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["Gifford Medical Center"]
["Tax ID No. 03-0179418"]
["Prices Effective 10/1/2022"]
[]
["Charge Code","Charge Code Description","Charge Type","IP/OP/Pro","Revenue Code","Revenue Code Name","CPT/HCPCS Code","CPT/HCPCS Code Description","Gross Charge","Uninsured Self Pay Charge","Minimum Commercial contracted rate","Maximum Commercial contracted rate","BCBS VT Non-Managed Care IP ","BCBS VT Non-Managed Care OP","BCBS VT Managed Care IP","BCBS VT Managed Care OP","TVHP Managed Care IP","TVHP Managed Care OP","CIGNA"]
["5R","ICU PRIVATE","Room & Board","IP",200,"Intensive Care (ICU)",null,null,4368,2184,3472.5600000000004,3712.7999999999997,3712.7999999999997,3712.7999999999997,3669.12,3538.0800000000004,3494.4,3472.5600000000004,3494.4]
["4R","NURSERY ","Room & Board","IP",170,"Nursery",null,null,1430,715,1136.8500000000001,1215.5,1215.5,1215.5,1201.2,1158.3000000000002,1144,1136.8500000000001,1144]
["3R","MED/SURG ICF SEMI-PRIVATE","Room & Board","IP",120,"Room-Board/Semi",null,null,484,242,384.78000000000003,411.4,411.4,411.4,406.56,392.04,387.20000000000005,384.78000000000003,387.20000000000005]
["2R","MED/SURG SNF SEMI-PRIVATE","Room & Board","IP",120,"Room-Board/Semi",null,null,775,387.5,616.125,658.75,658.75,658.75,651,627.75,620,616.125,620]
["1R","MED/SURG SEMI-PRIVATE","Room & Board","IP",120,"Room-Board/Semi",null,null,2158,1079,1715.6100000000001,1834.3,1834.3,1834.3,1812.72,1747.98,1726.4,1715.6100000000001,1726.4]
[58009607,"SUT ETHIBOND 0 CX31D","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009606,"KNIFE STRAIGHT COLD","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009605,"KNIFE HALF ROUND COLD","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009604,"VAPORIZATION BALL 24FR","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009603,"STRAIGHT LOOP 24/26FR .30MM","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009602,"COLLINS KNIFE 24/26FR .35MM","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009601,"BLADDER LOOP 24/26FR .30MM","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009600,"PROSTATE LOOP 24/26FR .35MM","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009580,"CONNECT Y TRAC","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58009576,"BIN LABELS AVERY 5160","CDM Code","IP/OP",270,"Med-Sur Supplies","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009575,"AARDVARK RF ABLATION","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009570,"SMOKE EVAC HI-FLOW TUBE SET","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[58009569,"ECG CABLE, 3-LEAD SINGLE PIN","CDM Code","IP/OP",270,"Med-Sur Supplies","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009566,"FUJI F2 CONNECTOR SINGLE USE","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009565,"F 24 HR TUBING KIT - TYPE F","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009564,"24 HR FUJI TUBING","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009563,"24 HR PUMP TUBING","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009562,"DETERGENT OUT TUBING","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009561,"DETERGENT IN TUBING","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009560,"TROCR 10MM","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58009541,"STETHOSCP SONATEMP 18","CDM Code","IP/OP",270,"Med-Sur Supplies","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58009540,"STETHOSCP SONATEMP 12","CDM Code","IP/OP",270,"Med-Sur Supplies","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58009530,"FOLEY CATH 100% SIL. 14FR 10ML COUDE 2WY","CDM Code","IP/OP",272,"Sterile Supply","","",249,124.5,197.95500000000001,211.65,211.65,211.65,209.16,201.69000000000003,199.20000000000002,197.95500000000001,199.20000000000002]
[58009527,"SLING ULTRA S","CDM Code","IP/OP",270,"Med-Sur Supplies","","",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[58009526,"SLING ULTRA M","CDM Code","IP/OP",270,"Med-Sur Supplies","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[58009525,"SLING ULTRA L","CDM Code","IP/OP",270,"Med-Sur Supplies","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[58009520,"GROUND PAD","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58009519,"OPTISPIKE DISPENSING PIN","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58009518,"BANDGE COBAN 1X5 COLOR non-sterile","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009514,"BB-TAK","CDM Code","IP/OP",272,"Sterile Supply","","",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[58009513,"FLUID TRAP","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58009512,"125MM SUCTION SLEEVE","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58009511,"LOOP VESSEL BLUE","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58009510,"LOOP OSTOMY ROD 90MM","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58009505,"SYRINGE PORTEX L.O.R","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58009504,"COLLECT SET DISP","CDM Code","IP/OP",270,"Med-Sur Supplies","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[58009503,"BLANKT BAR UPPR BOD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58009502,"BAG SPEC RETRIEVAL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",166,83,131.97,141.1,141.1,141.1,139.44,134.46,132.80000000000001,131.97,132.80000000000001]
[58009501,"PEN EYE MARK FN TIP W RULER","CDM Code","IP/OP",270,"Med-Sur Supplies","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58009500,"LABEL MOIST PROOF W/PEN","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58009301,"CUFF DISP 24X4 STER","CDM Code","IP/OP",272,"Sterile Supply","","",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[58009300,"CUFF DISP 18X3 STER","CDM Code","IP/OP",272,"Sterile Supply","","",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[58009202,"ELECTRD PEDI RETURN 9'","CDM Code","IP/OP",270,"Med-Sur Supplies","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[58009201,"DERMABOND PRINEO","CDM Code","IP/OP",272,"Sterile Supply","","",222,111,176.49,188.7,188.7,188.7,186.48,179.82000000000002,177.60000000000002,176.49,177.60000000000002]
[58009200,"CARRIER MESH DERMTME","CDM Code","IP/OP",270,"Med-Sur Supplies","","",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[58009106,"CANN SONOPLEX STIM 22GX80","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[58009105,"CANN SONOPLEX STIM 22GX50","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[58009104,"CANN CO2 PEDIATRIC GE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58009103,"CANN CO2 ADULT GE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",53,26.5,42.135000000000005,45.05,45.05,45.05,44.519999999999996,42.93,42.400000000000006,42.135000000000005,42.400000000000006]
[58009102,"CANN CHAM ANTERIOR RYCROFT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58009101,"PASSPORT CANNULA","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58009100,"CANN 26G ANG MCINTYRE A/C","CDM Code","IP/OP",270,"Med-Sur Supplies","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[58009016,"KIT AIRWY PEDI INF ADAPT","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[58009015,"KIT AIRWY ADT PEDI ADAPT","CDM Code","IP/OP",272,"Sterile Supply","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[58009014,"AIRWY ORL YW 90MM","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009013,"AIRWY ORL WT 70MM","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009012,"AIRWY ORL RD 100MM","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009011,"AIRWY ORL GR 80MM","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009010,"AIRWY ORL BL 50MM","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009009,"AIRWY ORL BK 60MM","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58009008,"AIRWY MASK LMA SUP 5","CDM Code","IP/OP",272,"Sterile Supply","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[58009007,"AIRWY MASK LMA SUP 4","CDM Code","IP/OP",272,"Sterile Supply","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[58009006,"AIRWY MASK LMA SUP 3","CDM Code","IP/OP",272,"Sterile Supply","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[58009005,"AIRWY MASK LMA SUP 2.5","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[58009004,"AIRWY MASK LMA CLASSIC 5","CDM Code","IP/OP",272,"Sterile Supply","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[58009003,"AIRWY MASK LMA CLASSIC 4","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58009002,"AIRWY MASK LMA CLASSIC 3","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58009001,"AIRWY MASK LMA CLASSIC 2.5","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58009000,"AIRWY MASK LMA CLASSIC 2","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58008531,"SEE ITEM 58008351","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58008407,"TROCR BLADLESS 5MM 100MM W/SLEEVE","CDM Code","IP/OP",272,"Sterile Supply","","",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[58008406,"TROCR BT TIP 12MM","CDM Code","IP/OP",272,"Sterile Supply","","",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[58008405,"TROCR BLADLESS 8MM","CDM Code","IP/OP",272,"Sterile Supply","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[58008404,"TROCR BLADLESS 5MM 150MM","CDM Code","IP/OP",272,"Sterile Supply","","",145,72.5,115.27500000000001,123.25,123.25,123.25,121.8,117.45,116,115.27500000000001,116]
[58008403,"TROCR BLADLESS 5MM 100MM","CDM Code","IP/OP",272,"Sterile Supply","","",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[58008402,"TROCR BLADLESS 12MM 150MM","CDM Code","IP/OP",272,"Sterile Supply","","",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[58008401,"TROCR BLADLESS 12MM 100MM","CDM Code","IP/OP",272,"Sterile Supply","","",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[58008400,"TROCAR 5.5MM LOCKING","CDM Code","IP/OP",272,"Sterile Supply","","",273,136.5,217.03500000000003,232.04999999999998,232.04999999999998,232.04999999999998,229.32,221.13000000000002,218.4,217.03500000000003,218.4]
[58008352,"STOCKNETTE IMPERV MED","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58008351,"STOCKNETTE IMPERV","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58008350,"COTTON STOCKINETTE 4\"","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58008303,"CAST PADDING 6X4","CDM Code","IP/OP",270,"Med-Sur Supplies","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58008302,"CAST PADDING 4X4","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58008301,"CAST FIBER PRE CUT 4X30","CDM Code","IP/OP",270,"Med-Sur Supplies","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[58008300,"CAST FIBER PRE CUT 3X35","CDM Code","IP/OP",270,"Med-Sur Supplies","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[58008102,"ARTHTO WAND SABER 30","CDM Code","IP/OP",272,"Sterile Supply","","",356,178,283.02000000000004,302.59999999999997,302.59999999999997,302.59999999999997,299.03999999999996,288.36,284.8,283.02000000000004,284.8]
[58008101,"90-S CRUISE WAND","CDM Code","IP/OP",272,"Sterile Supply","","",340,170,270.3,289,289,289,285.59999999999997,275.40000000000003,272,270.3,272]
[58008100,"50 DEGREE WAND","CDM Code","IP/OP",272,"Sterile Supply","","",351,175.5,279.04500000000002,298.34999999999997,298.34999999999997,298.34999999999997,294.83999999999997,284.31,280.8,279.04500000000002,280.8]
[58008053,"ACCESS BALLOON PORT 12MM X 70MM","CDM Code","IP/OP",272,"Sterile Supply","","",242,121,192.39000000000001,205.7,205.7,205.7,203.28,196.02,193.60000000000002,192.39000000000001,193.60000000000002]
[58008052,"5MM ACCESS PORT 120MM  LENGTH","CDM Code","IP/OP",272,"Sterile Supply","","",269,134.5,213.85500000000002,228.65,228.65,228.65,225.95999999999998,217.89000000000001,215.20000000000002,213.85500000000002,215.20000000000002]
[58008007,"NDL WHTACRE 25G x 3 1/2\"","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58008006,"NDL WHTACRE 25G x 4.69\"","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[58008005,"NDL WHTACRE 22G x 5\"","CDM Code","IP/OP",272,"Sterile Supply","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[58008004,"NDL WHITACRE 22G x 3 1/2\"","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58008003,"NDL SPINAL QUINCKE 22G x 5\"","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58008002,"NDL SPINAL 18G x 3.5\"","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58008001,"ANGIOCATH NEEDLE 14GX3.25","CDM Code","IP/OP",272,"Sterile Supply","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[58008000,"ANGIOCATH NEEDLE 12GX3","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[58007923,"WIREGUIDE 1.25 THD 150","CDM Code","IP/OP",272,"Sterile Supply","","",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[58007922,"WIREGUIDE 1.25 NON THD 150","CDM Code","IP/OP",272,"Sterile Supply","","",98,49,77.910000000000011,83.3,83.3,83.3,82.32,79.38000000000001,78.400000000000006,77.910000000000011,78.400000000000006]
[58007921,"WIREGUIDE 1.1 NON THR 150","CDM Code","IP/OP",272,"Sterile Supply","C1769","GUIDE WIRE",99,49.5,78.704999999999998,84.149999999999991,84.149999999999991,84.149999999999991,83.16,80.190000000000012,79.2,78.704999999999998,79.2]
[58007920,"WIREGUIDE 1.1 THR 150","CDM Code","IP/OP",272,"Sterile Supply","C1769","GUIDE WIRE",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[58007919,"WIRE K BLUNT 062MM 4","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[58007918,"WIRE K 062MM 4","CDM Code","IP/OP",272,"Sterile Supply","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[58007917,"WIRE K 062 X 9 THRD","CDM Code","IP/OP",272,"Sterile Supply","","",105,52.5,83.475000000000009,89.25,89.25,89.25,88.2,85.050000000000011,84,83.475000000000009,84]
[58007916,"WIRE K 062 X 9","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[58007915,"WIRE K 054MM 4","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58007914,"WIRE K 045MM 4","CDM Code","IP/OP",272,"Sterile Supply","C1769","GUIDE WIRE",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[58007913,"WIRE K 045 X 9 THRD","CDM Code","IP/OP",272,"Sterile Supply","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[58007912,"WIRE K 045 X 9","CDM Code","IP/OP",272,"Sterile Supply","","",105,52.5,83.475000000000009,89.25,89.25,89.25,88.2,85.050000000000011,84,83.475000000000009,84]
[58007911,"WIRE K 035MM 4","CDM Code","IP/OP",272,"Sterile Supply","","",85,42.5,67.575000000000003,72.25,72.25,72.25,71.399999999999991,68.850000000000009,68,67.575000000000003,68]
[58007910,"WIRE K 035 X 9 THRD","CDM Code","IP/OP",272,"Sterile Supply","","",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[58007909,"WIRE K 035 X 9","CDM Code","IP/OP",272,"Sterile Supply","","",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[58007908,"WIRE K 028MM 4","CDM Code","IP/OP",278,"Supply/Implants","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[58007907,"K-WIRE TROCAR POINT THR 1.6MM","CDM Code","IP/OP",272,"Sterile Supply","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[58007906,"K-WIRE TROCAR POINT 2.0MM","CDM Code","IP/OP",272,"Sterile Supply","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[58007905,"K-WIRE TROCAR POINT 1.25MM","CDM Code","IP/OP",272,"Sterile Supply","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[58007904,"K WIRE 1.6MM TROCAR POINT","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[58007903,"GUIDEWIRE 2.0 MM TROCAR TIP","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58007902,"GUIDEWIRE 1.6 MM TROCAR TIP","CDM Code","IP/OP",272,"Sterile Supply","","",57,28.5,45.315000000000005,48.449999999999996,48.449999999999996,48.449999999999996,47.879999999999995,46.17,45.6,45.315000000000005,45.6]
[58007901,"GUIDEWIRE 1.35MM TROCAR TIP TH","CDM Code","IP/OP",272,"Sterile Supply","","",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[58007900,"GUIDEWIRE 1.35MM TROCAR TIP","CDM Code","IP/OP",272,"Sterile Supply","","",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[58007881,"RASP SM TEAR CROSS CUT","CDM Code","IP/OP",272,"Sterile Supply","","",275,137.5,218.625,233.75,233.75,233.75,231,222.75000000000003,220,218.625,220]
[58007880,"RASP LG TEAR CROSS CUT","CDM Code","IP/OP",272,"Sterile Supply","","",275,137.5,218.625,233.75,233.75,233.75,231,222.75000000000003,220,218.625,220]
[58007860,"ROD GUIDE W SMOOTH TIP 3.0","CDM Code","IP/OP",272,"Sterile Supply","","",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[58007859,"ROD REAMING 3.0MM 950MM","CDM Code","IP/OP",272,"Sterile Supply","","",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[58007858,"REAMER 8 MM","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[58007857,"REAMER 7.5 MM","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[58007856,"REAMER 7 MM","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[58007855,"REAMER 6.5 MM","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[58007854,"REAMER 6 MM","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[58007853,"REAMER 5.5 MM","CDM Code","IP/OP",272,"Sterile Supply","","",419,209.5,333.10500000000002,356.15,356.15,356.15,351.96,339.39000000000004,335.20000000000005,333.10500000000002,335.20000000000005]
[58007852,"REAMER 5 MM","CDM Code","IP/OP",272,"Sterile Supply","","",419,209.5,333.10500000000002,356.15,356.15,356.15,351.96,339.39000000000004,335.20000000000005,333.10500000000002,335.20000000000005]
[58007851,"REAMER 4.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",419,209.5,333.10500000000002,356.15,356.15,356.15,351.96,339.39000000000004,335.20000000000005,333.10500000000002,335.20000000000005]
[58007850,"REAMER 4 MM","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[58007804,"COUNTER SINK","CDM Code","IP/OP",272,"Sterile Supply","","",369,184.5,293.35500000000002,313.64999999999998,313.64999999999998,313.64999999999998,309.95999999999998,298.89000000000004,295.2,293.35500000000002,295.2]
[58007803,"4.0MM CANNULATED COUNTERSINK","CDM Code","IP/OP",272,"Sterile Supply","","",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[58007802,"3.5/4.0MM COUNTERSINK","CDM Code","IP/OP",272,"Sterile Supply","","",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[58007801,"3.5 CANN COUNTERSINK","CDM Code","IP/OP",272,"Sterile Supply","","",430,215,341.85,365.5,365.5,365.5,361.2,348.3,344,341.85,344]
[58007800,"3.0 CANNULATED COUNTERSINK","CDM Code","IP/OP",272,"Sterile Supply","","",476,238,378.42,404.59999999999997,404.59999999999997,404.59999999999997,399.84,385.56,380.8,378.42,380.8]
[58007754,"BALL JURGAN 3/32","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[58007753,"BALL JURGAN 0.54-.062","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[58007752,"BALL JURGAN 0.065-5/64","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[58007751,"BALL JURGAN 0.045","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[58007644,"DRILL SPADE TIP FOR 4.75 SWV LCK ANCHOR","CDM Code","IP/OP",272,"Sterile Supply","","",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[58007643,"STRAIGHT DRILL GUIDE","CDM Code","IP/OP",272,"Sterile Supply","","",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[58007642,"CURVED DRILL GUIDE","CDM Code","IP/OP",272,"Sterile Supply","","",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[58007641,"DRILL DIAMETER","CDM Code","IP/OP",272,"Sterile Supply","","",443,221.5,352.185,376.55,376.55,376.55,372.12,358.83000000000004,354.40000000000003,352.185,354.40000000000003]
[58007640,"MICRO FX OCD UNIVERSAL DRILL","CDM Code","IP/OP",272,"Sterile Supply","","",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[58007639,"DRILL WIRE PASS 1.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[58007638,"DRILL WIRE PASS 1.1MM","CDM Code","IP/OP",272,"Sterile Supply","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[58007637,"DRILL PRECISION NEURO 3MMX3.8MM","CDM Code","IP/OP",272,"Sterile Supply","","",270,135,214.65,229.5,229.5,229.5,226.79999999999998,218.70000000000002,216,214.65,216]
[58007636,"DRILL ICONIX 2.3","CDM Code","IP/OP",272,"Sterile Supply","","",336,168,267.12,285.59999999999997,285.59999999999997,285.59999999999997,282.24,272.16000000000003,268.8,267.12,268.8]
[58007635,"DRILL ICONIX 1.4","CDM Code","IP/OP",272,"Sterile Supply","","",376,188,298.92,319.59999999999997,319.59999999999997,319.59999999999997,315.83999999999997,304.56,300.8,298.92,300.8]
[58007634,"DRILL CANCELLOUS 25MM","CDM Code","IP/OP",272,"Sterile Supply","","",264,132,209.88000000000002,224.4,224.4,224.4,221.76,213.84,211.20000000000002,209.88000000000002,211.20000000000002]
[58007633,"DRILL BIT GRAD LM 2.5","CDM Code","IP/OP",272,"Sterile Supply","","",274,137,217.83,232.9,232.9,232.9,230.16,221.94000000000003,219.20000000000002,217.83,219.20000000000002]
[58007632,"DRILL BIT GRAD 2MM","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58007631,"DRILL BIT CANN 2.6MM","CDM Code","IP/OP",272,"Sterile Supply","","",376,188,298.92,319.59999999999997,319.59999999999997,319.59999999999997,315.83999999999997,304.56,300.8,298.92,300.8]
[58007630,"DRILL BIT 7.3 CANN QC","CDM Code","IP/OP",272,"Sterile Supply","","",569,284.5,452.35500000000002,483.65,483.65,483.65,477.96,460.89000000000004,455.20000000000005,452.35500000000002,455.20000000000005]
[58007629,"DRILL BIT 6.5MM CANN 6.5 ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",529,264.5,420.55500000000001,449.65,449.65,449.65,444.35999999999996,428.49,423.20000000000005,420.55500000000001,423.20000000000005]
[58007628,"DRILL BIT 5.0 CANN QC","CDM Code","IP/OP",272,"Sterile Supply","","",484,242,384.78000000000003,411.4,411.4,411.4,406.56,392.04,387.20000000000005,384.78000000000003,387.20000000000005]
[58007626,"DRILL BIT 4.2MM CAL","CDM Code","IP/OP",272,"Sterile Supply","","",405,202.5,321.97500000000002,344.25,344.25,344.25,340.2,328.05,324,321.97500000000002,324]
[58007625,"DRILL BIT 4.0MM CAN 4.0 ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",461,230.5,366.495,391.84999999999997,391.84999999999997,391.84999999999997,387.24,373.41,368.8,366.495,368.8]
[58007624,"DRILL BIT 4.0 SYN TFN","CDM Code","IP/OP",272,"Sterile Supply","","",362,181,287.79000000000002,307.7,307.7,307.7,304.08,293.22000000000003,289.60000000000002,287.79000000000002,289.60000000000002]
[58007623,"DRILL BIT 3.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[58007622,"DRILL BIT 3.5 QC 110","CDM Code","IP/OP",272,"Sterile Supply","","",283,141.5,224.98500000000001,240.54999999999998,240.54999999999998,240.54999999999998,237.72,229.23000000000002,226.4,224.98500000000001,226.4]
[58007621,"DRILL BIT 3.2MM THR ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",357,178.5,283.815,303.45,303.45,303.45,299.88,289.17,285.60000000000002,283.815,285.60000000000002]
[58007620,"DRILL BIT 3.2MM CANN QC 170","CDM Code","IP/OP",272,"Sterile Supply","","",481,240.5,382.39500000000004,408.84999999999997,408.84999999999997,408.84999999999997,404.03999999999996,389.61,384.8,382.39500000000004,384.8]
[58007619,"DRILL BIT 3.0MM","CDM Code","IP/OP",272,"Sterile Supply","","",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[58007618,"DRILL BIT 2.8 QC 165","CDM Code","IP/OP",272,"Sterile Supply","","",271,135.5,215.44500000000002,230.35,230.35,230.35,227.64,219.51000000000002,216.8,215.44500000000002,216.8]
[58007617,"DRILL BIT 2.7MM CAN 4.0 ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",449,224.5,356.95500000000004,381.65,381.65,381.65,377.15999999999997,363.69,359.20000000000005,356.95500000000004,359.20000000000005]
[58007616,"DRILL BIT 2.7 QC 125","CDM Code","IP/OP",272,"Sterile Supply","","",290,145,230.55,246.5,246.5,246.5,243.6,234.9,232,230.55,232]
[58007615,"DRILL BIT 2.7 QC 100","CDM Code","IP/OP",272,"Sterile Supply","","",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[58007614,"DRILL BIT 2.7 CANN QC160","CDM Code","IP/OP",272,"Sterile Supply","","",490,245,389.55,416.5,416.5,416.5,411.59999999999997,396.90000000000003,392,389.55,392]
[58007613,"DRILL BIT 2.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",274,137,217.83,232.9,232.9,232.9,230.16,221.94000000000003,219.20000000000002,217.83,219.20000000000002]
[58007612,"DRILL BIT 2.5 GOLD QC 110","CDM Code","IP/OP",270,"Med-Sur Supplies","","",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[58007611,"DRILL BIT 2.3MM SM FRAG","CDM Code","IP/OP",272,"Sterile Supply","","",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[58007610,"DRILL BIT 2.0MM CANN 150MM","CDM Code","IP/OP",272,"Sterile Supply","","",528,264,419.76000000000005,448.8,448.8,448.8,443.52,427.68,422.40000000000003,419.76000000000005,422.40000000000003]
[58007609,"DRILL BIT 2.0 QC 125","CDM Code","IP/OP",272,"Sterile Supply","","",244,122,193.98000000000002,207.4,207.4,207.4,204.95999999999998,197.64000000000001,195.20000000000002,193.98000000000002,195.20000000000002]
[58007608,"DRILL BIT 2.0 MM","CDM Code","IP/OP",272,"Sterile Supply","","",230,115,182.85000000000002,195.5,195.5,195.5,193.2,186.3,184,182.85000000000002,184]
[58007607,"DRILL BIT 1.7MM","CDM Code","IP/OP",272,"Sterile Supply","","",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[58007606,"DRILL BIT 1.5MM QC 110","CDM Code","IP/OP",272,"Sterile Supply","","",267,133.5,212.26500000000001,226.95,226.95,226.95,224.28,216.27,213.60000000000002,212.26500000000001,213.60000000000002]
[58007605,"DRILL BIT 1.4MM 4.0 ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",329,164.5,261.55500000000001,279.64999999999998,279.64999999999998,279.64999999999998,276.36,266.49,263.2,261.55500000000001,263.2]
[58007604,"DRILL BICORTICAL POST","CDM Code","IP/OP",272,"Sterile Supply","","",245,122.5,194.77500000000001,208.25,208.25,208.25,205.79999999999998,198.45000000000002,196,194.77500000000001,196]
[58007603,"DRILL BICORTICAL BIOPOST","CDM Code","IP/OP",272,"Sterile Supply","","",330,165,262.35000000000002,280.5,280.5,280.5,277.2,267.3,264,262.35000000000002,264]
[58007602,"DRILL 4.5 SYN","CDM Code","IP/OP",272,"Sterile Supply","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[58007601,"DRILL 4.5 SYN","CDM Code","IP/OP",272,"Sterile Supply","","",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[58007600,"DRILL 3.2 SYN","CDM Code","IP/OP",272,"Sterile Supply","","",215,107.5,170.92500000000001,182.75,182.75,182.75,180.6,174.15,172,170.92500000000001,172]
[58007577,"MASK W/ADHESIVE LEVEL 1","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[58007576,"AIR/H20 TUB SET W/CO2 EXTEND","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[58007575,"SCALPEL DISP #20","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[58007553,"BLADE RECIP HEAVY DUTY LONG","CDM Code","IP/OP",272,"Sterile Supply","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[58007552,"BLADE SAGITTAL","CDM Code","IP/OP",272,"Sterile Supply","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[58007551,"BLADE SAG DUAL CUT","CDM Code","IP/OP",272,"Sterile Supply","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[58007550,"KNIFE SIDEPORT","CDM Code","IP/OP",272,"Sterile Supply","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[58007549,"BLADE, SAW, SAG 18.5X83.5MMX1.24","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[58007548,"BLADE SURG CLIPPER ASSEMBLY","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007547,"BLADE STANDARD","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58007546,"BLADE RECIP SHORT","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[58007545,"BLADE RECIP SH TAPER SHORT","CDM Code","IP/OP",272,"Sterile Supply","","",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[58007544,"BLADE RECIP LONG SHORT","CDM Code","IP/OP",272,"Sterile Supply","","",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[58007543,"BLADE RECIP LO TAPER SHORT","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[58007542,"BLADE PEAK PLASMA 3.0 W EXT","CDM Code","IP/OP",272,"Sterile Supply","","",459,229.5,364.90500000000003,390.15,390.15,390.15,385.56,371.79,367.20000000000005,364.90500000000003,367.20000000000005]
[58007541,"BLADE MCGRATH SIZE 4","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[58007540,"BLADE MCGRATH SIZE 3","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[58007539,"BLADE MCGRATH SIZE 2","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58007538,"BLADE LONG RECIP SHORT","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[58007537,"BLADE BEAVER MINI 62","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007536,"BLADE BEAVER MINI 61","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007535,"BLADE 5.0 HIP RESECTOR","CDM Code","IP/OP",272,"Sterile Supply","","",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[58007534,"SAGITTAL SAW BLADE 18MM","CDM Code","IP/OP",272,"Sterile Supply","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[58007533,"BLADE 4.5 ANG AGRS PLUS","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[58007532,"BLADE 4.0 RESECTOR","CDM Code","IP/OP",272,"Sterile Supply","","",167,83.5,132.76500000000001,141.94999999999999,141.94999999999999,141.94999999999999,140.28,135.27000000000001,133.6,132.76500000000001,133.6]
[58007531,"SYSTEM 6 BLADE","CDM Code","IP/OP",272,"Sterile Supply","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[58007530,"RECIPROCATING SAW BLADE","CDM Code","IP/OP",272,"Sterile Supply","","",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[58007529,"ENDOBLADE, PLANTAR FASCIA RELEASE SYS","CDM Code","IP/OP",272,"Sterile Supply","","",1010,505,802.95,858.5,858.5,858.5,848.4,818.1,808,802.95,808]
[58007528,"BLADE STR SCISSOR TIP DISP","CDM Code","IP/OP",272,"Sterile Supply","","",105,52.5,83.475000000000009,89.25,89.25,89.25,88.2,85.050000000000011,84,83.475000000000009,84]
