Bill Item Long Desc Bill Item Activity Type HCHD_CPT NDC HCHD_Technical [Price Schedule] AWP
99291 - Critical Care - 99291
1710.6
99285 - Level 5 - 99285
940.7
99284 - Level 4 - 99284
684.1
99283 - Level 3 - 99283
470.6
99282 - Level 2 - 99282
342
99281 - Level 1 - 99281
213.8
UNATTENDED ELECTRICAL THERAPY -

85.8
MECHANICAL TRACTION - 97012
41.2
PT RE-EVALUATION -

85.8
PT Evaluation Charge -

137.5
OT EVALUATION MODERATE COMPLEXITY -

260
OT REEVALUATION -

159.6
Yes - 97010
41.2
Yes, Wound size is less than or equal to 20 sq cm - 97597
145.9
Yes, Wound Size is greater than 20 sq cm - 97598
187.3
Yes - 97602
81.7
Selective Debridement, total wound surface area, first 20 sq cm or less - 97597
145.9
PT Whirlpool Full Body - 97022
121.9
Speech Fluency Eval - 92521
350.3
Blood typing Rh (D) AFC GENERIC ADD-ON 86901
56.2
LH LC AFC GENERIC ADD-ON 83002
60.3
Thyroid Panel LC AFC GENERIC ADD-ON 84479
17.9
Oxygen Therapy HCH Asmt/Tx/Monitoring

25.7
Immediate Spin Blood Bank



ABO/Rh Typing Blood Bank 86901
112.3
ABO/Rh Interp Blood Bank 86900
56.2
ABO/Rh Retype Blood Bank 86900
56.2
Immediate Spin Blood Bank 86920
140.8
37 degrees Celsius Blood Bank 86921
140.8
Anti-Human Globulin Blood Bank 86922
140.8
Antibody Screen Tube Blood Bank 86885
84.6
Direct Coombs. Blood Bank 86880
70.5
ABO/Rh. Interp Blood Bank 86900
56.2
Blood Bank Product Request Blood Bank 36430
769.7
Bill ABID Blood Bank 86870
232.3
RBC CP2D 500 LR Blood Bank Product

462.4
RBC CPD 500 LR Blood Bank Product

462.4
RBC CPD AS1 500 LR Blood Bank Product

462.4
RBC CPD AS5 500 LR Blood Bank Product

462.4
RBC CPDA1 500 LR Blood Bank Product

462.4
FFP CPD Blood Bank Product

184.8
FFP CPDA1 Blood Bank Product

184.8
Frz Plasma CP2D Blood Bank Product

184.8
RT Holter Monitor 24hr - MS TECH CHARGE CADDO Cardiac Tx/Procedures 93225
300
ECG 12-Lead Acquisition Cardiovascular 93005
171
ECG 12-Lead Acquisition Cardiovascular 93005
171
96360 - HYDRATION, FIRST HOUR Critical Care 96360
214
IV THERAPY HYDRATION, EACH ADDITIONAL HOUR Critical Care 96361
72.5
ZZZ96365 - IV TX, FIRST HOUR Critical Care 96365
256.8
ZZZ96366 - IV TX, EACH ADDITIONAL HOUR/CRITICAL CARE Critical Care 96366
76.6
96367 - IV tx, sequential infusion Critical Care 96367
256.8
ZZZ96368 - IV tx, concurrent infusion Critical Care 96368
256.8
zzz96372 - Subq/IM Injection Critical Care 96372
149.4
ZZZ96373 - Intra-Arterial injection Critical Care



IVP INJECTION therapeutic or diagnostic ER Critical Care 96374
149.4
IV Injection, add new drug THERAPEUTIC OR DIAGNOSTIC Critical Care 96375
72.5
96376 - IV Push, add same drug Critical Care 96376
72.5
99281 - ED Level 1 Critical Care 99281
213.8
99282 - ED Level 2 Critical Care 99282
342
99283 - ED Level 3 Critical Care 99283
470.6
99284 - ED Level 4 Critical Care 99284
684.1
99285 - ED Level 5 Critical Care 99285
940.7
H: 99291 - ED Critical Care Critical Care 99291
1710.6
Critical Care, each 30 min Critical Care 99292
814.6
HEMORRHOID EXCISION Charge Emer Charges 46250
4275.9
EXCISION BENIGN LESION TRUNK, ARMS OR LEGS 1.1 TO 2.0 CM CHARGE Emer Charges 11402
528.4
I&D ABSCESS SMPL/SNGL Emer Charges 10060
308.3
INCISION/DRAINAGE ABCESS Emer Charges 10061
718.2
I&D PILONIDAL CYST SMPL Emer Charges 10080
308.3
PNCTR ASP ABSCESS!CYST Emer Charges 10160
68.3
DEBRID OF NAIL Emer Charges 11720
102.7
AVULSION NAIL PLATE SIN Emer Charges 11730
213.8
AVULSION NAIL PLATE EA Emer Charges 11732
145.9
EVAC NAIL HEMATOMA Emer Charges 11740
102.7
REPAIR NAILBED Emer Charges 11760
194
RPR SMPL SCLP!NCK 2.5< Emer Charges 12001
316.5
RPR SMPLE SCLP!NCK!TRK Emer Charges 12002
316.5
RPR SMPL 7.6-12.5 Emer Charges 12004
316.5
RPR SMPL SCLP!NCK!TRK!1 Emer Charges 12005
316.5
RPR SMPL FACE!EAR!EYE 2 Emer Charges 12011
316.5
RPR INT SCALP!TRNK 2.6> Emer Charges 12032
367.6
RPR INT SCLP TRNK EXT! Emer Charges 12034
367.6
RPR INT SCLP TRNK EXT 1 Emer Charges 12035
367.6
RPR INT NCK!HNDS!FT 2.6 Emer Charges 12042
367.6
RPR INT NCK!HNDS!FT 7.6 Emer Charges 12044
367.6
RPR INT FCE EAR NOSE 2. Emer Charges 12051
367.6
RPR INT FCE!EAR!ELID 2. Emer Charges 12052
367.6
RPR INT FCE!EAR!ELID!NO Emer Charges 12053
367.6
RPR INT FCE!EAR!ELID 7. Emer Charges 12054
367.6
RPR CMPLX ARM! LEG 2.6- Emer Charges 13121
470.6
RPR CMPLX ARM!LEG EA + Emer Charges 13122
470.6
RPR CMPLX FHEAD!CKS!HND Emer Charges 13132
470.6
RPR CMPLX FHEAD!CKS!CHN Emer Charges 13133
470.6
RPR CMPLX ELID!NZ!EAR 1 Emer Charges 13151
470.6
ADJACENT TISSUE TRANSFER Emer Charges 14040
213.8
DRESS/DEBRIDE BURN SM W Emer Charges 16020
203.6
DRESS/DEBRIDE BURN MED W Emer Charges 16025
280.8
RMVE FB MUSCLE SMPLE Emer Charges 20520
735.8
ACENTESIS ASP/INJ JNT MJR Emer Charges 20610
410.4
CLDS TRT NASAL FAC W/M Emer Charges 21315
171
CLOSED TRT RIB FX EA Emer Charges

356.1
CLSD TRT CLAVICULAR FX Emer Charges 23500
356.1
CLSD TRT SHLDR DISLOC W Emer Charges 23650
356.1
CLSD TRT DISLOC SHLDR W Emer Charges 23655
1710.6
CLSD TRT HUM FX W/O MAN Emer Charges 24530
356.1
CLSD TRT NURSEMAID ELBO Emer Charges 24640
256.8
CLSD TRT RAD SHFT W/MAN Emer Charges 25505
356.1
CLSD TRT RAD/ULN W/MAN Emer Charges 25565
356.1
CLSD TRT COLLES FX W/MN Emer Charges 25605
359.3
CLSD RPR FINGER DISLOCA Emer Charges 26670
356.1
AMPUTATION OF FINGER/TH Emer Charges 26951
2138.1
EX TUMOR THIGH/KNEE SUB Emer Charges 27327
2565.7
TRT KNEE DISLOCATE CLD Emer Charges 27552
1710.6
CLSD TRT PATELLA DISLOCAT Emer Charges 27560
356.1
CLSD TRT PROX FIB FS CL Emer Charges 27781
356.1
CLSD TRT ANDKLE DISL W/O Emer Charges 27840
356.1
RMVE FB FOOT SUBQ Emer Charges 28190
213.8
CLSD TRT NT GR TOE FX W Emer Charges 28515
256.8
CAST ARM LONG APPLY Emer Charges 29065
213.8
CAST ARM SHORT APPLY Emer Charges 29075
213.8
SPLINT ARM LONG APPLY Emer Charges 29105
256.8
SPLINT ARM SHORT STATIC Emer Charges 29125
205.2
SPLINT FINGER APPLY STA Emer Charges 29130
205.2
STRAPPING SHOULDER Emer Charges 29240
205.2
CAST LEG SHORT APPLY Emer Charges 29405
213.8
CAST LEG SHORT W/WALKER Emer Charges 29425
239.3
SPLINT LEG LONG APPLY Emer Charges 29505
256.8
SPLINT LEG SHORT APPLY Emer Charges 29515
205.2
STRAPPING KNEE Emer Charges 29530
205.2
CNTRL NOSE BLEED ANT SM Emer Charges 30901
342
ET TUBE PLACEMENT Emer Charges 31500
513.1
THORACENTESIS W/TUBE IN Emer Charges 32554
603.8
I/O PLACEMENT IV THERAP Emer Charges 36680
359.3
RMVE FB FROM PHARYNX Emer Charges 42809
128.3
GASTRIC INTUBATE/ASPRAT Emer Charges 43753
325.2
INCISE THROMBOSED HEMOR Emer Charges 46083
718.2
BLADDER IRRIGATION Emer Charges 51700
145.9
STRAIGHT CATH PLACEMENT Emer Charges 51701
145.9
FOLEY PLACEMENT SIMPLE Emer Charges 51702
196.5
FOLEY PLACEMENT COMPLEX Emer Charges 51703
232.9
INJ NERVE BLOCK OCCIPIT Emer Charges 64405
384.8
RMVE FB EYE CONJUN SUPE Emer Charges 65205
289.8
RMVE FB EYE CORNEAL W/L Emer Charges 65222
410.4
RMVE FB EXT EAR Emer Charges 69200
128.3
RMVE IMPACTED CERUMEN Emer Charges 69210
128.3
INTERM EYE EXAM NEW PT Emer Charges 92002
256.8
HYDRO THRPY 31-60 Emer Charges 96360
214
HYDRO THRPY > 1HR Emer Charges 96361
72.5
IV INFUSION UP TO 1 HR Emer Charges 96365
256.8
IV INFUS EA ADDED HR TO Emer Charges 96366
76.6
2nd THER/DIAG CONCURRENTF Emer Charges 96368
256.8
SUBQTHER INFUSION, UP TOR Emer Charges 96369
256.8
SUBQTHER INFUSION, ADDL R Emer Charges 96370
76.6
INJECTION EA IM/SQ/ANTI Emer Charges 96372
149.4
IV INJ INITIAL DRUG Emer Charges 96374
149.4
IV INJ EA ADD NEW DRUG Emer Charges 96375
72.5
IV INJ EA ADD SAME DRUG Emer Charges 96376
72.5
MOD SEDATION 5YR+ INT 30 Emer Charges

