANT | $744,697 |
| MS016 | AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC OR T-CELL IMMUNOTHERAPY | $482,617 |
| MS020 | INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC | $631,090 |
| MS021 | INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC | $458,886 |
| MS022 | INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC | $262,359 |
| MS023 | CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX W MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY W NEUROSTIMULATOR | $524,985 |
| MS024 | CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC | $330,651 |
| MS025 | CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC | $314,060 |
| MS026 | CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W CC | $273,197 |
| MS027 | CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC | $253,063 |
| MS028 | SPINAL PROCEDURES W MCC | $364,804 |
| MS029 | SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS | $226,233 |
| MS030 | SPINAL PROCEDURES W/O CC/MCC | $154,373 |
| MS031 | VENTRICULAR SHUNT PROCEDURES W MCC | $263,249 |
| MS032 | VENTRICULAR SHUNT PROCEDURES W CC | $160,246 |
| MS033 | VENTRICULAR SHUNT PROCEDURES W/O CC/MCC | $110,179 |
| MS034 | CAROTID ARTERY STENT PROCEDURE W MCC | $284,779 |
| MS035 | CAROTID ARTERY STENT PROCEDURE W CC | $182,446 |
| MS036 | CAROTID ARTERY STENT PROCEDURE W/O CC/MCC | $158,700 |
| MS037 | EXTRACRANIAL PROCEDURES W MCC | $221,542 |
| MS038 | EXTRACRANIAL PROCEDURES W CC | $144,519 |
| MS039 | EXTRACRANIAL PROCEDURES W/O CC/MCC | $88,423 |
| MS040 | PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W MCC | $262,627 |
| MS041 | PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM | $211,599 |
| MS042 | PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W/O CC/MCC | $205,669 |
| MS052 | SPINAL DISORDERS INJURIES W CC/MCC | $340,694 |
| MS053 | SPINAL DISORDERS INJURIES W/O CC/MCC | $165,071 |
| MS054 | NERVOUS SYSTEM NEOPLASMS W MCC | $122,110 |
| MS055 | NERVOUS SYSTEM NEOPLASMS W/O MCC | $77,160 |
| MS056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC | $190,375 |
| MS057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC | $150,804 |
| MS058 | MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W MCC | $147,596 |
| MS059 | MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W CC | $99,753 |
| MS060 | MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W/O CC/MCC | $81,396 |
| MS061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W MCC | $241,540 |
| MS062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC | $171,641 |
| MS063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC | $149,375 |
| MS064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC | $149,124 |
| MS065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS | $95,883 |
| MS066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC | $70,396 |
| MS067 | NONSPECIFIC CVA PRECEREBRAL OCCLUSION W/O INFARCT W MCC | $104,780 |
| MS068 | NONSPECIFIC CVA PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC | $64,336 |
| MS069 | TRANSIENT ISCHEMIA W/O THROMBOLYTIC | $67,012 |
| MS070 | NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC | $175,575 |
| MS071 | NONSPECIFIC CEREBROVASCULAR DISORDERS W CC | $106,181 |
| MS072 | NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC | $75,074 |
| MS073 | CRANIAL PERIPHERAL NERVE DISORDERS W MCC | $166,705 |
| MS074 | CRANIAL PERIPHERAL NERVE DISORDERS W/O MCC | $89,722 |
| MS075 | VIRAL MENINGITIS W CC/MCC | $95,892 |
| MS076 | VIRAL MENINGITIS W/O CC/MCC | $37,858 |
| MS077 | HYPERTENSIVE ENCEPHALOPATHY W MCC | $83,111 |
| MS078 | HYPERTENSIVE ENCEPHALOPATHY W CC | $138,144 |
| MS080 | NONTRAUMATIC STUPOR COMA W MCC | $116,672 |
| MS081 | NONTRAUMATIC STUPOR COMA W/O MCC | $57,490 |
| MS082 | TRAUMATIC STUPOR COMA, COMA >1 HR W MCC | $127,111 |
| MS083 | TRAUMATIC STUPOR COMA, COMA >1 HR W CC | $101,163 |
| MS084 | TRAUMATIC STUPOR COMA, COMA >1 HR W/O CC/MCC | $59,711 |
| MS085 | TRAUMATIC STUPOR COMA, COMA <1 HR W MCC | $136,882 |
| MS086 | TRAUMATIC STUPOR COMA, COMA <1 HR W CC | $84,509 |
| MS087 | TRAUMATIC STUPOR COMA, COMA <1 HR W/O CC/MCC | $45,501 |
| MS089 | CONCUSSION W CC | $96,554 |
| MS090 | CONCUSSION W/O CC/MCC | $52,292 |
| MS091 | OTHER DISORDERS OF NERVOUS SYSTEM W MCC | $162,192 |
| MS092 | OTHER DISORDERS OF NERVOUS SYSTEM W CC | $127,073 |
| MS093 | OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC | $69,509 |
| MS094 | BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC | $188,314 |
| MS095 | BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC | $196,269 |
| MS096 | BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC | $185,819 |
| MS097 | NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC | $339,221 |
| MS098 | NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC | $178,315 |
| MS099 | NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC | $132,724 |
| MS100 | SEIZURES W MCC | $154,490 |
| MS101 | SEIZURES W/O MCC | $95,930 |
| MS102 | HEADACHES W MCC | $99,605 |
| MS103 | HEADACHES W/O MCC | $53,283 |
| MS113 | ORBITAL PROCEDURES W CC/MCC | $99,602 |
| MS114 | ORBITAL PROCEDURES W/O CC/MCC | $126,738 |
| MS115 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT | $148,438 |
| MS116 | INTRAOCULAR PROCEDURES W CC/MCC | $143,510 |
| MS117 | INTRAOCULAR PROCEDURES W/O CC/MCC | $52,810 |
| MS121 | ACUTE MAJOR EYE INFECTIONS W CC/MCC | $52,532 |
| MS122 | ACUTE MAJOR EYE INFECTIONS W/O CC/MCC | $31,211 |
| MS123 | NEUROLOGICAL EYE DISORDERS | $81,418 |
| MS124 | OTHER DISORDERS OF THE EYE W MCC | $107,559 |
| MS125 | OTHER DISORDERS OF THE EYE W/O MCC | $57,174 |
| MS129 | MAJOR HEAD NECK PROCEDURES W CC/MCC OR MAJOR DEVICE | $320,293 |
| MS130 | MAJOR HEAD NECK PROCEDURES W/O CC/MCC | $105,003 |
| MS131 | CRANIAL/FACIAL PROCEDURES W CC/MCC | $217,337 |
| MS132 | CRANIAL/FACIAL PROCEDURES W/O CC/MCC | $120,406 |
| MS133 | OTHER EAR, NOSE, MOUTH THROAT O.R. PROCEDURES W CC/MCC | $142,570 |
| MS134 | OTHER EAR, NOSE, MOUTH THROAT O.R. PROCEDURES W/O CC/MCC | $71,611 |