[58007527,"BLADE SAW 25MM","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007526,"BLADE SAG SYS 6 NARROW","CDM Code","IP/OP",272,"Sterile Supply","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[58007525,"BLADE SAG 6","CDM Code","IP/OP",272,"Sterile Supply","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[58007524,"BLADE RECIP MINI SHORT","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[58007523,"BLADE NARR 25 5X5","CDM Code","IP/OP",272,"Sterile Supply","","",96,48,76.320000000000007,81.599999999999994,81.599999999999994,81.599999999999994,80.64,77.760000000000005,76.800000000000011,76.320000000000007,76.800000000000011]
[58007522,"BLADE NARR 18X5.5","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007521,"BLADE MIC 31X9","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007520,"BLADE MIC 29.5X7","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007519,"BLADE MIC 18.5X7.0","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007518,"BLADE MIC 11.5X5.5","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007517,"BLADE INSULATED ELECTRODE 4\"","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[58007516,"BLADE INSULATED ELECTRODE 2.75\"","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58007515,"BLADE HOOK ENDO","CDM Code","IP/OP",272,"Sterile Supply","","",422,211,335.49,358.7,358.7,358.7,354.47999999999996,341.82000000000005,337.6,335.49,337.6]
[58007514,"BLADE HOOK ANGLED","CDM Code","IP/OP",272,"Sterile Supply","","",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[58007513,"BLADE ENDOTRAC","CDM Code","IP/OP",272,"Sterile Supply","","",681,340.5,541.39499999999998,578.85,578.85,578.85,572.04,551.61,544.80000000000007,541.39499999999998,544.80000000000007]
[58007512,"BLADE DERMATOME","CDM Code","IP/OP",272,"Sterile Supply","","",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[58007511,"BLADE CURVED SCISSOR TIP","CDM Code","IP/OP",272,"Sterile Supply","","",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[58007510,"BLADE CAUT PEN 1","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58007509,"BLADE BEAVER MINI 64","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58007508,"BLADE BEAVER MINI 180","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58007507,"BLADE AGRS SHVER CUTTER 2.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007506,"BLADE AGGRES PLUS 4.0MM","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007505,"BLADE 5.5 RESECTOR","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[58007504,"BLADE 4.0 BARREL BUR 12 FLUTE","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007503,"BLADE 3.5 TOMCAT","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[58007502,"BLADE 3.5 RESECTOR","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007501,"BLADE 3.5 AGRS PLUS","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007500,"BLADE 2.5 FULL RADIUS","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007440,"DIGITEX SUTURE DELIVERY DEVICE","CDM Code","IP/OP",272,"Sterile Supply","","",411,205.5,326.745,349.34999999999997,349.34999999999997,349.34999999999997,345.24,332.91,328.8,326.745,328.8]
[58007439,"FIBERLINK SUTURE","CDM Code","IP/OP",272,"Sterile Supply","","",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[58007438,"MONODEK ABS SUTURE","CDM Code","IP/OP",272,"Sterile Supply","","",131,65.5,104.14500000000001,111.35,111.35,111.35,110.03999999999999,106.11000000000001,104.80000000000001,104.14500000000001,104.80000000000001]
[58007410,"BANDGE COBAN 4\" STERILE","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58007404,"BANDGE STER WEBRIL 4","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58007403,"BANDGE STER WEBRIL 2","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[58007402,"BANDGE ESMARK 6X9","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007401,"BANDGE ESMARK 4X9","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007400,"BANDGE COBAN 1X5 COLOR non-sterile","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58007331,"TUBING SUCTION MEDI-VAC","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007330,"TUR Y-TYPE IRRIG SET","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007323,"SUT SILK 0 C027D","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007322,"SUT SILK 0 C021D","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007321,"SUT SILK 0 424H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007320,"SUT 0 SILK TIE SA86G","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007319,"SUT 2-0 SILK CO16D","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007318,"SUT PROLENE 3-0 8872H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007317,"SUT PROLENE 2-0 8833H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007309,"SUT 4-0 MONOCRYL D9600","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007308,"QUICK PASS SUT LASSO 90DEG STR","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007307,"QUICK PASS SUTURE LASSO CRESCENT","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007306,"QUICK PASS SUTURE LASSO 90 STR TIGHT CUR","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007305,"QUICK PASS SUTURE LASSO 90 RIGHT","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007304,"QUICK PASS SUTURE LASSO 90 LEFT","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007303,"QUICK PASS SUTURE LASSO 45 RIGHT","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007302,"QUICK PASS SUTURE LASSO 45 LEFT","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007301,"QUICK PASS SUTURE LASSO 25 TIGHT CURVE R","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007300,"WAX BONE 2.5 GRAMS","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58007299,"QUICK PASS SUTURE LASSO 25 TIGHT CURVE L","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[58007298,"SUT MERS 5.0 746G","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[58007297,"SUT VIC 2-0 D7585","CDM Code","IP/OP",272,"Sterile Supply","","",286,143,227.37,243.1,243.1,243.1,240.23999999999998,231.66000000000003,228.8,227.37,228.8]
[58007296,"SUT VIC 8.0 J974G","CDM Code","IP/OP",272,"Sterile Supply","","",53,26.5,42.135000000000005,45.05,45.05,45.05,44.519999999999996,42.93,42.400000000000006,42.135000000000005,42.400000000000006]
[58007295,"SUT VIC 6.0 J570G","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[58007294,"SUT VIC 4-0 CTD J422H","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007293,"SUT VIC 4.0 VR494 RAPIDE","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58007292,"SUT VIC 4.0 J496G","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58007291,"SUT VIC 4.0 J434H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007290,"SUT VIC 4.0 J315H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007289,"SUT VIC 3-0 J956H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007288,"SUT VIC 3-0 J864D","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58007287,"SUT VIC 3-0 J232H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007286,"SUT VIC 3.0 J936H PS1","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58007285,"SUT VIC 3.0 J824G","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58007284,"SUT VIC 3.0 J774D","CDM Code","IP/OP",272,"Sterile Supply","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[58007283,"SUT VIC 3.0 J393","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007282,"SUT VIC 3.0 J332H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007281,"SUT VIC 2-0 J957H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007280,"SUT VIC 2-0 J726D","CDM Code","IP/OP",272,"Sterile Supply","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58007279,"SUT VIC 2-0 J269H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007278,"SUT VIC 2.0 J917H V34","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007277,"SUT VIC 2.0 J785G","CDM Code","IP/OP",272,"Sterile Supply","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58007276,"SUT VIC 2.0 J602H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007275,"SUT VIC 2.0 J333H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007274,"SUT VIC 2.0 J306H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007273,"SUT VIC 2.0 J206G","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007272,"SUT VIC 1.0 VCP359H PLUS CT36","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007271,"SUT VIC 1.0 JB977","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007270,"SUT VIC 1.0 J977","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007269,"SUT VIC 1.0 J695H OS4","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007268,"SUT VIC 1.0 J359H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007267,"SUT VIC 0 JB840","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[58007266,"SUT VIC 0 J752D","CDM Code","IP/OP",272,"Sterile Supply","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58007265,"SUT VIC 0 J727D","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58007264,"SUT VIC 0 J603H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007263,"SUT VIC 0 J418H UND SH27","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007262,"SUT VIC 0 J334H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007261,"SUT VIC 0 J329H CT3","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007260,"SUT VIC 0 J270H CT2","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007259,"SUT VIC 0 J260H CT1","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007258,"SUT VIC 0 EJ10G","CDM Code","IP/OP",272,"Sterile Supply","","",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[58007257,"SUT STRATIFIX 2 CTX","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[58007256,"SUT SILK 4.0 SA83H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007255,"SUT SILK 4.0 SA63H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007254,"SUT SILK 3.0 SA84H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007253,"SUT SILK 3.0 C0135","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58007252,"SUT SILK 2.0 K833H","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58007251,"SUT SILK 0 624H","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58007250,"SUT QUILL MONODERM 2-0","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[58007249,"SUT PRO 8.0 M8753 BV175-8","CDM Code","IP/OP",272,"Sterile Supply","","",162,81,128.79000000000002,137.69999999999999,137.69999999999999,137.69999999999999,136.07999999999998,131.22,129.6,128.79000000000002,129.6]
[58007248,"SUT PRO 5.0 8686G","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58007247,"SUT PRO 2.0 8523H SH","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58007246,"SUT PRO 1.0 8824G TP1","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58007245,"SUT PRO 0 8434H CT","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007244,"SUT PRO 0 8412H CT2","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007243,"SUT PDS2 4.0 Z496G PS2","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58007242,"SUT PDS2 4.0 Z441H FS1","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58007241,"SUT PDS2 3.0 Z442H FS1","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58007240,"SUT PDS2 2.0 Z339H","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007239,"SUT PDS2 2.0 Z317H SH","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007238,"SUT PDS2 2.0 Z195T CP","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007237,"SUT PDS2 0 Z991G TP1","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58007236,"SUT PDS 0 Z358T","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007235,"SUT NYL 9.0","CDM Code","IP/OP",272,"Sterile Supply","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[58007234,"SUT NYL 10.0","CDM Code","IP/OP",272,"Sterile Supply","","",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[58007233,"SUT MONOCRYL 3-0 Y427H","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58007232,"SUT MONO 4.0 Y494G P3","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58007231,"SUT MONO 4.0 Y426H PS2","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58007230,"SUT MONO 3.0 Y416H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58007229,"SUT ETHLN L886T O","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007228,"SUT ETHLN 6.0 697G","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58007227,"SUT ETHLN 5.0 661G","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007226,"SUT ETHLN 4.0 1667G","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58007225,"SUT ETHLN 3.0 1669H PS2","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58007224,"SUT ETHLN 2.0 593H","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58007223,"SUT ETHBD 5.0 MB47","CDM Code","IP/OP",272,"Sterile Supply","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[58007222,"SUT ETHBD 2.0 X519H OS4","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58007221,"SUT ETHBD 2.0 X411H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007220,"SUT ETHBD 0 CX27D","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58007219,"SUT CHROMIC 5-0 1636G PS-3","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58007218,"SUT CHR GUT 0 CT-1 924H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007217,"SUT CHR 4.0 G121H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007216,"SUT CHR 3.0 G122H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007215,"SUT CHR 3.0 892H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007214,"SUT CHR 0 L114G","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58007213,"SUT 5-0 PRO HS-7 9702H","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[58007212,"SUT 5-0 PDS PDP495G","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58007211,"SUT 4-0 NUROLON C584D","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[58007210,"SUT 3-0 VICRYL UNDYED J416H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007209,"SUT 3-0 30\" VICRYL TIE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[58007208,"SUT 3-0 30\" SILK TIE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007207,"SUT 3-0 18\" VICRYL TIE J104T","CDM Code","IP/OP",270,"Med-Sur Supplies","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[58007206,"SUT 3 VICRYL J808T","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007205,"SUT 2-0 VICRYL J259H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007204,"SUT 2-0 POLYDIOXANONE W/NEEDLE","CDM Code","IP/OP",272,"Sterile Supply","","",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[58007203,"SUT 2-0 DIGITEX","CDM Code","IP/OP",272,"Sterile Supply","","",108,54,85.86,91.8,91.8,91.8,90.72,87.48,86.4,85.86,86.4]
[58007202,"SUT 2-0 CHR UR-6 N878H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58007201,"SUT 1 VICRYL J959H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58007200,"SUT 0 PDSII Z334H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58007009,"BUR SIDE CUT CARB 1.2","CDM Code","IP/OP",272,"Sterile Supply","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[58007008,"BUR BARREL LONG 6MM","CDM Code","IP/OP",272,"Sterile Supply","","",275,137.5,218.625,233.75,233.75,233.75,231,222.75000000000003,220,218.625,220]
[58007007,"BUR SLAP 4.0MM","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[58007006,"BUR SIDE CUT CARB 1.6","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58007005,"BUR ROUND POLISH 4MM","CDM Code","IP/OP",272,"Sterile Supply","","",133,66.5,105.735,113.05,113.05,113.05,111.72,107.73,106.4,105.735,106.4]
[58007004,"BUR ROUND 4MM","CDM Code","IP/OP",272,"Sterile Supply","","",125,62.5,99.375,106.25,106.25,106.25,105,101.25,100,99.375,100]
[58007003,"BUR MICRO EGG 4MM","CDM Code","IP/OP",272,"Sterile Supply","","",141,70.5,112.095,119.85,119.85,119.85,118.44,114.21000000000001,112.80000000000001,112.095,112.80000000000001]
[58007002,"BUR DIAMOND ROUND ELITE","CDM Code","IP/OP",272,"Sterile Supply","","",270,135,214.65,229.5,229.5,229.5,226.79999999999998,218.70000000000002,216,214.65,216]
[58007001,"BUR CARB OVAL 4MM","CDM Code","IP/OP",272,"Sterile Supply","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[58007000,"BUR BARREL DIAMOND EXTRA COARSE","CDM Code","IP/OP",272,"Sterile Supply","","",271,135.5,215.44500000000002,230.35,230.35,230.35,227.64,219.51000000000002,216.8,215.44500000000002,216.8]
[58006758,"GLOVE NITRAPRO 16\" CUFF LARGE","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58006757,"GLOVE NITRAPRO 16\" CUFF SMALL","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58006756,"GLOVE NITRAPRO 16\" CUFF MED","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58006755,"GLOVE NITRAPRO 16\" CUFF XL","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58006754,"CATH INJ 7F GOLD PR","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58006752,"CATH FOL 22F 5CC 2WY ROUND","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58006751,"CATH FOL 22F 5CC 2WY OPEN","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58006750,"CATH FOL 18F 5CC 2WY OPEN","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58006545,"SUTURE PDS II 5-0 Z303H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58006544,"SUT VICRYL 2.0 J417H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58006542,"SUT VICRYL 0 CT-2","CDM Code","IP/OP",272,"Sterile Supply","","",275,137.5,218.625,233.75,233.75,233.75,231,222.75000000000003,220,218.625,220]
[58006541,"SUT VIC 6.0 J492G","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58006540,"SUT VIC 5.0 J493G","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58006539,"SUT VIC 4.0 VR496 RAPIDE PS2","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[58006538,"SUT VIC 4.0 VCP504G P-2 UND","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58006537,"SUT VIC 4.0 J522H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006536,"SUT VIC 4.0 J337H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58006535,"SUT VIC 3.0 VR416","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006534,"SUT VIC 1 J650G TP 1","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[58006533,"SUT TI CRON 3.7","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[58006532,"SUT SUPRAMID 5.0 MPR50","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58006531,"SUT SUPRAMID 4.0 PR40","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58006530,"SUT SUPRAMID 3.0 PR30","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58006529,"SUT SILK 4.0 K831H","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58006528,"SUT SILK 4.0 735G","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58006527,"SUT PRO 5.0 8698G P3","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58006526,"SUT PRO 2.0 8623H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58006525,"SUT PLN GUT 6.0 1916G PC1","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58006524,"SUT PLN 0 L104G","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58006523,"SUT PDS2 4.0 Z494G PS3","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58006522,"SUT MONO 4.0 Y415H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006521,"SUT MONO 3.0 MCP523H","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[58006520,"SUT MONO 2-0 Y945H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006519,"SUT MONO 0 Y946H CT1","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006518,"SUT ETHLN 5.0 698H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58006517,"SUT ETHLN 4.0 BLK MONO FS 18 662H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58006516,"SUT ETHLN 3.0 1673H FSLX","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006515,"SUT ETHLN 2.0 BLK MONO FS 18","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58006514,"SUT ETHBD 3.0 X936H","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58006513,"SUT ETHBD 1.0 X425H CT1","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58006512,"SUT ETHBD 0 X412H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58006511,"SUT ETHBD 0 CX21D","CDM Code","IP/OP",272,"Sterile Supply","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[58006510,"SUT CHR GUT 3-0 882H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58006509,"SUT CHR GUT 2-0 UND 36\" 923H","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[58006508,"SUT CHR 3.0 L112G","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006507,"SUT CHR 3.0 810H","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58006506,"SUT CHR 0 884H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006505,"SUT CHR 0 812H","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006503,"SUT 3-0 18\" SILK TIE A184H","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58006502,"SUT 2-0 NON-ABS POLYPROPYLENE W/NEEDLE","CDM Code","IP/OP",272,"Sterile Supply","","",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[58006501,"SUT 2-0 CETERIX","CDM Code","IP/OP",272,"Sterile Supply","","",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[58006500,"SUT 0 PDSII Z352H","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[58006154,"AIRWY NASOPHARY 20","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58006153,"AIRWY NASOPHARY 18","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58006152,"AIRWY NASOPHARY 14","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58006151,"AIRWY MASK LMA CLASSIC 1","CDM Code","IP/OP",272,"Sterile Supply","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[58006101,"SPONG LAP 18X18","CDM Code","IP/OP",272,"Sterile Supply","","",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[58006100,"1/2 X 1/2 NEURO SPONGE","CDM Code","IP/OP",272,"Sterile Supply","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[58005536,"SHOE WALKWELL W SM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58005535,"SHOE WALKWELL M XLG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58005534,"SHOE PRESSURE RELIEF XLRG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[58005533,"SHOE PRESSURE RELIEF SMALL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[58005532,"SHOE PRESSURE RELIEF MED","CDM Code","IP/OP",270,"Med-Sur Supplies","","",300,150,238.5,255,255,255,252,243.00000000000003,240,238.5,240]
[58005531,"SHOE PRESSURE RELIEF LRG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[58005530,"SHOE PO CLASSIC M XXL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58005529,"SHOE BT CLOSE TOE XLG DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58005525,"PEDIATRIC POSTOP SHOE DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58005521,"SYS W SM PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[58005520,"SYS W MED PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[58005519,"SYS W LG PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[58005518,"SYS M XLG PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[58005517,"SYS M SM PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[58005516,"SYS M MED PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[58005515,"SYS M LG PEG ASSIST DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[58005514,"SHOE BT CLOSE TOE SM DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[58005513,"SHOE BT CLOSE TOE MED DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[58005512,"SHOE BT CLOSE TOE LG DARCO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[58005509,"SHOE DARCO W M","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58005508,"SHOE DARCO W LG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58005503,"SHOE DARCO M XLG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58005502,"SHOE DARCO M SM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58005500,"SHOE DARCO M LG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58004106,"SUT VIC 0 J358H","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58004079,"SUT PRO 4.0 8682G","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58004062,"SUT PLN 5.0 1626G","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58004061,"SUT PLN 4.0 1644G","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58003962,"STOCKING KNEE ELAST L","CDM Code","IP/OP",270,"Med-Sur Supplies","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58003946,"SPLINT FINGER SMALL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58003945,"SPLINT FINGER MEDIUM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58003944,"SPLINT FINGER LARGE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58003943,"SPLIN RT FORARM WRST","CDM Code","IP/OP",270,"Med-Sur Supplies","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[58003924,"IMMOB KNEE FOAM 24","CDM Code","IP/OP",270,"Med-Sur Supplies","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[58003919,"IMMOB KNEE FOAM 19","CDM Code","IP/OP",270,"Med-Sur Supplies","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[58003918,"IMMOB KNEE FOAM 18","CDM Code","IP/OP",270,"Med-Sur Supplies","","",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[58003914,"IMMOB KNEE FOAM 14","CDM Code","IP/OP",270,"Med-Sur Supplies","","",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[58003904,"COLLAR CER STIFF NK","CDM Code","IP/OP",270,"Med-Sur Supplies","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[58003901,"BELT RIB MALE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58003900,"BELT RIB FEMALE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[58003800,"TEGADERM ABS 5 7/8 X 6","CDM Code","IP/OP",272,"Sterile Supply","","",182,91,144.69,154.69999999999999,154.69999999999999,154.69999999999999,152.88,147.42000000000002,145.6,144.69,145.6]
[58003732,"PHYTOPLEX CREAM 2OZ","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003731,"HYDROGUARD CREAM 2OZ","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003730,"QUIET PACK","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003711,"SYS DRAPE MULTICARE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[58003710,"PEDI OXY MASK","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003709,"CPAP INTERFACE KIT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",57,28.5,45.315000000000005,48.449999999999996,48.449999999999996,48.449999999999996,47.879999999999995,46.17,45.6,45.315000000000005,45.6]
[58003708,"BARRIER MIO CLICK 50MM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58003707,"POUCH MIO CLICK EASI 70MM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003706,"BARRIER MIO CLICK 70MM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58003705,"POUCH MIO CLICK EASI 50MM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003704,"UROSTOMY CONVEX BARRIER/POUCH","CDM Code","IP/OP",270,"Med-Sur Supplies","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[58003703,"UROSTOMY FLAT BARRIER/POUCH","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003702,"SYS WECK SH PORT SITE CLOSURE","CDM Code","IP/OP",272,"Sterile Supply","","",282,141,224.19,239.7,239.7,239.7,236.88,228.42000000000002,225.60000000000002,224.19,225.60000000000002]
[58003701,"BAG OSTOMY CONVEX","CDM Code","IP/OP",270,"Med-Sur Supplies","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[58003700,"BAG COLLECTION FECAL MGMT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003616,"FILTER TISSUE ATEC","CDM Code","IP/OP",270,"Med-Sur Supplies","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[58003615,"NEOTRODE II","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003606,"NEEDLE GUIDE INFINITI","CDM Code","IP/OP",270,"Med-Sur Supplies","","",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[58003605,"NEEDLE GUIDE 9G EVIVA","CDM Code","IP/OP",270,"Med-Sur Supplies","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[58003604,"NEEDLE GUIDE  W COVER INFINITI","CDM Code","IP/OP",270,"Med-Sur Supplies","","",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[58003555,"PUNCH BIOPSY 8MM","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58003554,"PUNCH BIOPSY 6MM","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003553,"PUNCH BIOPSY 5MM","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58003552,"PUNCH BIOPSY 4MM","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58003551,"PUNCH BIOPSY 3MM","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58003550,"PUNCH BIOPSY 2MM","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58003350,"BOOT XLARGE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[58003349,"BOOT UBZ COFLEX 2 LAYER","CDM Code","IP/OP",270,"Med-Sur Supplies","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[58003348,"BOOT REGULAR","CDM Code","IP/OP",270,"Med-Sur Supplies","","",208,104,165.36,176.79999999999998,176.79999999999998,176.79999999999998,174.72,168.48000000000002,166.4,165.36,166.4]
[58003347,"BOOT MULTI XTR MED/LRG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",248,124,197.16,210.79999999999998,210.79999999999998,210.79999999999998,208.32,200.88000000000002,198.4,197.16,198.4]
[58003346,"BOOT MULTI X-CEL LRG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",324,162,257.58000000000004,275.39999999999998,275.39999999999998,275.39999999999998,272.15999999999997,262.44,259.2,257.58000000000004,259.2]
[58003345,"BOOT LINER MULTI M/LRG STANDARD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[58003344,"BOOT LARGE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",248,124,197.16,210.79999999999998,210.79999999999998,210.79999999999998,208.32,200.88000000000002,198.4,197.16,198.4]