236.4
MOD SEDATION 5YR+ ADDL 15 Emer Charges

81.3
RPR DERMABOND (MCR ONLY Emer Charges

162.8
RPR SMPL FACE!EAR!EYE 2.6 - 5.0 Emer Charges 12013
316.5
ACENTESIS ASP/INJ JNT INT Emer Charges 20605
300
WAITING TIME 1/2 HR INCREMENTS Emer Charges

64.8
ADD'L CREW MEMBERS Emer Charges

75.6
ALS 1 NON EMERGENCY Emer Charges

513.1
ALS 1 EMERGENCY Emer Charges

855.5
BLS NON-EMERGENCY Emer Charges

308.3
BLS EMERGENCY Emer Charges

469.7
ALS 2 Emer Charges

1140
AMB TREATMENT/NO TRANSPORT Emer Charges

146.8
CLSD TX MCP DISLOC SNGL W/MANIP Emer Charges 26700
356.1
27808 Closed Treatment of Bimalleolar Ankle Fracture, w/o Manipulation, ED Fee Emer Charges 27808
197.4
RPR INT NCK/HNDS/FEET [2.5 CM Emer Charges 12041
367.6
CLOSED TX FINGER FX WO MANIP Emer Charges 26720
356.1
RPR INT SCLP/TRNK/EXT [2.5CM] Emer Charges 12031
367.6
INCISION/RMVL FOREIGN BODY, SUBCU SMPL Emer Charges 10120
446.7
CLOSED TREATMENT OF PATELLAR DISLOCATION W/ ANESTHESIA Emer Charges 27562
1710.6
SPLINT ELBOW/WRIST STATIC Emer Charges 29260
195.4
21310 CLSD TX NOSE FX W/O MANI Emer Charges 21310
165.4
MODERATE SEDATION, LESS THAN 5 YO, FIRST 30 MINUTES Emer Charges 99143
248.9
I&D, PERIANAL ABSCESS, SUPERFICIAL Emer Charges 46050
347.3
CLOSED TREATMENT INTERPHALANGEAL JOINT DISLOCATION, SINGLE, W/MANIPULATION; W/O ANESTHESIA Emer Charges 26770
323
I&D, FINGER ABSCESS; SIMPLE Emer Charges 26010
208.4
CLOSED TREATMENT INTERPHALANGEAL JOINT DISLOCATION (TOE) Emer Charges 28660
307.6
CLOSED TREATMENT OF RADIAL & ULNAR SHAFT FX W/O MANIPULATION Emer Charges 25560
341.8
INJECTION(S) SINGLE OR MULTIPLE TRIGGER POINT(S), 1 OR 2 MUSCLES Emer Charges 20552
170.9
I & D EPIDIDYMIS, TESTIS, SCROTAL SPACE Emer Charges 54700
275.6
TX of closed elbow dislocation w/o anesthesia Emer Charges 24600
275.6
REDUCTION OF OPEN DISLOCATION ANKLE JOINT Emer Charges 27846
279
ER LEVEL 1 ER ER Charges 99281
213.8
ER LEVEL 2 ER ER Charges 99282
342
ER LEVEL 3 ER ER Charges 99283
470.6
ER LEVEL 4 ER ER Charges 99284
684.1
ER LEVEL 5 ER ER Charges 99285
940.7
ER - Critical Care ER Charges 99291
1710.6
99201 OV/OP VISIT NP L-1 Evaluation and Management



Amylase Level General Lab 82150
82.1
Glucose Level General Lab 82947
61.6
Blood Urea Nitrogen General Lab 84520
79.5
Creatinine General Lab 82565
63.8
Sodium Level General Lab 84295
61.3
Potassium Level General Lab 84132
61.6
Chloride Level General Lab 82435
32.8
Carbon Dioxide Level General Lab 82374
73.1
Albumin Level General Lab 82040
56.2
Alkaline Phosphatase General Lab 84075
57.5
Bilirubin Direct General Lab 82248
67
Bilirubin Total General Lab 82247
67.3
Calcium Level Total General Lab 82310
63.8
Cholesterol High Density Lipid General Lab 83718
59.1
Cholesterol Total General Lab 82465
62.2
Creatine Kinase General Lab 82550
97.6
D-Dimer General Lab 85379
230.7
Digoxin Level General Lab 80162
146.5
Ethanol Level General Lab 80320
67.7
Gamma Glutamyl Transferase General Lab 82977
56.6
Hemoglobin General Lab 85018
31.2
Hematocrit General Lab 85014
31.2
Ketones Urine General Lab 82009
26.5
Lactic Acid General Lab 83605
75
Lipase Level General Lab 83690
76.6
Magnesium Level General Lab 83735
48.5
Occult Blood Stool General Lab 82272
39.6
Prothrombin Time General Lab 85610
70.5
Partial Thromboplastin Time General Lab 85730
76.6
Phosphorus Level General Lab 84100
47.5
Protein Total General Lab 84155
25.2
Salicylate Level General Lab 80299
75.9
Sedimentation Rate General Lab 85651
51.4
Thyroid Stimulating Hormone General Lab 84443
134.1
Triglycerides General Lab 84478
107.6
Uric Acid General Lab 84550
53.6
Urine Dipstick General Lab 81003
26.5
Vancomycin Lvl Random General Lab 80202
64.4
Creatine Kinase-MB General Lab 82553
137.5
ALT 1 General Lab 84460
82.3
Triiodothyronine Free General Lab 84481
35.7
AST 1 General Lab 84450
82.3
COLLECTION: Arterial Draw General Lab 36600
25.5
COLLECTION: Venous Draw General Lab 36415
16.9
Hematocrit General Lab 85014
31.2
Hemoglobin General Lab 85018
31.2
CRP High Sensitivity General Lab 86141
112.7
Influenza A + B Rapid General Lab 87804
152.8
NT Pro-BNP General Lab 83880
241.3
Dilantin Level General Lab 80185
95.1
Acetaminophen Level General Lab 80299
75.9
Free T4 General Lab 84439
140.8
Hemoglobin A1c 1 General Lab 83036
70.5
Lipid Panel 1 General Lab 80061
112
Therapeutic Phlebotomy. General Lab 99195
154.1
Ketone Serum General Lab 82009
26.5
Troponin I General Lab 84484
137.5
hCG Urine Qualitative General Lab 81025
61.9
hCG Qualitative, Serum General Lab 84703
61.9
Electrolyte Panel1 General Lab 80051
104
Strep A Screen General Lab 87880
73.1
Respiratory Syncytial Virus General Lab 87807
100.9
Renal Panel 1 General Lab 80069
134.1
.GTT-1 Hr General Lab 82951
111.3
.GTT-2 Hr General Lab 82952
61.6
.GTT-3 Hr General Lab 82952
61.6
Venipuncture Charge. General Lab 36415
16.9
Ferritin, Serum LC General Lab 82728
35.7
LDH LC General Lab 83615
47.5
Thyroxine (T4) LC General Lab 84436
49.1
T3 Uptake LC General Lab 84479
48.9
Triiodothyronine (T3) LC General Lab 84480
54.6
Triiodothyronine,Free,Serum LC General Lab 84481
57.5
Testosterone, Serum LC General Lab 84402
35.7
Iron, Serum LC General Lab 83540
47.5
Iron and TIBC LC General Lab 83550
54.6
Vitamin B12 LC General Lab 82607
35.7
Copper Serum LC General Lab 82525
42.1
Zinc, Plasma or Serum LC General Lab 84630
36.5
Complement C3, Serum LC General Lab 86160
53.6
Complement C4, Serum LC General Lab 86160
49.1
Cancer Antigen (CA) 125 LC General Lab 86304
55.8
FSH, Serum LC General Lab 83001
35.7
FSH and LH LC General Lab 83002
54
Insulin LC General Lab 83525
49.8
hCG,Beta Subunit, Qnt, Serum LC General Lab 84702
56.5
Prolactin LC General Lab 84146
55.8
Estradiol LC General Lab 82670
35.7
Rheumatoid Arthritis Factor LC General Lab 86431
50.7
C-Reactive Protein, Quant LC General Lab 86140
37
C-Reactive Protein, Cardiac LC General Lab 86141
37.7
Ammonia, Plasma LC General Lab 82140
60
Valproic Acid (Depakote) LC General Lab 80164
51.7
Theophylline, Serum LC General Lab 80198
63.2
Digoxin Serum LC General Lab 80162
39.2
Phenytoin (Dilantin), Serum LC General Lab 80185
44.3
Carbamazepine(Tegretol), LC General Lab 80156
62.2
Oxcarbazepine (Trileptal), LC General Lab 82542
57.5
Phenobarbital, Serum LC General Lab 80184
65.1
Lead, Blood (Adult) LC General Lab 83655
48.5
Lead, Blood (Pediatric) LC General Lab 83655
48.5
C-Peptide, Serum LC General Lab 84681
53.6
Prostate-Specific Ag, Serum LC General Lab 84153
32.9
Creatinine, Urine LC General Lab 82570
50.7
PTH, Intact LC General Lab 83970
51.7
Vitamin D, 25-Hydroxy LC General Lab 82306
35.7
C difficile Toxins A+B, EIA LC General Lab 87324
61.6
HCV Antibody LC General Lab 86803
51.7
H. pylori IgG, Abs LC General Lab 86677
66.4
H pylori, IgM, IgG, IgA Ab LC General Lab 86677
75.3
Antineutrophil Cytoplasmic Ab LC General Lab 86256
51.7
Saccharomyces cerevisiae Panel LC General Lab 86671
78.5
HSV 1 and 2-Specific Ab, IgG LC General Lab 86696
75.1
ANA Comprehensive Panel LC General Lab 86235
292.3
EBV Acute Infection Antibodies LC General Lab 86665
83.3
Rocky Mtn Spotted Fever, IgM LC General Lab 86757
50.2
Rocky Mtn Spotted Fev, IgG, Qn LC General Lab 86757
45.7
Antinuclear Antibodies Direct LC General Lab 86038
49.8
Antinuclear Antibodies, IFA LC General Lab 86038
49.8
Ova + Parasite Exam LC General Lab 87177
60.7
Calcium, 24Hr Urine LC General Lab 82340
51.4
Protein Electro, 24-Hour Urine LC General Lab 84165
54.5
Hematopath Consultation, Smear LC General Lab 85060
64.8
Panel 083824 LC General Lab 86701
54
Hepatitis Panel (4) LC General Lab 80074
74.6
HCV RT-PCR, Quant (Non-Graph) LC General Lab 87522
399.2
Lyme, Western Blot, Serum LC General Lab 86617
53.6
Aldolase LC General Lab 82085
47.5
Calcium, Ionized, Serum LC General Lab 82330
56.5
Hep B Surface Ab Qual LC General Lab 86706
48.9
Mitochondrial (M2) Antibody LC General Lab 83516
38.6
Thyroid Peroxidase (TPO) Ab LC General Lab 86376
35.7
CCP Antibodies IgG/IgA LC General Lab 86200
52.1
Lupus Anticoagulant Comp LC General Lab 85732
284.5
Ct, Ng, Trich vag by NAA LC General Lab 87491