| MS135 | SINUS MASTOID PROCEDURES W CC/MCC | $163,319 |
| MS136 | SINUS MASTOID PROCEDURES W/O CC/MCC | $117,611 |
| MS137 | MOUTH PROCEDURES W CC/MCC | $52,623 |
| MS138 | MOUTH PROCEDURES W/O CC/MCC | $55,408 |
| MS146 | EAR, NOSE, MOUTH THROAT MALIGNANCY W MCC | $108,781 |
| MS147 | EAR, NOSE, MOUTH THROAT MALIGNANCY W CC | $53,718 |
| MS148 | EAR, NOSE, MOUTH THROAT MALIGNANCY W/O CC/MCC | $94,383 |
| MS149 | DYSEQUILIBRIUM | $58,338 |
| MS150 | EPISTAXIS W MCC | $501,959 |
| MS151 | EPISTAXIS W/O MCC | $54,333 |
| MS152 | OTITIS MEDIA URI W MCC | $60,293 |
| MS153 | OTITIS MEDIA URI W/O MCC | $26,827 |
| MS154 | OTHER EAR, NOSE, MOUTH THROAT DIAGNOSES W MCC | $171,104 |
| MS155 | OTHER EAR, NOSE, MOUTH THROAT DIAGNOSES W CC | $60,625 |
| MS156 | OTHER EAR, NOSE, MOUTH THROAT DIAGNOSES W/O CC/MCC | $34,882 |
| MS157 | DENTAL ORAL DISEASES W MCC | $107,935 |
| MS158 | DENTAL ORAL DISEASES W CC | $53,674 |
| MS159 | DENTAL ORAL DISEASES W/O CC/MCC | $40,935 |
| MS163 | MAJOR CHEST PROCEDURES W MCC | $275,944 |
| MS164 | MAJOR CHEST PROCEDURES W CC | $180,944 |
| MS165 | MAJOR CHEST PROCEDURES W/O CC/MCC | $157,027 |
| MS166 | OTHER RESP SYSTEM O.R. PROCEDURES W MCC | $319,894 |
| MS167 | OTHER RESP SYSTEM O.R. PROCEDURES W CC | $113,506 |
| MS168 | OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC | $112,346 |
| MS175 | PULMONARY EMBOLISM W MCC | $99,811 |
| MS176 | PULMONARY EMBOLISM W/O MCC | $51,415 |
| MS177 | RESPIRATORY INFECTIONS INFLAMMATIONS W MCC | $116,798 |
| MS178 | RESPIRATORY INFECTIONS INFLAMMATIONS W CC | $83,221 |
| MS179 | RESPIRATORY INFECTIONS INFLAMMATIONS W/O CC/MCC | $58,824 |
| MS180 | RESPIRATORY NEOPLASMS W MCC | $100,836 |
| MS181 | RESPIRATORY NEOPLASMS W CC | $56,263 |
| MS182 | RESPIRATORY NEOPLASMS W/O CC/MCC | $32,563 |
| MS183 | MAJOR CHEST TRAUMA W MCC | $137,130 |
| MS184 | MAJOR CHEST TRAUMA W CC | $71,261 |
| MS185 | MAJOR CHEST TRAUMA W/O CC/MCC | $49,842 |
| MS186 | PLEURAL EFFUSION W MCC | $87,999 |
| MS187 | PLEURAL EFFUSION W CC | $62,907 |
| MS188 | PLEURAL EFFUSION W/O CC/MCC | $41,094 |
| MS189 | PULMONARY EDEMA RESPIRATORY FAILURE | $77,236 |
| MS190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC | $73,893 |
| MS191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC | $54,775 |
| MS192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC | $46,092 |
| MS193 | SIMPLE PNEUMONIA PLEURISY W MCC | $80,552 |
| MS194 | SIMPLE PNEUMONIA PLEURISY W CC | $48,734 |
| MS195 | SIMPLE PNEUMONIA PLEURISY W/O CC/MCC | $34,374 |
| MS196 | INTERSTITIAL LUNG DISEASE W MCC | $123,953 |
| MS197 | INTERSTITIAL LUNG DISEASE W CC | $72,985 |
| MS198 | INTERSTITIAL LUNG DISEASE W/O CC/MCC | $45,841 |
| MS199 | PNEUMOTHORAX W MCC | $88,910 |
| MS200 | PNEUMOTHORAX W CC | $49,796 |
| MS201 | PNEUMOTHORAX W/O CC/MCC | $37,385 |
| MS202 | BRONCHITIS ASTHMA W CC/MCC | $54,994 |
| MS203 | BRONCHITIS ASTHMA W/O CC/MCC | $26,105 |
| MS204 | RESPIRATORY SIGNS SYMPTOMS | $43,800 |
| MS205 | OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC | $96,703 |
| MS206 | OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC | $56,260 |
| MS207 | RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $402,573 |
| MS208 | RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS | $140,261 |
| MS215 | OTHER HEART ASSIST SYSTEM IMPLANT | $807,160 |
| MS216 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC | $561,819 |
| MS217 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC | $395,029 |
| MS218 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC | $320,035 |
| MS219 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC | $396,326 |
| MS220 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC | $313,226 |
| MS221 | CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC | $255,564 |
| MS222 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC | $734,184 |
| MS223 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC | $259,111 |
| MS224 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC | $712,800 |
| MS225 | CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC | $519,149 |
| MS226 | CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC | $491,938 |
| MS227 | CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC | $432,552 |
| MS228 | OTHER CARDIOTHORACIC PROCEDURES W MCC | $378,002 |
| MS229 | OTHER CARDIOTHORACIC PROCEDURES W/O MCC | $255,111 |
| MS231 | CORONARY BYPASS W PTCA W MCC | $915,465 |
| MS232 | CORONARY BYPASS W PTCA W/O MCC | $331,909 |
| MS233 | CORONARY BYPASS W CARDIAC CATH W MCC | $413,468 |
| MS234 | CORONARY BYPASS W CARDIAC CATH W/O MCC | $302,174 |
| MS235 | CORONARY BYPASS W/O CARDIAC CATH W MCC | $297,994 |
| MS236 | CORONARY BYPASS W/O CARDIAC CATH W/O MCC | $236,143 |
| MS239 | AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W MCC | $379,160 |
| MS240 | AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W CC | $243,858 |
| MS241 | AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W/O CC/MCC | $214,437 |
| MS242 | PERMANENT CARDIAC PACEMAKER IMPLANT W MCC | $267,551 |
| MS243 | PERMANENT CARDIAC PACEMAKER IMPLANT W CC | $222,942 |
| MS244 | PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC | $163,847 |
| MS245 | AICD GENERATOR PROCEDURES | $362,316 |
| MS246 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS | $230,609 |
| MS247 | PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC | $164,611 |
| MS248 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS | $192,793 |
| MS249 | PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC | $150,631 |
| MS250 | PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC | $170,145 |
| MS251 | PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC | $139,305 |
| MS252 | OTHER VASCULAR PROCEDURES W MCC | $269,885 |
| MS253 | OTHER VASCULAR PROCEDURES W CC | $198,435 |
| MS254 | OTHER VASCULAR PROCEDURES W/O CC/MCC | $145,160 |
| MS255 | UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC | $191,994 |
| MS256 | UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC | $98,160 |