[58003343,"BOOT CAST XL CLSDTOE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[58003342,"BOOT CAST S CLSDTOE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58003341,"BOOT CAST ME CLSDTOE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58003340,"BOOT CAST L CLSDTOE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58003339,"CAST TAPE YELLOW 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003338,"CAST TAPE YELLOW 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003337,"CAST TAPE YELLOW 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003336,"CAST TAPE WHITE 5X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58003335,"CAST TAPE WHITE 1X2YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003334,"CAST TAPE RED 5X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[58003333,"CAST TAPE RED 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003332,"CAST TAPE RED 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003331,"CAST TAPE RED 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003330,"CAST TAPE PURPLE 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003329,"CAST TAPE PURPLE 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003328,"CAST TAPE PURPLE 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003327,"CAST TAPE LT BLUE 5X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[58003326,"CAST TAPE LT BLUE 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003325,"CAST TAPE LT BLUE 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003324,"CAST TAPE LT BLUE 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003323,"CAST TAPE GREEN 5X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[58003322,"CAST TAPE GREEN 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003321,"CAST TAPE GREEN 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003320,"CAST TAPE GREEN 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003319,"CAST TAPE BR PINK 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003318,"CAST TAPE BR PINK 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003317,"CAST TAPE BR PINK 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003316,"CAST TAPE BR ORNG 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003315,"CAST TAPE BR ORNG 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003314,"CAST TAPE BR ORNG 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003313,"CAST TAPE BLUE 5X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[58003312,"CAST TAPE BLUE 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003311,"CAST TAPE BLUE 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003310,"CAST TAPE BLUE 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003309,"CAST TAPE BLACK 4X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[58003308,"CAST TAPE BLACK 3X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[58003307,"CAST TAPE BLACK 2X4YD","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003306,"CAST SYSTEM 4\"","CDM Code","IP/OP",270,"Med-Sur Supplies","","",317,158.5,252.01500000000001,269.45,269.45,269.45,266.27999999999997,256.77000000000004,253.60000000000002,252.01500000000001,253.60000000000002]
[58003305,"CAST SYSTEM 3\" 5 SYS","CDM Code","IP/OP",270,"Med-Sur Supplies","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[58003304,"CAST SYS 4\" W/BOOT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",1215,607.5,965.92500000000007,1032.75,1032.75,1032.75,1020.5999999999999,984.15000000000009,972,965.92500000000007,972]
[58003303,"CAST SYS 4\" W/2 REG BOOT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",291,145.5,231.345,247.35,247.35,247.35,244.44,235.71,232.8,231.345,232.8]
[58003302,"CAST SYS 3\" W/2 REG BOOT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",277,138.5,220.215,235.45,235.45,235.45,232.67999999999998,224.37,221.60000000000002,220.215,221.60000000000002]
[58003301,"CAST PADDING 6X4 NON STERILE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[58003300,"CAST PADDING 4X4 NON STERILE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58003244,"TRAY FOLEY 16F DOVER SILICONE","CDM Code","IP/OP",272,"Sterile Supply","","",65,32.5,51.675000000000004,55.25,55.25,55.25,54.6,52.650000000000006,52,51.675000000000004,52]
[58003242,"CATH FOLEY 5CC 14FR SILICON","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[58003241,"CATH FOLEY 2WAY 14FR 5CC BALLOON","CDM Code","IP/OP",272,"Sterile Supply","","",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[58003240,"CATH FOLEY 2WAY 14FR 10CC SILICON","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[58003239,"CATH FOLEY 2WAY 12FR 5CC BALLOON","CDM Code","IP/OP",272,"Sterile Supply","","",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[58003238,"CATH FOL TIEMANN 14F 5CC 2WY","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[58003237,"CATH FOL SIL 24F 30CC 2WY","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[58003236,"CATH FOL SIL 22F 5CC 3WY","CDM Code","IP/OP",272,"Sterile Supply","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[58003235,"CATH FOL IRR 18F 3WY","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[58003234,"CATH FOL 24F 5CC 3WY LTX","CDM Code","IP/OP",272,"Sterile Supply","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[58003233,"CATH FOL 24F 30CC 2WY ROUND","CDM Code","IP/OP",272,"Sterile Supply","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[58003232,"CATH FOL 20F 30CC 2WY ROUND","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[58003231,"CATH FOL 18F 30CC 2WY ROUND","CDM Code","IP/OP",272,"Sterile Supply","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[58003230,"CATH FIXATION DEVICE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[58003229,"CATH DRAIN 8F MULTI","CDM Code","IP/OP",272,"Sterile Supply","","",252,126,200.34,214.2,214.2,214.2,211.67999999999998,204.12,201.60000000000002,200.34,201.60000000000002]
[58003228,"CATH DRAIN 8.5 MUELLER","CDM Code","IP/OP",272,"Sterile Supply","","",236,118,187.62,200.6,200.6,200.6,198.23999999999998,191.16000000000003,188.8,187.62,188.8]
[58003227,"CATH DRAIN 12F MULTI","CDM Code","IP/OP",272,"Sterile Supply","","",252,126,200.34,214.2,214.2,214.2,211.67999999999998,204.12,201.60000000000002,200.34,201.60000000000002]
[58003226,"CATH DRAIN 10F MULTI","CDM Code","IP/OP",272,"Sterile Supply","","",252,126,200.34,214.2,214.2,214.2,211.67999999999998,204.12,201.60000000000002,200.34,201.60000000000002]
[58003225,"CATH 22FR FOL SILVER IMPREG","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[58003224,"CATH 22F FOLEY 6 EYES","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[58003223,"CATH 22F FOLEY","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[58003222,"CATH 18FR FOLEY","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[58003216,"CATH 12F FOLEY 5CC 2WY ROUND","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58003205,"CATH 16F FOLEY 5CC 2WY ROUND","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58003188,"SPIROMETER VOLDYNE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[58003185,"CHAMBR AERSOL ENHANC AEROCHAMBER","CDM Code","IP/OP",270,"Med-Sur Supplies","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[58002997,"SCALPEL DISP 10","CDM Code","IP/OP",270,"Med-Sur Supplies","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[58002975,"US PROSTATE BIOPSY 18GX20CM","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58002942,"SET INFUS NEEDL 20G 1","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[58002718,"BANDGE COBAN 4\" NONSTERILE TAN","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[58002717,"BANDGE COBAN 3X5 LF COLOR","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[58002716,"BANDGE COBAN 2X5 LF COLOR","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[58002715,"SPONG 4X4 STERILE","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58002704,"DRESSG TEGADERM 3X3","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58002634,"MOISTURE BARRIER ANTIFUNGAL CREAM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[58002633,"ADH DERMABOND PROPEN","CDM Code","IP/OP",272,"Sterile Supply","","",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[58002632,"ILEX SKIN PROTECTANT 57 GR TUBE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[58002630,"ADVANCED SKIN PROTECTANT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[58002613,"CAUTRY PENC SUC 10F","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[58002612,"CAUTRY DISP VAS","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[58002601,"ADHESIVE .75ML DERMABOND","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[58002378,"MASK NON REBREATH PEDI","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[58001282,"OPTIFLOW CANNULA MED","CDM Code","IP/OP",270,"Med-Sur Supplies","E0560","HUMIDIFIER SUPPLEMENTAL W/ I",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[58001281,"OPTIFLOW CANNULA LARGE","CDM Code","IP/OP",270,"Med-Sur Supplies","E0560","HUMIDIFIER SUPPLEMENTAL W/ I",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[58001280,"OPTIFLOW CANNULA SMALL","CDM Code","IP/OP",270,"Med-Sur Supplies","E0560","HUMIDIFIER SUPPLEMENTAL W/ I",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[58001273,"CONCHA COLUMN","CDM Code","IP/OP",270,"Med-Sur Supplies","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[58001272,"HOOD INFANT LARGE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[58001246,"INTERPULSE FEMORAL CANAL TIP","CDM Code","IP/OP",270,"Med-Sur Supplies","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[58001147,"65MM SUCTION SLEEVE","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[57000308,"STERILE WATER 250ML","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[57000285,"CUTIMED SORBACT RIBBON 19.5X3/4","CDM Code","IP/OP",272,"Sterile Supply","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[57000283,"TEGA SACRAL FOAM LRG","CDM Code","IP/OP",272,"Sterile Supply","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[57000262,"CATH EXTERNAL TEXAS","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[57000243,"CATH 20F COUDE","CDM Code","IP/OP",272,"Sterile Supply","","",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[57000226,"DRESSG MEPILEX 4X4 BORD","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[57000113,"IRRIG NACL 500ML","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[57000111,"STOCKNG KNEE ELAST XL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[57000110,"STOCKNG KNEE ELAST M","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[57000109,"STOCKNG KNEE ELAST L","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[57000108,"STOCKNG KNEE ELAST S","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[57000098,"TRAY IRRIG PISTON","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[57000086,"SPRAY DERMAGRAM","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[57000069,"SOL AQUAPK HUM 340 ML","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[57000057,"OINT Z-GUARD ZINC 4OZ","CDM Code","IP/OP",270,"Med-Sur Supplies","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[57000055,"NEBULIZER T UPDRFT","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[57000051,"LEG STRAP CATH","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[57000049,"IRRIG WATER 500ML","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[57000044,"DRESSG TEGADERM 4X4","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[57000043,"DRESSG TEGADERM 3X3","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[57000042,"DRESSG SACRM MEPLX BORD 7X7","CDM Code","IP/OP",272,"Sterile Supply","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[57000041,"DRESSG MEPILEX BORD 3X3","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[57000040,"DRESSG HEEL","CDM Code","IP/OP",272,"Sterile Supply","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[57000039,"DRESSING ALLDRESS 4X4","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[57000038,"DRESSING ALLDRESS 6X6","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[57000022,"CATH TRAY URET 14F LATEX FREE","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[57000021,"CATH TRAY 18F LATEX FREE","CDM Code","IP/OP",272,"Sterile Supply","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[57000020,"CATH TRAY 16F LATEX FREE","CDM Code","IP/OP",272,"Sterile Supply","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[57000019,"CATH FOL SIL 20F 5CC 2WY","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[57000009,"BANDGE CONFORM 4","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[57000007,"BAG URINE 2000ML","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[57000006,"BAG LEG URINARY 500ML","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[50000094,"PT ONLINE 5-10 MIN","CDM Code","IP/OP",420,"Physical Therp","G2061","QUAL NONMD EST PT 5-10M",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[7900014,"HEP B SERIES INDIV ADMIN 1ST IN SERIES","CDM Code","IP/OP",999,"Pt Conv/Other","","",100,50,79.5,85,85,85,84,81,80,79.5,80]
[7900013,"HEP B SERIES GROUP ADMIN 1ST IN SERIES","CDM Code","IP/OP",999,"Pt Conv/Other","","",83,41.5,65.984999999999999,70.55,70.55,70.55,69.72,67.23,66.400000000000006,65.984999999999999,66.400000000000006]
[7900012,"TETANUS MUNICIPAL-OH","CDM Code","IP/OP",999,"Pt Conv/Other","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[7900011,"HEPATITIS B VACCINE MUNICIPAL-OH","CDM Code","IP/OP",999,"Pt Conv/Other","","",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[7900010,"PFT VC-OH","CDM Code","IP/OP",999,"Pt Conv/Other","","",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[7900009,"FUNCTION CAPACITY EVALUATION","CDM Code","IP/OP",999,"Pt Conv/Other","","",1913,956.5,1520.835,1626.05,1626.05,1626.05,1606.9199999999998,1549.5300000000002,1530.4,1520.835,1530.4]
[7900008,"AUDIOMETER TEST-OHO","CDM Code","IP/OP",999,"Pt Conv/Other","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[7900007,"AUDIOMETER TEST-OHT","CDM Code","IP/OP",999,"Pt Conv/Other","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[7900006,"OCCUPATIONAL NURSE EDUCATION/HR","CDM Code","IP/OP",999,"Pt Conv/Other","","",96,48,76.320000000000007,81.599999999999994,81.599999999999994,81.599999999999994,80.64,77.760000000000005,76.800000000000011,76.320000000000007,76.800000000000011]
[7900005,"HEPATITIS B VACCINE-OH","CDM Code","IP/OP",999,"Pt Conv/Other","","",136,68,108.12,115.6,115.6,115.6,114.24,110.16000000000001,108.80000000000001,108.12,108.80000000000001]
[7900004,"RESPIRATORY QUESTIONNAIRE-OH","CDM Code","IP/OP",999,"Pt Conv/Other","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[7900003,"INFLUENZA A/B -OB","CDM Code","IP/OP",999,"Pt Conv/Other","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[7900001,"OCC MED HEARING SCREEN-15 MIN","CDM Code","IP/OP",999,"Pt Conv/Other","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[7800007,"DIAB CLINIC GROUP 30 MIN COMMER SELFPAY","CDM Code","IP/OP",942,"Educ/Training","G0109","DIAB MANAGE TRN IND/GROUP",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[7800004,"DIAB CLINIC INDIV 30 MIN COMMER SELFPAY","CDM Code","IP/OP",942,"Educ/Training","G0108","DIAB MANAGE TRN  PER INDIV",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[6500004,"*ANTICOAG CLINIC POC INR","CDM Code","IP/OP",300,"Lab",85610,"PROTHROMBIN TIME",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[6500003,"ANTICOAG CLINIC LEVEL 3","CDM Code","IP/OP",942,"Educ/Training",99213,"OFFICE O/P EST LOW 20-29 MIN",196,98,155.82000000000002,166.6,166.6,166.6,164.64,158.76000000000002,156.80000000000001,155.82000000000002,156.80000000000001]
[6500002,"ANTICOAG CLINIC LEVEL 2","CDM Code","IP/OP",942,"Educ/Training",99212,"OFFICE O/P EST SF 10-19 MIN",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[6500001,"ANTICOAG CLINIC LEVEL 1","CDM Code","IP/OP",942,"Educ/Training",99211,"OFF/OP EST MAY X REQ PHY/QHP",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[6100154,"HC-RPR LAC 2.5 CM/<MOUTH&ANT","CDM Code","IP/OP",450,"Emerg Room",41250,"REPAIR TONGUE LACERATION",532,266,422.94,452.2,452.2,452.2,446.88,430.92,425.6,422.94,425.6]
[6100153,"HC-OPHTHALMIC US DX B-SCAN W/WO NON QUAN","CDM Code","IP/OP",450,"Emerg Room",76512,"OPH US DX B-SCAN",638,319,507.21000000000004,542.29999999999995,542.29999999999995,542.29999999999995,535.91999999999996,516.78000000000009,510.40000000000003,507.21000000000004,510.40000000000003]
[6100150,"HC - US VASC ACCESS SITS VSL PATENCY NDL","CDM Code","IP/OP",450,"Emerg Room",76937,"US GUIDE VASCULAR ACCESS",105,52.5,83.475000000000009,89.25,89.25,89.25,88.2,85.050000000000011,84,83.475000000000009,84]
[6100147,"ER-US ABDOMINAL REAL TIME W/IMAGE","CDM Code","IP/OP",450,"Emerg Room",76700,"US EXAM ABDOM COMPLETE",1047,523.5,832.36500000000001,889.94999999999993,889.94999999999993,889.94999999999993,879.48,848.07,837.6,832.36500000000001,837.6]
[6100141,"VT MCD ED PER DIEM","CDM Code","IP/OP",900,"Behavior Health Treatments/Services","H0046","MENTAL HEALTH SERVICE, NOS",200,100,159,170,170,170,168,162,160,159,160]
[6100137,"HC - REPAIR INTERMEDIATE F/E/E/N/L&/MUC","CDM Code","IP/OP",450,"Emerg Room",12051,"INTMD RPR FACE/MM 2.5 CM/<",776,388,616.92000000000007,659.6,659.6,659.6,651.84,628.56000000000006,620.80000000000007,616.92000000000007,620.80000000000007]
[6100136,"REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM","CDM Code","IP/OP",450,"Emerg Room",12036,"INTMD RPR S/A/T/EXT 20.1-30",1064,532,845.88,904.4,904.4,904.4,893.76,861.84,851.2,845.88,851.2]
[6100135,"IV INJ BEBTELOVIMAB","CDM Code","IP/OP",260,"IV Therapy","M0222","BEBTELOVIMAB INJECTION",540,270,429.3,459,459,459,453.59999999999997,437.40000000000003,432,429.3,432]
[6100134,"THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI","CDM Code","IP/OP",450,"Emerg Room",32555,"ASPIRATE PLEURA W/ IMAGING",868,434,690.06000000000006,737.8,737.8,737.8,729.12,703.08,694.40000000000009,690.06000000000006,694.40000000000009]
[6100130,"PERQ DRAINAGE PLEURA INSERT CATH W/O","CDM Code","IP/OP",450,"Emerg Room",32556,"INSERT CATH PLEURA W/O IMAGE",660,330,524.70000000000005,561,561,561,554.4,534.6,528,524.70000000000005,528]
[6100115,"ADMIN IV INFUSION SOTROVIMAB INCLUDES IN","CDM Code","IP/OP",450,"Emerg Room","M0247","SOTROVIMAB INFUSION",530,265,421.35,450.5,450.5,450.5,445.2,429.3,424,421.35,424]
[6100107,"SIMPLE REPAIR SUPERFICIAL WOUNDS OF FACE","CDM Code","IP/OP",450,"Emerg Room",12014,"RPR F/E/E/N/L/M 5.1-7.5 CM",582,291,462.69,494.7,494.7,494.7,488.88,471.42,465.6,462.69,465.6]
[6100105,"SIMP RPR WOUNDS SCALP, NECK 7.6-12.5 CM","CDM Code","IP/OP",450,"Emerg Room",12004,"RPR S/N/AX/GEN/TRK7.6-12.5CM",562,281,446.79,477.7,477.7,477.7,472.08,455.22,449.6,446.79,449.6]
[6100102,"RPR FACE COMPLETX 2.6-7.5 CM (ER)","CDM Code","IP/OP",450,"Emerg Room",13152,"CMPLX RPR E/N/E/L 2.6-7.5 CM",1520,760,1208.4000000000001,1292,1292,1292,1276.8,1231.2,1216,1208.4000000000001,1216]
[6100101,"ER OBSERVATION PER HOUR","CDM Code","IP/OP",762,"Observation Rm","G0378","HOSPITAL OBSERVATION PER HR",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[6100100,"URINE DIP AUTOMATIC","CDM Code","IP/OP",300,"Lab",81003,"URINALYSIS AUTO W/O SCOPE",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[6100099,"MOD SED SAME PHY EA ADDTL 15MIN","CDM Code","IP/OP",450,"Emerg Room",99153,"MOD SED SAME PHYS/QHP EA",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[6100098,"MOD SED SAME PHY 5+ YRS OLD INITAL 15MIN","CDM Code","IP/OP",450,"Emerg Room",99152,"MOD SED SAME PHYS/QHP 5/>YRS",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[6100097,"MOD SED SAME PHY <5 YRS OLD INITAL 15MIN","CDM Code","IP/OP",450,"Emerg Room",99151,"MOD SED SAME PHYS/QHP <5 YRS",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[6100096,"STOOL FIT FECAL BLOOD","CDM Code","IP/OP",300,"Lab",82274,"ASSAY TEST FOR BLOOD FECAL",86,43,68.37,73.099999999999994,73.099999999999994,73.099999999999994,72.239999999999995,69.660000000000011,68.8,68.37,68.8]
[6100095,"RAPID STREP","CDM Code","IP/OP",300,"Lab",87880,"STREP A ASSAY W/OPTIC",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[6100094,"INDEPENDANT BLOOD ALCOHOL DRAW KIT STATE","CDM Code","IP/OP",999,"Pt Conv/Other","","",133,66.5,105.735,113.05,113.05,113.05,111.72,107.73,106.4,105.735,106.4]
[6100093,"IV PUSH EACH ADDITIONAL SEQUENTIAL","CDM Code","IP/OP",260,"IV Therapy",96376,"TX/PRO/DX INJ SAME DRUG ADON",335,167.5,266.32499999999999,284.75,284.75,284.75,281.39999999999998,271.35000000000002,268,266.32499999999999,268]
[6100092,"COLLECT BLOOD SPECIMEN COMPLETELY IMPLAN","CDM Code","IP/OP",260,"IV Therapy",36591,"DRAW BLOOD OFF VENOUS DEVICE",272,136,216.24,231.2,231.2,231.2,228.48,220.32000000000002,217.60000000000002,216.24,217.60000000000002]
[6100091,"IV PUSH EA ADDITIONAL SEQ SUBSTANCE","CDM Code","IP/OP",260,"IV Therapy",96375,"TX/PRO/DX INJ NEW DRUG ADDON",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[6100090,"INFUSION THERAPY CONCURRENT INFUSION","CDM Code","IP/OP",260,"IV Therapy",96368,"THER/DIAG CONCURRENT INF",312,156,248.04000000000002,265.2,265.2,265.2,262.08,252.72000000000003,249.60000000000002,248.04000000000002,249.60000000000002]
[6100089,"INFUSION THERAPY SEQ SUBSTANCE 1ST HOUR","CDM Code","IP/OP",260,"IV Therapy",96367,"TX/PROPH/DG ADDL SEQ IV INF",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[6100088,"INFUSION THERAPY OR PROPHYLAXIS EA ADDTL","CDM Code","IP/OP",260,"IV Therapy",96366,"THER/PROPH/DIAG IV INF ADDON",283,141.5,224.98500000000001,240.54999999999998,240.54999999999998,240.54999999999998,237.72,229.23000000000002,226.4,224.98500000000001,226.4]
[6100087,"INFUSION THERAPY OR PROPHYLAXIS 1ST HR","CDM Code","IP/OP",260,"IV Therapy",96365,"THER/PROPH/DIAG IV INF INIT",753,376.5,598.63499999999999,640.04999999999995,640.04999999999995,640.04999999999995,632.52,609.93000000000006,602.4,598.63499999999999,602.4]
[6100086,"INFUSION THER HYDRATION EA ADDTL HOUR","CDM Code","IP/OP",260,"IV Therapy",96361,"HYDRATE IV INFUSION ADD-ON",283,141.5,224.98500000000001,240.54999999999998,240.54999999999998,240.54999999999998,237.72,229.23000000000002,226.4,224.98500000000001,226.4]
[6100085,"INFUSION THER HYDRATION 1ST HOUR","CDM Code","IP/OP",260,"IV Therapy",96360,"HYDRATION IV INFUSION INIT",515,257.5,409.42500000000001,437.75,437.75,437.75,432.59999999999997,417.15000000000003,412,409.42500000000001,412]
[6100084,"IMMUNIZATION ADMIN 1 SINGLE OR COMBINATI","CDM Code","IP/OP",771,"Preventive Care Services: Admin. of vaccine",90471,"IMMUNIZATION ADMIN",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[6100083,"MEDIPORT FLUSH","CDM Code","IP/OP",450,"Emerg Room",96523,"IRRIG DRUG DELIVERY DEVICE",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[6100081,"INSERT TEMP INDWELLING BLADDER CATHETER","CDM Code","IP/OP",450,"Emerg Room",51702,"INSERT TEMP BLADDER CATH",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[6100080,"STRAIGHT CATHERIZATION OF BLADDER","CDM Code","IP/OP",450,"Emerg Room",51701,"INSERT BLADDER CATHETER",207,103.5,164.565,175.95,175.95,175.95,173.88,167.67000000000002,165.60000000000002,164.565,165.60000000000002]
[6100079,"URINE DIP PREGNANCY","CDM Code","IP/OP",300,"Lab",81025,"URINE PREGNANCY TEST",57,28.5,45.315000000000005,48.449999999999996,48.449999999999996,48.449999999999996,47.879999999999995,46.17,45.6,45.315000000000005,45.6]
[6100077,"MODERATE SEDATION 30 MIN AGE 5 AND OLDER","CDM Code","IP/OP",370,"Anesthesia",99144,"MOD SEDAT PHYS/QHP 5YRS/>",676,338,537.42000000000007,574.6,574.6,574.6,567.84,547.56000000000006,540.80000000000007,537.42000000000007,540.80000000000007]
[6100075,"IV PUSH INITIAL","CDM Code","IP/OP",260,"IV Therapy",96374,"THER/PROPH/DIAG INJ IV PUSH",524,262,416.58000000000004,445.4,445.4,445.4,440.15999999999997,424.44000000000005,419.20000000000005,416.58000000000004,419.20000000000005]
[6100074,"SUBCUTANEOUS","CDM Code","IP/OP",940,"Other Rx Svcs",96372,"THER/PROPH/DIAG INJ SC/IM",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[6100073,"APPLICATION OF LEG SPLINT","CDM Code","IP/OP",450,"Emerg Room",29505,"APPLICATION LONG LEG SPLINT",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[6100072,"REPAIR SIMPLE 2.6CM TO 7.5CM","CDM Code","IP/OP",450,"Emerg Room",12002,"RPR S/N/AX/GEN/TRNK2.6-7.5CM",533,266.5,423.73500000000001,453.05,453.05,453.05,447.71999999999997,431.73,426.40000000000003,423.73500000000001,426.40000000000003]
[6100071,"REPAIR SIMPLE 2.5 CM OR LESS","CDM Code","IP/OP",450,"Emerg Room",12001,"RPR S/N/AX/GEN/TRNK 2.5CM/<",533,266.5,423.73500000000001,453.05,453.05,453.05,447.71999999999997,431.73,426.40000000000003,423.73500000000001,426.40000000000003]
[6100066,"VENIPUNCTURE-THA-","CDM Code","IP/OP",300,"Lab",36415,"ROUTINE VENIPUNCTURE",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[6100058,"CRITICAL CARE EA ADDITIONAL 30 MIN","CDM Code","IP/OP",450,"Emerg Room",99292,"CRITICAL CARE ADDL 30 MIN",716,358,569.22,608.6,608.6,608.6,601.43999999999994,579.96,572.80000000000007,569.22,572.80000000000007]
[6100057,"CRITICAL CARE FIRST HR","CDM Code","IP/OP",450,"Emerg Room",99291,"CRITICAL CARE FIRST HOUR",3292,1646,2617.1400000000003,2798.2,2798.2,2798.2,2765.2799999999997,2666.52,2633.6000000000004,2617.1400000000003,2633.6000000000004]
[6100056,"E D LEVEL 5","CDM Code","IP/OP",450,"Emerg Room",99285,"EMERGENCY DEPT VISIT HI MDM",1439,719.5,1144.0050000000001,1223.1499999999999,1223.1499999999999,1223.1499999999999,1208.76,1165.5900000000001,1151.2,1144.0050000000001,1151.2]
[6100055,"E D LEVEL 4","CDM Code","IP/OP",450,"Emerg Room",99284,"EMERGENCY DEPT VISIT MOD MDM",995,497.5,791.02500000000009,845.75,845.75,845.75,835.8,805.95,796,791.02500000000009,796]
[6100054,"E D LEVEL 3","CDM Code","IP/OP",450,"Emerg Room",99283,"EMERGENCY DEPT VISIT LOW MDM",655,327.5,520.72500000000002,556.75,556.75,556.75,550.19999999999993,530.55000000000007,524,520.72500000000002,524]
[6100053,"E D LEVEL 2","CDM Code","IP/OP",450,"Emerg Room",99282,"EMERGENCY DEPT VISIT SF MDM",397,198.5,315.61500000000001,337.45,337.45,337.45,333.47999999999996,321.57,317.60000000000002,315.61500000000001,317.60000000000002]
[6100052,"E D LEVEL 1","CDM Code","IP/OP",450,"Emerg Room",99281,"EMR DPT VST MAYX REQ PHY/QHP",273,136.5,217.03500000000003,232.04999999999998,232.04999999999998,232.04999999999998,229.32,221.13000000000002,218.4,217.03500000000003,218.4]
[6100043,"HC - PUNCTURE ASPIRATION ABSCESS HEMATOM","CDM Code","IP/OP",450,"Emerg Room",10160,"PUNCTURE DRAINAGE OF LESION",200,100,159,170,170,170,168,162,160,159,160]
[6100037,"CARDIOPULMONARY RESUSCITATION","CDM Code","IP/OP",450,"Emerg Room",92950,"HEART/LUNG RESUSCITATION CPR",725,362.5,576.375,616.25,616.25,616.25,609,587.25,580,576.375,580]
[6100035,"URINE DIP STICK","CDM Code","IP/OP",300,"Lab",81002,"URINALYSIS NONAUTO W/O SCOPE",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[6100034,"REMOVAL IMPACTED CERUMEN ONE OR BOTH EAR","CDM Code","IP/OP",450,"Emerg Room",69210,"REMOVE IMPACTED EAR WAX UNI",204,102,162.18,173.4,173.4,173.4,171.35999999999999,165.24,163.20000000000002,162.18,163.20000000000002]
[6100033,"REMOVAL FOREIGN BODY","CDM Code","IP/OP",450,"Emerg Room",69200,"CLEAR OUTER EAR CANAL",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[6100032,"REMOVAL F B CORNEAL WITH SLIT LAMP","CDM Code","IP/OP",450,"Emerg Room",65222,"REMOVE FOREIGN BODY FROM EYE",352,176,279.84000000000003,299.2,299.2,299.2,295.68,285.12,281.60000000000002,279.84000000000003,281.60000000000002]
[6100030,"REMOVAL F B EXTERNAL EYE CONJUCT SUPERFI","CDM Code","IP/OP",450,"Emerg Room",65205,"REMOVE FOREIGN BODY FROM EYE",219,109.5,174.10500000000002,186.15,186.15,186.15,183.95999999999998,177.39000000000001,175.20000000000002,174.10500000000002,175.20000000000002]
[6100029,"SPINAL PUNCTURE LUMBAT DIAGNOSTIC","CDM Code","IP/OP",450,"Emerg Room",62270,"DX LMBR SPI PNXR",478,239,380.01,406.3,406.3,406.3,401.52,387.18,382.40000000000003,380.01,382.40000000000003]
[6100025,"BLOOD TRANSFUSION +6 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1509,754.5,1199.655,1282.6499999999999,1282.6499999999999,1282.6499999999999,1267.56,1222.2900000000002,1207.2,1199.655,1207.2]
[6100024,"BLOOD TRANSFUSION 4-6 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1179,589.5,937.30500000000006,1002.15,1002.15,1002.15,990.36,954.99,943.2,937.30500000000006,943.2]
[6100023,"BLOOD TRANSFUSION 2-4 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1090,545,866.55000000000007,926.5,926.5,926.5,915.6,882.90000000000009,872,866.55000000000007,872]
[6100022,"BLOOD TRANSFUSION -2 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",797,398.5,633.61500000000001,677.44999999999993,677.44999999999993,677.44999999999993,669.48,645.57000000000005,637.6,633.61500000000001,637.6]
[6100020,"INTUBATION ENDOTRACHEAL EMERGENCY PROCED","CDM Code","IP/OP",450,"Emerg Room",31500,"INSERT EMERGENCY AIRWAY",724,362,575.58000000000004,615.4,615.4,615.4,608.16,586.44000000000005,579.20000000000005,575.58000000000004,579.20000000000005]
[6100019,"CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE","CDM Code","IP/OP",450,"Emerg Room",30901,"CONTROL OF NOSEBLEED",290,145,230.55,246.5,246.5,246.5,243.6,234.9,232,230.55,232]
[6100018,"REMOVAL FOREIGN BODY INTRANASAL OFFICE","CDM Code","IP/OP",450,"Emerg Room",30300,"REMOVE NASAL FOREIGN BODY",632,316,502.44,537.19999999999993,537.19999999999993,537.19999999999993,530.88,511.92,505.6,502.44,505.6]
[6100017,"STRAPPING KNEE","CDM Code","IP/OP",450,"Emerg Room",29530,"STRAPPING OF KNEE",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[6100016,"APPLICATION OF SHORT LEG SPLINT","CDM Code","IP/OP",450,"Emerg Room",29515,"APPLICATION LOWER LEG SPLINT",228,114,181.26000000000002,193.79999999999998,193.79999999999998,193.79999999999998,191.51999999999998,184.68,182.4,181.26000000000002,182.4]
[6100015,"APPLIC OF FINGER SPLINT STATIC","CDM Code","IP/OP",450,"Emerg Room",29130,"APPLICATION OF FINGER SPLINT",143,71.5,113.685,121.55,121.55,121.55,120.11999999999999,115.83000000000001,114.4,113.685,114.4]
[6100014,"APPLICATION OF SHORT ARM SPLINT (STATIC)","CDM Code","IP/OP",450,"Emerg Room",29125,"APPLY FOREARM SPLINT",195,97.5,155.02500000000001,165.75,165.75,165.75,163.79999999999998,157.95000000000002,156,155.02500000000001,156]