Chlamydia/GC Amplification LC General Lab 87591
53
Chlamydia by NAA LC General Lab 87491
55.3
Gonococcus by NAA LC General Lab 87591
55.3
Trich vag by NAA LC General Lab 87661
55.3
LH LC General Lab 83002
60.3
FSH LC General Lab 83001
54.6
Creatinine, Urine LC General Lab 82570
17.6
Microalbumin, Urine LC General Lab 82043
17.6
Osmolality LC General Lab 83930
49.5
Stool Culture LC General Lab 87045
76.2
Anaerobic and Aerobic Culture LC General Lab



.Anaerobic Result LC General Lab 87186
23.9
.Aerobic Result LC General Lab 87186
23.9
Anaerobic/Aerobic/Gram Stain LC General Lab 87205
71.4
.Campylobacter Cult Result LC General Lab 87186
23.9
Blood Culture, Routine LC General Lab 87040
57.5
.Blood Cult Result LC General Lab 87186
23.9
Upper Respiratory Culture LC General Lab 87070
56.5
.Upper Resp Cult Result LC General Lab 87186
23.9
Aerobic Bacterial Culture LC General Lab 87070
59.1
.Aerobic Bact Cult Result LC General Lab 87186
23.9
Urine Culture, Routine LC General Lab 87086
54.9
.Urine Cult Result LC General Lab 87186
23.9
Anaerobic Culture LC General Lab 87075
70.5
.Anaerobic Cult Result LC General Lab 87186
23.9
Gram Stain Evaluation With Sputum Culture Reflex LC General Lab 87205
48.8
.Lower Resp Cult Result LC General Lab 87186
23.9
.Sputum Culture LC General Lab 87205
23.9
Anaerobic Culture LC General Lab 87075
70.5
Aerobic Culture LC General Lab 87070
59.1
Bill Antigen Type RBCs General Lab 86905
111.7
Glucose 1 Hour PP General Lab 82950
64.4
Urine Micro Albumin General Lab 82044
154.1
.GTT-4 Hr General Lab 82952
61.6
.GTT-5 Hr General Lab 82952
61.6
Microalbumin Level Urine General Lab 82043
154.1
HBsAg Screen LC General Lab 87340
48.9
Folate (Folic Acid), Serum LC General Lab 82746
51.4
GGT LC General Lab 82977
47.5
Tacrolimus (FK506), Blood LC General Lab 80197
135.7
Lithium (Eskalith), Serum LC General Lab 80178
49.5
Renin Activity, Plasma LC General Lab 84244
64.8
Creatinine Clearance LC General Lab 82575
63.8
Protein Total, Qn, 24-Hr Urine LC General Lab 84156
50.5
Calcitriol(1,25 di-OH Vit D) LC General Lab 82652
72.1
Homocyst(e)ine, Plasma LC General Lab 83090
66.2
IFE and PE, Serum LC General Lab 86334
100.2
Lamotrigine (Lamictal), Serum LC General Lab 80175
97.6
Osmolality, Urine LC General Lab 83935
52.4
Prealbumin LC General Lab 84134
56.2
Rotavirus Ag, EIA LC General Lab 87425
39.4
Sodium, Urine LC General Lab 84300
45.3
Testosterone, Free, Direct LC General Lab 84403
32.9
Uric Acid, 24 hr Urine LC General Lab 84560
32
Varicella-Zoster V Ab, IgG LC General Lab 86787
35.7
White Blood Cells (WBC), Stool LC General Lab 89055
53.2
ACTH, Plasma LC General Lab 82024
79.7
AFP, Serum, Tumor Marker LC General Lab 82105
51.7
Alk Phos Isoenzyme LC General Lab 84080
57.5
Anti-dsDNA Antibodies LC General Lab 86225
54.2
Antistreptolysin O Ab LC General Lab 86060
33.9
Ceruloplasmin LC General Lab 82390
35.3
Complement, Total (CH50) LC General Lab 31
39.6
Cortisol LC General Lab 82533
53.2
Cortisol, Urinary Free LC General Lab 82530
60
Dehydroepiandrosterone Sulfate LC General Lab 82627
59.3
Erythropoietin (EPO), Serum LC General Lab 82668
51.7
Estrogens, Total LC General Lab 82672
75.4
Factor V Leiden Mutation LC General Lab 81241
97.3
HAPTOGLOBIN QUAN General Lab 83010
54.6
Hep A Ab, Total LC General Lab 86708
37.6
HLA B27 Disease Association LC General Lab 81374
51.8
IGF-1 LC General Lab 84305
44.1
LDL Cholesterol (Direct) LC General Lab 83721
53.2
Levetiracetam (Keppra), S LC General Lab

75.4
Metanephrines, Frac, Qn, 24-Hr LC General Lab 83835
77.9
Potassium, 24 hr Urine LC General Lab 84133
34.4
Progesterone LC General Lab 84144
59.1
Reticulocyte Count LC General Lab 85045
48.5
Protein S, Free LC General Lab 85306
72.3
Testosterone,Free and Total LC General Lab 84403
75.4
Transferrin LC General Lab 84466
53.6
Vitamin B6 LC General Lab 84207
58.7
Aldosterone LCMS, Serum LC General Lab 82088
64.4
Immunoglobulin G, Qn, Serum LC General Lab 82784
19.8
BK Quant PCR (Plasma/Serum) LC General Lab 87799
428.8
Oxalate, Quant, 24-Hour Urine LC General Lab 83945
39.7
Methylmalonic Acid, Serum LC General Lab 83921
49.6
Chromogranin A LC General Lab 86316
73.5
Calculi, Urinary LC General Lab 82360
66
Luteinizing Hormone(LH), S LC General Lab 83002
60.3
H. pylori Stool Ag, EIA LC General Lab 87338
83
Acetaminophen (Tylenol), S LC General Lab