| MS257 | UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC | $26,871 |
| MS258 | CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC | $301,929 |
| MS259 | CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC | $153,040 |
| MS260 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC | $211,963 |
| MS261 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC | $179,521 |
| MS262 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC | $168,821 |
| MS263 | VEIN LIGATION STRIPPING | $197,128 |
| MS264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $215,539 |
| MS265 | AICD LEAD PROCEDURES | $346,850 |
| MS266 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC | $425,685 |
| MS267 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC | $388,182 |
| MS268 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC | $556,921 |
| MS269 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC | $340,848 |
| MS270 | OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC | $347,929 |
| MS271 | OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC | $250,015 |
| MS272 | OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC | $223,392 |
| MS273 | PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC | $320,158 |
| MS274 | PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC | $292,476 |
| MS280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC | $99,363 |
| MS281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC | $68,891 |
| MS282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC | $52,110 |
| MS283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC | $123,695 |
| MS284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC | $16,818 |
| MS286 | CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC | $153,763 |
| MS287 | CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC | $88,950 |
| MS288 | ACUTE SUBACUTE ENDOCARDITIS W MCC | $98,901 |
| MS289 | ACUTE SUBACUTE ENDOCARDITIS W CC | $157,125 |
| MS290 | ACUTE SUBACUTE ENDOCARDITIS W/O CC/MCC | $119,148 |
| MS291 | HEART FAILURE SHOCK W MCC OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $87,219 |
| MS292 | HEART FAILURE SHOCK W CC | $61,652 |
| MS293 | HEART FAILURE SHOCK W/O CC/MCC | $41,822 |
| MS294 | DEEP VEIN THROMBOPHLEBITIS W CC/MCC | $23,191 |
| MS296 | CARDIAC ARREST, UNEXPLAINED W MCC OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $210,001 |
| MS297 | CARDIAC ARREST, UNEXPLAINED W CC | $5,657 |
| MS299 | PERIPHERAL VASCULAR DISORDERS W MCC | $85,460 |
| MS300 | PERIPHERAL VASCULAR DISORDERS W CC | $63,200 |
| MS301 | PERIPHERAL VASCULAR DISORDERS W/O CC/MCC | $52,246 |
| MS302 | ATHEROSCLEROSIS W MCC | $87,406 |
| MS303 | ATHEROSCLEROSIS W/O MCC | $45,989 |
| MS304 | HYPERTENSION W MCC | $86,491 |
| MS305 | HYPERTENSION W/O MCC | $52,232 |
| MS306 | CARDIAC CONGENITAL VALVULAR DISORDERS W MCC | $107,681 |
| MS307 | CARDIAC CONGENITAL VALVULAR DISORDERS W/O MCC | $48,737 |
| MS308 | CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W MCC | $80,492 |
| MS309 | CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC | $47,141 |
| MS310 | CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W/O CC/MCC | $34,421 |
| MS311 | ANGINA PECTORIS | $48,054 |
| MS312 | SYNCOPE COLLAPSE | $54,989 |
| MS313 | CHEST PAIN | $40,337 |
| MS314 | OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC | $116,694 |
| MS315 | OTHER CIRCULATORY SYSTEM DIAGNOSES W CC | $63,414 |
| MS316 | OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC | $52,210 |
| MS319 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES W MCC | $247,970 |
| MS320 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES W/O MCC | $68,732 |
| MS326 | STOMACH, ESOPHAGEAL DUODENAL PROC W MCC | $344,336 |
| MS327 | STOMACH, ESOPHAGEAL DUODENAL PROC W CC | $168,756 |
| MS328 | STOMACH, ESOPHAGEAL DUODENAL PROC W/O CC/MCC | $127,044 |
| MS329 | MAJOR SMALL LARGE BOWEL PROCEDURES W MCC | $308,797 |
| MS330 | MAJOR SMALL LARGE BOWEL PROCEDURES W CC | $165,777 |
| MS331 | MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC | $135,125 |
| MS332 | RECTAL RESECTION W MCC | $209,696 |
| MS333 | RECTAL RESECTION W CC | $181,909 |
| MS334 | RECTAL RESECTION W/O CC/MCC | $176,248 |
| MS335 | PERITONEAL ADHESIOLYSIS W MCC | $236,149 |
| MS336 | PERITONEAL ADHESIOLYSIS W CC | $151,788 |
| MS337 | PERITONEAL ADHESIOLYSIS W/O CC/MCC | $126,440 |
| MS338 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC | $210,547 |
| MS339 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC | $115,268 |
| MS340 | APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC | $89,489 |
| MS341 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC | $98,507 |
| MS342 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC | $90,215 |
| MS343 | APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC | $75,996 |
| MS344 | MINOR SMALL LARGE BOWEL PROCEDURES W MCC | $128,650 |
| MS345 | MINOR SMALL LARGE BOWEL PROCEDURES W CC | $100,513 |
| MS346 | MINOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC | $113,034 |
| MS347 | ANAL STOMAL PROCEDURES W MCC | $174,760 |
| MS348 | ANAL STOMAL PROCEDURES W CC | $75,767 |
| MS349 | ANAL STOMAL PROCEDURES W/O CC/MCC | $51,375 |
| MS350 | INGUINAL FEMORAL HERNIA PROCEDURES W MCC | $164,418 |
| MS351 | INGUINAL FEMORAL HERNIA PROCEDURES W CC | $107,554 |
| MS352 | INGUINAL FEMORAL HERNIA PROCEDURES W/O CC/MCC | $83,228 |
| MS353 | HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W MCC | $235,584 |
| MS354 | HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W CC | $119,391 |
| MS355 | HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W/O CC/MCC | $107,664 |
| MS356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC | $282,837 |
| MS357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC | $128,532 |
| MS358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC | $136,394 |
| MS368 | MAJOR ESOPHAGEAL DISORDERS W MCC | $154,817 |
| MS369 | MAJOR ESOPHAGEAL DISORDERS W CC | $59,972 |
| MS370 | MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC | $55,859 |