[6100013,"APPLICATION OF LONG ARM","CDM Code","IP/OP",450,"Emerg Room",29105,"APPLY LONG ARM SPLINT",214,107,170.13,181.9,181.9,181.9,179.76,173.34,171.20000000000002,170.13,171.20000000000002]
[6100011,"REMOVAL F B FOOT SUBCUTANEOUS","CDM Code","IP/OP",450,"Emerg Room",28190,"REMOVAL OF FOOT FOREIGN BODY",661,330.5,525.495,561.85,561.85,561.85,555.24,535.41000000000008,528.80000000000007,525.495,528.80000000000007]
[6100010,"CLOSED TREATMENT ANKLE DISLOCATION","CDM Code","IP/OP",450,"Emerg Room",27840,"TREAT ANKLE DISLOCATION",626,313,497.67,532.1,532.1,532.1,525.84,507.06000000000006,500.8,497.67,500.8]
[6100008,"CLOSED SHOULDER DISLOC W/MANIP W/O ANES","CDM Code","IP/OP",450,"Emerg Room",23650,"CLTX SHO DSLC W/MNPJ WO ANES",521,260.5,414.19499999999999,442.84999999999997,442.84999999999997,442.84999999999997,437.64,422.01000000000005,416.8,414.19499999999999,416.8]
[6100006,"DRESSINGS DEBRIDE W/O ANESTHESIA","CDM Code","IP/OP",450,"Emerg Room",16020,"DRESS/DEBRID P-THICK BURN S",252,126,200.34,214.2,214.2,214.2,211.67999999999998,204.12,201.60000000000002,200.34,201.60000000000002]
[6100005,"SIMPLE REPAIR SUPERFIC 2.5CM OR LESS","CDM Code","IP/OP",450,"Emerg Room",12011,"RPR F/E/E/N/L/M 2.5 CM/<",472,236,375.24,401.2,401.2,401.2,396.47999999999996,382.32000000000005,377.6,375.24,377.6]
[6100004,"AVULSION OF NAIL PLATE PART/COMP SIMPLE","CDM Code","IP/OP",450,"Emerg Room",11730,"REMOVAL OF NAIL PLATE",227,113.5,180.465,192.95,192.95,192.95,190.68,183.87,181.60000000000002,180.465,181.60000000000002]
[6100003,"INCISION & REMOVAL F B SIMPLE","CDM Code","IP/OP",450,"Emerg Room",10120,"REMOVE FOREIGN BODY",332,166,263.94,282.2,282.2,282.2,278.88,268.92,265.60000000000002,263.94,265.60000000000002]
[6100002,"INCISION & DRAINAGE PILONIDAL CYST SIM","CDM Code","IP/OP",450,"Emerg Room",10080,"DRAINAGE OF PILONIDAL CYST",411,205.5,326.745,349.34999999999997,349.34999999999997,349.34999999999997,345.24,332.91,328.8,326.745,328.8]
[6100001,"I&D OF ABSCESS SIMPLE OR SINGLE","CDM Code","IP/OP",450,"Emerg Room",10060,"DRAINAGE OF SKIN ABSCESS",235,117.5,186.82500000000002,199.75,199.75,199.75,197.4,190.35000000000002,188,186.82500000000002,188]
[5800059,"LITHOTRIPSY","CDM Code","IP/OP",790,"Extra-Corp Shock Wave Therapy",50590,"FRAGMENTING OF KIDNEY STONE",19221,9610.5,15280.695000000002,16337.85,16337.85,16337.85,16145.64,15569.01,15376.800000000001,15280.695000000002,15376.800000000001]
[5800004,"BLOOD TRANSFUSION OVER 6 HRS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1509,754.5,1199.655,1282.6499999999999,1282.6499999999999,1282.6499999999999,1267.56,1222.2900000000002,1207.2,1199.655,1207.2]
[5800003,"BLOOD TRANSFUSION 4-6 HRS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1253,626.5,996.1350000000001,1065.05,1065.05,1065.05,1052.52,1014.9300000000001,1002.4000000000001,996.1350000000001,1002.4000000000001]
[5800002,"BLOOD TRANSFUSION 2-4 HRS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",995,497.5,791.02500000000009,845.75,845.75,845.75,835.8,805.95,796,791.02500000000009,796]
[5800001,"BLOOD TRANSFUSION <2 HRS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",833,416.5,662.23500000000001,708.05,708.05,708.05,699.72,674.73,666.40000000000009,662.23500000000001,666.40000000000009]
[5690263,"FLUCONAZOLE 100 MG/50 ML - RX TO SUPPLY","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5690259,"LR 1000 ML W/ MULTIVITAMIN & KCL 40MEQ","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690227,"BEVACIZUMAB-BVZR (ZIRABEV) 400MG/16ML","CDM Code","IP/OP",259,"Drugs/Other","Q5118","INJ., ZIRABEV, 10 MG",2172,1086,1726.74,1846.2,1846.2,1846.2,1824.48,1759.3200000000002,1737.6000000000001,1726.74,1737.6000000000001]
[5690226,"BEVACIZUMAB-BVZR (ZIRABEV) 100MG/4ML","CDM Code","IP/OP",259,"Drugs/Other","Q5118","INJ., ZIRABEV, 10 MG",543,271.5,431.685,461.55,461.55,461.55,456.12,439.83000000000004,434.40000000000003,431.685,434.40000000000003]
[5690199,"PIP-TAZO (ZOSYN) 2.25GM TRADITIONAL INFU","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",66,33,52.470000000000006,56.1,56.1,56.1,55.44,53.46,52.800000000000004,52.470000000000006,52.800000000000004]
[5690198,"PIP-TAZO (ZOSYN) 3.375GM TRADITIONAL INF","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",66,33,52.470000000000006,56.1,56.1,56.1,55.44,53.46,52.800000000000004,52.470000000000006,52.800000000000004]
[5690197,"PIP-TAZO (ZOSYN) 4.5GM EXTENDED INFU","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",66,33,52.470000000000006,56.1,56.1,56.1,55.44,53.46,52.800000000000004,52.470000000000006,52.800000000000004]
[5690195,"ROPIV 0.2%/FENT Epidu 100ml - GMC MADE","CDM Code","IP/OP",259,"Drugs/Other","","",221,110.5,175.69500000000002,187.85,187.85,187.85,185.64,179.01000000000002,176.8,175.69500000000002,176.8]
[5690172,"FILGRASTIM (ZARXIO) 300MCG/0.5ML","CDM Code","IP/OP",636,"Drug/Detail Code","Q5101","INJECTION, ZARXIO",875,437.5,695.625,743.75,743.75,743.75,735,708.75,700,695.625,700]
[5690152,"TRANEXAMIC ACID 3000 MG *IA*","CDM Code","IP/OP",250,"Pharmacy","","",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[5690151,"TRANEXAMIC ACID 1000 MG *IV*","CDM Code","IP/OP",250,"Pharmacy","","",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[5690109,"HYDROmorphone PCA 200 MG/100 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5690108,"HYDROmorphone PCA 80 MG/40 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5690107,"HYDROmorphone PCA 40 MG/20 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5690094,"LR 1000 ML W/ MULTIVITAMIN","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690092,"PIP-TAZO (ZOSYN) 4.5GM TRADITIONAL INFU","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",66,33,52.470000000000006,56.1,56.1,56.1,55.44,53.46,52.800000000000004,52.470000000000006,52.800000000000004]
[5690086,"REMOVE LIDOCAINE PATCH","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690033,"VANCOMYCIN ORAL FOR C DIFF","CDM Code","IP/OP",259,"Drugs/Other","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5690027,"COMBIVENT NEB","CDM Code","IP/OP",259,"Drugs/Other","","",185,92.5,147.07500000000002,157.25,157.25,157.25,155.4,149.85000000000002,148,147.07500000000002,148]
[5690026,"PHENYTOIN 1000 MG/NS 100 ML-RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690025,"PHENYTOIN 750 MG/NS 100 ML- RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690024,"PHENYTOIN 500 MG/NS 100 ML- RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690023,"PAMIDRONATE 90MG/NS 500ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2430","PAMIDRONATE DISODIUM /30 MG",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690022,"PAMIDRONATE 30MG/NS 250ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2430","PAMIDRONATE DISODIUM /30 MG",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690020,"MAGNESIUM SULF 4GM/NS100ML-RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690019,"MAGNESIUM SULF 3GM/NS100ML -RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690018,"MAGNESIUM SULF 2GM/NS50ML - RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690017,"MAGNESIUM SULF 1GM/NS50ML - RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690016,"INSULIN (REG) DRIP 100 UNITS/NS 100 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690015,"GENTAMICIN 400 MG/NS 100 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690014,"GENTAMICIN 350 MG/NS 100 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690013,"GENTAMICIN 300 MG/NS 100 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690012,"GENTAMICIN 250 MG/NS 100 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690011,"FUROSEMIDE DRIP 100MG/100ML-RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690010,"CLINDAMYCIN 450 MG/NS 50 ML-rx to supply","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690009,"CIPROFLOXACIN 400MG-D5W PB 200ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690008,"CEFAZOLIN 2 GM/NS 50 ML - RX TO SUPPLY","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690007,"AMINOPHYLINE 500MG/500ML DRIP","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690006,"AMBIEN 5 MG ** PT'S OWN MED **","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690004,"REMOVE NITROglycerin PATCH","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690002,"SALINE FLUSH 10 ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5690001,"FENTANYL FOR INFUSION","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5684524,"NF-Pyridostigmine Bromide Oral Tablet 60","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5684504,"NF-cloBAZam Oral Tablet 10MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5682546,"NF-Hydrocortisone Rectal Enema 100MG/60M","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5682534,"NF-Ranexa Extended-Release Tablet 500MG","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5682508,"NF-Dronabinol Liquid Filled Capsule 5MG","CDM Code","IP/OP",250,"Pharmacy","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5682415,"NF-Mestinon Tablet 60MG","CDM Code","IP/OP",250,"Pharmacy","","",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[5682397,"NF-Tacrolimus Oral Capsule 0.5MG","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5682242,"NF-Tacrolimus Oral Capsule 1MG","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5682004,"NF-chlorproMAZINE HCl Tablet 25MG","CDM Code","IP/OP",250,"Pharmacy","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5681849,"NF-COSOPT PF 2%-0.5% OPHTHALMIC SOLUTION","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5681793,"NF-DORZOLAMIDE HCL-TIMOLOL 22.3MG-6.8MG/","CDM Code","IP/OP",250,"Pharmacy","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5681727,"NF-DEMECLOCYCLINE HCL ORAL TABLET 300MG","CDM Code","IP/OP",250,"Pharmacy","","",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[5681671,"NF-XARELTO 20MG ORAL TABLET","CDM Code","IP/OP",250,"Pharmacy","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5681605,"NF-MYCOPHENOLATE MOFETIL 500MG ORAL TABL","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5681400,"NF-Flovent HFA Inh/Neb Aer Pwd 0.044MG/1","CDM Code","IP/OP",250,"Pharmacy","","",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[5681397,"NF-Floxin Otic Solution 0.3%","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5681396,"NF-Clotrimazole Solution 1%","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5681395,"NF-PYRIDOXINE HCL TABLET 100MG","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5681144,"NF-PERMETHRIN CRM 5%","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5681139,"NF-BRIMONIDINE TARTRATE 0.2% OPHTHALMIC","CDM Code","IP/OP",250,"Pharmacy","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5680954,"NF-ENTACAPONE ORAL TABLET 200MG","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5680774,"DICYCLOMINE HCL TABLET 20MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5680729,"NF-XARELTO ORAL TABLET 10MG","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5680476,"HYDROXYUREA CAP 500MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5680223,"NF-DRONABINOL LIQ CAP 2.5MG","CDM Code","IP/OP",250,"Pharmacy","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5680206,"NF-BUMETANIDE TAB 1MG","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5680152,"NF-FLUPHENAZINE HCL TAB 5MG","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5680099,"NF-CLARITHROMYCIN ORAL TABLET  500MG","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5680033,"MONTELUKAST ORAL TABLET 10 MG","CDM Code","IP/OP",250,"Pharmacy","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5606159,"RITUXIMAB-PVVR 500MG/50ML VIAL (CHEMO)","CDM Code","IP/OP",259,"Drugs/Other","Q5119","INJ RUXIENCE, 10 MG",5172,2586,4111.74,4396.2,4396.2,4396.2,4344.4799999999996,4189.3200000000006,4137.6000000000004,4111.74,4137.6000000000004]
[5606157,"BELIMUMAB (BENLYSTA) 400 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0490","BELIMUMAB INJECTION",6136,3068,4878.12,5215.5999999999995,5215.5999999999995,5215.5999999999995,5154.24,4970.1600000000008,4908.8,4878.12,4908.8]
[5606156,"BELIMUMAB (BENLYSTA) 120 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0490","BELIMUMAB INJECTION",1841,920.5,1463.595,1564.85,1564.85,1564.85,1546.44,1491.21,1472.8000000000002,1463.595,1472.8000000000002]
[5606155,"KETOROLAC (ACULAR) EYE DROP","CDM Code","IP/OP",259,"Drugs/Other","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5606154,"MOXIFLOXACIN (VIGAMOX) EYE DROP","CDM Code","IP/OP",259,"Drugs/Other","","",462,231,367.29,392.7,392.7,392.7,388.08,374.22,369.6,367.29,369.6]
[5606153,"TOCILIZUMAB (ACTEMRA) 400 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3262","TOCILIZUMAB INJECTION",4746,2373,3773.07,4034.1,4034.1,4034.1,3986.64,3844.26,3796.8,3773.07,3796.8]
[5606152,"MORPHINE (DURAMORPH) 10MG -anes only","CDM Code","IP/OP",636,"Drug/Detail Code","J2274","INJ MORPHINE PF EPID ITHC",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[5606150,"TESTOSTERONE VIAL 200 MG/1 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1071","INJ TESTOSTERONE CYPIONATE",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5606149,"OSELTAMIVIR (TAMIFLU) 30 MG CAPSULE","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5606148,"MONOVISC 22 MG/ML 4 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J7327","MONOVISC INJ PER DOSE",2011,1005.5,1598.7450000000001,1709.35,1709.35,1709.35,1689.24,1628.91,1608.8000000000002,1598.7450000000001,1608.8000000000002]
[5606147,"PHENYLEPHRINE 0.1 MG/ML OPTHALMIC SYR","CDM Code","IP/OP",250,"Pharmacy","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5606145,"LEUCOVORIN 350MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J0640","LEUCOVORIN CALCIUM INJECTION",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[5606144,"ELOXATIN 50MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9263","OXALIPLATIN",1914,957,1521.63,1626.8999999999999,1626.8999999999999,1626.8999999999999,1607.76,1550.3400000000001,1531.2,1521.63,1531.2]
[5606143,"FENTANYL (DURAGESIC) 12 MCG/HR PATCH","CDM Code","IP/OP",259,"Drugs/Other","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5606142,"BUPIVacaine MPF 0.5% W EPI 1:200000 30ML","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5606141,"LIDOCAINE MPF 2% VIAL 5 ML","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5606140,"OXALIPLATIN 100 MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9263","OXALIPLATIN",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5606139,"PANTOPRAZOLE IVPB (PROTONIX) 80 MG BOLUS","CDM Code","IP/OP",250,"Pharmacy","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5606138,"CISATRACURIUM (NF) 20MG/10ML","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5606137,"AMOX/CLAV (AUGM) 875MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5606136,"PANTOPRAZOLE 20 MG TABLET (NF)","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5606135,"CIPROFLOXACIN 200MG/20ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[5606134,"PANTOPRAZOLE (PROTONIX) 40 MG TABLET","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606133,"ADVAIR 250/50 INHALER","CDM Code","IP/OP",250,"Pharmacy","","",334,167,265.53000000000003,283.89999999999998,283.89999999999998,283.89999999999998,280.56,270.54000000000002,267.2,265.53000000000003,267.2]
[5606132,"ADVAIR 100/50 INHALER","CDM Code","IP/OP",250,"Pharmacy","","",324,162,257.58000000000004,275.39999999999998,275.39999999999998,275.39999999999998,272.15999999999997,262.44,259.2,257.58000000000004,259.2]
[5606131,"CEFUROXIME EYE SYRINGE","CDM Code","IP/OP",259,"Drugs/Other","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[5606130,"OSELTAMIVIR (TAMIFLU) 75 MG CAPSULE","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5606129,"LEVOTHYROXINE TAB (NF) 88 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606128,"SMOOTH MOVE STIMULANT TEA","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606127,"LET TOPICAL GEL 3ML SYRINGE","CDM Code","IP/OP",250,"Pharmacy","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5606126,"NS 100 ML MINI-BAG +PLUS+","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5606125,"NS 50 ML MINI-BAG +PLUS+","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5606124,"PERTUSSIS, DIPTHERIA, TETANUS VACCINE","CDM Code","IP/OP",636,"Drug/Detail Code",90715,"TDAP VACCINE 7 YRS/> IM",142,71,112.89,120.7,120.7,120.7,119.28,115.02000000000001,113.60000000000001,112.89,113.60000000000001]
[5606123,"ELECTROLYTES FOR TPN/PPN 20 ML VIAL (NF)","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5606122,"DIAZEPAM (DIASTAT) 2.5 MG RECTAL GEL","CDM Code","IP/OP",250,"Pharmacy","","",390,195,310.05,331.5,331.5,331.5,327.59999999999997,315.90000000000003,312,310.05,312]
[5606121,"LIDOCAINE VISCOUS 2% SOLN : 15 ML","CDM Code","IP/OP",259,"Drugs/Other","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5606119,"ENZYMATIC DEBRIDMENT OINTMENT","CDM Code","IP/OP",259,"Drugs/Other","","",521,260.5,414.19499999999999,442.84999999999997,442.84999999999997,442.84999999999997,437.64,422.01000000000005,416.8,414.19499999999999,416.8]
[5606118,"DARBOPOETIN 100 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",1291,645.5,1026.345,1097.3499999999999,1097.3499999999999,1097.3499999999999,1084.44,1045.71,1032.8,1026.345,1032.8]
[5606117,"PACLITAXEL PROTEIN BOUND 100 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9264","PACLITAXEL PROTEIN BOUND",2194,1097,1744.23,1864.8999999999999,1864.8999999999999,1864.8999999999999,1842.96,1777.14,1755.2,1744.23,1755.2]
[5606116,"ESOMEPRAZOLE 40MG IV (NF)","CDM Code","IP/OP",250,"Pharmacy","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5606115,"LEVONORGESTREL 0.75MG/TAB - ER USE ONLY","CDM Code","IP/OP",250,"Pharmacy","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5606114,"PEMETREXED 500 MG INJECTION (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9305","INJ. PEMETREXED NOS 10MG",6249,3124.5,4967.9549999999999,5311.65,5311.65,5311.65,5249.16,5061.6900000000005,4999.2000000000007,4967.9549999999999,4999.2000000000007]
[5606113,"GI COCKTAIL (BEN/MYL/LIDO 1:1:1) 15ML NF","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5606112,"METHACHOLINE CHALLENGE NEB 100MG","CDM Code","IP/OP",636,"Drug/Detail Code","J7674","METHACHOLINE CHLORIDE, NEB",374,187,297.33000000000004,317.89999999999998,317.89999999999998,317.89999999999998,314.15999999999997,302.94,299.2,297.33000000000004,299.2]
[5606111,"ESOMEPRAZOLE 40 MG CAPSULE (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5606110,"ESOMEPRAZOLE 20 MG CAPSULE (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5606107,"LIDOCAINE 1% 20 ML MDV","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5606106,"SODIUM ACETATE 40 MEQ/20 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606105,"INSULIN (REG)100UNIT/ML OR 1UNIT/0.01ML","CDM Code","IP/OP",250,"Pharmacy","J1815","INSULIN INJECTION",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606104,"INSULIN(NPH)100 UNIT/ML OR 1UNIT/0.01ML","CDM Code","IP/OP",250,"Pharmacy","J1815","INSULIN INJECTION",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606103,"INSULIN 70/30 100 UNIT/ML OR 1 UN/0.01ML","CDM Code","IP/OP",250,"Pharmacy","J1815","INSULIN INJECTION",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606102,"INSULIN(LANTUS)100UNIT/ML OR 1UNIT/0.01M","CDM Code","IP/OP",636,"Drug/Detail Code","J1817","INSULIN FOR INSULIN PUMP USE",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606100,"INSULIN *RAPID ACTING* 100 UNIT/ML","CDM Code","IP/OP",250,"Pharmacy","J1815","INSULIN INJECTION",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606098,"DIGIBIND 38MG VIAL (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J1162","DIGOXIN IMMUNE FAB (OVINE)",1086,543,863.37,923.1,923.1,923.1,912.24,879.66000000000008,868.80000000000007,863.37,868.80000000000007]
[5606097,"VITRASE OVINE 200 UN/ML","CDM Code","IP/OP",250,"Pharmacy","","",101,50.5,80.295000000000002,85.85,85.85,85.85,84.84,81.81,80.800000000000011,80.295000000000002,80.800000000000011]
[5606096,"VALPROATE ACID 500MG VIAL (NF)","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5606095,"LANSOPRAZOLE IV 30MG NS 50ML","CDM Code","IP/OP",250,"Pharmacy","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5606093,"DEXTROAMPHETAMINE 10MG TAB (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606092,"FINASTERIDE 5MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606091,"LINEZOLID 600MG/300ML (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J2020","LINEZOLID INJECTION",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[5606090,"THALIDOMIDE 200 MG CAPSULE (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",318,159,252.81,270.3,270.3,270.3,267.12,257.58000000000004,254.4,252.81,254.4]
[5606089,"ACETAZOLAMIDE SEQUELS 500MG CAP (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5606088,"NABUMETONE 500MG TAB - NF","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606087,"DOXYCYCLINE 100MG VIAL","CDM Code","IP/OP",250,"Pharmacy","","",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[5606086,"CARVEDILOL 6.25 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606085,"PHENYLEPHRINE 10% OPTH DROP: 5ML","CDM Code","IP/OP",259,"Drugs/Other","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5606084,"MEROPENEM 500 MG/NS 50 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2185","MEROPENEM",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5606083,"TRIAMCINOLONE ACET VIAL  40 MG/ML 5 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J3301","TRIAMCINOLONE ACET INJ NOS",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[5606082,"VECURONIUM 10MG/10ML VIAL - NF","CDM Code","IP/OP",250,"Pharmacy","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5606080,"DARBOPOETIN 200 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",1634,817,1299.03,1388.8999999999999,1388.8999999999999,1388.8999999999999,1372.56,1323.5400000000002,1307.2,1299.03,1307.2]
[5606079,"BOTULINUM A TOXIN 100 UNIT","CDM Code","IP/OP",636,"Drug/Detail Code","J0585","INJECTION,ONABOTULINUMTOXINA",1268,634,1008.0600000000001,1077.8,1077.8,1077.8,1065.1199999999999,1027.0800000000002,1014.4000000000001,1008.0600000000001,1014.4000000000001]
[5606078,"DARBOPOETIN 300 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",3574,1787,2841.33,3037.9,3037.9,3037.9,3002.16,2894.94,2859.2000000000003,2841.33,2859.2000000000003]
[5606077,"LEVOTHYROXINE TAB (NF) 112 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606076,"CEFOXITIN 2 GRAM VIAL","CDM Code","IP/OP",250,"Pharmacy","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5606075,"CEFOXITIN 1 GRAM VIAL (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J0694","CEFOXITIN SODIUM INJECTION",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5606074,"METHADONE 10MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606073,"PEGFILGRASTIM-BMEZ 6 MG SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J2506","INJ PEGFILGRAST EX BIO 0.5MG",6100,3050,4849.5,5185,5185,5185,5124,4941,4880,4849.5,4880]
[5606072,"IBUPROFEN 100MG/5ML 120 ML","CDM Code","IP/OP",259,"Drugs/Other","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5606071,"IRON SUCROSE (VENOFER) 100MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1756","IRON SUCROSE INJECTION",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[5606070,"EPOETIN ALFA 4000 UNITS","CDM Code","IP/OP",634,"Drugs Require Specific ID: EPO under 10,000 units","J0885","EPOETIN ALFA, NON-ESRD",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[5606069,"SUCRALFATE (CARAFATE) TAB 1 GRAM","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606068,"MOXIFLOXACIN ORAL: 400MG/TAB","CDM Code","IP/OP",259,"Drugs/Other","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5606067,"MOXIFLOXACIN IV:400 MG/250 ML BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J2280","INJ, MOXIFLOXACIN 100 MG",145,72.5,115.27500000000001,123.25,123.25,123.25,121.8,117.45,116,115.27500000000001,116]
[5606066,"NAPROXEN 250 MG TABLET - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5606065,"PHARMACY CLINIC LEVEL 3","CDM Code","Pro",510,"Clinic",99213,"OFFICE O/P EST LOW 20-29 MIN",231,115.5,183.64500000000001,196.35,196.35,196.35,194.04,187.11,184.8,183.64500000000001,184.8]
[5606064,"PHARMACY CLINIC LEVEL 2","CDM Code","Pro",510,"Clinic",99212,"OFFICE O/P EST SF 10-19 MIN",196,98,155.82000000000002,166.6,166.6,166.6,164.64,158.76000000000002,156.80000000000001,155.82000000000002,156.80000000000001]
[5606063,"PHARMACY CLINIC LEVEL 1","CDM Code","Pro",510,"Clinic",99211,"OFF/OP EST MAY X REQ PHY/QHP",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[5606062,"NALBUPHINE (NUBAIN) 10MG/ML 1ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5606061,"METHYLPREDNISOLONE (DEPO) VIAL 80 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1040","METHYLPREDNISOLONE 80 MG INJ",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5606060,"1/4 NS: 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5606059,"1/2 NS :100ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5606058,"PERIPHERAL STANDARD FORMULAS(PPN-PLAIN):","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606057,"PERIPHERAL STANDARD FORMULAS(PPN-MVI):","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606056,"ENOXAPARIN (LOVENOX) 100 MG SYRINGE","CDM Code","IP/OP",250,"Pharmacy","J1650","INJ ENOXAPARIN SODIUM",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5606055,"ENOXAPARIN (LOVENOX) 60MG SYRINGE","CDM Code","IP/OP",250,"Pharmacy","J1650","INJ ENOXAPARIN SODIUM",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5606054,"ENOXAPARIN (LOVENOX) 40MG SYRINGE","CDM Code","IP/OP",250,"Pharmacy","J1650","INJ ENOXAPARIN SODIUM",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5606053,"EPOETIN ALFA 40000 UNITS","CDM Code","IP/OP",635,"Drugs Require Specific ID: EPO over 10,000 units","J0885","EPOETIN ALFA, NON-ESRD",1155,577.5,918.22500000000002,981.75,981.75,981.75,970.19999999999993,935.55000000000007,924,918.22500000000002,924]
[5606052,"ESTRADIOL(CLIMARA): 0.05MG - DON'T USE","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5606051,"COPPER: 0.4MG/ML 10ML VIAL (NF)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606050,"FLUVOXAMINE(LUVOX) NF: 100MG/TAB","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5606049,"CARBIDOPA-LEVODOPA(SINEMET):25/250MG/TAB","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606048,"METRONIDAZOLE TOP GEL 0.75% 45GM","CDM Code","IP/OP",259,"Drugs/Other","","",266,133,211.47,226.1,226.1,226.1,223.44,215.46,212.8,211.47,212.8]
[5606047,"POTASSIUM ACETATE 40MEQ/20ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606046,"LIDOCAINE MPF 1% 30ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5606045,"BUPIVacaine MPF 0.5% VIAL : 10ML","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5606044,"EPIRUBICIN 50MG/25ML INJ (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9178","INJ, EPIRUBICIN HCL, 2 MG",1285,642.5,1021.575,1092.25,1092.25,1092.25,1079.3999999999999,1040.8500000000001,1028,1021.575,1028]
[5606043,"VANCOMYCIN 1 GRAM/250 ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606042,"VANCOMYCIN 500 MG/NS 100 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606040,"NITROGLYCERIN 50 MG/D5W 500 ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5606024,"CEFTRIAXONE 1 GM/NS 50 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0696","CEFTRIAXONE SODIUM INJECTION",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5606017,"CEFAZOLIN 1 GM/NS 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603942,"PEGFILGRASTIM-jmdb 6 MG SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J2506","INJ PEGFILGRAST EX BIO 0.5MG",3032,1516,2410.44,2577.1999999999998,2577.1999999999998,2577.1999999999998,2546.88,2455.92,2425.6,2410.44,2425.6]
[5603941,"DOFETILIDE 125 MCG CAP","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603939,"KETOROLAC 30 MG/ML 1ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J1885","KETOROLAC TROMETHAMINE INJ",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5603938,"KETOROLAC 15 MG/ML 1ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1885","KETOROLAC TROMETHAMINE INJ",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5603937,"ENALAPRIL 1.25 MG/ML","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5603936,"CLOZAPINE 25 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603935,"MISOPROSTOL 800 MCG 4 TAB PACK (OB USE)","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603934,"HYDROmorphone 0.2 MG/1 ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603933,"MISOPROSTOL (CYTOTEC) TAB 200 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603932,"DIPHENHYDRAMINE 25 MG STARTER PACK","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603931,"TRASTUZUMAB-PKRB  150 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","Q5113","INJ HERZUMA 10 MG",1409,704.5,1120.155,1197.6499999999999,1197.6499999999999,1197.6499999999999,1183.56,1141.29,1127.2,1120.155,1127.2]
[5603930,"RITUXIMAB-ARRX 500MG/50ML VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J3590","UNCLASSIFIED BIOLOGICS",4415,2207.5,3509.9250000000002,3752.75,3752.75,3752.75,3708.6,3576.15,3532,3509.9250000000002,3532]