201.3
Vitamin A, Serum LC General Lab 84590
59.1
Catecholamines, Plasma LC General Lab 82384
85.2
Cytomegalovirus (CMV) Ab, IgM LC General Lab 86645
51
Catecholamines,Ur.,Free,24 Hr LC General Lab 82384
71.5
Phosphorus, 24 hr Urine LC General Lab 84105
46.3
IgG, Subclasses(1-4) LC General Lab 82784
97.7
Rubella Antibodies, IgG LC General Lab 86762
51.7
Cytomegalovirus (CMV) Ab, IgG LC General Lab 86644
50.7
Actin (Smooth Muscle) Antibody LC General Lab 83516
36.2
5-HIAA,Quant.,24 Hr Urine LC General Lab 83497
53.2
Alpha-1-Antitrypsin Phenotyp LC General Lab 82103
50.2
B.pertussisB.parapertussis PCR LC General Lab 87798
176.2
CMV PCR LC General Lab 87496
183.6
Cryptosporidium Detection LC General Lab 87328
131.5
Ethosuximide (Zarontin), Serum LC General Lab 80168
45.2
Fecal Fat, Qualitative LC General Lab 82705
54.6
Hep A Ab, IgM LC General Lab 86709
37.4
Hep B Core Ab, Tot LC General Lab 86705
48.9
Hgb Frac. w/o Solubility LC General Lab 83021
65.1
HSV, IgM I/II Combination LC General Lab 86694
43.5
Immunoglobulins A/G/M, Qn, Ser LC General Lab 82784
44.1
Insulin (6 Specimens) LC General Lab 83525
67.7
Lyme Disease Ab, Quant, IgM LC General Lab 86618
67.3
Myoglobin, Serum LC General Lab 83874
39.1
Protein Electro, Random Urine LC General Lab 84156
37.6
Protein,Total,Urine LC General Lab 84156
50.5
PTHrP (PTH-Related Peptide) LC General Lab 82397
56.2
Reverse T3 LC General Lab 84482
81.7
Thyroid Antibodies LC General Lab 86376
51.7
Thyrotropin Receptor Ab, Serum LC General Lab 83519
51.7
t-Transglutaminase (tTG) IgA LC General Lab 83516
100.9
C Diff Ag General Lab 87449
42
C Diff Toxin General Lab 87324
42
RPR LC General Lab 86593
47.5
Immunofixation, Serum LC General Lab 86334
91.3
CEA LC General Lab 82378
55.8
Parvovirus B19, Human, IgG/IgM LC General Lab 86747
68.9
Measles/Mumps/Rubella Immunity LC General Lab 86765
162.1
HSV IgG Rflx I/II Type Sp LC General Lab 86696
118.75
Carbohydrate Antigen 19-9 LC General Lab 86301
36.8
T pallidum Ab (FTA-Ab) LC General Lab 86780
36
CA 27.29 LC General Lab 86300
44.3
Sex Hormone Binding Globulin LC General Lab 84270
56.2
Bill Handling/Collection General Lab 36415
16.9
Glucose, POC General Lab 82962
65.1
WBC w/ Auto Diff General Lab 85048
32
CBC/Hemogram General Lab 85027
35.7
CBC w/ Auto Differential General Lab 85025
68.3
Vitamin C LC General Lab 82180
42.6
Bill Fungal culture General Lab 87101
57.1
West Nile Virus LC General Lab 86789
171
Giardia Lamblia Direct Detection EIA, LC General Lab 87329
72.1
Immunoglobulin A, Quant. Serum LC General Lab 82784
19.8
Mono Screen 1 General Lab 86308
85.6
Crystal, Synovial/Fluid LC General Lab 89060
35.9
Growth Hormone, Serum LC General Lab 83003
36
Bill Irradiation General Lab 86945
114.9
HCV RNA, PCR, Quant (Reflex to Genotyping LC General Lab 87522
179.2
Androstenedione LC General Lab 82157
50.9
Cobalt LC General Lab 83018
114.3
Chromium LC General Lab 82495
146.1
Varicella-Zoster IgM Ab LC General Lab 86787
70.3
Serotonin LC General Lab 84260
65.8
Cryoglobulin Ql LC General Lab 82595
47.9
Vitamin K1 LC General Lab 84597
241.2
Calprotectin Fecal LC General Lab 83993
335
Pregnenolone MS LC General Lab 84140
74
Thyroid Stim Immunoglobulin LC General Lab 84445
80.9
IGF-2 LC General Lab 83519
134.9
Protein C Activity (Chrom) LC General Lab 85303
106.9
Vitamin B1 (Thiamine) Whl Blood LC General Lab 84425
66.4
Mycoplasma pneu IgG IgM Abs LC General Lab 86738
43.5
QuantiFERON Client Incubated LC General Lab 86460
84
Mumps Antibodies, IgG LC General Lab 86735
35
Toxoplasma gondii Ab, IgG, Qn LC General Lab 86777
67
Thyroglobulin Reflex Profile LC General Lab 86800
32.6
.Thyroglobulin, Serum LC General Lab 86800
64.8
Anti-Centromere B Antibodies LC General Lab 86235
72.1
MRSA Screening Culture LC General Lab 87081
77.6
PT/INR 1 General Lab 85610
70.5
ABG 12 General Lab 82803
236.8
UDS 5 General Lab 80305
116.4
UA Complete 3 General Lab 81001
56.2
Manual Differential 2 General Lab 85007
42.8
CMP 11 General Lab 80053
172
BMP 8 General Lab 80048
147.1
Hepatic Panel 8 General Lab 80076
184.4
UA Micro 12 General Lab 81015
37.7
Whole Blood Glucose (WBG) General Lab 82962
65.1
O'Sullivan Test General Lab 82947
64.4
Toxin A/B. General Lab 87324
42
C Antigen General Lab 87449
42
Bill Drug Screen Collection Fee General Lab

41.9
General Health Panel 3 General Lab 80050
389.3
Salicylate, Serum LC General Lab

91.9
Acetylcholine Receptor Ab, All LC General Lab 83519
376.6
Insulin (5 Specimens) LC General Lab 83525
61.3
Mumps Antibodies, IgM LC General Lab 86735
54.2
Brucella Antibody IgM, EIA LC General Lab 86622
61.9
Celiac Disease Comprehensive LC General Lab 86255
96.4
Occult Blood, Gastric Fluid LC General Lab 31
39.6
Lyme Ab, Total/IgM Responses LC General Lab 86618
67.3
Protein Elec + Interp, Serum LC General Lab 84165
44.7
SLE Profile C LC General Lab 86235
70.3
Cystic Fibrosis Profile LC General Lab

591.2
PSA Total (Reflex To Free) LC General Lab 84153
107.2
HBV RT PCR, Quant (Graph) LC General Lab 87517
70.5
Aspergillus flavus Antibodies LC General Lab 86606
74.9
Gentamicin, Serum, Peak/Trough LC General Lab 80170
65.4
Lactoferrin LC General Lab 83630
89.7
Occult Blood 3x General Lab 82270
111.3
Bill DOT Drug Screen Fee General Lab 88175
61.3
Bill Medical Review Officer General Lab 99080
43
Bill Non-DOT Drug Screen Fee General Lab

61.3
Newborn Screening Test 3 General Lab 99001
88.7
Bill Volume Measurement General Lab 81050
21.8
Bill Semen Analysis General Lab 89320
47.5
Bill Endomysial Ab IgA General Lab 86255
69.5
Bill Paraneo Profile II General Lab

112.7
Bill Sulfate U24 General Lab 84392
58.7
Bill Tobramycin Peak & Trough General Lab 80200
86.8
Bill Crystal Exam BF General Lab 89060
61.6
Bill Cystine Qnt Urine General Lab 82131
59.1
Bill U Protein Electro General Lab 84166
89.7
Bill Cholinesterase General Lab 82480
60.3
Bill Fructosamine General Lab 82985
49.1
Bill CK Isoenzyme General Lab 82552
54.6
Bill Hep A Ab General Lab 86708
49.1
Bill Aluminum General Lab 82108
63.2
Bill CA 19-9 General Lab 86301
58.4
Bill LDH Isoenzyme General Lab 83625
60.3
Bill Chloride Urine General Lab 82436
45.3
Bill Cold Agglutinins General Lab 86157
57.1
Bill Thyroid Antiglobulin General Lab 86800
54.2
Bill Zinc General Lab 84630
48.5
Bill Fibrinogen General Lab 85384
48.9
Bill AFP Tetra General Lab 82105
102.7
Bill ASO Titer General Lab 86060
47.3
Bill Oxalate U24 General Lab 83945
57.7
Bill Cell Count BF General Lab 89051
44.7
Bill Thyroid Autoantibodies General Lab 86376
65.4
Bill IgG Subclass 4 General Lab 82787
63.8
Bill Magnesium Urine General Lab 83735
49.8
Bill Antithrombin Activity General Lab 85300
82.1
Bill Protein C Antigen General Lab 85302
99.9
Bill Lactic Acid General Lab 83605
56.2
Bill Ammonia Urine General Lab 82140
59.3
Bill Homocystine General Lab 83090
85.8
Bill T3 Uptake Panel General Lab 84479
26.1
Bill Thyroid Perox Panel General Lab 86376
32.6
Bill Proinsulin General Lab 84206
91.9
Bill Vitamin E General Lab 84446
55.2
Bill Growth Hormone General Lab 83003
54.9
Bill Beta 2 Microglobulin General Lab 82232
56.2
Bill Topiramate General Lab 80201
89.7
Bill VMA Urine General Lab 84585
59.1
Bill Gabapentin General Lab