| MS371 | MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W MCC | $124,025 |
| MS372 | MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W CC | $58,888 |
| MS373 | MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W/O CC/MCC | $36,614 |
| MS374 | DIGESTIVE MALIGNANCY W MCC | $120,629 |
| MS375 | DIGESTIVE MALIGNANCY W CC | $80,408 |
| MS376 | DIGESTIVE MALIGNANCY W/O CC/MCC | $122,465 |
| MS377 | G.I. HEMORRHAGE W MCC | $117,418 |
| MS378 | G.I. HEMORRHAGE W CC | $73,619 |
| MS379 | G.I. HEMORRHAGE W/O CC/MCC | $43,360 |
| MS380 | COMPLICATED PEPTIC ULCER W MCC | $131,103 |
| MS381 | COMPLICATED PEPTIC ULCER W CC | $94,651 |
| MS382 | COMPLICATED PEPTIC ULCER W/O CC/MCC | $68,762 |
| MS383 | UNCOMPLICATED PEPTIC ULCER W MCC | $426,557 |
| MS384 | UNCOMPLICATED PEPTIC ULCER W/O MCC | $54,308 |
| MS385 | INFLAMMATORY BOWEL DISEASE W MCC | $127,836 |
| MS386 | INFLAMMATORY BOWEL DISEASE W CC | $79,751 |
| MS387 | INFLAMMATORY BOWEL DISEASE W/O CC/MCC | $71,219 |
| MS388 | G.I. OBSTRUCTION W MCC | $124,282 |
| MS389 | G.I. OBSTRUCTION W CC | $58,457 |
| MS390 | G.I. OBSTRUCTION W/O CC/MCC | $47,254 |
| MS391 | ESOPHAGITIS, GASTROENT MISC DIGEST DISORDERS W MCC | $98,848 |
| MS392 | ESOPHAGITIS, GASTROENT MISC DIGEST DISORDERS W/O MCC | $48,549 |
| MS393 | OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC | $129,850 |
| MS394 | OTHER DIGESTIVE SYSTEM DIAGNOSES W CC | $67,006 |
| MS395 | OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC | $44,554 |
| MS405 | PANCREAS, LIVER SHUNT PROCEDURES W MCC | $494,240 |
| MS406 | PANCREAS, LIVER SHUNT PROCEDURES W CC | $231,766 |
| MS407 | PANCREAS, LIVER SHUNT PROCEDURES W/O CC/MCC | $172,209 |
| MS408 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC | $248,240 |
| MS409 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC | $155,065 |
| MS410 | BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC | $142,573 |
| MS412 | CHOLECYSTECTOMY W C.D.E. W CC | $384,815 |
| MS414 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC | $198,133 |
| MS415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC | $132,236 |
| MS416 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC | $131,946 |
| MS417 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC | $155,351 |
| MS418 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC | $114,931 |
| MS419 | LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC | $93,288 |
| MS420 | HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC | $345,510 |
| MS421 | HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC | $110,482 |
| MS422 | HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC | $157,546 |
| MS423 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC | $598,507 |
| MS424 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC | $111,724 |
| MS432 | CIRRHOSIS ALCOHOLIC HEPATITIS W MCC | $132,455 |
| MS433 | CIRRHOSIS ALCOHOLIC HEPATITIS W CC | $61,377 |
| MS434 | CIRRHOSIS ALCOHOLIC HEPATITIS W/O CC/MCC | $52,120 |
| MS435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC | $116,363 |
| MS436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC | $77,118 |
| MS437 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC | $84,316 |
| MS438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC | $121,329 |
| MS439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC | $60,292 |
| MS440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC | $42,162 |
| MS441 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC | $159,238 |
| MS442 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC | $80,035 |
| MS443 | DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC | $55,744 |
| MS444 | DISORDERS OF THE BILIARY TRACT W MCC | $123,943 |
| MS445 | DISORDERS OF THE BILIARY TRACT W CC | $88,942 |
| MS446 | DISORDERS OF THE BILIARY TRACT W/O CC/MCC | $59,155 |
| MS453 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC | $606,058 |
| MS454 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC | $480,219 |
| MS455 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC | $361,193 |
| MS456 | SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC | $426,067 |
| MS457 | SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC | $421,954 |
| MS458 | SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC | $393,963 |
| MS459 | SPINAL FUSION EXCEPT CERVICAL W MCC | $458,905 |
| MS460 | SPINAL FUSION EXCEPT CERVICAL W/O MCC | $298,884 |
| MS462 | BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC | $281,637 |
| MS463 | WND DEBRID SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC | $308,542 |
| MS464 | WND DEBRID SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC | $228,656 |
| MS465 | WND DEBRID SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC | $178,654 |
| MS466 | REVISION OF HIP OR KNEE REPLACEMENT W MCC | $396,001 |
| MS467 | REVISION OF HIP OR KNEE REPLACEMENT W CC | $262,443 |
| MS468 | REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC | $212,391 |
| MS469 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT | $264,446 |
| MS470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC | $156,543 |
| MS471 | CERVICAL SPINAL FUSION W MCC | $349,205 |
| MS472 | CERVICAL SPINAL FUSION W CC | $224,378 |
| MS473 | CERVICAL SPINAL FUSION W/O CC/MCC | $183,208 |
| MS474 | AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W MCC | $308,983 |
| MS475 | AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W CC | $177,006 |
| MS476 | AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W/O CC/MCC | $45,044 |
| MS477 | BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC | $366,150 |
| MS478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC | $211,601 |
| MS479 | BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC | $139,763 |
| MS480 | HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC | $216,019 |
| MS481 | HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC | $163,663 |
| MS482 | HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC | $125,268 |