[5603929,"DORZOLAMIDE 2% EYE DROPS","CDM Code","IP/OP",259,"Drugs/Other","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5603926,"MEMANTADINE 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603925,"SUCROSE ORAL SOLN 24% 1 ML UD BULLET-NF","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603924,"CEFAZOLIN 2 GRAM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0690","CEFAZOLIN SODIUM INJECTION",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603922,"LABETALOL VIAL 5 MG/ML *40 ML* (OR USE)","CDM Code","IP/OP",250,"Pharmacy","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5603921,"INSULIN *RAPID* 100 UNIT/ML PEN","CDM Code","IP/OP",250,"Pharmacy","J1815","INSULIN INJECTION",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[5603920,"INFLIXIMAB (GENERIC) 100 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1745","INFLIXIMAB NOT BIOSIMIL 10MG",1376,688,1093.92,1169.5999999999999,1169.5999999999999,1169.5999999999999,1155.8399999999999,1114.5600000000002,1100.8,1093.92,1100.8]
[5603919,"PRIVIGEN 10% (IVIG) 5 GM/50 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1459","INJ IVIG PRIVIGEN 500 MG",1053,526.5,837.13499999999999,895.05,895.05,895.05,884.52,852.93000000000006,842.40000000000009,837.13499999999999,842.40000000000009]
[5603918,"BRENTUXIMAB 50 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9042","BRENTUXIMAB VEDOTIN INJ",21756,10878,17296.02,18492.599999999999,18492.599999999999,18492.599999999999,18275.04,17622.36,17404.8,17296.02,17404.8]
[5603917,"BUPIVacaine MPF 0.5% W EPI 1:200000 10ML","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603916,"BORTEZOMIB 3.5 MG VIAL (GENERIC)","CDM Code","IP/OP",636,"Drug/Detail Code","J9044","INJ, BORTEZOMIB, NOS, 0.1 MG",694,347,551.73,589.9,589.9,589.9,582.95999999999992,562.14,555.20000000000005,551.73,555.20000000000005]
[5603915,"MEPIVACAINE HCL 2% VIAL 20 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0670","INJ MEPIVACAINE HCL/10 ML",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5603914,"SUGAMMADEX 100 MG/ML 2 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3490","DRUGS UNCLASSIFIED INJECTION",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[5603913,"ROPIVACAINE 0.5% 20 ML SDV - NF","CDM Code","IP/OP",259,"Drugs/Other","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5603911,"BENZOCAINE & MENTHOL SPRAY 2.75 OZ CAN","CDM Code","IP/OP",259,"Drugs/Other","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5603908,"DIPHENHYDRAMINE SYRINGE 50 MG/1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1200","DIPHENHYDRAMINE HCL INJECTIO",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603907,"CARBIDOPA-LEVO 25-100 *ER* TAB - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603906,"FLEBOGAMMA 10% (IVIG) 5 GM/50 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1572","FLEBOGAMMA INJECTION",962,481,764.79000000000008,817.69999999999993,817.69999999999993,817.69999999999993,808.07999999999993,779.22,769.6,764.79000000000008,769.6]
[5603905,"ATEZOLIZUMAB 1200 MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9022","INJ, ATEZOLIZUMAB,10 MG",19697,9848.5,15659.115000000002,16742.45,16742.45,16742.45,16545.48,15954.570000000002,15757.6,15659.115000000002,15757.6]
[5603903,"VANCOMYCIN 1.25 GM/250 ML-NO PREGNANT","CDM Code","IP/OP",259,"Drugs/Other","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5603902,"COMPOUNDED CREAM","CDM Code","IP/OP",250,"Pharmacy","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5603901,"LEUPROLIDE (ELIGARD) 45MG INJ","CDM Code","IP/OP",259,"Drugs/Other","J9217","LEUPROLIDE ACETATE SUSPNSION",1299,649.5,1032.7050000000002,1104.1499999999999,1104.1499999999999,1104.1499999999999,1091.1599999999999,1052.19,1039.2,1032.7050000000002,1039.2]
[5603899,"INTRA INF CASIRIVIMAB & IMDEVIMAD","CDM Code","IP/OP",771,"Preventive Care Services: Admin. of vaccine","M0243","CASIRIVI AND IMDEVI INJ",540,270,429.3,459,459,459,453.59999999999997,437.40000000000003,432,429.3,432]
[5603898,"INTRA INFU BAMLANIVIMAB &ETESEVIMAB","CDM Code","IP/OP",771,"Preventive Care Services: Admin. of vaccine","M0245","BAMLAN AND ETESEV INFUSION",540,270,429.3,459,459,459,453.59999999999997,437.40000000000003,432,429.3,432]
[5603896,"TOPIRAMATE 25 MG TABLET","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603895,"BARICITINIB 2MG TABLET","CDM Code","IP/OP",250,"Pharmacy","J8499","ORAL PRESCRIP DRUG NON CHEMO",328,164,260.76,278.8,278.8,278.8,275.52,265.68,262.40000000000003,260.76,262.40000000000003]
[5603894,"USTEKINUMAB (STELARA) 130 MG/26 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3358","USTEKINUMAB, IV INJECT, 1 MG",3516,1758,2795.2200000000003,2988.6,2988.6,2988.6,2953.44,2847.96,2812.8,2795.2200000000003,2812.8]
[5603893,"QUETIAPINE 50 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603892,"HYDROmorphone 1 MG/1 ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603891,"HYDROmorphone 0.5 MG/0.5 ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603890,"FENTANYL 50 MCG/ML 1 ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J3010","FENTANYL CITRATE INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603889,"PROMETHAZINE 25MG SUPP STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603887,"CEFAZOLIN 10 GRAM VIAL **RX USE ONLY**","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603885,"DOXYCYCLINE 25 MG/5 ML ORAL SUSP 60 ML","CDM Code","IP/OP",250,"Pharmacy","J3490","DRUGS UNCLASSIFIED INJECTION",53,26.5,42.135000000000005,45.05,45.05,45.05,44.519999999999996,42.93,42.400000000000006,42.135000000000005,42.400000000000006]
[5603884,"NF-ATOVAQUONE 750 MG/5 ML ORAL SUSP","CDM Code","IP/OP",259,"Drugs/Other","","",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[5603883,"ENALAPRIL TAB 20 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603882,"PREDNISONE TAB 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603881,"FLEBOGAMMA 10% (IVIG) 20 GM/200 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1572","FLEBOGAMMA INJECTION",3545,1772.5,2818.2750000000001,3013.25,3013.25,3013.25,2977.7999999999997,2871.4500000000003,2836,2818.2750000000001,2836]
[5603880,"FLEBOGAMMA 10% (IVIG) 10 GM/100 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1572","FLEBOGAMMA INJECTION",1283,641.5,1019.985,1090.55,1090.55,1090.55,1077.72,1039.23,1026.4000000000001,1019.985,1026.4000000000001]
[5603878,"PRIVIGEN 10% (IVIG) 40 GM/400 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1459","INJ IVIG PRIVIGEN 500 MG",5630,2815,4475.8500000000004,4785.5,4785.5,4785.5,4729.2,4560.3,4504,4475.8500000000004,4504]
[5603877,"PRIVIGEN 10% (IVIG) 20 GM/200 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1459","INJ IVIG PRIVIGEN 500 MG",2808,1404,2232.36,2386.7999999999997,2386.7999999999997,2386.7999999999997,2358.7199999999998,2274.48,2246.4,2232.36,2246.4]
[5603876,"PRIVIGEN 10% (IVIG) 10 GM/100 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1459","INJ IVIG PRIVIGEN 500 MG",1404,702,1116.18,1193.3999999999999,1193.3999999999999,1193.3999999999999,1179.3599999999999,1137.24,1123.2,1116.18,1123.2]
[5603875,"FERUMOXYTOL (FERAHEME) 510 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","Q0138","FERUMOXYTOL, NON-ESRD",639,319.5,508.00500000000005,543.15,543.15,543.15,536.76,517.59,511.20000000000005,508.00500000000005,511.20000000000005]
[5603872,"NF-PENICILLIN G BENZA 600,000 UNITS","CDM Code","IP/OP",250,"Pharmacy","J0561","PENICILLIN G BENZATHINE INJ",369,184.5,293.35500000000002,313.64999999999998,313.64999999999998,313.64999999999998,309.95999999999998,298.89000000000004,295.2,293.35500000000002,295.2]
[5603871,"CABAZITAXEL (JEVTANA) 60 MG/1.5 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9043","CABAZITAXEL INJECTION",11013,5506.5,8755.3350000000009,9361.0499999999993,9361.0499999999993,9361.0499999999993,9250.92,8920.5300000000007,8810.4,8755.3350000000009,8810.4]
[5603870,"KYLEENA IUD","CDM Code","IP/OP",636,"Drug/Detail Code","J7296","KYLEENA, 19.5 MG",1196,598,950.82,1016.6,1016.6,1016.6,1004.64,968.7600000000001,956.80000000000007,950.82,956.80000000000007]
[5603869,"CHLOROPROCAINE ** 2% ** 20ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2400","CHLOROPROCAINE HCL INJECTION",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[5603866,"METOPROLOL SUCCINATE *ER* TAB 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603865,"LIDOCAINE MPF 1.5% 10ML AMP-EPIDURAL USE","CDM Code","IP/OP",259,"Drugs/Other","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5603864,"NAPROXEN 500 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603863,"ARIPIPRAZOLE 5 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603862,"TOBRAMYCIN/DEXAMETH OS 2.5 ML SP","CDM Code","IP/OP",259,"Drugs/Other","","",292,146,232.14000000000001,248.2,248.2,248.2,245.28,236.52,233.60000000000002,232.14000000000001,233.60000000000002]
[5603858,"FUROSEMIDE 100 MG VIAL","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603857,"OLANZAPINE 5 MG ODT TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5603856,"IRINOTECAN 300 MG/15 ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9206","IRINOTECAN INJECTION",196,98,155.82000000000002,166.6,166.6,166.6,164.64,158.76000000000002,156.80000000000001,155.82000000000002,156.80000000000001]
[5603855,"REMDESIVIR 100 MG VIAL (LYOPHILIZED PWD)","CDM Code","IP/OP",250,"Pharmacy","J0248","INJ, REMDESIVIR, 1 MG",1143,571.5,908.68500000000006,971.55,971.55,971.55,960.12,925.83,914.40000000000009,908.68500000000006,914.40000000000009]
[5603854,"RECK (PREMIXED JOINT COCKTAIL) 50ML","CDM Code","IP/OP",259,"Drugs/Other","","",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5603851,"METHACHOLINE INHALATION KIT (NEPHRON)","CDM Code","IP/OP",259,"Drugs/Other","","",405,202.5,321.97500000000002,344.25,344.25,344.25,340.2,328.05,324,321.97500000000002,324]
[5603850,"AZITHROMYCIN 500 MG VIAL - RX USE ONLY","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603849,"INSULIN *DRIP* 100 UN/100 ML PREMIX BAG","CDM Code","IP/OP",250,"Pharmacy","J1815","INSULIN INJECTION",66,33,52.470000000000006,56.1,56.1,56.1,55.44,53.46,52.800000000000004,52.470000000000006,52.800000000000004]
[5603848,"EPOETIN ALFA-EPBX 40,000 UNITS/ML","CDM Code","IP/OP",636,"Drug/Detail Code","Q5106","INJ RETACRIT NON-ESRD USE",1046,523,831.57,889.1,889.1,889.1,878.64,847.2600000000001,836.80000000000007,831.57,836.80000000000007]
[5603847,"NS IRRIGATION BOTTLE 1 LITER","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603845,"SILODOSIN (RAPAFLO) 4 MG CAP - NF","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603844,"INFLIXIMAB-ABDA (RENFLEXIS) 100 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","Q5104","INJECTION, RENFLEXIS",1110,555,882.45,943.5,943.5,943.5,932.4,899.1,888,882.45,888]
[5603843,"RABIES IMMUNE GLOB 300 U/ML * 5ML VIAL *","CDM Code","IP/OP",636,"Drug/Detail Code",90376,"RABIES IG HEAT TREATED",6224,3112,4948.08,5290.4,5290.4,5290.4,5228.16,5041.4400000000005,4979.2000000000007,4948.08,4979.2000000000007]
[5603842,"RABIES IMMUNE GLOB 300 U/ML * 3ML VIAL *","CDM Code","IP/OP",636,"Drug/Detail Code",90376,"RABIES IG HEAT TREATED",2854,1427,2268.9300000000003,2425.9,2425.9,2425.9,2397.36,2311.7400000000002,2283.2000000000003,2268.9300000000003,2283.2000000000003]
[5603841,"ROMIPLOSTIM (NPLATE) 500 MCG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2796","ROMIPLOSTIM INJECTION",8259,4129.5,6565.9050000000007,7020.15,7020.15,7020.15,6937.5599999999995,6689.7900000000009,6607.2000000000007,6565.9050000000007,6607.2000000000007]
[5603840,"GABAPENTIN 600 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603839,"BOTULINUM A TOXIN *200* UNITS","CDM Code","IP/OP",636,"Drug/Detail Code","J0585","INJECTION,ONABOTULINUMTOXINA",2488,1244,1977.96,2114.7999999999997,2114.7999999999997,2114.7999999999997,2089.92,2015.2800000000002,1990.4,1977.96,1990.4]
[5603838,"FLUCONAZOLE (DIFLUCAN) TAB 150 MG","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603837,"BENRALIZUMAB 30 MG SYR","CDM Code","IP/OP",636,"Drug/Detail Code","J0517","INJ., BENRALIZUMAB, 1 MG",9471,4735.5,7529.4450000000006,8050.3499999999995,8050.3499999999995,8050.3499999999995,7955.6399999999994,7671.51,7576.8,7529.4450000000006,7576.8]
[5603836,"VANCOMYCIN 2 GM/400 ML-NOT FOR PREGNANT","CDM Code","IP/OP",259,"Drugs/Other","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[5603835,"LUSPATERCEPT-AAMT  75 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0896","INJ LUSPATERCEPT-AAMT 0.25MG",20647,10323.5,16414.365000000002,17549.95,17549.95,17549.95,17343.48,16724.07,16517.600000000002,16414.365000000002,16517.600000000002]
[5603834,"LUSPATERCEPT-AAMT  25 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0896","INJ LUSPATERCEPT-AAMT 0.25MG",6882,3441,5471.1900000000005,5849.7,5849.7,5849.7,5780.88,5574.42,5505.6,5471.1900000000005,5505.6]
[5603833,"LUPRON 22.5 MG INJ (NF)","CDM Code","IP/OP",259,"Drugs/Other","J9217","LEUPROLIDE ACETATE SUSPNSION",1183,591.5,940.48500000000001,1005.55,1005.55,1005.55,993.71999999999991,958.23,946.40000000000009,940.48500000000001,946.40000000000009]
[5603832,"TRASTUZUMAB-ANNS  420 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","Q5117","INJ., KANJINTI, 10 MG",5940,2970,4722.3,5049,5049,5049,4989.5999999999995,4811.4000000000005,4752,4722.3,4752]
[5603831,"DEXMEDETOMIDINE 400 MCG/100 ML NS  (NF)","CDM Code","IP/OP",250,"Pharmacy","","",148,74,117.66000000000001,125.8,125.8,125.8,124.32,119.88000000000001,118.4,117.66000000000001,118.4]
[5603830,"DEXMEDETOMIDINE 200 MCG/50 ML NS (NF)","CDM Code","IP/OP",250,"Pharmacy","","",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[5603829,"OXYTOCIN 30 UNITS IN 500ML-QUVA MADE","CDM Code","IP/OP",259,"Drugs/Other","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[5603828,"GIVOSIRAN 189 MG/ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0223","INJ GIVOSIRAN 0.5 MG",78000,39000,62010,66300,66300,66300,65520,63180.000000000007,62400,62010,62400]
[5603827,"PANCURONIUM 10MG/10ML VIAL - ANES ONLY","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5603826,"CLINDAMYCIN 900 MG/50 ML (PREMIX)","CDM Code","IP/OP",259,"Drugs/Other","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5603824,"SPIRONOLACTONE TAB 12.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603823,"ROSUVASTATIN 10 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603822,"HEPATITIS B (ENGERIX-B) 20MCG/1ML-ADULT","CDM Code","IP/OP",636,"Drug/Detail Code",90744,"HEPB VACC 3 DOSE PED/ADOL IM",230,115,182.85000000000002,195.5,195.5,195.5,193.2,186.3,184,182.85000000000002,184]
[5603821,"PAROXETINE (PAXIL) TAB 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603820,"SCOPOLAMINE PATCH 1 MG - NF - don't use","CDM Code","IP/OP",259,"Drugs/Other","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5603819,"ALBUMIN 25 GM - 100 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",273,136.5,217.03500000000003,232.04999999999998,232.04999999999998,232.04999999999998,229.32,221.13000000000002,218.4,217.03500000000003,218.4]
[5603818,"EUCERIN (GENERIC) CREAM 1 OZ","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603817,"BETADINE 5% OPTHALMIC SOLN","CDM Code","IP/OP",259,"Drugs/Other","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5603815,"PANHEMATIN 350MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1640","HEMIN, 1 MG",15804,7902,12564.18,13433.4,13433.4,13433.4,13275.359999999999,12801.240000000002,12643.2,12564.18,12643.2]
[5603814,"MORPHINE INJECTION 4 MG/ML 1 ML VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603813,"VANCOMYCIN 125MG CAPS","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603812,"MISOPROSTOL (CYTOTEC) TAB 50 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603811,"MISOPROSTOL (CYTOTEC) TAB 25 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603810,"LEUPROLIDE (LUPRON) 45MG INJ (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J9217","LEUPROLIDE ACETATE SUSPNSION",1582,791,1257.69,1344.7,1344.7,1344.7,1328.8799999999999,1281.42,1265.6000000000001,1257.69,1265.6000000000001]
[5603809,"SIMETHICONE PO LIQ 1.5ML UD SYR FOR COLO","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603808,"DEXMEDETOMIDINE 200MCG/2ML VIAL (ANES)","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603807,"TORSEMIDE 20 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603806,"INFLIXIMAB-DYYB (INFLECTRA) 100 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","Q5103","INJECTION, INFLECTRA",1340,670,1065.3,1139,1139,1139,1125.5999999999999,1085.4000000000001,1072,1065.3,1072]
[5603805,"OCRELIZUMAB (OCREVUS) 300 MG/10 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2350","INJECTION, OCRELIZUMAB, 1 MG",37551,18775.5,29853.045000000002,31918.35,31918.35,31918.35,31542.84,30416.31,30040.800000000003,29853.045000000002,30040.800000000003]
[5603804,"ALP1-PROTEINASE INHIB 1000MG/20ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0256","ALPHA 1 PROTEINASE INHIBITOR",1090,545,866.55000000000007,926.5,926.5,926.5,915.6,882.90000000000009,872,866.55000000000007,872]
[5603803,"VANCOMYCIN 1.5 GM/300 ML-NOT FOR PREGNAN","CDM Code","IP/OP",259,"Drugs/Other","","",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[5603802,"ARTIFICIAL TEAR EYE LUBRICANT UD DROPPER","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603800,"BUPRENORP/NALOX 8MG/2MG FILM RAM PACK","CDM Code","IP/OP",250,"Pharmacy","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5603799,"BUPRENORP/NALOX 8MG/2MG FILM -Suboxone","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603797,"RABIES IMMUNE GLOB 300 U/ML * 1ML VIAL *","CDM Code","IP/OP",636,"Drug/Detail Code",90376,"RABIES IG HEAT TREATED",1242,621,987.3900000000001,1055.7,1055.7,1055.7,1043.28,1006.0200000000001,993.6,987.3900000000001,993.6]
[5603795,"WARFARIN SODIUM (COUMADIN) TAB 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603794,"NF-SUGAMMADEX 100 MG/ML 5 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3490","DRUGS UNCLASSIFIED INJECTION",587,293.5,466.66500000000002,498.95,498.95,498.95,493.08,475.47,469.6,466.66500000000002,469.6]
[5603793,"CLINIMIX E 4.25/5 2000ML","CDM Code","IP/OP",259,"Drugs/Other","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[5603792,"ALVIMOPAN (ENTEREG) 12 MG CAPSULES","CDM Code","IP/OP",259,"Drugs/Other","","",520,260,413.40000000000003,442,442,442,436.8,421.20000000000005,416,413.40000000000003,416]
[5603791,"BENZOCAINE 20% 0.5 ML UD SPRAY","CDM Code","IP/OP",259,"Drugs/Other","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5603770,"LUGOL'S SOLUTION 0.8 ML FOR NUCLEAR","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603769,"AMOXICILLIN SUSP 400MG/5ML 100ML *SP*","CDM Code","IP/OP",250,"Pharmacy","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5603768,"AMOXICILLIN SUSP 400MG/5ML 100ML","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603767,"OMIDRIA 1-0.3% 4 ML OCULAR INJ","CDM Code","IP/OP",250,"Pharmacy","J1097","PHENYLEP KETOROLAC OPTH SOLN",1499,749.5,1191.7050000000002,1274.1499999999999,1274.1499999999999,1274.1499999999999,1259.1599999999999,1214.19,1199.2,1191.7050000000002,1199.2]
[5603766,"PRESERVISION AREDS 2 CAPSULE","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603765,"FISH OIL 1000 MG GELCAP","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603764,"VEDOLIZUMAB 300 MG IN NS 250 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J3380","INJECTION, VEDOLIZUMAB",16352,8176,12999.84,13899.199999999999,13899.199999999999,13899.199999999999,13735.68,13245.12,13081.6,12999.84,13081.6]
[5603763,"RITUXIMAB VIAL 100 MG 10ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9312","INJ., RITUXIMAB, 10 MG",2019,1009.5,1605.105,1716.1499999999999,1716.1499999999999,1716.1499999999999,1695.96,1635.39,1615.2,1605.105,1615.2]
[5603762,"PEP HIV STARTER PACK - ER USE ONLY","CDM Code","IP/OP",259,"Drugs/Other","","",293,146.5,232.935,249.04999999999998,249.04999999999998,249.04999999999998,246.12,237.33,234.4,232.935,234.4]
[5603761,"SKYLA IUD","CDM Code","IP/OP",259,"Drugs/Other","J7301","SKYLA, 13.5 MG",1627,813.5,1293.4650000000001,1382.95,1382.95,1382.95,1366.6799999999998,1317.8700000000001,1301.6000000000001,1293.4650000000001,1301.6000000000001]
[5603760,"BRIMONIDINE 0.2% OPTH SOLN","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603759,"MIRENA IUD","CDM Code","IP/OP",250,"Pharmacy","J7298","MIRENA, 52 MG",2032,1016,1615.44,1727.2,1727.2,1727.2,1706.8799999999999,1645.92,1625.6000000000001,1615.44,1625.6000000000001]
[5603758,"MEROPENEM 1 GRAM/50 ML DUPLEX BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J2185","MEROPENEM",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5603757,"CYCLOPHOSPHAMIDE(CYTOXAN) 500 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9070","CYCLOPHOSPHAMIDE 100 MG INJ",376,188,298.92,319.59999999999997,319.59999999999997,319.59999999999997,315.83999999999997,304.56,300.8,298.92,300.8]
[5603756,"NIVOLUMAB (OPDIVO) 100 MG/10 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9299","INJECTION, NIVOLUMAB",5636,2818,4480.62,4790.5999999999995,4790.5999999999995,4790.5999999999995,4734.24,4565.16,4508.8,4480.62,4508.8]
[5603755,"IPILIMUMAB (YERVOY - CHEMO) 50 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9228","IPILIMUMAB INJECTION",15419,7709.5,12258.105000000001,13106.15,13106.15,13106.15,12951.96,12489.390000000001,12335.2,12258.105000000001,12335.2]
[5603754,"MONSEL'S SOLUTION 8 ML JAR","CDM Code","IP/OP",259,"Drugs/Other","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5603753,"CEFDINIR 300 MG STARTER PACK","CDM Code","IP/OP",259,"Drugs/Other","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5603752,"METHADONE 10MG/ML ORAL CONCENTRATE","CDM Code","IP/OP",259,"Drugs/Other","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5603751,"MITOMYCIN 40 MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9280","MITOMYCIN INJECTION",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5603750,"KETAMINE 500 MG/5 ML **AMBULANCE ONLY**","CDM Code","IP/OP",250,"Pharmacy","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5603749,"DENOSUMAB (PROLIA) 60 MG/ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J0897","DENOSUMAB INJECTION",3022,1511,2402.4900000000002,2568.6999999999998,2568.6999999999998,2568.6999999999998,2538.48,2447.8200000000002,2417.6,2402.4900000000002,2417.6]
[5603748,"ROPIV 0.2%/FENT Epidu 100ml-QUVA","CDM Code","IP/OP",250,"Pharmacy","","",151,75.5,120.045,128.35,128.35,128.35,126.83999999999999,122.31,120.80000000000001,120.045,120.80000000000001]
[5603747,"CAFFEINE CITRATE 60 MG/3 ML VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5603746,"PHENYLEPHRINE 40MCG/ML 10 ML SYR (ANES)","CDM Code","IP/OP",636,"Drug/Detail Code","J2370","PHENYLEPHRINE HCL INJECTION",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5603745,"EPInephrine 1MG/1ML VIAL for ANAPHYLAXIS","CDM Code","IP/OP",636,"Drug/Detail Code","J0171","ADRENALIN EPINEPHRINE INJECT",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[5603744,"MORPHINE PCA **HIGH DOSE** 150 MG/30 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2270","MORPHINE SULFATE INJECTION",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5603743,"MORPHINE ORAL *CONC* 10 MG/0.5ML PO SYR","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603742,"NICARDIPINE 25 MG/10 ML VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",72,36,57.24,61.199999999999996,61.199999999999996,61.199999999999996,60.48,58.320000000000007,57.6,57.24,57.6]
[5603741,"LEVETIRACETAM (KEPPRA) 500MG/5ML VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603740,"HEPARIN 50,000 UNITS/10 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1644","INJ HEPARIN SODIUM PER 1000U",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5603739,"SODIUM BICARBONATE 8.4% **VIAL** 50ML","CDM Code","IP/OP",250,"Pharmacy","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5603738,"METOCLOPRAMIDE (REGLAN) **SYR** 10MG/2ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2765","METOCLOPRAMIDE HCL INJECTION",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603737,"NIVOLUMAB (OPDIVO) 240 MG/24 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9299","INJECTION, NIVOLUMAB",13729,6864.5,10914.555,11669.65,11669.65,11669.65,11532.359999999999,11120.490000000002,10983.2,10914.555,10983.2]
[5603736,"KETAMINE ** 50 MG/5ML ** (10MG/ML) SYR","CDM Code","IP/OP",259,"Drugs/Other","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5603735,"ACETAMINOPHEN *IV*-650mg/65ml-RX TO SUP","CDM Code","IP/OP",636,"Drug/Detail Code","J0131","INJ, ACETAMINOPHEN (NOS)",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5603734,"BUPIV0.0625%/FENT Epidu 250ml-Pharmedium","CDM Code","IP/OP",250,"Pharmacy","","",367,183.5,291.76499999999999,311.95,311.95,311.95,308.27999999999997,297.27000000000004,293.60000000000002,291.76499999999999,293.60000000000002]
[5603733,"MEPOLIZUMAB (NUCALA) 100 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2182","INJECTION, MEPOLIZUMAB, 1MG",6017,3008.5,4783.5150000000003,5114.45,5114.45,5114.45,5054.28,4873.7700000000004,4813.6000000000004,4783.5150000000003,4813.6000000000004]
[5603732,"DIAZEPAM (DIASTAT) 10 MG RECTAL GEL","CDM Code","IP/OP",250,"Pharmacy","","",362,181,287.79000000000002,307.7,307.7,307.7,304.08,293.22000000000003,289.60000000000002,287.79000000000002,289.60000000000002]
[5603731,"PEMBROLIZUMAB (KEYTRUDA) 100MG/4ML-CHEMO","CDM Code","IP/OP",636,"Drug/Detail Code","J9271","INJ PEMBROLIZUMAB",9994,4997,7945.2300000000005,8494.9,8494.9,8494.9,8394.9599999999991,8095.14,7995.2000000000007,7945.2300000000005,7995.2000000000007]
[5603730,"LIDOCAINE 1% 5 ML AMP FOR SPINALS","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603729,"BUPIVAC 0.75%-DEXT 8.25% 2ML *SPINAL*-NF","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603726,"D5 BAG 250 ML","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603725,"DOPamine 400MG-D5W 250ML *PEDIATRIC*","CDM Code","IP/OP",250,"Pharmacy","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5603724,"CALCIUM GLUC 1GM/10ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5603723,"METHYLENE BLUE 0.5% 10 ML AMP - NF","CDM Code","IP/OP",636,"Drug/Detail Code","Q9968","VISUALIZATION ADJUNCT",581,290.5,461.89500000000004,493.84999999999997,493.84999999999997,493.84999999999997,488.03999999999996,470.61,464.8,461.89500000000004,464.8]
[5603722,"D5-NS-40MEQ KCL 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603721,"CLONIDINE 1000 MCG/10 ML INJECTION","CDM Code","IP/OP",259,"Drugs/Other","","",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[5603719,"SUCCINYLCHOLINE SYRINGE 100 MG/5 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0330","SUCCINYCHOLINE CHLORIDE INJ",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5603718,"CLOZAPINE 100 MG TAB","CDM Code","IP/OP",636,"Drug/Detail Code","S0136","CLOZAPINE, 25 MG",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603717,"HYPERTONIC 3% SALINE 500 ML PREMADE","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603716,"SODIUM BICARBONATE 650 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603715,"DEXAMETHASONE SOD PHOS VIAL 10MG/ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1100","DEXAMETHASONE SODIUM PHOS",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5603714,"BUPIVacaine MPF0.25% W EPI 1:200000 10ML","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5603713,"TRIAZOLAM (HALCION) TAB 0.125 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603712,"HYDROMORPHONE 10 MG/ML **RX USE ONLY**","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",257,128.5,204.315,218.45,218.45,218.45,215.88,208.17000000000002,205.60000000000002,204.315,205.60000000000002]
[5603711,"NS FOR IRRIGATION 2L - NOT FOR IV USE","CDM Code","IP/OP",259,"Drugs/Other","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5603710,"APIXABAN (ELIQUIS) *2.5* MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5603709,"TRASTUZUMAB VIAL 150MG SDV (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9355","INJ TRASTUZUMAB EXCL BIOSIMI",3350,1675,2663.25,2847.5,2847.5,2847.5,2814,2713.5,2680,2663.25,2680]
[5603708,"GENTAMICIN 100 MG/NS 100 ML PREMIX-NF","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603707,"MORPHINE ORAL 15 MG 2 TAB STARTER PACK","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603706,"GOLIMUMAB (SIMPONI) 50MG/4ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1602","GOLIMUMAB FOR IV USE 1MG",3861,1930.5,3069.4950000000003,3281.85,3281.85,3281.85,3243.24,3127.4100000000003,3088.8,3069.4950000000003,3088.8]
[5603705,"NS *20*ML VIAL TO USE FOR DRUG DILUTION","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603704,"NALOXONE 4MG NASAL SPRAY","CDM Code","IP/OP",250,"Pharmacy","","",113,56.5,89.835000000000008,96.05,96.05,96.05,94.92,91.53,90.4,89.835000000000008,90.4]
[5603703,"PANTOPRAZOLE (PROTONIX) 40 MG IVP","CDM Code","IP/OP",250,"Pharmacy","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5603702,"TRIAM-EUCERIN-CAMPHOR 1:1:1 (NF)","CDM Code","IP/OP",250,"Pharmacy","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5603701,"LAMOTRIGINE ORAL TABLET 100MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603700,"MORPHINE PCA 30MG FOR NON PCA USE","CDM Code","IP/OP",250,"Pharmacy","J2270","MORPHINE SULFATE INJECTION",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5603699,"DARATUMUMAB 100MG/5ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9145","INJECTION, DARATUMUMAB 10 MG",1557,778.5,1237.8150000000001,1323.45,1323.45,1323.45,1307.8799999999999,1261.17,1245.6000000000001,1237.8150000000001,1245.6000000000001]
[5603698,"D5-1/2NS-40MEQ KCL/1000ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603697,"PHENYLEPHRINE 5 MG/50 ML SYR  **ANES**","CDM Code","IP/OP",636,"Drug/Detail Code","J2370","PHENYLEPHRINE HCL INJECTION",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[5603696,"PHENYLEPHRINE 40MCG/ML 5 ML SYR (ANES)","CDM Code","IP/OP",636,"Drug/Detail Code","J2370","PHENYLEPHRINE HCL INJECTION",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603695,"PNEUMONIA VACCINE (PREVNAR 13)","CDM Code","IP/OP",636,"Drug/Detail Code",90670,"PCV13 VACCINE IM",560,280,445.20000000000005,476,476,476,470.4,453.6,448,445.20000000000005,448]