92.5
Bill Zonegran General Lab 82542
166.5
Bill 5 HIAA General Lab 83497
61.6
Bill Potassium Urine General Lab 84133
48.9
Bill Vasopressin General Lab 84588
67
Bill Immunofixation Urine General Lab 86335
92.5
Bill DHEAS General Lab 82627
59.1
Bill Maternal Serum General Lab 82105
63.2
Bill Protein S Antigen General Lab 85306
104
Bill Cardiolipin General Lab 86147
95.4
Bill Parvovirus B19 IgG/IgM General Lab 86747
51
Bill Brucella Abortis IgG General Lab 86622
61.9
Bill Hep A Ab IgM General Lab 86709
49.1
Bill CA 27.29 General Lab 86300
58.4
Bill Rocky Mtn Spotted IgG General Lab 86757
69.3
Bill Sjogren's Anti A & B General Lab 86235
68.6
Bill Insulin Autoantibodies General Lab 86337
83.9
Bill Rubeola Titer General Lab 86765
53.6
Bill CCP Antibody General Lab 86200
46.6
Bill Ehrlichia Chaf DNA PCR General Lab 87798
278.2
Bill CMV Qual PCR General Lab 87496
258.2
Bill Rotavirus General Lab 87425
59.1
Bill Amebiasis Antibodies General Lab 86753
104
Bill Methylmalonic Acid General Lab 83921
66
Bill Actin (Smooth Muscle) General Lab 83516
100.9
Bill Myoglobin General Lab 83874
130.8
Bill Transfusion Reaction General Lab 86078
446.7
Bill PSA Screening General Lab

91.5
Microalbumin, 24 Hour LC General Lab 82043
33.9
Liver-Kidney Microsomal Ab LC General Lab 86376
39.82
Creatinine, Urine LC General Lab 82570
9.1
Calcium, Urine LC General Lab 82340
9.1
Osmolality, Urine LC General Lab 83935
9.1
Uric Acid, Urine LC General Lab 84560
9.1
Citric Acid, 24hr U LC General Lab 82507
9.1
Oxalates, Urine 24hr LC General Lab 83945
9.1
Phosphorus, Urine 24hr LC General Lab 84105
9.1
Magnesium, U LC General Lab 83735
9.1
Sulfate, Ur, mEq/L LC General Lab 84392
9.1
Cystine, Quant Ur LC General Lab 82131
9.1
Chloride, Urine mmol/24 hr LC General Lab 82436
9.1
Sodium, Urine 24hr LC General Lab 84300
9.1
Potassium, Urine 24hr LC General Lab 84133
9.1
pH, 24 Hr Urine LC General Lab 81003
9.1
Ammonia, Urine LC General Lab 82140
9.1
Salivary Cortisol LC General Lab 82533
75.6
Systemic Lupus Profile A LC General Lab 86431
59.9
Free and Total Insulin LC General Lab 83527
39.3
Selenium, Serum/Plasma LC General Lab 84255
67.4
HIV 4th Gen Screen w Reflex LC General Lab 87389
66.2
B pertussis IgA Ab LC General Lab 86615
127.6
C. difficile, Toxigenic by PCR General Lab 87493
69.3
Thyroid Panel LC General Lab 84436
18.1
Stool Culture, Vibrio Only LC General Lab 87046
70.9
Stool Culture, Yersinia Only LC General Lab 87046
57.8
Respiratory Syncytial Virus, Molecular General Lab 87801
127.3
Viral Culture,Rapid,Lesion LC General Lab 87254
76.1
Soluble Liver Ag (IgG Ab) LC General Lab 83516
140.63
Antidiuretic Hormone (ADH) Profile LC General Lab 84588
68.4
HRT Initial Male General Lab 82670
441
HRT Initial Female General Lab 83001
374.9
Influenza A + B Rapid Molecular General Lab 87502
191.6
Strep A Molecular General Lab 87651
79.2
Ketones, whole blood General Lab 82010
62.4
Neuron-specific Enolase (NSE) LC General Lab 86316
64.6
hCG, Quantitative Serum General Lab 84702
47.22
EGD DX GI Tx/Procedures 43235
2360.5
EGD W/ BIOPSY GI Tx/Procedures 43239
2360.5
COLONOSCOPY FLEX - DX GI Tx/Procedures 45378
2095.3
COLONOSCOPY FLEX W/BIOPSY, SNGL OR MULT GI Tx/Procedures 45380
2095.3
COLONOSCOPY FLEX WITH LESION ABLATION OR ERMOVAL OF TUMORS, POLPS, OR OTHER LESIONS (DIALATION & WIR GI Tx/Procedures 45388
2095.3
COLONOSCOPY FLEX W/RMVL LESION BY SNARE GI Tx/Procedures 45385
2095.3
COLONOSCOPY SCREEN - HIGHRISK PATIENT GI Tx/Procedures

1907.1
COLONOSCOPY SCREEN - NOT HIGHRISK GI Tx/Procedures

1907.1
Admin of Pneumococcal Immunization Immunization Charge



90471 IMMUNIZATION ADMINISTRATION Immunization Charge 90471
149.4
IMMUNIZATION ADM STATE Immunization Charge 90472
72.5
G0009 ADMIN OF PNEU VAC Immunization Charge 90471
42.8
G0008 ADMIN OF INFL VAC Immunization Charge 90471
42.2
96367 SEQ INFUSION UP TO 1HR IV Therapy Charges 96367
256.8
96413 CHEMO IV INFUSION 1 HR IV Therapy Charges 96413
268
96415 CHEMO IV INFUSION ADDTL IV Therapy Charges 96415
83
Irrigation of VAD Misc Charges 96523
52.9
29700 RMVE CAST BOOT OR BODY Misc Charges 29700
213.8
11300 I&D ABSCESS SMPL/SNGL Misc Charges 10060
308.3
92950 CPR Misc Charges 92950
513.1
SHAVE LESION, SNGL <0.5 CM Misc Charges 11300
308.3
RPR SMPL FACE/EAR/EYE/NOSE <2.5 Misc Charges 12011
241.5
LESION DESTRUCTION BENIGN, UP TO 14 LESIONS Misc Charges 17110
162.8
RMVE CAST BOOT OR BODY Misc Charges 29700
213.8
DEBRIDE <20 CM Misc Charges 97597
145.9
DEBRIDE, NON SELECTIVE Misc Charges 97602
167.5
TREATMENT ROOM Misc Charges 99211
171
TREATMENT ROOM (ESTABLISHED) Misc Charges 99211
171
SLEEP LAB POLYSOMNOGRAM Misc Charges 95810
2822.2
SLEEP LAB SPLIT NIGHT STD Misc Charges 95811
2993.2
PAS AIDE VISIT/HR Misc Charges

24.3
97802 MNT INDIV INITIAL ASSESSMENT AND INTERVENTION (EA 15 MIN) CHARGE Nutrition Services Charges 97803
49.6
97803 MNT INDIV REASSESSMENT AND INTERVENTION (EA 15 MIN) CHARGE Nutrition Services Charges 97803
40.3
Community/Work Reintegration Charges Occupational Therapy Charges 97537
94.1
Cognitive Skills Development Charges Occupational Therapy Charges 97532
82.7
Group Therapy Charge Occupational Therapy Charges 97150
54.6
Therapeutic Activities Charges Occupational Therapy Charges 97530
106.9
Therapeutic Exercise Charges Occupational Therapy Charges 97110
94.1
ADL Training Charges Occupational Therapy Charges 97535
106.9
OT Self Care, Home Management Charges Occupational Therapy Charges 97535
106.9
97003 OT EVALUATION CHARGE Occupational Therapy Charges

260
97004 OT RE-EVALUATION CHARGE Occupational Therapy Charges

159.6
97110 THER EXERCISE-OT CHARGE Occupational Therapy Charges 97110
94.1
97150 OT GROUP THERAPY CHARGE Occupational Therapy Charges 97150
54.6
97530 OT THERAPEUTIC ACTIVITY CHARGE Occupational Therapy Charges 97530
106.9
97532 OT COGNITIVE SKILLS DEVELOPMENT CHARGE Occupational Therapy Charges 97532
82.7
97533 OT SENSORY INTEGRATIVE TECHNIQUE CHARGE Occupational Therapy Charges 97533
90
97537 OT COMMUNITY/WORK REINTEGRATION CHARGE Occupational Therapy Charges 97537
94.1
97542 OT WHEELCHAIR MGMT TRAINING CHARGE Occupational Therapy Charges 97542
94.1
OT Sensory Integrative Techniques Units OT Tx/Procedures 97533
90
OT Wheelchair Management Units OT Tx/Procedures 97542
94.1
Diathermy Mode Patient Care 97024
75.4
Add'l 30 Min Increments CC > 74 Patient Care 99292
814.6
EKG 12 Lead (Nursing) Patient Care 93005
171
Ambulance Mileage One Patient Care