| MS483 | MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | $179,970 |
| MS485 | KNEE PROCEDURES W PDX OF INFECTION W MCC | $289,470 |
| MS486 | KNEE PROCEDURES W PDX OF INFECTION W CC | $169,083 |
| MS487 | KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC | $117,139 |
| MS488 | KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC | $177,890 |
| MS489 | KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC | $130,823 |
| MS492 | LOWER EXTREM HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC | $272,515 |
| MS493 | LOWER EXTREM HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC | $200,317 |
| MS494 | LOWER EXTREM HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC | $154,154 |
| MS495 | LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W MCC | $267,592 |
| MS496 | LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W CC | $199,191 |
| MS497 | LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W/O CC/MCC | $103,758 |
| MS498 | LOCAL EXCISION REMOVAL INT FIX DEVICES OF HIP FEMUR W CC/MCC | $118,384 |
| MS499 | LOCAL EXCISION REMOVAL INT FIX DEVICES OF HIP FEMUR W/O CC/MCC | $107,552 |
| MS500 | SOFT TISSUE PROCEDURES W MCC | $246,845 |
| MS501 | SOFT TISSUE PROCEDURES W CC | $134,244 |
| MS502 | SOFT TISSUE PROCEDURES W/O CC/MCC | $111,943 |
| MS503 | FOOT PROCEDURES W MCC | $155,846 |
| MS504 | FOOT PROCEDURES W CC | $172,698 |
| MS505 | FOOT PROCEDURES W/O CC/MCC | $99,770 |
| MS506 | MAJOR THUMB OR JOINT PROCEDURES | $92,445 |
| MS507 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC | $159,510 |
| MS508 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC | $75,633 |
| MS510 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC | $214,690 |
| MS511 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC | $146,522 |
| MS512 | SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC | $106,170 |
| MS513 | HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC | $96,970 |
| MS514 | HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC | $78,429 |
| MS515 | OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W MCC | $304,833 |
| MS516 | OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W CC | $170,987 |
| MS517 | OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W/O CC/MCC | $124,429 |
| MS518 | BACK NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM | $265,899 |
| MS519 | BACK NECK PROC EXC SPINAL FUSION W CC | $144,153 |
| MS520 | BACK NECK PROC EXC SPINAL FUSION W/O CC/MCC | $95,970 |
| MS533 | FRACTURES OF FEMUR W MCC | $88,471 |
| MS534 | FRACTURES OF FEMUR W/O MCC | $51,695 |
| MS535 | FRACTURES OF HIP PELVIS W MCC | $95,399 |
| MS536 | FRACTURES OF HIP PELVIS W/O MCC | $60,384 |
| MS537 | SPRAINS, STRAINS, DISLOCATIONS OF HIP, PELVIS THIGH W CC/MCC | $77,666 |
| MS538 | SPRAINS, STRAINS, DISLOCATIONS OF HIP, PELVIS THIGH W/O CC/MCC | $41,956 |
| MS539 | OSTEOMYELITIS W MCC | $98,258 |
| MS540 | OSTEOMYELITIS W CC | $70,103 |
| MS541 | OSTEOMYELITIS W/O CC/MCC | $40,655 |
| MS542 | PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W MCC | $127,448 |
| MS543 | PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W CC | $92,963 |
| MS544 | PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W/O CC/MCC | $67,699 |
| MS545 | CONNECTIVE TISSUE DISORDERS W MCC | $158,656 |
| MS546 | CONNECTIVE TISSUE DISORDERS W CC | $80,198 |
| MS547 | CONNECTIVE TISSUE DISORDERS W/O CC/MCC | $55,518 |
| MS548 | SEPTIC ARTHRITIS W MCC | $122,743 |
| MS549 | SEPTIC ARTHRITIS W CC | $47,372 |
| MS550 | SEPTIC ARTHRITIS W/O CC/MCC | $61,938 |
| MS551 | MEDICAL BACK PROBLEMS W MCC | $89,418 |
| MS552 | MEDICAL BACK PROBLEMS W/O MCC | $60,451 |
| MS553 | BONE DISEASES ARTHROPATHIES W MCC | $128,605 |
| MS554 | BONE DISEASES ARTHROPATHIES W/O MCC | $44,667 |
| MS555 | SIGNS SYMPTOMS OF MUSCULOSKELETAL SYSTEM CONN TISSUE W MCC | $72,964 |
| MS556 | SIGNS SYMPTOMS OF MUSCULOSKELETAL SYSTEM CONN TISSUE W/O MCC | $54,850 |
| MS557 | TENDONITIS, MYOSITIS BURSITIS W MCC | $99,191 |
| MS558 | TENDONITIS, MYOSITIS BURSITIS W/O MCC | $64,953 |
| MS559 | AFTERCARE, MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC | $172,079 |
| MS560 | AFTERCARE, MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC | $145,192 |
| MS561 | AFTERCARE, MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC | $105,759 |
| MS562 | FX, SPRN, STRN DISL EXCEPT FEMUR, HIP, PELVIS THIGH W MCC | $93,381 |
| MS563 | FX, SPRN, STRN DISL EXCEPT FEMUR, HIP, PELVIS THIGH W/O MCC | $52,289 |
| MS564 | OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W MCC | $104,470 |
| MS565 | OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W CC | $75,033 |
| MS566 | OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC | $53,681 |
| MS570 | SKIN DEBRIDEMENT W MCC | $170,080 |
| MS571 | SKIN DEBRIDEMENT W CC | $109,176 |
| MS572 | SKIN DEBRIDEMENT W/O CC/MCC | $106,262 |
| MS573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC | $278,235 |
| MS574 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC | $152,467 |
| MS575 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC | $73,201 |
| MS576 | SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC | $455,388 |
| MS577 | SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC | $179,721 |
| MS578 | SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC | $123,390 |
| MS579 | OTHER SKIN, SUBCUT TISS BREAST PROC W MCC | $122,495 |
| MS580 | OTHER SKIN, SUBCUT TISS BREAST PROC W CC | $129,804 |
| MS581 | OTHER SKIN, SUBCUT TISS BREAST PROC W/O CC/MCC | $144,410 |
| MS582 | MASTECTOMY FOR MALIGNANCY W CC/MCC | $188,142 |
| MS583 | MASTECTOMY FOR MALIGNANCY W/O CC/MCC | $150,938 |
| MS584 | BREAST BIOPSY, LOCAL EXCISION OTHER BREAST PROCEDURES W CC/MCC | $153,980 |
| MS585 | BREAST BIOPSY, LOCAL EXCISION OTHER BREAST PROCEDURES W/O CC/MCC | $141,844 |
| MS592 | SKIN ULCERS W MCC | $85,586 |
| MS593 | SKIN ULCERS W CC | $61,525 |
| MS594 | SKIN ULCERS W/O CC/MCC | $25,351 |
| MS595 | MAJOR SKIN DISORDERS W MCC | $111,374 |
| MS596 | MAJOR SKIN DISORDERS W/O MCC | $46,925 |
| MS597 | MALIGNANT BREAST DISORDERS W MCC | $139,173 |