[5603694,"TBO-FILGRASTIM 480 MCG","CDM Code","IP/OP",636,"Drug/Detail Code","J1447","INJ TBO FILGRASTIM 1 MICROG",818,409,650.31000000000006,695.3,695.3,695.3,687.12,662.58,654.40000000000009,650.31000000000006,654.40000000000009]
[5603693,"INFLUENZA VACCINE *HIGH DOSE* 65YO+ ONLY","CDM Code","IP/OP",636,"Drug/Detail Code",90662,"IIV NO PRSV INCREASED AG IM",235,117.5,186.82500000000002,199.75,199.75,199.75,197.4,190.35000000000002,188,186.82500000000002,188]
[5603692,"NEOSTIGMINE 1 MG/1 ML 5 ML SYR (1:1000)","CDM Code","IP/OP",250,"Pharmacy","","",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[5603691,"SUCCINYLCHOLINE SYRINGE 140 MG/7 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0330","SUCCINYCHOLINE CHLORIDE INJ",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5603690,"MORPHINE DRIP VIAL 50MG/ML 10 ML","CDM Code","IP/OP",250,"Pharmacy","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5603689,"MAGNESIUM SULF 4 GM/100 ML PREMIX BAG","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5603688,"ALBUMIN 12.5 GM - 50 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",133,66.5,105.735,113.05,113.05,113.05,111.72,107.73,106.4,105.735,106.4]
[5603687,"APIXABAN (ELIQUIS) 5 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603685,"IDARUCIZUMAB (PRAXBIND) 2500 MG/VIAL-NF","CDM Code","IP/OP",636,"Drug/Detail Code","J3590","UNCLASSIFIED BIOLOGICS",2886,1443,2294.37,2453.1,2453.1,2453.1,2424.2399999999998,2337.6600000000003,2308.8000000000002,2294.37,2308.8000000000002]
[5603684,"KCENTRA (4 FACTOR PCC) 500 U","CDM Code","IP/OP",636,"Drug/Detail Code","J7168","PROTHROMBIN COMPLEX KCENTRA",1899,949.5,1509.7050000000002,1614.1499999999999,1614.1499999999999,1614.1499999999999,1595.1599999999999,1538.19,1519.2,1509.7050000000002,1519.2]
[5603683,"KCENTRA (4 FACTOR PCC) 1000 U","CDM Code","IP/OP",636,"Drug/Detail Code","J7168","PROTHROMBIN COMPLEX KCENTRA",4195,2097.5,3335.0250000000001,3565.75,3565.75,3565.75,3523.7999999999997,3397.9500000000003,3356,3335.0250000000001,3356]
[5603682,"BUTORPHANOL (STADOL) **4 MG/2 ML** (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J0595","BUTORPHANOL TARTRATE 1 MG",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5603681,"EPINEPHRINE 30 MG/30 ML MDV","CDM Code","IP/OP",250,"Pharmacy","","",473,236.5,376.03500000000003,402.05,402.05,402.05,397.32,383.13000000000005,378.40000000000003,376.03500000000003,378.40000000000003]
[5603680,"GENTAMICIN 120 MG/NS 100 ML OB KIT-NF","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603679,"GRANISETRON 1MG/ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1626","GRANISETRON HCL INJECTION",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5603678,"GENTAMICIN 80 MG/NS *50 ML* PREMIX","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603677,"CELECOXIB (CELEBREX) 100 MG CAP - NF","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603676,"RIVAROXABAN (XARELTO) 10 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5603675,"CALCIUM GLUC PO ADMIN 1 GRAM","CDM Code","IP/OP",259,"Drugs/Other","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5603674,"NITROFURANTOIN (MACROBID) 100MG SP","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603673,"EPInephrine 0.3 mg autoinjector *SP*","CDM Code","IP/OP",636,"Drug/Detail Code","J0171","ADRENALIN EPINEPHRINE INJECT",342,171,271.89,290.7,290.7,290.7,287.27999999999997,277.02000000000004,273.60000000000002,271.89,273.60000000000002]
[5603672,"PROPOFOL (DIPRIVAN) VIAL 10MG/ML 10ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2704","INJ, PROPOFOL, 10 MG",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603671,"GANCICLOVIR 500 MG VIAL - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J1570","GANCICLOVIR SODIUM INJECTION",291,145.5,231.345,247.35,247.35,247.35,244.44,235.71,232.8,231.345,232.8]
[5603670,"PIP-TAZO 2.25G VIAL-(RX USE ONLY)","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603669,"VANCOMYCIN ORAL SUSP FOR C-DIFF 150 ML","CDM Code","IP/OP",259,"Drugs/Other","","",411,205.5,326.745,349.34999999999997,349.34999999999997,349.34999999999997,345.24,332.91,328.8,326.745,328.8]
[5603668,"DONEPEZIL (ARICEPT) TAB 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603667,"ARANESP 150 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",1198,599,952.41000000000008,1018.3,1018.3,1018.3,1006.3199999999999,970.38000000000011,958.40000000000009,952.41000000000008,958.40000000000009]
[5603665,"AMPICILLIN/SULB 1.5 GM VIAL -RX USE ONLY","CDM Code","IP/OP",636,"Drug/Detail Code","J0295","AMPICILLIN SULBACTAM 1.5 GM",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603664,"VANCOMYCIN HCL VIAL : 1 GM (RX USE ONLY)","CDM Code","IP/OP",636,"Drug/Detail Code","J3370","VANCOMYCIN HCL INJECTION",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5603663,"FLUCONAZOLE 400 MG/200 ML IVPB (NF)","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603662,"PREDNISOLONE EYE DROP STARTER PACK","CDM Code","IP/OP",259,"Drugs/Other","","",190,95,151.05000000000001,161.5,161.5,161.5,159.6,153.9,152,151.05000000000001,152]
[5603661,"FERRIC CARBOXYMALTOSE 750MG/15ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1439","INJ FERRIC CARBOXYMALTOS 1MG",1544,772,1227.48,1312.3999999999999,1312.3999999999999,1312.3999999999999,1296.96,1250.6400000000001,1235.2,1227.48,1235.2]
[5603659,"ATORVASTATIN 40 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603658,"CEFTAZIDIME 1 GM DUPLEX BAG - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J0713","INJ CEFTAZIDIME PER 500 MG",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5603657,"AMPHOTERICIN B 50MG VIAL (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J0285","AMPHOTERICIN B",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[5603656,"MICONAZOLE VAGINAL SUPPS 100 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603655,"TOBRAMYCIN 1.2G PWD (OR BEAD USE ONLY)","CDM Code","IP/OP",250,"Pharmacy","","",279,139.5,221.80500000000001,237.15,237.15,237.15,234.35999999999999,225.99,223.20000000000002,221.80500000000001,223.20000000000002]
[5603654,"CETUXIMAB 200 MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9055","CETUXIMAB INJECTION",2900,1450,2305.5,2465,2465,2465,2436,2349,2320,2305.5,2320]
[5603652,"ADENOSINE VIAL 6 MG/2 ML (6MG X1 DOSE)","CDM Code","IP/OP",636,"Drug/Detail Code","J0153","ADENOSINE INJ 1MG",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5603651,"MELOXICAM 7.5MG TABLET - NF","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603649,"MELATONIN TAB 3MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603648,"DABIGATRAN 75 MG CAP - NF","CDM Code","IP/OP",250,"Pharmacy","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5603647,"OBINUTUZUMAB 1000 MG/40 ML VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9301","OBINUTUZUMAB INJ",11378,5689,9045.51,9671.2999999999993,9671.2999999999993,9671.2999999999993,9557.52,9216.18,9102.4,9045.51,9102.4]
[5603646,"DOCUSATE LIQUID FOR EAR CLEANING","CDM Code","IP/OP",250,"Pharmacy","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5603645,"DARBOPOETIN 40 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",480,240,381.6,408,408,408,403.2,388.8,384,381.6,384]
[5603644,"PACLITAXEL (TAXOL) 300 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9267","PACLITAXEL INJECTION",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5603643,"MOMETASONE (ASMANEX) INH (PER PUFF)","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603642,"TRIAMCINOLONE 0.1% OINTMENT","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603639,"COLISTIMETHATE 150MG BOLUS-RX TO SUPPLY","CDM Code","IP/OP",636,"Drug/Detail Code","J0770","COLISTIMETHATE SODIUM INJ",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5603638,"MAGNESIUM SULF 2 GRAM/50 ML PREMIX BAG","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603637,"CLINIMIX E 4.25/10 2000ML","CDM Code","IP/OP",259,"Drugs/Other","","",233,116.5,185.23500000000001,198.04999999999998,198.04999999999998,198.04999999999998,195.72,188.73000000000002,186.4,185.23500000000001,186.4]
[5603636,"amiKACIN (aminoglycoside abx)-RX TO SUPP","CDM Code","IP/OP",636,"Drug/Detail Code","J0278","AMIKACIN SULFATE INJECTION",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5603634,"DULOXETINE 30 MG CAPSULE","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603633,"TRIAMCINOLONE-EUCERIN 1:1 CREAM","CDM Code","IP/OP",250,"Pharmacy","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5603632,"PHENYTOIN 100 MG/2 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1165","PHENYTOIN SODIUM INJECTION",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603631,"TRIMETHOPRIM/POLYMIXIN B OPTH SOLN SP-NF","CDM Code","IP/OP",250,"Pharmacy","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5603630,"LIDOCAINE OPTH GEL 3.5% 1ML - NF","CDM Code","IP/OP",250,"Pharmacy","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5603629,"CARBI-LEVO (SINEMET) 10-100 IR TAB - NF","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603628,"ENTACAPONE 200 MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603627,"VALACYCLOVIR 500 MG TABLET","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603626,"IPILIMUMAB (YERVOY - CHEMO) 200 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9228","IPILIMUMAB INJECTION",54664,27332,43457.880000000005,46464.4,46464.4,46464.4,45917.759999999995,44277.840000000004,43731.200000000004,43457.880000000005,43731.200000000004]
[5603625,"DARBOPOETIN 25 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",323,161.5,256.78500000000003,274.55,274.55,274.55,271.32,261.63,258.40000000000003,256.78500000000003,258.40000000000003]
[5603624,"CEFTRIAXONE 2 GRAMS/50 ML DUPLEX BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J0696","CEFTRIAXONE SODIUM INJECTION",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[5603623,"FILGRASTIM SYR 480 MCG/0.8 ML (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J1442","INJ FILGRASTIM EXCL BIOSIMIL",1082,541,860.19,919.69999999999993,919.69999999999993,919.69999999999993,908.88,876.42000000000007,865.6,860.19,865.6]
[5603622,"LIDOCAINE 5% & DEXTROSE 7.5% 2 ML AMP-NF","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603621,"ACETAMINOPHEN *IV* 1000 MG/100 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0131","INJ, ACETAMINOPHEN (NOS)",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5603620,"TRAMADOL 50 MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603619,"PROBIOTIC - SACCHAROMYCES (FLORASTOR)","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603616,"PERTUZUMAB (PERJETA) 420 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9306","INJECTION, PERTUZUMAB, 1 MG",12673,6336.5,10075.035,10772.05,10772.05,10772.05,10645.32,10265.130000000001,10138.400000000001,10075.035,10138.400000000001]
[5603615,"ZOLEDRONIC ACID (RECLAST) 5 MG INFUSION","CDM Code","IP/OP",636,"Drug/Detail Code","J3489","ZOLEDRONIC ACID 1MG",435,217.5,345.82500000000005,369.75,369.75,369.75,365.4,352.35,348,345.82500000000005,348]
[5603612,"ZOLEDRONIC ACID (ZOMETA) 4 MG INFUSION","CDM Code","IP/OP",636,"Drug/Detail Code","J3489","ZOLEDRONIC ACID 1MG",101,50.5,80.295000000000002,85.85,85.85,85.85,84.84,81.81,80.800000000000011,80.295000000000002,80.800000000000011]
[5603611,"FILGRASTIM VIAL  300MCG/ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1442","INJ FILGRASTIM EXCL BIOSIMIL",962,481,764.79000000000008,817.69999999999993,817.69999999999993,817.69999999999993,808.07999999999993,779.22,769.6,764.79000000000008,769.6]
[5603610,"BUPIVACAINE ***LIPOSOMAL*** 20 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","C9290","INJ, BUPIVACAINE LIPOSOME",1064,532,845.88,904.4,904.4,904.4,893.76,861.84,851.2,845.88,851.2]
[5603609,"TRANEXAMIC ACID 1000MG/10ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603608,"VITAMIN D 1000 IU TAB (1000 iu = 25 mcg)","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603607,"PROPARACAINE 0.5% OPTH SOLN 15 ML","CDM Code","IP/OP",250,"Pharmacy","","",108,54,85.86,91.8,91.8,91.8,90.72,87.48,86.4,85.86,86.4]
[5603606,"ROPIV 0.125%/FENT Epidu 100ml-Pharmedium","CDM Code","IP/OP",250,"Pharmacy","","",190,95,151.05000000000001,161.5,161.5,161.5,159.6,153.9,152,151.05000000000001,152]
[5603605,"LEVALBUTEROL (XOPENEX)1.25 MG NEBS (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J7614","LEVALBUTEROL NON-COMP UNIT",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5603604,"DEXTROSE (Glutose) 40% ORAL GEL 15 GRAMS","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603603,"KETAMINE 50 MG/1 ML SYRINGE - NF","CDM Code","IP/OP",259,"Drugs/Other","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5603602,"LIDOCAINE 5% OINTMENT - NF","CDM Code","IP/OP",250,"Pharmacy","","",226,113,179.67000000000002,192.1,192.1,192.1,189.84,183.06,180.8,179.67000000000002,180.8]
[5603601,"AMOX/CLAV (AUGM) 600MG/42.9MG/5ML *SP*","CDM Code","IP/OP",250,"Pharmacy","","",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[5603600,"AMOX/CLAV (AUGM) 600MG/42.9MG/5ML PO SUS","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5603599,"CASPOFUNGIN 50 MG (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J0637","CASPOFUNGIN ACETATE",1047,523.5,832.36500000000001,889.94999999999993,889.94999999999993,889.94999999999993,879.48,848.07,837.6,832.36500000000001,837.6]
[5603598,"PIPERACILLIN-TAZOBAC (ZOSYN) 4.5 GM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603596,"BUPRENORP/NALOX 2MG/0.5MG FILM -Suboxone","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603595,"MOISTURIZING MOUTH SPRAY","CDM Code","IP/OP",250,"Pharmacy","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5603594,"DOCUSATE 100 MG/10 ML UD CUP","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603593,"MANNITOL 20% BAG (100 GRAMS/500 ML)","CDM Code","IP/OP",259,"Drugs/Other","","",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[5603592,"hydrOXYZINE HCL *100 MG/2 ML* (NF)","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5603590,"LATANOPROST 0.005% EYE DROP","CDM Code","IP/OP",250,"Pharmacy","","",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[5603589,"MISOPROSTOL 1000 MCG SUPPOSITORY","CDM Code","IP/OP",250,"Pharmacy","","",142,71,112.89,120.7,120.7,120.7,119.28,115.02000000000001,113.60000000000001,112.89,113.60000000000001]
[5603588,"TALC FOR PLEURODESIS","CDM Code","IP/OP",250,"Pharmacy","","",395,197.5,314.02500000000003,335.75,335.75,335.75,331.8,319.95000000000005,316,314.02500000000003,316]
[5603587,"BUMETANIDE 2.5 MG/10 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603586,"BUPRENORPHINE 8 MG TAB (Subutex)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603585,"NEOSTIGMINE 1 MG/1 ML 10 ML VIAL(1:1000)","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5603583,"ROPIVacaine/FENT Epidu 250ml-Pharmedium","CDM Code","IP/OP",250,"Pharmacy","","",367,183.5,291.76499999999999,311.95,311.95,311.95,308.27999999999997,297.27000000000004,293.60000000000002,291.76499999999999,293.60000000000002]
[5603582,"ROPIVacaine PLAIN Epidu 250ML-Pharmedium","CDM Code","IP/OP",250,"Pharmacy","","",276,138,219.42000000000002,234.6,234.6,234.6,231.84,223.56,220.8,219.42000000000002,220.8]
[5603581,"NICOTINE 2 MG GUM","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603580,"ROPIVACAINE 0.2% **200 ML** SDV","CDM Code","IP/OP",636,"Drug/Detail Code","J2795","ROPIVACAINE HCL INJECTION",160,80,127.2,136,136,136,134.4,129.60000000000002,128,127.2,128]
[5603579,"ROPIVACAINE 0.2% 20 ML SDV","CDM Code","IP/OP",636,"Drug/Detail Code","J2795","ROPIVACAINE HCL INJECTION",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5603578,"LIDOCAINE MPF 2% EPI 1:200,000 20 ML","CDM Code","IP/OP",250,"Pharmacy","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5603577,"NICOTINE INHALER 10 MG/CARTRIDGE","CDM Code","IP/OP",250,"Pharmacy","","",215,107.5,170.92500000000001,182.75,182.75,182.75,180.6,174.15,172,170.92500000000001,172]
[5603576,"NS 10ML VIAL TO USE FOR DRUG DILUTION","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603575,"NYSTATIN 500,000 UNITS/5 ML UD CUP -  NF","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603574,"CEFEPIME 2 GRAM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0692","CEFEPIME HCL FOR INJECTION",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5603573,"hydroCODONE W APAP 5/325 (VICODIN) SP","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603572,"hydroCODONE-APAP 5/325 (VICODIN) TAB","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603571,"FOSAPREPITANT (EMEND) 150MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1453","FOSAPREPITANT INJECTION",1001,500.5,795.79500000000007,850.85,850.85,850.85,840.83999999999992,810.81000000000006,800.80000000000007,795.79500000000007,800.80000000000007]
[5603570,"MICAFUNGIN 100 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2248","MICAFUNGIN SODIUM INJECTION",333,166.5,264.73500000000001,283.05,283.05,283.05,279.71999999999997,269.73,266.40000000000003,264.73500000000001,266.40000000000003]
[5603569,"IDARUBICIN 5 MG/5 ML VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9211","IDARUBICIN HCL INJECTION",165,82.5,131.17500000000001,140.25,140.25,140.25,138.6,133.65,132,131.17500000000001,132]
[5603568,"TIGECYCLINE 50 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3243","TIGECYCLINE INJECTION",307,153.5,244.06500000000003,260.95,260.95,260.95,257.88,248.67000000000002,245.60000000000002,244.06500000000003,245.60000000000002]
[5603567,"VENLAFAXINE XR : 37.5 MG CAP (NF)","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603566,"LIDOCAINE MPF 1% EPI 1:200000 30 ML","CDM Code","IP/OP",250,"Pharmacy","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5603565,"SUMATRIPTAN 50 MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603564,"NITROGLYCERIN 25 MG/250 ML D5W","CDM Code","IP/OP",250,"Pharmacy","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5603563,"acetylCYSTEINE INJ (ACETADOTE) 200 MG","CDM Code","IP/OP",250,"Pharmacy","","",156,78,124.02000000000001,132.6,132.6,132.6,131.04,126.36000000000001,124.80000000000001,124.02000000000001,124.80000000000001]
[5603562,"CEFAZOLIN 2 GRAM/50 ML DUPLEX BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J0690","CEFAZOLIN SODIUM INJECTION",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5603561,"CEFTAZIDIME VIAL 2 GM","CDM Code","IP/OP",636,"Drug/Detail Code","J0713","INJ CEFTAZIDIME PER 500 MG",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5603560,"MISOPROSTOL 1000MCG 10 TAB PACK (OB USE)","CDM Code","IP/OP",250,"Pharmacy","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603559,"DENOSUMAB (XGEVA) 70 MG/ML 1.7 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0897","DENOSUMAB INJECTION",5559,2779.5,4419.4050000000007,4725.1499999999996,4725.1499999999996,4725.1499999999996,4669.5599999999995,4502.79,4447.2,4419.4050000000007,4447.2]
[5603558,"ERIBULIN (HALAVEN) 1MG/2ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9179","ERIBULIN MESYLATE INJECTION",2360,1180,1876.2,2006,2006,2006,1982.3999999999999,1911.6000000000001,1888,1876.2,1888]
[5603556,"MITOMYCIN 20 MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9280","MITOMYCIN INJECTION",1246,623,990.57,1059.0999999999999,1059.0999999999999,1059.0999999999999,1046.6399999999999,1009.2600000000001,996.80000000000007,990.57,996.80000000000007]
[5603555,"NORETHINDR/ETHINYL ESTRADIO 1/35 TAB-NF","CDM Code","IP/OP",250,"Pharmacy","","",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[5603554,"NS 250 MG IVPB PVC & DEHP FREE","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603553,"ESTRADIOL PATCH 0.05MG/DAY","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5603550,"ETOPOSIDE VIAL 100MG 5ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9181","ETOPOSIDE INJECTION",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603549,"ONDANSETRON ODT (DISINTEGRATING TAB)4MG","CDM Code","IP/OP",636,"Drug/Detail Code","Q0162","ONDANSETRON ORAL",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603548,"BORTEZOMIB 3.5 MG VIAL (BRAND VELCADE)","CDM Code","IP/OP",636,"Drug/Detail Code","J9041","INJECTION, BORTEZOMIB, 0.1MG",3365,1682.5,2675.1750000000002,2860.25,2860.25,2860.25,2826.6,2725.65,2692,2675.1750000000002,2692]
[5603547,"ATROPINE DROPS 1% OS - COMFORT CARE","CDM Code","IP/OP",250,"Pharmacy","","",142,71,112.89,120.7,120.7,120.7,119.28,115.02000000000001,113.60000000000001,112.89,113.60000000000001]
[5603546,"DOXYLamine 25 MG TABLET - NF","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603544,"ACYCLOVIR (ZOVIRAX) 800 MG TAB (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J8499","ORAL PRESCRIP DRUG NON CHEMO",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603543,"FENTANYL 250 MCG/5 ML AMP - ANES ONLY","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603542,"ORPHENADRINE 60 MG VIAL (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J2360","ORPHENADRINE INJECTION",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5603541,"clonAZEPAM (KLONIPIN) TAB 0.25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603540,"ALFENTANIL 1000MCG/2ML AMP","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603539,"ABATACEPT (ORENCIA) 250 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0129","ABATACEPT INJECTION",2671,1335.5,2123.4450000000002,2270.35,2270.35,2270.35,2243.64,2163.5100000000002,2136.8000000000002,2123.4450000000002,2136.8000000000002]
[5603538,"INFLUENZA INTRADERMAL","CDM Code","IP/OP",636,"Drug/Detail Code",90654,"FLU VACC IIV3 NO PRESERV ID",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5603537,"CLADRIBINE 10 MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9065","INJ CLADRIBINE PER 1 MG",668,334,531.06000000000006,567.79999999999995,567.79999999999995,567.79999999999995,561.12,541.08000000000004,534.4,531.06000000000006,534.4]
[5603536,"BUPIVacaine MPF0.25% W EPI 1:200000 30ML","CDM Code","IP/OP",250,"Pharmacy","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5603535,"TETRACAINE INJECTION 1% 2ML AMP - NF","CDM Code","IP/OP",259,"Drugs/Other","","",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[5603534,"ATROPINE VIAL/SYRINGE 1 MG/1 ML","CDM Code","IP/OP",250,"Pharmacy","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5603533,"HYDROMORPHONE AMPULE 2 MG/ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603532,"LORAZEPAM 20MG/10ML VIAL (RX USE ONLY)NF","CDM Code","IP/OP",259,"Drugs/Other","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5603531,"DORIPENEM 500 MG VIAL - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J1267","DORIPENEM INJECTION",117,58.5,93.015000000000001,99.45,99.45,99.45,98.28,94.77000000000001,93.600000000000009,93.015000000000001,93.600000000000009]
[5603530,"PALONOSETRON 250 MCG/5 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2469","PALONOSETRON HCL",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603529,"AMINOCAPROIC ACID VIAL 5 GM/20 ML","CDM Code","IP/OP",250,"Pharmacy","S0017","INJECT AMINOCAPROIC ACID",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5603528,"Daptomycin - Rx To Supply","CDM Code","IP/OP",636,"Drug/Detail Code","J0878","DAPTOMYCIN INJECTION",119,59.5,94.605000000000004,101.14999999999999,101.14999999999999,101.14999999999999,99.96,96.39,95.2,94.605000000000004,95.2]
[5603527,"levoFLOXACIN 750 MG/150 ML BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J1956","LEVOFLOXACIN INJECTION",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603526,"PRAMIPEXOLE 0.125 MG TABS","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603525,"LIDOCAINE VISCOUS FLAVORED 2% SOLN:20 ML","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603524,"CARBIDOPA 25 MG TABLET (NF)","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603523,"BACITRACIN OPHT OINT STARTER PACK","CDM Code","IP/OP",259,"Drugs/Other","","",207,103.5,164.565,175.95,175.95,175.95,173.88,167.67000000000002,165.60000000000002,164.565,165.60000000000002]
[5603522,"DORIPENEM 250 MG VIAL - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J1267","DORIPENEM INJECTION",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[5603520,"METOPROLOL TARTRATE *IR* TAB 25 MG","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603519,"VENLAFAXINE EXTEN RELEASE 75 MG CAPSULE","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603518,"HYPERTONIC 3% SALINE FOR NEBULIZATION","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603517,"HEPARIN 100 UNITS/ML 5ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","J1642","INJ HEPARIN SODIUM PER 10 U",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603516,"PREGABALIN 50 MG CAPSULE","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603515,"PHENTOLAMINE 5MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2760","PHENTOLAINE MESYLATE INJ",364,182,289.38,309.39999999999998,309.39999999999998,309.39999999999998,305.76,294.84000000000003,291.2,289.38,291.2]
[5603514,"MEMANTINE 5 MG TAB - NF","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5603513,"NORepinephrine DRIP","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603512,"METRONIDAZOLE (FLAGYL) TAB 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603511,"VINCRISTINE VIAL : 2 MG/2 ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9370","VINCRISTINE SULFATE 1 MG INJ",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5603510,"TOPOTECAN HCL VIAL : 4 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9351","TOPOTECAN INJECTION",1578,789,1254.51,1341.3,1341.3,1341.3,1325.52,1278.18,1262.4000000000001,1254.51,1262.4000000000001]
[5603509,"DACARBAZINE (CHEMO) 200 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J9130","DACARBAZINE 100 MG INJ",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5603508,"CYTARABINE VIAL : 1 GM (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9100","CYTARABINE HCL 100 MG INJ",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[5603507,"CYCLOPHOSPHAMIDE(CYTOXAN)1000 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9070","CYCLOPHOSPHAMIDE 100 MG INJ",759,379.5,603.40500000000009,645.15,645.15,645.15,637.55999999999995,614.79000000000008,607.20000000000005,603.40500000000009,607.20000000000005]
[5603505,"CISPLATIN VIAL (CHEMO): 50MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9060","CISPLATIN 10 MG INJECTION",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5603504,"EPInephrine 0.3 MG AUTOINJECTOR","CDM Code","IP/OP",636,"Drug/Detail Code","J0171","ADRENALIN EPINEPHRINE INJECT",342,171,271.89,290.7,290.7,290.7,287.27999999999997,277.02000000000004,273.60000000000002,271.89,273.60000000000002]
[5603503,"EPInephrine 1-1000 INJ 1MG/1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0171","ADRENALIN EPINEPHRINE INJECT",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5603501,"CHOLESTYRAMINE POWDER 4 gram PACKS - NF","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603500,"MIDAZOLAM 50MG/10ML VIAL (RX USE ONLY)","CDM Code","IP/OP",259,"Drugs/Other","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5603499,"D5-1/2 NS (0.45%) 500 ML","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603498,"D5-1/2NS W/ 10 mEq KCL/500 ML-RX TO SUPP","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603497,"ACETAZOLAMIDE 250 MG TABLET (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603496,"LEVOCARNITINE 1 GRAM/5 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1955","INJ LEVOCARNITINE PER 1 GM",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5603495,"levoFLOXACIN 250 MG/50 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1956","LEVOFLOXACIN INJECTION",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603494,"levoFLOXACIN 500 MG/100 ML BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J1956","LEVOFLOXACIN INJECTION",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5603493,"levoFLOXACIN 500 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603492,"D5W 0.2%NS 500 ML","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603491,"D5-1/2NS (0.45%) W/ 10 MEQ KCL/500 ML","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603490,"MORPHINE ORAL (MS CONTIN) 60 MG TAB (NF)","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603489,"FLUMIST NASAL FLU VACCINE","CDM Code","IP/OP",636,"Drug/Detail Code",90660,"LAIV3 VACCINE INTRANASAL",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[5603488,"HALOPERIDOL (HALDOL) MDV: 50 MG/10 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1630","HALOPERIDOL INJECTION",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5603487,"KINEVAC (SINCLIDE) 5 MCG","CDM Code","IP/OP",636,"Drug/Detail Code","J2805","SINCALIDE INJECTION",314,157,249.63000000000002,266.89999999999998,266.89999999999998,266.89999999999998,263.76,254.34,251.20000000000002,249.63000000000002,251.20000000000002]
[5603486,"DARBOPOETIN 60 MCG PFS","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",735,367.5,584.32500000000005,624.75,624.75,624.75,617.4,595.35,588,584.32500000000005,588]
[5603485,"GUAIFENESIN ER 600MG TABLET","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603484,"CLINIMIX E 5/15 2000ML","CDM Code","IP/OP",259,"Drugs/Other","","",203,101.5,161.38500000000002,172.54999999999998,172.54999999999998,172.54999999999998,170.51999999999998,164.43,162.4,161.38500000000002,162.4]