9.6
Ambulance Mileage Two Patient Care

9.6
Ambulance Mileage Three Patient Care



Ambulance Mileage One Patient Care

9.6
Ambulance Mileage Two Patient Care

9.6
Ambulance Mileage Three Patient Care

9.6
ROOM/BED: Private Person Management

641.7
ROOM/BED: Semi Private Person Management

598.6
ROOM/BED: Swing Person Management

282.1
ROOM/BED: Observation Person Management

26.5
ROOM/BED: Level 2 Person Management

213.8
ROOM/BED: Level 3 Person Management

375
ROOM/BED: Level 1 Person Management

145.9
ROOM/BED: Respite Self Person Management

100.9
00713-0165-12 - acetaminophen 650 mg Supp [HCHD] Pharmacy
00713-0165-12
1.25
68094-0593-58 - acetaminophen 160 mg/5 mL Oral Susp 5 mL [HCHD] Pharmacy
68094-0593-58
1.4
63739-0002-01 - acetaminophen 325 mg Tab [HCHD] Pharmacy
63739-0002-01
0.78
00713-0118-12 - acetaminophen 120 mg Supp [HCHD] Pharmacy
00713-0118-12
1.25
00713-0164-12 - acetaminophen 325 mg Supp [HCHD] Pharmacy
00713-0164-12
1.25
63739-0001-01 - acetaminophen 500 mg Tab [HCHD] Pharmacy
63739-0001-01
0.78
00121-0504-05 - acetaminophen-codeine 120 mg-12 mg/5 mL Oral Liq 5 mL [HCHD] Pharmacy
00121-0504-05
0.78
63739-0004-10 - acetaminophen-codeine 300 mg-30 mg Tab [HCHD] Pharmacy
63739-0004-10
0.9
63323-0690-30 - acetylcysteine 20% Inh Sol 30 mL [HCHD] Pharmacy
63323-0690-30
3.46
00054-3027-02 - acetylcysteine 10% Inh Sol 10 mL [HCHD] Pharmacy
00054-3027-02
1.2
00378-2200-01 - acyclovir 200 mg Cap [HCHD] Pharmacy
00378-2200-01
2.552
25021-0301-02 - adenosine 3 mg/mL inj 2 mL [HCHD] Pharmacy
25021-0301-02
21.62
00121-1761-30 - Alum hyd/Mg hyd/simeth Mag-AL Plus Susp 30 mL [HCHD] Pharmacy
00121-1761-30
2.8
44206-0251-05 - albumin human 25% IV Sol 50 mL [HCHD] Pharmacy
44206-0251-05
1.16
00173-0682-24 - albuterol CFC free 90 mcg/ inh Ventolin 8 gm [HCHD] Pharmacy
00173-0682-24
0.78
49502-0672-60 - albuterol-ipratropium Inh Sol 3 mL [HCHD] Pharmacy
49502-0672-60
2.911
51079-0789-20 - ALPRAZolam 0.5 mg Tab [HCHD] Pharmacy
51079-0789-20
0.77
00409-4346-73 - aminocaproic acid 250 mg/mL vial 20 mL [HCHD] Pharmacy
00409-4346-73
10.9
00093-9133-06 - amiodarone 200 mg Tab [HCHD] Pharmacy
00093-9133-06
7.94
63323-0616-03 - amiodarone 150 mg/3 mL Inj [HCHD] Pharmacy
63323-0616-03
4.36
51079-0107-20 - amitriptyline 25 mg Tab [HCHD] Pharmacy
51079-0107-20
0.88
51079-0451-20 - amLODIPine 5 mg Tab [HCHD] Pharmacy
51079-0451-20
4.82
00093-4155-79 - amoxicillin 250 mg/5 mL Oral Liq 5 mL [HCHD] Pharmacy
00093-4155-79
0.78
00093-3107-05 - amoxicillin 250 mg Cap [HCHD] Pharmacy
00093-3107-05
0.78
68084-0235-01 - amoxicillin-clavulanate 500 mg-125 mg Tab [HCHD] Pharmacy
68084-0235-01
5.24
66685-1001-01 - amoxicillin-clavulanate 875 mg-125 mg Tab [HCHD] Pharmacy
66685-1001-01
6.99
43598-0012-51 - amoxicillin-clavulanate 125 mg-31.25 mg/5 mL Powder-Rec [HCHD] Pharmacy
43598-0012-51
10.8
63323-0389-10 - ampicillin 1GM vial [HCHD] Pharmacy
63323-0389-10
11.97
63323-0368-20 - ampicillin-sulbactam 1.5 gm vial [HCHD] Pharmacy
63323-0368-20
10.73
11098-0507-01 - Cyanide Antidote Kit [HCHD] Pharmacy
11098-0507-01
459.68
24208-0561-62 - antipyrine-benzocaine Otic Sol [HCHD] Pharmacy
24208-0561-62
1.79
50633-0110-12 - antivenin (Crotalidae) polyvalent vial [HCHD] Pharmacy
50633-0110-12
3565.2
00182-0068-01 - ascorbic acid 500 mg Tab [HCHD] Pharmacy
00182-0068-01
0.78
00904-2009-40 - aspirin 325 mg Tab [HCHD] Pharmacy
00904-2009-40
0.78
00536-3297-36 - aspirin 81 mg Chew Tab [HCHD] Pharmacy
00536-3297-36
0.78
49692-0903-77 - aspirin 325 mg Oral EC Tab [HCHD] Pharmacy
49692-0903-77
0.78
63739-0522-10 - aspirin 81 mg Oral EC Tab [HCHD] Pharmacy
63739-0522-10
0.78
00597-0001-60 - aspirin-dipyridamole 25 mg-200 mg SA Cap [HCHD] Pharmacy
00597-0001-60
9.294
63304-0621-01 - atenolol 25 mg Tab [HCHD] Pharmacy
63304-0621-01
1.3
00071-0155-40 - atorvastatin 10 mg Tab [HCHD] Pharmacy
00071-0155-40
6.42
00517-0101-25 - atropine 1 mg/mL inj 1 mL [HCHD] Pharmacy
00517-0101-25
19.03
00781-1496-69 - azithromycin 250 mg Tab [HCHD] Pharmacy
00781-1496-69
12.68
10019-0648-02 - azithromycin 500 mg vial [HCHD] Pharmacy
10019-0648-02
19.8
59762-3120-01 - azithromycin 200 mg/5 mL oral syr [HCHD] Pharmacy
59762-3120-01
16.1
00603-0441-50 - bacitracin Top 500 units/g Oint 28 gm [HCHD] Pharmacy
00603-0441-50
0.77
00168-0012-31 - bacitracin/neomycin/polymyxin B Top Oint 28.4 gm [HCHD] Pharmacy
00168-0012-31
7.97
00168-0012-09 - bacitracin/neomycin/polymyxin B Top Oint packet [HCHD] Pharmacy
00168-0012-09
0.77
00172-4096-60 - baclofen 10 mg Tab [HCHD] Pharmacy
00172-4096-60
3.42
00283-0679-02 - benzocaine Top 20% Hurricaine Spray [HCHD] Pharmacy
00283-0679-02
0.61
68084-0214-01 - benzonatate 100 mg Cap [HCHD] Pharmacy
68084-0214-01
1.11
00182-1992-01 - bisacodyl 5 mg Oral EC Tab [HCHD] Pharmacy
00182-1992-01
0.78
51285-0060-01 - bisoprolol 5 mg Tab [HCHD] Pharmacy
51285-0060-01
5.39
00185-0704-01 - bisoprolol-hydrochlorothiazide 5 mg-6.25 mg Tab [HCHD] Pharmacy
00185-0704-01
1.142
00186-1989-04 - budesonide 0.5 mg/2 mL Inh Susp [HCHD] Pharmacy
00186-1989-04
15.35
00409-1560-29 - bupivacaine 0.5% PF 30 mL inj [HCHD] Pharmacy
00409-1560-29
0.42
00173-0135-55 - buPROPion 150 mg SR Tab [HCHD] Pharmacy
00173-0135-55
4.899
00409-1626-01 - butorphanol 2 mg/mL vial 1mL [HCHD] Pharmacy
00409-1626-01
8.86
00245-0008-35 - calcitonin 200 intl units/inh Nasal Spray [HCHD] Pharmacy
00245-0008-35
39.52
76329-3304-01 - calcium chloride 100 mg/mL 10 mL IV syr [HCHD] Pharmacy
76329-3304-01
1.5
63323-0311-10 - calcium gluconate 100 mg/mL vial 10 mL [HCHD] Pharmacy
63323-0311-10
1.17
00536-7817-08 - calcium-vitamin D 500 mg-200 intl units Tab [HCHD] Pharmacy
00536-7817-08
0.78
00378-3007-10 - captopril 12.5 mg Tab [HCHD] Pharmacy
00378-3007-10
0.005
00093-0293-10 - carbidopa-levodopa 25 mg-100 mg Tab [HCHD] Pharmacy
00093-0293-10
1.76
00007-4139-20 - carvedilol 3.125 mg Tab [HCHD] Pharmacy
00007-4139-20
2.95
51079-0931-20 - carvedilol 12.5 mg Tab [HCHD] Pharmacy
51079-0931-20
2.9
00093-3196-01 - cefadroxil 500 mg Cap [HCHD] Pharmacy
00093-3196-01
3.72
63323-0237-10 - ceFAZolin 1 g vial [HCHD] Pharmacy
63323-0237-10
7.2
63323-0341-20 - cefOXitin 1 g Inj vial [HCHD] Pharmacy
63323-0341-20
7.66
00409-7332-01 - cefTRIAXone 1 g Inj vial [HCHD] Pharmacy
00409-7332-01
18
68084-0218-01 - cefuroxime 250 mg Tab [HCHD] Pharmacy
68084-0218-01
6.04
00025-1520-34 - celecoxib 100 mg Cap [HCHD] Pharmacy