| MS598 | MALIGNANT BREAST DISORDERS W CC | $45,368 |
| MS600 | NON-MALIGNANT BREAST DISORDERS W CC/MCC | $72,452 |
| MS601 | NON-MALIGNANT BREAST DISORDERS W/O CC/MCC | $29,271 |
| MS602 | CELLULITIS W MCC | $96,183 |
| MS603 | CELLULITIS W/O MCC | $45,647 |
| MS604 | TRAUMA TO THE SKIN, SUBCUT TISS BREAST W MCC | $176,006 |
| MS605 | TRAUMA TO THE SKIN, SUBCUT TISS BREAST W/O MCC | $48,490 |
| MS606 | MINOR SKIN DISORDERS W MCC | $86,432 |
| MS607 | MINOR SKIN DISORDERS W/O MCC | $50,662 |
| MS614 | ADRENAL PITUITARY PROCEDURES W CC/MCC | $221,264 |
| MS615 | ADRENAL PITUITARY PROCEDURES W/O CC/MCC | $131,288 |
| MS616 | AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT, METABOL DIS W MCC | $258,086 |
| MS617 | AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT, METABOL DIS W CC | $154,652 |
| MS619 | O.R. PROCEDURES FOR OBESITY W MCC | $228,871 |
| MS620 | O.R. PROCEDURES FOR OBESITY W CC | $164,945 |
| MS621 | O.R. PROCEDURES FOR OBESITY W/O CC/MCC | $141,893 |
| MS622 | SKIN GRAFTS WOUND DEBRID FOR ENDOC, NUTRIT METAB DIS W MCC | $241,315 |
| MS623 | SKIN GRAFTS WOUND DEBRID FOR ENDOC, NUTRIT METAB DIS W CC | $127,644 |
| MS624 | SKIN GRAFTS WOUND DEBRID FOR ENDOC, NUTRIT METAB DIS W/O CC/MCC | $35,152 |
| MS625 | THYROID, PARATHYROID THYROGLOSSAL PROCEDURES W MCC | $139,768 |
| MS626 | THYROID, PARATHYROID THYROGLOSSAL PROCEDURES W CC | $123,281 |
| MS627 | THYROID, PARATHYROID THYROGLOSSAL PROCEDURES W/O CC/MCC | $100,285 |
| MS628 | OTHER ENDOCRINE, NUTRIT METAB O.R. PROC W MCC | $196,590 |
| MS629 | OTHER ENDOCRINE, NUTRIT METAB O.R. PROC W CC | $145,737 |
| MS630 | OTHER ENDOCRINE, NUTRIT METAB O.R. PROC W/O CC/MCC | $95,845 |
| MS637 | DIABETES W MCC | $94,696 |
| MS638 | DIABETES W CC | $60,795 |
| MS639 | DIABETES W/O CC/MCC | $41,210 |
| MS640 | MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC | $82,345 |
| MS641 | MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC | $49,908 |
| MS642 | INBORN AND OTHER DISORDERS OF METABOLISM | $60,222 |
| MS643 | ENDOCRINE DISORDERS W MCC | $110,100 |
| MS644 | ENDOCRINE DISORDERS W CC | $68,779 |
| MS645 | ENDOCRINE DISORDERS W/O CC/MCC | $43,957 |
| MS652 | KIDNEY TRANSPLANT | $712,408 |
| MS653 | MAJOR BLADDER PROCEDURES W MCC | $271,692 |
| MS654 | MAJOR BLADDER PROCEDURES W CC | $220,206 |
| MS655 | MAJOR BLADDER PROCEDURES W/O CC/MCC | $204,908 |
| MS656 | KIDNEY URETER PROCEDURES FOR NEOPLASM W MCC | $223,509 |
| MS657 | KIDNEY URETER PROCEDURES FOR NEOPLASM W CC | $165,029 |
| MS658 | KIDNEY URETER PROCEDURES FOR NEOPLASM W/O CC/MCC | $146,579 |
| MS659 | KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W MCC | $217,613 |
| MS660 | KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W CC | $124,305 |
| MS661 | KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC | $109,909 |
| MS662 | MINOR BLADDER PROCEDURES W MCC | $319,042 |
| MS663 | MINOR BLADDER PROCEDURES W CC | $191,822 |
| MS664 | MINOR BLADDER PROCEDURES W/O CC/MCC | $196,180 |
| MS665 | PROSTATECTOMY W MCC | $255,712 |
| MS666 | PROSTATECTOMY W CC | $137,306 |
| MS667 | PROSTATECTOMY W/O CC/MCC | $82,278 |
| MS668 | TRANSURETHRAL PROCEDURES W MCC | $234,757 |
| MS669 | TRANSURETHRAL PROCEDURES W CC | $104,896 |
| MS670 | TRANSURETHRAL PROCEDURES W/O CC/MCC | $84,105 |
| MS671 | URETHRAL PROCEDURES W CC/MCC | $393,749 |
| MS672 | URETHRAL PROCEDURES W/O CC/MCC | $148,053 |
| MS673 | OTHER KIDNEY URINARY TRACT PROCEDURES W MCC | $314,840 |
| MS674 | OTHER KIDNEY URINARY TRACT PROCEDURES W CC | $151,379 |
| MS675 | OTHER KIDNEY URINARY TRACT PROCEDURES W/O CC/MCC | $67,173 |
| MS682 | RENAL FAILURE W MCC | $96,894 |
| MS683 | RENAL FAILURE W CC | $61,592 |
| MS684 | RENAL FAILURE W/O CC/MCC | $212,573 |
| MS686 | KIDNEY URINARY TRACT NEOPLASMS W MCC | $127,260 |
| MS687 | KIDNEY URINARY TRACT NEOPLASMS W CC | $75,360 |
| MS688 | KIDNEY URINARY TRACT NEOPLASMS W/O CC/MCC | $44,276 |
| MS689 | KIDNEY URINARY TRACT INFECTIONS W MCC | $73,673 |
| MS690 | KIDNEY URINARY TRACT INFECTIONS W/O MCC | $49,747 |
| MS693 | URINARY STONES W/O ESW LITHOTRIPSY W MCC | $71,864 |
| MS694 | URINARY STONES W/O ESW LITHOTRIPSY W/O MCC | $30,181 |
| MS695 | KIDNEY URINARY TRACT SIGNS SYMPTOMS W MCC | $43,725 |
| MS696 | KIDNEY URINARY TRACT SIGNS SYMPTOMS W/O MCC | $39,709 |
| MS697 | URETHRAL STRICTURE | $75,529 |
| MS698 | OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC | $103,108 |
| MS699 | OTHER KIDNEY URINARY TRACT DIAGNOSES W CC | $70,746 |
| MS700 | OTHER KIDNEY URINARY TRACT DIAGNOSES W/O CC/MCC | $50,321 |
| MS707 | MAJOR MALE PELVIC PROCEDURES W CC/MCC | $195,625 |
| MS708 | MAJOR MALE PELVIC PROCEDURES W/O CC/MCC | $156,389 |
| MS709 | PENIS PROCEDURES W CC/MCC | $95,092 |
| MS710 | PENIS PROCEDURES W/O CC/MCC | $223,221 |
| MS711 | TESTES PROCEDURES W CC/MCC | $119,337 |
| MS712 | TESTES PROCEDURES W/O CC/MCC | $105,015 |
| MS713 | TRANSURETHRAL PROSTATECTOMY W CC/MCC | $84,041 |
| MS714 | TRANSURETHRAL PROSTATECTOMY W/O CC/MCC | $70,279 |
| MS715 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC | $165,553 |
| MS716 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W/O CC/MCC | $154,386 |
| MS717 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC | $210,078 |
| MS718 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC | $88,702 |
| MS722 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC | $60,094 |
| MS723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC | $88,103 |
| MS725 | BENIGN PROSTATIC HYPERTROPHY W MCC | $87,145 |
| MS726 | BENIGN PROSTATIC HYPERTROPHY W/O MCC | $50,256 |
| MS727 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC | $73,174 |
| MS728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC | $50,966 |
| MS729 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC | $120,042 |
| MS730 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC | $26,317 |
| MS734 | PELVIC EVISCERATION, RAD HYSTERECTOMY RAD VULVECTOMY W CC/MCC | $445,761 |
| MS736 | UTERINE ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC | $377,435 |