[5603483,"OLANZAPINE 10 MG VIAL FOR IM ADMIN","CDM Code","IP/OP",259,"Drugs/Other","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[5603482,"METHOHEXITAL (BREVITAL) 500MG VIAL","CDM Code","IP/OP",250,"Pharmacy","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[5603481,"SIMVASTATIN (ZOCOR) TAB 40 MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603479,"OXYTOCIN 30 UNITS IN 500ML-GMC MADE","CDM Code","IP/OP",636,"Drug/Detail Code","J2590","OXYTOCIN INJECTION",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5603478,"PROPOFOL (DIPRIVAN) VIAL 10MG/ML 100ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2704","INJ, PROPOFOL, 10 MG",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5603476,"LIDOCAINE 5% PATCH","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603475,"CEFDINIR 250 MG/5 ML ORAL SUSP - NF","CDM Code","IP/OP",250,"Pharmacy","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5603474,"oxyCONTIN 80 MG TAB (EXT REL) - NF","CDM Code","IP/OP",250,"Pharmacy","","",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[5603473,"LINEZOLID 600 MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603472,"TENECTEPLASE 50 MG KIT","CDM Code","IP/OP",636,"Drug/Detail Code","J3101","TENECTEPLASE INJECTION",12288,6144,9768.9600000000009,10444.799999999999,10444.799999999999,10444.799999999999,10321.92,9953.2800000000007,9830.4000000000015,9768.9600000000009,9830.4000000000015]
[5603471,"TOPIRAMATE 50 MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603470,"CATHFLO 2 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2997","ALTEPLASE RECOMBINANT",488,244,387.96000000000004,414.8,414.8,414.8,409.91999999999996,395.28000000000003,390.40000000000003,387.96000000000004,390.40000000000003]
[5603469,"SYNVISC 16 MG INJECTION","CDM Code","IP/OP",636,"Drug/Detail Code","J7325","SYNVISC OR SYNVISC-ONE",800,400,636,680,680,680,672,648,640,636,640]
[5603468,"ATROPINE SYR 0.1 MG/ML 10ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0461","ATROPINE SULFATE INJECTION",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5603467,"DOCETAXEL VIAL 160 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9171","DOCETAXEL INJECTION",890,445,707.55000000000007,756.5,756.5,756.5,747.6,720.90000000000009,712,707.55000000000007,712]
[5603466,"COSYNTROPIN VIAL (CORTROSYN): 0.25 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J0834","INJ., COSYNTROPIN, 0.25 MG",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5603465,"POTASSIUM 10 MEQ/100 ML NS (KCL RUNNER)","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603464,"CHLOROPROCAINE ** 3% ** 20ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2400","CHLOROPROCAINE HCL INJECTION",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5603463,"ACIDOPHILUS CAPS/TABS","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603462,"THROMBIN 5000 UNIT KIT","CDM Code","IP/OP",259,"Drugs/Other","","",206,103,163.77000000000001,175.1,175.1,175.1,173.04,166.86,164.8,163.77000000000001,164.8]
[5603461,"ALBUTEROL 2.5MG/3 ML NEB","CDM Code","IP/OP",250,"Pharmacy","J7613","ALBUTEROL NON-COMP UNIT",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603460,"ALBUTEROL 3MG & IPRATROPIUM 0.5MG NEB","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603459,"BUDESONIDE 0.5 MG/2 ML NEBULE","CDM Code","IP/OP",250,"Pharmacy","J7626","BUDESONIDE NON-COMP UNIT",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603458,"AMPICILLIN/SULBACTAM VIAL 3 GRAM/50","CDM Code","IP/OP",636,"Drug/Detail Code","J0295","AMPICILLIN SULBACTAM 1.5 GM",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5603457,"METHOCARBAMOL 500 MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603456,"BENDAMUSTINE 100MG VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9033","INJ., TREANDA 1 MG",4309,2154.5,3425.6550000000002,3662.65,3662.65,3662.65,3619.56,3490.2900000000004,3447.2000000000003,3425.6550000000002,3447.2000000000003]
[5603455,"LEXISCAN 5ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2785","REGADENOSON INJECTION",646,323,513.57000000000005,549.1,549.1,549.1,542.64,523.26,516.80000000000007,513.57000000000005,516.80000000000007]
[5603454,"AGGRENOX 25 MG/200 MG (NF)","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603453,"CHLORASEPTIC THROAT SPRAY","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603451,"CLINDAMYCIN 150 MG CAPS STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603450,"LIDOCAINE 4% TOPICAL ANESTHETIC CREAM","CDM Code","IP/OP",259,"Drugs/Other","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5603449,"KETAMINE 200MG/20ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[5603448,"TRIESENCE 40MG/ML","CDM Code","IP/OP",636,"Drug/Detail Code","J3300","TRIAMCINOLONE A INJ PRS-FREE",442,221,351.39000000000004,375.7,375.7,375.7,371.28,358.02000000000004,353.6,351.39000000000004,353.6]
[5603447,"CEFAZOLIN 1 GRAM/50 ML DUPLEX BAG","CDM Code","IP/OP",250,"Pharmacy","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5603446,"RIFAMPIN 300 MG CAPSULES","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603445,"TRIAMCINOLONE CREAM STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603444,"AMOX/CLAV (AUGM) SP 200 MG/5 ML 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5603443,"AMOX/CLAV (AUGM) PO SUSP 200MG/5ML 50ML","CDM Code","IP/OP",250,"Pharmacy","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5603442,"CEFTRIAXONE 1 GRAM/50 ML DUPLEX BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J0696","CEFTRIAXONE SODIUM INJECTION",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5603441,"BEVACIZUMAB 400 MG VIAL (AVASTIN-CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9035","BEVACIZUMAB INJECTION",6090,3045,4841.55,5176.5,5176.5,5176.5,5115.5999999999995,4932.9000000000005,4872,4841.55,4872]
[5603440,"BALM BARR CREME 6 OZ","CDM Code","IP/OP",250,"Pharmacy","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5603439,"MORPHINE INJECTION 2 MG/ML 1 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2270","MORPHINE SULFATE INJECTION",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5603438,"AZITHROMYCIN 200 MG/5 ML Starter Pack","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5603437,"ROPIVACAINE 0.5% 30 ML SDV","CDM Code","IP/OP",636,"Drug/Detail Code","J2795","ROPIVACAINE HCL INJECTION",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5603436,"PIPERACILLIN-TAZOBAC (ZOSYN) 2.25GM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603435,"CLINDAMYCIN 600 MG/50 ML (PREMIX)","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603434,"levETIRACEtam 500 MG TABLETS","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603433,"FULVESTRANT 250 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9395","INJECTION, FULVESTRANT",343,171.5,272.685,291.55,291.55,291.55,288.12,277.83000000000004,274.40000000000003,272.685,274.40000000000003]
[5603432,"GUAIFENESIN & DEXTROMETH 10 ML UD","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603431,"LIDOCAINE MPF 1% EPI 1:200000 10 ML","CDM Code","IP/OP",259,"Drugs/Other","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5603430,"NICOTINE 2 MG LOZENGES - NF","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603429,"ROCURONIUM 10 MG/ML 5 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5603428,"B&O SUPPOSITORIES 30-16.2 MG","CDM Code","IP/OP",250,"Pharmacy","","",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5603427,"HYDROMORPHONE 40 MG/20 ML (RX USE ONLY)","CDM Code","IP/OP",636,"Drug/Detail Code","J1170","HYDROMORPHONE INJECTION",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5603426,"MEROPENEM 1 GRAM/NS 50 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2185","MEROPENEM",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5603425,"FENTANYL 2500 MCG/50 ML (RX USE ONLY)","CDM Code","IP/OP",636,"Drug/Detail Code","J3010","FENTANYL CITRATE INJECTION",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5603424,"MIDAZOLAM 10 MG/10 ML (RX USE ONLY)","CDM Code","IP/OP",636,"Drug/Detail Code","J2250","INJ MIDAZOLAM HYDROCHLORIDE",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603422,"ASTRINGYN 8 GRAM UD VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5603421,"PREDNISOLONE ORAL SOLN 15MG/5ML (PER ML)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603420,"SUCROSE ORAL SOLN 24% 15 ML UD CUP","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603419,"ARGININE 10% 300 ML INJECTABLE SOLUTION","CDM Code","IP/OP",259,"Drugs/Other","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5603418,"BUPRENORP/NALOX 2MG/0.5MG TAB (Suboxone)","CDM Code","IP/OP",250,"Pharmacy","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5603416,"INFLUENZA VACCINE *EGG FREE* (FLUBLOK)","CDM Code","IP/OP",636,"Drug/Detail Code",90682,"RIV4 VACC RECOMBINANT DNA IM",233,116.5,185.23500000000001,198.04999999999998,198.04999999999998,198.04999999999998,195.72,188.73000000000002,186.4,185.23500000000001,186.4]
[5603415,"FENTANYL 100 MCG/2 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3010","FENTANYL CITRATE INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603413,"CHLORDIAZEPOXIDE 25 MG CAPS","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603412,"LEVALBUTEROL (XOPENEX) 0.63MG NEBS (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J7614","LEVALBUTEROL NON-COMP UNIT",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603411,"NORETHINDRONE 5 MG - NF","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603410,"CELLUVISC 0.4 ML UD GEL (NF)","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603409,"PENICILLIN 2.5 MILLION UNITS/NS 50 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603408,"IBANDRONATE 3MG/3ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1740","IBANDRONATE SODIUM INJECTION",181,90.5,143.89500000000001,153.85,153.85,153.85,152.04,146.61000000000001,144.80000000000001,143.89500000000001,144.80000000000001]
[5603404,"ONDANSETRON ODT 4 MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5603403,"ESTROGEN VAGINAL CREAM","CDM Code","IP/OP",250,"Pharmacy","","",873,436.5,694.03500000000008,742.05,742.05,742.05,733.31999999999994,707.13,698.40000000000009,694.03500000000008,698.40000000000009]
[5603402,"ABHR CREAM","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5603400,"ALBUTEROL 2.5MG/0.5 ML NEB (NOT FOR HP)","CDM Code","IP/OP",250,"Pharmacy","J7613","ALBUTEROL NON-COMP UNIT",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603399,"IMMUNE GLOBULIN (HUMAN) VIAL : 1 GM","CDM Code","IP/OP",636,"Drug/Detail Code","J1572","FLEBOGAMMA INJECTION",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[5603397,"BANANA BAG (HOSPITALIST SERVICE RECIPE)","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603396,"EVACUATED CONTAINER 1 LITER","CDM Code","IP/OP",259,"Drugs/Other","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5603395,"HEPARIN 1000 UNITS/ML 10 ML (ER USE)","CDM Code","IP/OP",636,"Drug/Detail Code","J1642","INJ HEPARIN SODIUM PER 10 U",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603394,"IBUTILIDE 1 MG/10 ML VIAL (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J1742","IBUTILIDE FUMARATE INJECTION",273,136.5,217.03500000000003,232.04999999999998,232.04999999999998,232.04999999999998,229.32,221.13000000000002,218.4,217.03500000000003,218.4]
[5603393,"MIRALAX 17 GRAM DOSE","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603392,"LIPIDS 20% (250 MG BAG)","CDM Code","IP/OP",259,"Drugs/Other","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5603391,"D20% & AMINO ACID 4.25%/1000ML BAG (nf)","CDM Code","IP/OP",259,"Drugs/Other","","",65,32.5,51.675000000000004,55.25,55.25,55.25,54.6,52.650000000000006,52,51.675000000000004,52]
[5603390,"D10% & AMINO ACID 4.25% IN 1000ML BAG","CDM Code","IP/OP",250,"Pharmacy","","",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[5603389,"DIPYRIDAMOLE 5MG/ML 10ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1245","DIPYRIDAMOLE INJECTION",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5603388,"ACETAMINOPHEN LIQ 160MG/5ML UD CUP","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603384,"CIPROFLOXACIN 400 MG/200 ML BAG","CDM Code","IP/OP",636,"Drug/Detail Code","J0744","CIPROFLOXACIN IV",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603383,"CEFDINIR 300 MG CAPSULE","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603382,"COMBIVENT INHALER","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603381,"ERTAPENEM 1 GRAM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1335","ERTAPENEM INJECTION",95,47.5,75.525000000000006,80.75,80.75,80.75,79.8,76.95,76,75.525000000000006,76]
[5603380,"ASCORBIC ACID 500 MG/ML 50 ML VIAL - NF","CDM Code","IP/OP",259,"Drugs/Other","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5603379,"LIDOCAINE MPF 2% WITH EPI 10ML","CDM Code","IP/OP",259,"Drugs/Other","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5603378,"FLUTICASONE 110 MCG (PER PUFF) - NF","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603377,"ALBUTEROL INHALER (CHARGES PER PUFF)","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603376,"ADVAIR INHALER 230/21 (CHARGES PER PUFF)","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5603375,"ADVAIR INHALER 115/21 (CHARGES PER PUFF)","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603373,"IBUPROFEN LIQUID 100 MG/5 ML UD CUP","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603372,"DIPHENHYDRAMINE LIQUID 12.5 MG/5 ML","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603371,"AMOX/CLAV (AUGM) 875MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5603368,"HEPARIN 500 UNITS/5 ML SYR (ONCOLOGY)","CDM Code","IP/OP",636,"Drug/Detail Code","J1642","INJ HEPARIN SODIUM PER 10 U",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603367,"LORAZEPAM ORAL CONC *1 MG/0.5 ML* SOLN","CDM Code","IP/OP",250,"Pharmacy","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5603366,"MORPHINE ORAL *CONC* 20 MG/ML BOTTLE","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5603364,"PIPERACILLIN-TAZOBA (ZOSYN) 3.375GM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2543","PIPERACILLIN/TAZOBACTAM",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5603363,"THIAMINE 100 MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603362,"PROCHLORPERAZINE 5MG TAB STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603361,"PENICILLIN 5 MILLION UNIT VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5603360,"SODIUM PHOSPHATE 45MMOL/15ML VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",79,39.5,62.805,67.149999999999991,67.149999999999991,67.149999999999991,66.36,63.99,63.2,62.805,63.2]
[5603359,"MECLIZINE TAB 25MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603358,"LORAZEPAM TAB 0.5MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603357,"INDOMETHACIN (INDOCIN) CAP 25MG SP-(NF)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603356,"IBUPROFEN TAB 800MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603355,"GENTAMYCIN OPTH OINTMENT STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[5603354,"CYCLOBENZAPRINE (FLEXERIL) TAB 10MG STAR","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603353,"FAMOTIDINE TAB 20MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603352,"ERYTHROMYCIN OPTH OINTMENT STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[5603351,"ERYTHROMYCIN (E.E.S) SUSP SP (NF)","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5603350,"hydroCODONE W APAP 5/500 (VICODIN) SP-NF","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603349,"ACETAMINOPHEN W COD (TYLENOL#3) TAB SP","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603348,"BACTRIM DS (GENERIC) TAB STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603347,"BACTRIM (GENERIC)SUSP 60 ML STARTER PAC","CDM Code","IP/OP",250,"Pharmacy","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5603346,"SULFACETAMIDE OPTH OINT STARTER PK (NF)","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603345,"SULFACETAMIDE OPTH SOLN 5ML STARTER PAC","CDM Code","IP/OP",250,"Pharmacy","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[5603344,"SILVADENE CREAM 25 GRAM STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5603343,"GUAIFENESIN & CODEINE ELIX 60ML STARTER","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603342,"PROMETHAZINE (PHENERGAN) TAB 25MG SP-NF","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603341,"PREDNISONE TAB 20MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603340,"PREDNISONE TAB 5 MG STARTER PACK (NF)","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603339,"PREDNISOLONE SOLN (3MG/ML) 20ML START PK","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5603338,"PHENAZOPYRIDINE (PYRIDUIM) TAB 100MG SP","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603337,"PENICILLIN TAB 250 MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603336,"PENICILLIN SUSP (250MG/5ML)100ML SP","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603335,"NITROGLYCERIN SUBLINGUAL TAB STARTER PAC","CDM Code","IP/OP",250,"Pharmacy","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5603334,"METRONIDZOLE (FLAGYL) TAB 500MG SP","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5603333,"PAMIDRONATE 90MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2430","PAMIDRONATE DISODIUM /30 MG",324,162,257.58000000000004,275.39999999999998,275.39999999999998,275.39999999999998,272.15999999999997,262.44,259.2,257.58000000000004,259.2]
[5603332,"IRINOTECAN 40MG/2ML VIAL (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9206","IRINOTECAN INJECTION",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5603331,"IRINOTECAN 100 MG/5 ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9206","IRINOTECAN INJECTION",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5603330,"DIBUCAINE OINTMENT 1%","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5603329,"REMIFENTANIL 2MG VIAL","CDM Code","IP/OP",259,"Drugs/Other","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[5603328,"DESFLURANE (ANES) (SUPRANE) : 240ML","CDM Code","IP/OP",259,"Drugs/Other","","",480,240,381.6,408,408,408,403.2,388.8,384,381.6,384]
[5603327,"TOLTERODINE (DETROL) LA 4 MG CAP (NF)","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5603326,"TIOTROPIUM (SPIRIVA) 18 MCG INHALER-NF","CDM Code","IP/OP",250,"Pharmacy","","",202,101,160.59,171.7,171.7,171.7,169.68,163.62,161.60000000000002,160.59,161.60000000000002]
[5603325,"LIDOCAINE MPF 1% VIAL 5 ML","CDM Code","IP/OP",259,"Drugs/Other","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5603324,"ERYTHROMYCIN TABLETS 333MG SP (NF)","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603323,"DOXYCYCLINE 100MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5603322,"DARVOCET N-100 STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5603321,"CORTISPORIN OTIC SUSP 10ML STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",213,106.5,169.33500000000001,181.04999999999998,181.04999999999998,181.04999999999998,178.92,172.53,170.4,169.33500000000001,170.4]
[5603320,"PROCHLORPERAZINE25MG SUPP SP - NF","CDM Code","IP/OP",250,"Pharmacy","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5603319,"CIPROFLOXACIN TABLETS 500MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603318,"CIPROFLOXACIN TABLETS 250MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603317,"CIPROFLOXACIN OPTH SOLN STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5603316,"CEPHALEXIN CAPSULES 250MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603315,"CEPHALEXIN (125MG/5ML) OS STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5603314,"ANTIPYR-BENZO OTIC DROPS STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5603313,"AUGMENTIN CHEWABLE TABS 250MG STARTER PA","CDM Code","IP/OP",250,"Pharmacy","","",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[5603312,"AMOXICILLIN CAPSULES 250MG STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603311,"AMOXICILLIN CHEW TABS 250MG SP (NF)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603310,"AMOXICILLIN SUSP(250MG/5ML) 100ML BTL SP","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603309,"AMOXICILLIN SUSP(125MG/5ML) 150ML BTL SP","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5603308,"ALBUTEROL SOLN STARTER PACK 60 ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5603307,"ALBUTEROL INHALER STARTER PACK","CDM Code","IP/OP",250,"Pharmacy","","",83,41.5,65.984999999999999,70.55,70.55,70.55,69.72,67.23,66.400000000000006,65.984999999999999,66.400000000000006]
[5603306,"IBUPROFEN (MOTRIN) TAB 200 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603305,"MAGNESIUM HYDR/ALUM SUSP: 80MEQ/30ML","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5603036,"VANCOMYCIN 1GM/D5W 250ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603034,"VANCOMYCIN 500MG/D5W 100ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603033,"NITROGLYCERIN 50MG/D5W 500ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603032,"NAFACILLIN 2GM/D5W 100ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603031,"NAFACILLIN 1GM/D5W 50ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603030,"METRONIDAZOLE 500MG/100ML PREMIXED","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603029,"IMIPENEM/CISLASTATIN/500MG/NS 100ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603028,"GENTAMYCIN 80MG/100ML PREMIXED","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5603027,"ERYTHROMYCIN 1GM/NS 250ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603026,"ERYTHROMYCIN 500MG/NS 100ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603025,"FLUCONAZOLE 200MG/100ML PREMIXED","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5603024,"CIPROFLOXACIN 400MG/200ML (2X200MG) NF","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603023,"CIPROFLOXACIN 200MG/100ML PREMIXED","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603022,"CLINDAMYCIN 900MG/D5W 100ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603021,"CLINDAMYCIN 600MG/D5W 50ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603020,"CLINDAMYCIN 300MG / D5W 50ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603019,"CEFUROXIME 750MG / D5W 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603018,"CEFTRIAXONE 2GM / D5W 100ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603017,"CEFTRIAXONE 1GM / D5W 50ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603016,"CEFTRIAXONE 500MG / D5W 50ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603015,"CEFTRIAXONE 250MG / D5W 50ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603014,"CEFTAZIDIME 2GM / D5W 100ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603013,"CEFTAZIDIME 1 GM/NS 50 ML - RX TO SUPPLY","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5603003,"hydrOXYZINE (VISTARIL)  LIQuid (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5602935,"AZITHROMYCIN 200 MG/5 ML ORAL SUSP","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5602934,"FAMOTIDINE (PEPCID) TAB 20MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602933,"LEUKINE 250 MCG/VIAL (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J2820","SARGRAMOSTIM INJECTION",362,181,287.79000000000002,307.7,307.7,307.7,304.08,293.22000000000003,289.60000000000002,287.79000000000002,289.60000000000002]
[5602932,"SPECIAL PHARMACEUTICAL","CDM Code","IP/OP",250,"Pharmacy","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[5602931,"SPECIAL ORAL PHARMACEUTICAL","CDM Code","IP/OP",259,"Drugs/Other","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602930,"ROPINIROLE 1 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602928,"DEPO-TESTADIOL 50MG-2MG 10ML INJ(NF)","CDM Code","IP/OP",250,"Pharmacy","","",518,259,411.81,440.3,440.3,440.3,435.12,419.58000000000004,414.40000000000003,411.81,414.40000000000003]
[5602927,"GLATIRAMER (COPAXONE)VIAL : 20 MG(NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J1595","INJECTION GLATIRAMER ACETATE",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[5602926,"EPOETIN ALFA 10000 UNITS","CDM Code","IP/OP",635,"Drugs Require Specific ID: EPO over 10,000 units","J0885","EPOETIN ALFA, NON-ESRD",349,174.5,277.45500000000004,296.64999999999998,296.64999999999998,296.64999999999998,293.15999999999997,282.69,279.2,277.45500000000004,279.2]
[5602925,"VINORELBINE VIAL 10 MG/ML 5ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9390","VINORELBINE TARTRATE INJ",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[5602919,"VINBLASTINE VIAL : 10MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9360","VINBLASTINE SULFATE INJ",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5602914,"MITOXANTRONE VIAL : 20 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9293","MITOXANTRONE HYDROCHL / 5 MG",1880,940,1494.6000000000001,1598,1598,1598,1579.2,1522.8000000000002,1504,1494.6000000000001,1504]
[5602911,"MITOMYCIN VIAL : 5 MG (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J9280","MITOMYCIN INJECTION",284,142,225.78,241.4,241.4,241.4,238.56,230.04000000000002,227.20000000000002,225.78,227.20000000000002]
[5602907,"METHOTREXATE SODIUM VIAL 50MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9260","METHOTREXATE SODIUM INJ",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602904,"LEUPROLIDE (LUPRON) 7.5 MG INJ (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J9217","LEUPROLIDE ACETATE SUSPNSION",1008,504,801.36,856.8,856.8,856.8,846.71999999999991,816.48,806.40000000000009,801.36,806.40000000000009]
[5602903,"INTERFERON ALFA-2B,RECOMB. VIAL : 100000","CDM Code","IP/OP",636,"Drug/Detail Code","J9214","INTERFERON ALFA-2B INJ",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5602902,"IRINOTECAN HCL VIAL : 20 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9206","IRINOTECAN INJECTION",402,201,319.59000000000003,341.7,341.7,341.7,337.68,325.62,321.60000000000002,319.59000000000003,321.60000000000002]
[5602899,"GEMCITABINE HCL VIAL : 200 MG(CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9201","IN GEMCITABINE HCL NOS 200MG",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[5602897,"FLUOROURACIL VIAL 1000MG 20ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9190","FLUOROURACIL INJECTION",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602896,"FLUDARABINE VIAL : 50 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9185","FLUDARABINE PHOSPHATE INJ",573,286.5,455.53500000000003,487.05,487.05,487.05,481.32,464.13000000000005,458.40000000000003,455.53500000000003,458.40000000000003]
[5602893,"CYTARABINE VIAL : 100 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9100","CYTARABINE HCL 100 MG INJ",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5602882,"CARMUSTINE VIAL (CHEMO): 100 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9050","CARMUSTINE INJECTION",379,189.5,301.30500000000001,322.14999999999998,322.14999999999998,322.14999999999998,318.36,306.99,303.2,301.30500000000001,303.2]
[5602880,"CARBOPLATIN VIAL (CHEMO): 50 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9045","CARBOPLATIN INJECTION",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602877,"BLEOMYCIN SULFATE (CHEMO)VIAL : 15 U","CDM Code","IP/OP",636,"Drug/Detail Code","J9040","BLEOMYCIN SULFATE INJECTION",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[5602873,"DOXORUBICIN VIAL : 50MG/25ML (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J9000","DOXORUBICIN HCL INJECTION",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[5602870,"METHOTREXATE TAB : 2.5 MG (CHEMO) (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J8610","METHOTREXATE ORAL 2.5 MG",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602869,"MELPHALAN TAB : 2 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J8600","MELPHALAN ORAL 2 MG",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602867,"PAMIDRONATE VIAL : 30 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2430","PAMIDRONATE DISODIUM /30 MG",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5602866,"ONDANSETRON(ZOFRAN)VIAL 4MG/2ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2405","ONDANSETRON HCL INJECTION",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602865,"LEUPROLIDE (LUPRON) 3.75 MG INJ (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J1950","LEUPROLIDE ACETATE /3.75 MG",2231,1115.5,1773.645,1896.35,1896.35,1896.35,1874.04,1807.1100000000001,1784.8000000000002,1773.645,1784.8000000000002]
[5602864,"INFLIXIMAB (REMICADE) 100 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1745","INFLIXIMAB NOT BIOSIMIL 10MG",2260,1130,1796.7,1921,1921,1921,1898.3999999999999,1830.6000000000001,1808,1796.7,1808]
[5602862,"EPTIFIBATIDE BOLUS 20MG/10ML - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J1327","EPTIFIBATIDE INJECTION",401,200.5,318.79500000000002,340.84999999999997,340.84999999999997,340.84999999999997,336.84,324.81,320.8,318.79500000000002,320.8]
[5602861,"EPTIFIBATIDE INFUSION 75MG/100ML - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J1327","EPTIFIBATIDE INJECTION",466,233,370.47,396.09999999999997,396.09999999999997,396.09999999999997,391.44,377.46000000000004,372.8,370.47,372.8]
[5602857,"OCTREOTIDE ACETATE DEPOT KIT 1 MG (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J2353","OCTREOTIDE INJECTION, DEPOT",262,131,208.29000000000002,222.7,222.7,222.7,220.07999999999998,212.22000000000003,209.60000000000002,208.29000000000002,209.60000000000002]
[5602856,"TPN USING AMINO ACID 15% 2000ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",156,78,124.02000000000001,132.6,132.6,132.6,131.04,126.36000000000001,124.80000000000001,124.02000000000001,124.80000000000001]