00025-1520-34
6.39
62584-0235-01 - cephalexin 250 mg Cap [HCHD] Pharmacy
62584-0235-01
1.71
66689-0202-04 - charcoal 25 g Oral Susp 120 mL [HCHD] Pharmacy
66689-0202-04
0.2
66689-0201-08 - charcoal 50 g Oral Susp 240 mL [HCHD] Pharmacy
66689-0201-08
0.15
51079-0141-20 - chlordiazePOXIDE 25 mg Cap [HCHD] Pharmacy
51079-0141-20
0.93
53014-0548-67 - chlorpheniramine-HYDROcodone 8 mg-10 mg/5 mL Oral Susp, ER 5 mL [HCHD] Pharmacy
53014-0548-67
0.657
68084-0069-01 - ciprofloxacin 250 mg Tab [HCHD] Pharmacy
68084-0069-01
5.459
00409-4778-86 - ciprofloxacin 400 mg/40 mL vial [HCHD] Pharmacy
00409-4778-86
0.104
00409-4777-02 - ciprofloxacin/D5W 400 mg/200 mL IVPB [HCHD] Pharmacy
00409-4777-02
0.04
60505-2519-03 - citalopram 20 mg Tab [HCHD] Pharmacy
60505-2519-03
3.73
63323-0282-04 - clindamycin 600 mg/4 mL vial [HCHD] Pharmacy
63323-0282-04
4.82
68084-0243-01 - clindamycin 150 mg Cap [HCHD] Pharmacy
68084-0243-01
1.59
51079-0881-21 - clonazePAM 0.5 mg Tab [HCHD] Pharmacy
51079-0881-21
1.1
62584-0657-01 - cloNIDine 0.1 mg Tab [HCHD] Pharmacy
62584-0657-01
3.2
00597-0031-34 - cloNIDine 0.1 mg/24 hr Transderm Patch [HCHD] Pharmacy
00597-0031-34
53.892
52959-0679-12 - cloNIDine 0.2 mg/24 hr Transderm Patch [HCHD] Pharmacy
52959-0679-12
55.765
00597-0033-34 - cloNIDine 0.3 mg/24 hr Transderm Patch [HCHD] Pharmacy
00597-0033-34
77.36
63653-1171-03 - clopidogrel 75 mg Tab [HCHD] Pharmacy
63653-1171-03
7.735
13310-0119-01 - colchicine 0.6 mg Tab [HCHD] Pharmacy
13310-0119-01
10.94
00536-3542-01 - cyanocobalamin 100 mcg Tab [HCHD] Pharmacy
00536-3542-01
0.78
00517-0031-25 - cyanocobalamin 1000 mcg/mL INJ SOLN [HCHD] Pharmacy
00517-0031-25
12.1
00093-1919-93 - cyclobenzaprine 10 mg Tab [HCHD] Pharmacy
00093-1919-93
0.989
00054-4184-25 - dexamethasone 4 mg Tab [HCHD] Pharmacy
00054-4184-25
0.94
00069-4547-02 - dexamethasone 4 mg/mL 1 mL vial [HCHD] Pharmacy
00069-4547-02
3.66
24208-0720-02 - dexamethasone Opth 0.1% Sol 5 mL [HCHD] Pharmacy
24208-0720-02
17.85
37205-0712-26 - dextromethorphan-guaifenesin 10 mg-100 mg/5 mL Liquid 10 mL [HCHD] Pharmacy
37205-0712-26
0.034
00264-7612-00 - Dextrose 5%/0.45% NaCl 1000 mL [HCHD] Pharmacy
00264-7612-00
0.05
00264-7612-10 - Dextrose 5%/0.45% NaCl 500 mL [HCHD] Pharmacy
00264-7612-10
0.05
00409-6648-02 - Dextrose 50%/Water 50 mL inj [HCHD] Pharmacy
00409-6648-02
0.27
00409-1273-32 - diazepam 5 mg/mL Inj Sol 2 mL syringe [HCHD] Pharmacy
00409-1273-32
29.99
51079-0285-20 - diazepam 5 mg Tab [HCHD] Pharmacy
51079-0285-20
1.06
00378-0271-05 - diazepam 2 mg Tab [HCHD] Pharmacy
00378-0271-05
1.06
00228-2551-11 - diclofenac sodium 75 mg Oral DR Tab [HCHD] Pharmacy
00228-2551-11
2.46
00591-0794-01 - dicyclomine 10 mg Cap [HCHD] Pharmacy
00591-0794-01
0.84
00173-0242-56 - digoxin 125 mcg (0.125 mg) Tab [HCHD] Pharmacy
00173-0242-56
2.88
00527-1325-01 - digoxin 250 mcg (0.25 mg) Tab [HCHD] Pharmacy
00527-1325-01
3.55
62584-0976-01 - diltiazem 240 mg/24 hours Cap-CD [HCHD] Pharmacy
62584-0976-01
3.55
51079-0745-20 - diltiazem 30 mg Tab [HCHD] Pharmacy
51079-0745-20
0.78
62584-0975-01 - diltiazem 180 mg CD Cap [HCHD] Pharmacy
62584-0975-01
2.49
00093-5112-98 - diltiazem 120 mg/24 hours Cap-CD [HCHD] Pharmacy
00093-5112-98
2.07
00121-0489-05 - diphenhydrAMINE 12.5 mg/5 mL Oral Liq -5mL [HCHD] Pharmacy
00121-0489-05
2.6
00904-5306-61 - diphenhydrAMINE 25 mg Cap [HCHD] Pharmacy
00904-5306-61
0.78
00378-0415-10 - diphenoxylate-atropine 2.5 mg-0.025 mg Tab [HCHD] Pharmacy
00378-0415-10
0.97
00409-2344-02 - DOBUTamine 12.5 mg/mL vial 20 mL [HCHD] Pharmacy
00409-2344-02
0.78
60258-0955-01 - docusate sodium 100 mg Cap [HCHD] Pharmacy
60258-0955-01
0.78
00182-1113-10 - docusate-senna 50 mg-8.6 mg Tab [HCHD] Pharmacy
00182-1113-10
1.81
62856-0245-41 - donepezil 5 mg Tab [HCHD] Pharmacy
62856-0245-41
12.11
00409-9104-20 - DOPamine 40 mg/mL vial 10 mL [HCHD] Pharmacy
00409-9104-20
0.4
55390-0110-10 - doxycycline 100 mg vial [HCHD] Pharmacy
55390-0110-10
28.99
00591-5440-05 - doxycycline hyclate 100 mg Cap [HCHD] Pharmacy
00591-5440-05
8.511
00002-3235-60 - DULoxetine 20 mg Cap [HCHD] Pharmacy
00002-3235-60
7.776
00002-3270-30 - DULoxetine 60 mg Cap [HCHD] Pharmacy
00002-3270-30
8.72
00002-3240-30 - DULoxetine 30 mg Cap [HCHD] Pharmacy
00002-3240-30
8.72
00781-3356-66 - enoxaparin 60 mg/0.6 mL SubQ syringe [HCHD] Pharmacy
00781-3356-66
99.34
00075-0624-30 - enoxaparin 30 mg/0.3 mL SubQ syringe [HCHD] Pharmacy
00075-0624-30
99.233
00781-3224-64 - enoxaparin 40 mg/0.4 mL SubQ syringe [HCHD] Pharmacy
00781-3224-64
99.225
00517-1071-25 - EPINEPHrine 1 mg/mL Amp [HCHD] Pharmacy
00517-1071-25
24.23
00143-9984-90 - EPINEPHrine 1 mg/mL 30 mL vial [HCHD] Pharmacy
00143-9984-90
0.28
76329-3316-01 - EPINEPHrine 0.1 mg/mL Inj Syr 10 mL [HCHD] Pharmacy
76329-3316-01
1
49502-0500-01 - EPINEPHrine 0.3 mg Inj kit [HCHD] Pharmacy
49502-0500-01
182.345
49502-0501-01 - EPINEPHrine 0.15 mg Inj kit [HCHD] Pharmacy
49502-0501-01
182.345
17478-0070-35 - erythromycin Opth 0.5% Oint 3.5 gm tube [HCHD] Pharmacy
17478-0070-35
9.9
00456-2010-63 - escitalopram 10 mg Tab [HCHD] Pharmacy
00456-2010-63
6.06
00378-1454-01 - estradiol 1 mg Tab [HCHD] Pharmacy
00378-1454-01
0.024
00009-0271-01 - estradiol cypionate 25 mg/5 mL vial [HCHD] Pharmacy
00009-0271-01
11.746
00409-6695-02 - etomidate 2 mg/mL 20 mL vial [HCHD] Pharmacy
00409-6695-02
0.78
00172-5728-10 - famotidine 20 mg Tab [HCHD] Pharmacy
00172-5728-10
2.4
00378-5012-01 - felodipine 5 mg ER Tab [HCHD] Pharmacy
00378-5012-01
2.11
00074-6123-90 - fenofibrate 145 mg Tab [HCHD] Pharmacy
00074-6123-90
7.13
00067-4347-90 - ferrous sulfate (as elemental iron) 45 mg Tab-ER [HCHD] Pharmacy
00067-4347-90
0.78
45802-0571-78 - fexofenadine 180 mg Tab [HCHD] Pharmacy
45802-0571-78
1.05
00172-5411-10 - fluconazole 100 mg Tab [HCHD] Pharmacy
00172-5411-10
12.14
00703-2084-03 - flumazenil 0.5 mg/5 mL vial [HCHD] Pharmacy
00703-2084-03
11.26
00777-3104-02 - FLUoxetine 10 mg Cap [HCHD] Pharmacy
00777-3104-02
3.98
00054-3270-99 - fluticasone Nasal 0.05 mg/inh Spry [HCHD] Pharmacy
00054-3270-99
7.3
00173-0696-04 - fluticasone-salmet 250 mcg-50 mcg Inh Pwdr DISKUS #14 [HCHD] Pharmacy
00173-0696-04
16.52
00173-0695-04 - fluticasone-salmet 100 mcg-50 mcg Inh Pwdr DISKUS #14 [HCHD] Pharmacy
00173-0695-04
19.448
00173-0697-04 - fluticasone-salmet 500 mcg-50 mcg Inh Pwdr DISKUS #14 [HCHD] Pharmacy