| MS737 | UTERINE ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC | $168,846 |
| MS738 | UTERINE ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC | $153,487 |
| MS739 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC | $265,373 |
| MS740 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC | $144,025 |
| MS741 | UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC | $121,633 |
| MS742 | UTERINE ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC | $110,554 |
| MS743 | UTERINE ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC | $85,605 |
| MS744 | DC, CONIZATION, LAPAROSCOPY TUBAL INTERRUPTION W CC/MCC | $121,856 |
| MS745 | DC, CONIZATION, LAPAROSCOPY TUBAL INTERRUPTION W/O CC/MCC | $102,313 |
| MS746 | VAGINA, CERVIX VULVA PROCEDURES W CC/MCC | $120,616 |
| MS747 | VAGINA, CERVIX VULVA PROCEDURES W/O CC/MCC | $150,580 |
| MS748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | $135,517 |
| MS749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC | $138,018 |
| MS754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC | $118,011 |
| MS755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC | $55,618 |
| MS756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC | $56,800 |
| MS757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC | $81,000 |
| MS758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC | $50,676 |
| MS759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC | $44,576 |
| MS760 | MENSTRUAL OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC | $56,056 |
| MS761 | MENSTRUAL OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC | $30,363 |
| MS768 | VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC | $36,873 |
| MS769 | POSTPARTUM POST ABORTION DIAGNOSES W O.R. PROCEDURE | $88,108 |
| MS770 | ABORTION W DC, ASPIRATION CURETTAGE OR HYSTEROTOMY | $54,789 |
| MS776 | POSTPARTUM POST ABORTION DIAGNOSES W/O O.R. PROCEDURE | $45,641 |
| MS779 | ABORTION W/O DC | $37,200 |
| MS783 | CESAREAN SECTION W STERILIZATION W MCC | $131,143 |
| MS784 | CESAREAN SECTION W STERILIZATION W CC | $81,559 |
| MS785 | CESAREAN SECTION W STERILIZATION W/O CC/MCC | $73,400 |
| MS786 | CESAREAN SECTION W/O STERILIZATION W MCC | $96,412 |
| MS787 | CESAREAN SECTION W/O STERILIZATION W CC | $72,723 |
| MS788 | CESAREAN SECTION W/O STERILIZATION W/O CC/MCC | $64,083 |
| MS789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $453,714 |
| MS790 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | $516,518 |
| MS791 | PREMATURITY W MAJOR PROBLEMS | $111,277 |
| MS792 | PREMATURITY W/O MAJOR PROBLEMS | $50,637 |
| MS793 | FULL TERM NEONATE W MAJOR PROBLEMS | $89,033 |
| MS794 | NEONATE W OTHER SIGNIFICANT PROBLEMS | $25,975 |
| MS795 | NORMAL NEWBORN | $22,951 |
| MS796 | VAGINAL DELIVERY W STERILIZATION/DC W MCC | $59,576 |
| MS797 | VAGINAL DELIVERY W STERILIZATION/DC W CC | $61,367 |
| MS798 | VAGINAL DELIVERY W STERILIZATION/DC WO CC/MCC | $54,733 |
| MS799 | SPLENECTOMY W MCC | $757,649 |
| MS800 | SPLENECTOMY W CC | $176,683 |
| MS801 | SPLENECTOMY W/O CC/MCC | $108,962 |
| MS802 | OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W MCC | $221,965 |
| MS803 | OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W CC | $132,804 |
| MS804 | OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W/O CC/MCC | $111,838 |
| MS805 | VAGINAL DELIVERY W/O STERILIZATION/DC W MCC | $37,355 |
| MS806 | VAGINAL DELIVERY W/O STERILIZATION/DC W CC | $32,225 |
| MS807 | VAGINAL DELIVERY W/O STERILIZATION/DC W/O CC/MCC | $28,181 |
| MS808 | MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W MCC | $165,917 |
| MS809 | MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W CC | $83,095 |
| MS810 | MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W/O CC/MCC | $128,580 |
| MS811 | RED BLOOD CELL DISORDERS W MCC | $72,285 |
| MS812 | RED BLOOD CELL DISORDERS W/O MCC | $51,139 |
| MS813 | COAGULATION DISORDERS | $105,035 |
| MS814 | RETICULOENDOTHELIAL IMMUNITY DISORDERS W MCC | $81,268 |
| MS815 | RETICULOENDOTHELIAL IMMUNITY DISORDERS W CC | $60,959 |
| MS816 | RETICULOENDOTHELIAL IMMUNITY DISORDERS W/O CC/MCC | $49,741 |
| MS817 | OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCC | $102,472 |
| MS818 | OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W CC | $89,671 |
| MS819 | OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W/O CC/MCC | $62,695 |
| MS820 | LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W MCC | $363,646 |
| MS821 | LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W CC | $256,831 |
| MS822 | LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC | $131,000 |
| MS823 | LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W MCC | $410,545 |
| MS824 | LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W CC | $175,454 |
| MS825 | LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC | $129,182 |
| MS826 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC | $353,137 |
| MS827 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC | $190,782 |
| MS828 | MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC | $179,743 |
| MS829 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC | $355,998 |
| MS830 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W/O CC/MCC | $194,575 |
| MS831 | OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W MCC | $67,311 |
| MS832 | OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC | $55,242 |
| MS833 | OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC | $44,663 |
| MS834 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC | $512,453 |
| MS835 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC | $339,095 |
| MS836 | ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC | $151,633 |
| MS837 | CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC | $227,092 |
| MS838 | CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT | $100,657 |
| MS839 | CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC | $76,942 |
| MS840 | LYMPHOMA NON-ACUTE LEUKEMIA W MCC | $188,893 |
| MS841 | LYMPHOMA NON-ACUTE LEUKEMIA W CC | $118,698 |
| MS842 | LYMPHOMA NON-ACUTE LEUKEMIA W/O CC/MCC | $83,878 |
| MS843 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC | $123,074 |
| MS844 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC | $66,035 |
| MS845 | OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC/MCC | $76,664 |
| MS846 | CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC | $124,310 |
| MS847 | CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC | $79,682 |
| MS849 | RADIOTHERAPY | $196,135 |
| MS853 | INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC | $363,640 |
| MS854 | INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CC | $136,353 |
| MS855 | INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC | $41,676 |
| MS856 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC | $301,538 |
| MS857 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC | $119,034 |
| MS858 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC | $77,567 |
| MS862 | POSTOPERATIVE POST-TRAUMATIC INFECTIONS W MCC | $96,561 |
| MS863 | POSTOPERATIVE POST-TRAUMATIC INFECTIONS W/O MCC | $62,065 |
| MS864 | FEVER AND INFLAMMATORY CONDITIONS | $52,044 |
| MS865 | VIRAL ILLNESS W MCC | $131,795 |
| MS866 | VIRAL ILLNESS W/O MCC | $50,826 |
| MS867 | OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W MCC | $92,244 |
| MS868 | OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W CC | $80,655 |
| MS869 | OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W/O CC/MCC | $46,440 |
| MS870 | SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS OR PERIPHERAL EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) | $379,886 |
| MS871 | SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC | $120,723 |
| MS872 | SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC | $65,548 |
| MS876 | O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS | $214,739 |
| MS880 | ACUTE ADJUSTMENT REACTION PSYCHOSOCIAL DYSFUNCTION | $68,872 |
| MS881 | DEPRESSIVE NEUROSES | $46,339 |
| MS882 | NEUROSES EXCEPT DEPRESSIVE | $48,421 |
| MS883 | DISORDERS OF PERSONALITY IMPULSE CONTROL | $52,571 |
| MS884 | ORGANIC DISTURBANCES INTELLECTUAL DISABILITY | $77,949 |
| MS885 | PSYCHOSES | $80,668 |
| MS886 | BEHAVIORAL DEVELOPMENTAL DISORDERS | $39,278 |
| MS887 | OTHER MENTAL DISORDER DIAGNOSES | $64,567 |
| MS894 | ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA | $35,072 |
| MS895 | ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY | $32,606 |
| MS896 | ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC | $89,183 |
| MS897 | ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC | $45,779 |
| MS901 | WOUND DEBRIDEMENTS FOR INJURIES W MCC | $379,584 |
| MS902 | WOUND DEBRIDEMENTS FOR INJURIES W CC | $136,961 |
| MS903 | WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC | $62,274 |
| MS904 | SKIN GRAFTS FOR INJURIES W CC/MCC | $224,028 |
| MS905 | SKIN GRAFTS FOR INJURIES W/O CC/MCC | $103,377 |
| MS906 | HAND PROCEDURES FOR INJURIES | $57,260 |
| MS907 | OTHER O.R. PROCEDURES FOR INJURIES W MCC | $289,609 |
| MS908 | OTHER O.R. PROCEDURES FOR INJURIES W CC | $137,301 |
| MS909 | OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC | $93,503 |
| MS913 | TRAUMATIC INJURY W MCC | $70,779 |
| MS914 | TRAUMATIC INJURY W/O MCC | $46,180 |
| MS915 | ALLERGIC REACTIONS W MCC | $85,982 |
| MS916 | ALLERGIC REACTIONS W/O MCC | $34,681 |
| MS917 | POISONING TOXIC EFFECTS OF DRUGS W MCC | $92,500 |
| MS918 | POISONING TOXIC EFFECTS OF DRUGS W/O MCC | $47,270 |
| MS919 | COMPLICATIONS OF TREATMENT W MCC | $129,948 |
| MS920 | COMPLICATIONS OF TREATMENT W CC | $71,526 |
| MS921 | COMPLICATIONS OF TREATMENT W/O CC/MCC | $53,768 |
| MS922 | OTHER INJURY, POISONING TOXIC EFFECT DIAG W MCC | $128,367 |
| MS923 | OTHER INJURY, POISONING TOXIC EFFECT DIAG W/O MCC | $34,483 |
| MS934 | FULL THICKNESS BURN W/O SKIN GRAFT OR INHAL INJ | $102,650 |
| MS935 | NON-EXTENSIVE BURNS | $26,360 |
| MS939 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC | $400,117 |
| MS940 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC | $256,901 |
| MS941 | O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC | $148,448 |
| MS945 | REHABILITATION W CC/MCC | $182,975 |
| MS946 | REHABILITATION W/O CC/MCC | $115,592 |
| MS947 | SIGNS SYMPTOMS W MCC | $76,021 |
| MS948 | SIGNS SYMPTOMS W/O MCC | $55,494 |
| MS949 | AFTERCARE W CC/MCC | $157,317 |
| MS950 | AFTERCARE W/O CC/MCC | $109,236 |
| MS951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $32,562 |
| MS955 | CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA | $772,359 |
| MS956 | LIMB REATTACHMENT, HIP FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA | $314,155 |
| MS957 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC | $1,155,150 |
| MS958 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC | $259,260 |
| MS959 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC | $110,933 |
| MS963 | OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC | $244,677 |
| MS964 | OTHER MULTIPLE SIGNIFICANT TRAUMA W CC | $98,949 |
| MS965 | OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC | $58,152 |
| MS969 | HIV W EXTENSIVE O.R. PROCEDURE W MCC | $601,039 |
| MS970 | HIV W EXTENSIVE O.R. PROCEDURE W/O MCC | $135,444 |
| MS974 | HIV W MAJOR RELATED CONDITION W MCC | $307,064 |
| MS975 | HIV W MAJOR RELATED CONDITION W CC | $71,087 |
| MS976 | HIV W MAJOR RELATED CONDITION W/O CC/MCC | $48,639 |
| MS977 | HIV W OR W/O OTHER RELATED CONDITION | $157,733 |
| MS981 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC | $335,722 |
| MS982 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC | $188,234 |
| MS983 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC | $122,809 |
| MS987 | NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC | $327,240 |
| MS988 | NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC | $104,397 |
| MS989 | NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC | $90,878 |
| MS998 | PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS | $50,237 |