00173-0697-04
33.01
00143-1248-01 - folic acid 1 mg Tab [HCHD] Pharmacy
00143-1248-01
0.79
00409-4857-02 - fosphenytoin (PE) 100 mg/2 mL vial [HCHD] Pharmacy
00409-4857-02
47.04
68084-0014-01 - furosemide 20 mg Tab [HCHD] Pharmacy
68084-0014-01
0.78
68084-0016-01 - furosemide 40 mg Tab[HCHD] Pharmacy
68084-0016-01
0.78
00409-6102-04 - furosemide 40 mg/4 mL vial [HCHD] Pharmacy
00409-6102-04
5.16
68084-0079-65 - gabapentin 100 mg Cap [HCHD] Pharmacy
68084-0079-65
0.96
00409-1207-03 - gentamicin 40 mg/mL vial 2 mL [HCHD] Pharmacy
00409-1207-03
1.548
61314-0633-05 - gentamicin Opth 0.3% Sol 5 mL [HCHD] Pharmacy
61314-0633-05
19.67
00049-1560-66 - glipiZIDE 10 mg XL Tab [HCHD] Pharmacy
00049-1560-66
1.25
68084-0111-01 - glipiZIDE 5 mg XL Tab [HCHD] Pharmacy
68084-0111-01
1
00182-1994-89 - glipiZIDE 5 mg Tab [HCHD] Pharmacy
00182-1994-89
0.79
55390-0004-01 - glucagon recombinant 1 mg vial [HCHD] Pharmacy
55390-0004-01
336.96
00574-0069-30 - glucose 40% Oral gel 15 gm tube [HCHD] Pharmacy
00574-0069-30
0.37
00093-8344-10 - glyBURIDE 5 mg Tab [HCHD] Pharmacy
00093-8344-10
1.25
45802-0498-78 - guaiFENesin 600 mg ER Tab [HCHD] Pharmacy
45802-0498-78
1.39
00378-0257-01 - haloperidol 1 mg Tab [HCHD] Pharmacy
00378-0257-01
0.79
51079-0736-20 - haloperidol 5 mg Tab [HCHD] Pharmacy
51079-0736-20
1.092
63323-0474-01 - haloperidol lac 5 mg/mL vial 1 mL [HCHD] Pharmacy
63323-0474-01
9.96
63323-0540-11 - heparin 1000 units/mL SOLN 10 mL vial [HCHD] Pharmacy
63323-0540-11
4.04
62584-0733-01 - hydrALAZINE 25 mg Tab [HCHD] Pharmacy
62584-0733-01
0.78
00172-2083-80 - hydrochlorothiazide 25 mg Tab [HCHD] Pharmacy
00172-2083-80
0.78
00406-0367-05 - HYDROcodone -acetaminophen 10 mg-325 mg tab [HCHD] Pharmacy
00406-0367-05
2.17
00406-0365-62 - HYDROcodone -acetaminophen 5 mg-325 mg tab [HCHD] Pharmacy
00406-0365-62
0.92
00406-0366-62 - HYDROcodone -acetaminophen 7.5 mg-325 mg tab [HCHD] Pharmacy
00406-0366-62
1.23
64980-0301-30 - hydrocortisone 2.5% Rectal Crm w/Appl [HCHD] Pharmacy
64980-0301-30
2.911
63739-0486-10 - hydrOXYzine Hcl 25 mg Tab [HCHD] Pharmacy
63739-0486-10
0.78
00185-0613-01 - hydrOXYzine pamoate 25 mg Cap [HCHD] Pharmacy
00185-0613-01
0.299
50532-0113-10 - hyoscyamine 0.125 mg sublingual Tab [HCHD] Pharmacy
50532-0113-10
0.192
62584-0746-01 - ibuprofen 400 mg Tab [HCHD] Pharmacy
62584-0746-01
0.78
68094-0494-58 - ibuprofen 100 mg/5 mL Oral Susp 5 mL [HCHD] Pharmacy
68094-0494-58
1.2
00904-5187-60 - ibuprofen 800 mg Tab [HCHD] Pharmacy
00904-5187-60
0.78
62584-0747-01 - ibuprofen 600 mg Tab[HCHD] Pharmacy
62584-0747-01
0.78
51079-0190-20 - indomethacin 25 mg Cap [HCHD] Pharmacy
51079-0190-20
0.78
00088-2220-33 - insulin glargine Lantus 1 unit/0.01 mL syringe [HCHD] Pharmacy
00088-2220-33
29.82
00002-7510-01 - insulin lispro HumaLOG 1 unit/0.01mL syringe [HCHD] Pharmacy
00002-7510-01
39.37
49502-0685-26 - ipratropium 0.5mg Inh Sol 2.5 mL [HCHD] Pharmacy
49502-0685-26
1.82
00087-2772-35 - irbesartan 150 mg Tab [HCHD] Pharmacy
00087-2772-35
4.34
00143-2230-01 - isosorbide mononitrate 30 mg ER Tab [HCHD] Pharmacy
00143-2230-01
2.32
62175-0107-01 - isosorbide mononitrate 20 mg Tab [HCHD] Pharmacy
62175-0107-01
0.412
00409-2053-10 - ketamine 50 mg/mL vial 10 mL [HCHD] Pharmacy
00409-2053-10
14.2
58177-0301-04 - ketorolac 10 mg Tab [HCHD] Pharmacy
58177-0301-04
1.135
00409-2339-34 - labetalol 20 mg/4 mL inj [HCHD] Pharmacy
00409-2339-34
0.949
00172-4365-60 - labetalol 200 mg Tab [HCHD] Pharmacy
00172-4365-60
1.6
00574-0043-16 - lanolin Top Oint [HCHD] Pharmacy
00574-0043-16
0.054
63402-0512-24 - levalbuterol 0.63 mg/3 mL Inh Sol [HCHD] Pharmacy
63402-0512-24
2.97
63402-0513-24 - levalbuterol 1.25 mg/3 mL Inh Sol [HCHD] Pharmacy
63402-0513-24
2.97
50458-0925-50 - levofloxacin 500 mg Tab [HCHD] Pharmacy
50458-0925-50
26.17
50458-0164-20 - levofloxacin 500 mg/20 mL vial [HCHD] Pharmacy
50458-0164-20
2.6
00143-9721-01 - levofloxacin/D5W 500 mg/100 mL IVPB [HCHD] Pharmacy
00143-9721-01
0.165
00143-9720-01 - levofloxacin/D5W 750 mg/150 mL IVPB [HCHD] Pharmacy
00143-9720-01
0.17
62584-0154-01 - levothyroxine 50 mcg (0.05mg) Tab [HCHD] Pharmacy
62584-0154-01
2
62584-0146-01 - levothyroxine 25 mcg (0.025 mg) Tab [HCHD] Pharmacy
62584-0146-01
0.928
00456-1329-01 - levothyroxine 88 mcg (0.088 mg) Tab [HCHD] Pharmacy
00456-1329-01
1.78
62584-0218-01 - levothyroxine 100 mcg (0.1 mg) Tab [HCHD] Pharmacy
62584-0218-01
2.02
00409-4276-01 - lidocaine 1% inj 20 mL [HCHD] Pharmacy
00409-4276-01
0.06
00409-4277-01 - lidocaine 2% vial 20 mL [HCHD] Pharmacy
00409-4277-01
0.2
00409-1323-05 - lidocaine 2% IV Syringe 5 mL [HCHD] Pharmacy
00409-1323-05
1.07
17478-0711-10 - lidocaine Top 2% Gel 5 mL [HCHD] Pharmacy
17478-0711-10
1.56
00409-3178-01 - lidocaine-EPINEPHrine 1:100,000-1% vial 20 mL [HCHD] Pharmacy
00409-3178-01
1.73
68084-0061-01 - lisinopril 10 mg Tab [HCHD] Pharmacy
68084-0061-01
1.72
00172-5033-10 - lisinopril-hydrochlorothiazide 10 mg-12.5 mg Tab [HCHD] Pharmacy
00172-5033-10
0.077
00172-5034-10 - lisinopril-hydrochlorothiazide 20 mg-12.5 mg Tab [HCHD] Pharmacy
00172-5034-10
1.215
00172-5032-10 - lisinopril-hydrochlorothiazide 20 mg-25 mg Tab [HCHD] Pharmacy
00172-5032-10
1.229
51079-0690-20 - loperamide 2 mg Cap [HCHD] Pharmacy
51079-0690-20
1.21
00904-0036-20 - loperamide 1 mg/5 mL Oral Liq 5 mL [HCHD] Pharmacy
00904-0036-20
0.362
68084-0248-01 - loratadine 10 mg Tab [HCHD] Pharmacy
68084-0248-01
1.19
11523-7161-02 - loratadine-pseudoephedrine 10 mg-240 mg Tab-ER [HCHD] Pharmacy
11523-7161-02
1.28
51079-0417-21 - LORazepam 0.5 mg Tab [HCHD] Pharmacy
51079-0417-21
0.78
00054-0124-22 - losartan 50 mg Tab [HCHD] Pharmacy
00054-0124-22
2.43
00904-7911-52 - magnesium chloride 64 mg SA Tab [HCHD] Pharmacy
00904-7911-52
0.12
00869-0693-38 - magnesium citrate Oral Liq 300 mL [HCHD] Pharmacy
00869-0693-38
2.31
00121-0431-30 - magnesium hydroxide 8% Oral Susp 30 mL [HCHD] Pharmacy
00121-0431-30
0.11
63739-0354-10 - magnesium oxide 400 mg Tab [HCHD] Pharmacy
63739-0354-10
0.78
63323-0064-02 - magnesium sulfate 50% inj 2 mL [HCHD] Pharmacy
63323-0064-02
2.63
00264-7578-10 - mannitol 20% 500 mL [HCHD] Pharmacy
00264-7578-10
0.06
51079-0090-20 - meclizine 25 mg Tab [HCHD] Pharmacy
51079-0090-20
2.34
00054-4604-25 - megestrol 40 mg Tab [HCHD] Pharmacy
00054-4604-25
1.45
51079-0457-20 - meloxicam 7.5 mg Tab [HCHD] Pharmacy
51079-0457-20
4.29