[5602855,"WATER FOR INJECTION,STERILE 1000 ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602854,"FAT EMULSIONS 10% IVSL : 500ML - NF","CDM Code","IP/OP",250,"Pharmacy","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5602853,"DEXTROSE 70% : 500ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5602852,"DEXTROSE 50% 500 ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5602851,"D5-NS 1000 ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602850,"D5 ADD-VANTAGE IVSL : 100ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602849,"D5 ADD-VANTAGE IVSL : 50ML","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602848,"D5 BAG 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602847,"D5% BAG : 100ML","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602846,"DEXTROSE 5% 1000ML BAG","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602845,"D5% GLASS 500ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602844,"D5 BAG 500ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602843,"D5% GLASS 250ML","CDM Code","IP/OP",250,"Pharmacy","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602842,"D5 BAG 250ML VISIV BAG","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602841,"DEXTROSE 40% 500ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602840,"DEXTROSE 20% IVSL 500ML","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5602839,"D10% IVSL 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602838,"DEXTROSE 30% IVSL : 500ML","CDM Code","IP/OP",250,"Pharmacy","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5602837,"D10% IVSL : 500ML","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602836,"D5-1/4 NS (0.225%) 1000 ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602835,"D5-1/2 NS (0.45%) 1000 ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602834,"AMINO ACIDS 8.5%-ELECTROL IVSL : 500ML","CDM Code","IP/OP",250,"Pharmacy","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602833,"AMINO ACIDS 8.5% IVSL : 500ML","CDM Code","IP/OP",250,"Pharmacy","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5602832,"NS 100 ML BAG","CDM Code","IP/OP",250,"Pharmacy","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5602831,"NS 50 ML BAG","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602830,"NS 1000 ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602829,"NS 500 ML","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602828,"NS 250 ML","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602827,"SODIUM CHLORIDE(1/2NS) : 1/2NS 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602826,"1/2 NS : 500ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602825,"NS ADD-VANTAGE IVSL : 100ML","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602824,"NS VIAL 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602823,"LR 1000 ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602822,"LR 500 ML","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602821,"RINGERS SOLUTION IVSL : 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602820,"D5-LR BAG 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602819,"D5-LR BAG 500ML-FOR PEDI-RX TO SUPPLY","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602818,"D5%-1/4NS-KCL 20MEQ  : 1000ML","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602817,"D5-1/2NS-20MEQ KCL/1000ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602816,"D5%-1/2NS-KCL 10MEQ :1000ML","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602815,"LIDOCAINE 2GM-D5W IVSL : 500ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602814,"HEPARIN 25,000 UNITS/500ML","CDM Code","IP/OP",250,"Pharmacy","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5602813,"MULTIVITAMINS TAB BOTTLE (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602810,"FIBERCON TAB:625MG BULK (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5602809,"CALCIUM CITRATE-VIT D TAB (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5602808,"CALCIUM WITH VIT D (OSCAL-D)TAB 1 TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602806,"FEEDING PUMP/DAILY CHG","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602805,"PCA PUMP/DAILY CHG","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602804,"IV PUMP/DAILY CHG","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602803,"hydroCORTISONE EYE SYRINGE","CDM Code","IP/OP",250,"Pharmacy","","",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[5602802,"VANCO 0.5MG EYE SYRINGE","CDM Code","IP/OP",250,"Pharmacy","","",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[5602801,"VANCO 1.5MG EYE SYRINGE","CDM Code","IP/OP",250,"Pharmacy","","",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[5602800,"GOSERELIN ACETATE VIAL 3.6 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9202","GOSERELIN ACETATE IMPLANT",1396,698,1109.8200000000002,1186.5999999999999,1186.5999999999999,1186.5999999999999,1172.6399999999999,1130.76,1116.8,1109.8200000000002,1116.8]
[5602799,"BICALTUTAMIDE (CASODEX) (NF) TAB 50 MG","CDM Code","IP/OP",250,"Pharmacy","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5602798,"CALCITONIN-SALMON(MIACALCIN)SPRAY: 2200U","CDM Code","IP/OP",259,"Drugs/Other","","",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[5602796,"LEVOCARNITINE VIAL 500 MG (NF)","CDM Code","IP/OP",250,"Pharmacy","","",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[5602794,"NALTREXONE HCL TAB 50 MG","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602792,"ELECTROLYTES (CERALYTE) PACK 10 GM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602791,"SODIUM PHOSPHATE SOLN 45ML (FLEETS)-NF","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602790,"SODIUM PHOSPHATE SOLN : 90ML","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602788,"GLYCOPYRROLATE VIAL : 0.2 MG/ML 5ML","CDM Code","IP/OP",250,"Pharmacy","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5602787,"NYSTATIN TAB 100,000 UNITS (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602786,"SEVOFLURANE (ANES) (ULTANE) : 20ML","CDM Code","IP/OP",250,"Pharmacy","","",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[5602785,"KETAMINE VIAL 500 MG/10 ML","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5602784,"CYCLOPENTOLATE HCL 1% OPHTH DROP","CDM Code","IP/OP",259,"Drugs/Other","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5602783,"PHENYLEPHRINE-CYCLOPENTOLATE : 5ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5602782,"BETAXOLOL 0.25% OPHTH DROP : 10ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[5602781,"HEPATITIS A (VAQTA) ADULT SYRD : 50 U","CDM Code","IP/OP",250,"Pharmacy","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[5602780,"ALENDRONATE LA (FOSAMAX) TAB 70 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602779,"ALENDRONATE (FOSAMAX) TAB 10 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602777,"ACETYLCHOLINE (MIOCHOL-E) DROP : 2ML","CDM Code","IP/OP",259,"Drugs/Other","","",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[5602776,"HEPATITIS A VIRUS VACCINE SYRD : 720 U","CDM Code","IP/OP",250,"Pharmacy","","",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[5602775,"CODEINE-APAP ELIX UD: 5 ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602774,"LINDANE 1% SHAM : 60ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602773,"METHYLENE BLUE 1% VIAL : 10ML","CDM Code","IP/OP",250,"Pharmacy","","",416,208,330.72,353.59999999999997,353.59999999999997,353.59999999999997,349.44,336.96000000000004,332.8,330.72,332.8]
[5602772,"GUAIFENESIN & CODEINE SYRUP 5 ML UD CUP","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602771,"FENTANYL (DURAGESIC) 75 MCG/HR PATC","CDM Code","IP/OP",259,"Drugs/Other","","",56,28,44.52,47.6,47.6,47.6,47.04,45.36,44.800000000000004,44.52,44.800000000000004]
[5602770,"PHOSPHORUS (PHOSPHA NEUTRAL) TAB 250 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602769,"GUAIFENESIN & CODEINE SYRUP 120ML","CDM Code","IP/OP",259,"Drugs/Other","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602768,"LIDOCAINE 2% JELLY 20ML","CDM Code","IP/OP",250,"Pharmacy","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5602767,"TETANUS IMMUNE GLOBULIN SYRD : 250 U","CDM Code","IP/OP",636,"Drug/Detail Code","J1670","TETANUS IMMUNE GLOBULIN INJ",991,495.5,787.84500000000003,842.35,842.35,842.35,832.43999999999994,802.71,792.80000000000007,787.84500000000003,792.80000000000007]
[5602765,"MULTIVITAMINS TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602764,"PHENYLEPHRINE 0.5% NASAL SPRY :15ML","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602763,"LIDOCAINE HCL 1% VIAL : 30ML","CDM Code","IP/OP",250,"Pharmacy","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5602762,"NEOMYCIN-BACITRA-POLYMYXIN OINT 30GM","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602761,"COD-ZINC OXIDE (DIAPER RASH)OINT : 120GM","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602760,"BECAPLERMIN (NF) GEL : 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",1202,601,955.59,1021.6999999999999,1021.6999999999999,1021.6999999999999,1009.68,973.62000000000012,961.6,955.59,961.6]
[5602757,"BACITRACIN ZINC OINT 120 GRAM TUBE","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602756,"NYSTATIN OINT 30 GM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602755,"ALUMINUM -CALCIUM(DOMEBORO)PACK","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602754,"GLYCOPYRROLATE VIAL : 0.2 MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602753,"WATER FOR INJECTION STERILE VIAL : 10ML","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602752,"PETROLATUM WHITE JEL   390 GM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602751,"PEPPERMINT OIL SPIR : 30ML","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602750,"GLYCERIN LIQUID : 120ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602748,"HEALON GV : 14 MG","CDM Code","IP/OP",250,"Pharmacy","","",394,197,313.23,334.9,334.9,334.9,330.96,319.14000000000004,315.20000000000005,313.23,315.20000000000005]
[5602745,"SODIUM FLUORIDE DROP : 0.5 MG/ML 50ML","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5602744,"OCTREOTIDE 100 MCG/ML 1ML INJECTION","CDM Code","IP/OP",636,"Drug/Detail Code","J2353","OCTREOTIDE INJECTION, DEPOT",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602743,"METHYLENE BLUE 1% VIAL 1 ML-NF","CDM Code","IP/OP",636,"Drug/Detail Code","Q9968","VISUALIZATION ADJUNCT",583,291.5,463.48500000000001,495.55,495.55,495.55,489.71999999999997,472.23,466.40000000000003,463.48500000000001,466.40000000000003]
[5602742,"LEUCOVORIN CALCIUM VIAL : 50 MG (CHEMO)","CDM Code","IP/OP",636,"Drug/Detail Code","J0640","LEUCOVORIN CALCIUM INJECTION",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602741,"DINOPROSTONE SUPP 20 MG (NF)","CDM Code","IP/OP",250,"Pharmacy","","",382,191,303.69,324.7,324.7,324.7,320.88,309.42,305.60000000000002,303.69,305.60000000000002]
[5602740,"DINOPROSTONE SUPP 10 MG","CDM Code","IP/OP",250,"Pharmacy","","",1401,700.5,1113.7950000000001,1190.8499999999999,1190.8499999999999,1190.8499999999999,1176.8399999999999,1134.8100000000002,1120.8,1113.7950000000001,1120.8]
[5602739,"PROBENECID TAB : 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602738,"COLCHICINE (COLCRYS) CAP 0.6 MG","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602735,"BROMOCRIPTINE MESYLATE TAB 2.5 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602734,"NF-ALLOPURINOL TAB 300 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602733,"ALLOPURINOL TAB 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602732,"ALENDRONATE SODIUM (FOSAMAX) TAB : 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602731,"MULTIVITAMINS LIQUID","CDM Code","IP/OP",259,"Drugs/Other","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602728,"MULTIVITAMINS INFUSION VIAL : 10ML","CDM Code","IP/OP",250,"Pharmacy","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5602727,"PHYTONADIONE (ADULT) 10 MG/ML PO/IM/SC","CDM Code","IP/OP",636,"Drug/Detail Code","J3430","VITAMIN K PHYTONADIONE INJ",95,47.5,75.525000000000006,80.75,80.75,80.75,79.8,76.95,76,75.525000000000006,76]
[5602726,"PHYTONADIONE (NEWBORN) 1 MG/0.5 ML","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5602724,"VITAMIN D 50,000 IU - FOR WEEKLY USE","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602723,"CALCITRIOL CAP 0.25 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602721,"ASCORBIC ACID TAB (VITAMIN C) 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602720,"THIAMINE HCL VIAL 100 MG/ML 2ML","CDM Code","IP/OP",636,"Drug/Detail Code","J3411","THIAMINE HCL 100 MG",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602718,"PYRIDOXINE VIAL 100 MG/ML 1ML - NF","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5602717,"FOLIC ACID-VITAMIN B COMP W-C CAP : 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602716,"FOLIC ACID VIAL : 5 MG","CDM Code","IP/OP",250,"Pharmacy","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602714,"FOLIC ACID TAB 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602713,"CYANOCOBALAMIN (VIT B12) VIAL1000 MCG/ML","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602712,"CYANOCOBALAMIN (VIT B12)TAB 500 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602709,"NF-THEOPHYLLINE TAB : 200 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602708,"THEOPHYLLINE ANHYDROUS SOLN : 80 MG/15ML","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602707,"AMINOPHYLLINE VIAL 500 MG/20 ML","CDM Code","IP/OP",250,"Pharmacy","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5602706,"oxyBUTYNIN CHLORIDE (DITROPAN)TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602705,"ZINC OXIDE OINT 60GM","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602704,"HEMORRHOIDAL OINT 28 GM","CDM Code","IP/OP",259,"Drugs/Other","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602703,"ISOPROPYL ALCOHOL 70% SOLN : 480ML","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602702,"CAPSAICIN (ZOSTRIX)CREAM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5602701,"ZINC OXIDE PAST : 30GM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602700,"EUCERIN (GENERIC) CREAM 4 OZ","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602699,"METHYL SALIC-MENT OINT (BEN-GAY): 57GM","CDM Code","IP/OP",259,"Drugs/Other","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602698,"CALAMINE LOTION: 120ML","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602696,"PHENAZOPYRIDINE (PYRIDIUM) TAB 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602695,"LIDOCAINE-PRILOCAINE 2.5%/2.5% 5 gram","CDM Code","IP/OP",259,"Drugs/Other","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5602694,"TRIAMCINOLONE 0.1% CREM: 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5602693,"TRIAMCINOLONE ACETONIDE 0.1% CREM : 80GM","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602692,"hydroCORTISONE 1% CREM : 30GM","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602691,"HYDROCORTISONE VALERATE 0.2% CREM : 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5602690,"hydroCORTISONE SUPP 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602689,"FLUOCINONIDE 0.05% CREM : 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602688,"BETAMETHASONE VALERATE 0.1% CREM : 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5602687,"SILVER SULFADIAZINE 1% CREME : 400GM","CDM Code","IP/OP",259,"Drugs/Other","","",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[5602686,"SILVER SULFADIAZINE 1% CREME 25GM","CDM Code","IP/OP",259,"Drugs/Other","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602685,"POVIDONE-IODINE 7.5% SCRUB : 4 OZ","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602684,"POVIDONE-IODINE 10% SOLN : 4 OZ","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602683,"BAG BALM OINT (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5602682,"LINDANE 1% SHAM : 480ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602681,"NYSTATIN CREAM 15 GM","CDM Code","IP/OP",259,"Drugs/Other","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5602680,"MICONAZOLE NITRATE 2% CREAM : 45GM","CDM Code","IP/OP",259,"Drugs/Other","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5602679,"KETOCONAZOLE 2% SHAM : 120ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",83,41.5,65.984999999999999,70.55,70.55,70.55,69.72,67.23,66.400000000000006,65.984999999999999,66.400000000000006]
[5602678,"KETOCONAZOLE 2% CREAM 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5602677,"CLOTRIMAZOLE-BETAMETHASONE CREM : 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5602676,"CLOTRIMAZOLE 1% (LOTRIMIN)CREM : 15GM","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602674,"MUPIROCIN (BACTROBAN) 2% OINT : 22GM","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5602673,"BACITRACIN ZINC OINT 15 GRAM TUBE","CDM Code","IP/OP",259,"Drugs/Other","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602672,"BACITRACIN TOPICAL UD PACK","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602671,"TYPHOID VI VACCINE 25 MCG/0.5ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",300,150,238.5,255,255,255,252,243.00000000000003,240,238.5,240]
[5602670,"RUBELLA VACCINE VIAL :","CDM Code","IP/OP",250,"Pharmacy","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5602669,"RABIES VACCINE 2.5 UNITS","CDM Code","IP/OP",250,"Pharmacy",90675,"RABIES VACCINE IM",841,420.5,668.59500000000003,714.85,714.85,714.85,706.43999999999994,681.21,672.80000000000007,668.59500000000003,672.80000000000007]
[5602668,"RABIES VACCINE,HUMAN DIPLOID SYRD : 0.25","CDM Code","IP/OP",250,"Pharmacy","","",332,166,263.94,282.2,282.2,282.2,278.88,268.92,265.60000000000002,263.94,265.60000000000002]
[5602667,"INFLUENZA VACCINE FOR 64 YO AND YOUNGER","CDM Code","IP/OP",636,"Drug/Detail Code",90658,"IIV3 VACCINE SPLT 0.5 ML IM",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[5602666,"PNEUMOCOCCAL VACC 23-VALENT VIAL :0.5ML","CDM Code","IP/OP",636,"Drug/Detail Code",90732,"PPSV23 VACC 2 YRS+ SUBQ/IM",309,154.5,245.655,262.64999999999998,262.64999999999998,262.64999999999998,259.56,250.29000000000002,247.20000000000002,245.655,247.20000000000002]
[5602665,"MEASLES,MUMPS&RUBELLA VACCINE VIAL","CDM Code","IP/OP",636,"Drug/Detail Code",90707,"MMR VACCINE SC",286,143,227.37,243.1,243.1,243.1,240.23999999999998,231.66000000000003,228.8,227.37,228.8]
[5602664,"HEPATITIS B (ENGERIX-B) 10MCG/0.5ML-PEDI","CDM Code","IP/OP",636,"Drug/Detail Code",90744,"HEPB VACC 3 DOSE PED/ADOL IM",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[5602663,"HEPATITIS A VIRUS VACCINE SYR 1440 U","CDM Code","IP/OP",250,"Pharmacy","","",267,133.5,212.26500000000001,226.95,226.95,226.95,224.28,216.27,213.60000000000002,212.26500000000001,213.60000000000002]
[5602662,"TETANUS DIPH TOXOID ADULT SYRD : 0.5ML","CDM Code","IP/OP",636,"Drug/Detail Code",90714,"TD VACC NO PRESV 7 YRS+ IM",106,53,84.27000000000001,90.1,90.1,90.1,89.039999999999992,85.86,84.800000000000011,84.27000000000001,84.800000000000011]
[5602660,"oxyTOCIN VIAL 10 U","CDM Code","IP/OP",636,"Drug/Detail Code","J2590","OXYTOCIN INJECTION",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602659,"METHYLERGONOVINE MALEATE TAB 0.2 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",234,117,186.03,198.9,198.9,198.9,196.56,189.54000000000002,187.20000000000002,186.03,187.20000000000002]
[5602658,"METHYLERGONOVINE MALEATE AMP : 0.2 MG/ML","CDM Code","IP/OP",250,"Pharmacy","","",61,30.5,48.495000000000005,51.85,51.85,51.85,51.239999999999995,49.410000000000004,48.800000000000004,48.495000000000005,48.800000000000004]
[5602657,"CARBOPROST (HEMABATE) AMP:250MCG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",766,383,608.97,651.1,651.1,651.1,643.43999999999994,620.46,612.80000000000007,608.97,612.80000000000007]
[5602656,"PROCAINE HCL 10% AMP : 2ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5602655,"MEPIVACAINE HCL 1.5% VIAL 30ML","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5602654,"LIDOCAINE 1%-EPI 1:100000 VIAL 20ML","CDM Code","IP/OP",250,"Pharmacy","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602653,"LIDOCAINE 1%-EPI 1:100000 VIAL 10ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602652,"LIDOCAINE 1.5%-EPI 1:200000 VIAL 30ML-NF","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5602651,"LIDOCAINE 4% AMP 5ML - NF","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602650,"LIDOCAINE 2% VIAL 5ML - NF","CDM Code","IP/OP",250,"Pharmacy","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602649,"ETHYL ANESTHESIA TOP SPRAY (NF)","CDM Code","IP/OP",250,"Pharmacy","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5602648,"LIDOCAINE 2% 20 ML MDV","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5602647,"LIDOCAINE MPF 1% STERILE-PAK:10ML","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5602646,"LIDOCAINE MPF 1% VIAL 30ML - DO NOT USE","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602645,"LIDOCAINE 1% VIAL : 2ML","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602644,"LIDOCAINE MPF 0.5% VIAL 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602643,"LIDOCAINE 1% 10 ML MDV","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602642,"BUPIVacaine MPF 0.5% VIAL : 30ML","CDM Code","IP/OP",250,"Pharmacy","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5602641,"BUPIVacaine plain 0.5% VIAL : 10ML","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602640,"BUPIVACAINE 0.25%-EPI 1:200000 VIAL 30ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602639,"BUPIVacaine MPF 0.25% VIAL : 30ML","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602638,"BUPIVacaine MPF 0.25% VIAL : 10ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602636,"METHIMAZOLE (TAPAZOLE) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602634,"levoTHYROXINE (SYNTHROID) VIAL 100 MCG","CDM Code","IP/OP",250,"Pharmacy","","",316,158,251.22,268.59999999999997,268.59999999999997,268.59999999999997,265.44,255.96,252.8,251.22,252.8]
[5602630,"levoTHYROXINE (SYNTHROID) TAB 25 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602626,"levoTHYROXINE (SYNTHROID) TAB 100 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602625,"MEDROXYPROG (DEPO-PROVERA) 150MG/ML","CDM Code","IP/OP",250,"Pharmacy","","",172,86,136.74,146.19999999999999,146.19999999999999,146.19999999999999,144.47999999999999,139.32000000000002,137.6,136.74,137.6]
[5602624,"MEDROXYPROGESTERONE TAB 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602622,"VASOPRESSIN VIAL 20 UNITS","CDM Code","IP/OP",250,"Pharmacy","","",548,274,435.66,465.8,465.8,465.8,460.32,443.88000000000005,438.40000000000003,435.66,438.40000000000003]
[5602621,"DESMOPRESSIN (DDAVP) 4 MCG/ML 10 ML (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J2597","INJ DESMOPRESSIN ACETATE",1332,666,1058.94,1132.2,1132.2,1132.2,1118.8799999999999,1078.92,1065.6000000000001,1058.94,1065.6000000000001]
[5602620,"DESMOPRESSIN NASAL SPRAY 0.1MG/ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",195,97.5,155.02500000000001,165.75,165.75,165.75,163.79999999999998,157.95000000000002,156,155.02500000000001,156]
[5602619,"CALCITONIN-SALMON VIAL 200U/ML 2ML (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J0630","CALCITONIN SALMON INJECTION",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5602618,"METFORMIN (GLUCOPHAGE) TAB 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602617,"GLUCAGON VIAL : 1 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1610","GLUCAGON HYDROCHLORIDE/1 MG",476,238,378.42,404.59999999999997,404.59999999999997,404.59999999999997,399.84,385.56,380.8,378.42,380.8]
[5602614,"ROSIGLITAZONE MALEATE TAB : 4 MG","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602613,"GLIMEPIRIDE (AMARYL) TAB : 4 MG","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602612,"GLYBURIDE (MICRONASE) TAB : 5 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602611,"GLYBURIDE (MICRONASE) TAB : 2.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602609,"GLIPIZIDE (GLUCOTROL) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602608,"INSULIN (LENTE) : 100 U/ML","CDM Code","IP/OP",259,"Drugs/Other","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5602607,"INSULIN REG HUMAN VIAL : 100U/ML","CDM Code","IP/OP",259,"Drugs/Other","","",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[5602606,"INSULIN LANTUS VIAL : 100U/ML","CDM Code","IP/OP",259,"Drugs/Other","","",219,109.5,174.10500000000002,186.15,186.15,186.15,183.95999999999998,177.39000000000001,175.20000000000002,174.10500000000002,175.20000000000002]
[5602605,"INSULIN NPH VIAL : 100U/ML","CDM Code","IP/OP",259,"Drugs/Other","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5602603,"INSULIN (ULTRALENTE): 100U/ML","CDM Code","IP/OP",259,"Drugs/Other","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5602602,"INSULIN NPH 70/30 VIAL : 100U/ML","CDM Code","IP/OP",259,"Drugs/Other","","",185,92.5,147.07500000000002,157.25,157.25,157.25,155.4,149.85000000000002,148,147.07500000000002,148]
[5602601,"ESTROGENS,CONJ (PREMARIN) VIAL 25 MG(NF)","CDM Code","IP/OP",250,"Pharmacy","","",666,333,529.47,566.1,566.1,566.1,559.43999999999994,539.46,532.80000000000007,529.47,532.80000000000007]
[5602600,"ESTROGENS,CONJ (PREMARIN) 0.3 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602598,"ESTROGENS,CONJ (PREMARIN) 0.625MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602597,"ESTROGENS,CONJUG (PREMARIN) TAB : 0.9 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602596,"ESTRADIOL (DEPO) VIAL 5MG/ML 5ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5602594,"ESTRADIOL (ESTRACE) TAB 1 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602592,"TRIAMCINOLONE DIAC 25MG/ML 25ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[5602591,"TRIAMCINOLONE ACET VIAL  40 MG/ML 1 ML","CDM Code","IP/OP",250,"Pharmacy","J3301","TRIAMCINOLONE ACET INJ NOS",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602590,"TRIAMCINOLONE ACETONIDE ARED (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",267,133.5,212.26500000000001,226.95,226.95,226.95,224.28,216.27,213.60000000000002,212.26500000000001,213.60000000000002]
[5602589,"PREDNISONE TAB 10 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602588,"PREDNISONE TAB 20 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602586,"PREDNISOLONE SOLN:5MG/5ML 120ML","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602585,"METHYLPRED (SOLU-MEDROL) 125 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2930","METHYLPREDNISOLONE INJECTION",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5602584,"METHYLPRED (SOLU-MEDROL) 40MG","CDM Code","IP/OP",250,"Pharmacy","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5602583,"METHYLPREDNI SOD SUC(SOLU-MEDROL) 1000MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2930","METHYLPREDNISOLONE INJECTION",163,81.5,129.58500000000001,138.54999999999998,138.54999999999998,138.54999999999998,136.91999999999999,132.03,130.4,129.58500000000001,130.4]
[5602582,"METHYLPREDNI SOD SUCC(SOLU-MEDROL) 500MG","CDM Code","IP/OP",250,"Pharmacy","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5602581,"METHYLPREDNISOLONE (DEPO) VIAL 40 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2920","METHYLPREDNISOLONE INJECTION",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5602580,"hydroCORTISONE SOD SUCCI VIAL 250MG-NF","CDM Code","IP/OP",636,"Drug/Detail Code","J1720","HYDROCORTISONE SODIUM SUCC I",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602579,"HYDROCORTISONE SOD SUCCI VIAL 100MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1720","HYDROCORTISONE SODIUM SUCC I",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5602578,"HYDROCORTISONE TAB 10 MG","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602577,"FLUTICASONE (FLOVENT) INH 110MCG-NF","CDM Code","IP/OP",259,"Drugs/Other","","",546,273,434.07000000000005,464.09999999999997,464.09999999999997,464.09999999999997,458.64,442.26000000000005,436.8,434.07000000000005,436.8]
[5602576,"FLUTICASONE (FLOVENT) ARED : 44 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",188,94,149.46,159.79999999999998,159.79999999999998,159.79999999999998,157.91999999999999,152.28,150.4,149.46,150.4]
[5602575,"MIDODRINE TAB 2.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602574,"FLUDROCORTISONE TAB 0.1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602573,"DEXAMETHASONE SOD PHOS VIAL 4MG/ML 5ML","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602572,"DEXAMETHASONE SOD PHOS VIAL 4MG/ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1100","DEXAMETHASONE SODIUM PHOS",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602571,"DEXAMETHASONE TAB 4 MG","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602569,"BETAMETH PHOS-BETAMETH VIAL: 6MG/ML 5ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0702","BETAMETHASONE ACET&SOD PHOSP",145,72.5,115.27500000000001,123.25,123.25,123.25,121.8,117.45,116,115.27500000000001,116]
[5602568,"BECLOMETHASONE DIPROPIONATE ARED: 16.8GM","CDM Code","IP/OP",259,"Drugs/Other","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[5602567,"SUCRALFATE TAB : 1 GM","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602566,"SUCRALFATE TAB : 1 GM","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602565,"SUCRALFATE SUSP:1GM/10ML 480ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",137,68.5,108.91500000000001,116.45,116.45,116.45,115.08,110.97000000000001,109.60000000000001,108.91500000000001,109.60000000000001]
[5602564,"LANSOPRAZOLE (PREVACID) CPDR : 30 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602563,"LANSOPRAZOLE (PREVACID)CPDR : 15 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602562,"OMEPRAZOLE CAP 20 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602560,"MISOPROSTOL (CYTOTEC) TAB 100 MCG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602559,"METOCLOPRAMIDE (REGLAN) VIAL 10MG/2ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2765","METOCLOPRAMIDE HCL INJECTION",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602558,"METOCLOPRAMIDE (REGLAN) TAB 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602557,"MESALAMINE (ASACOL) TAB 400 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602556,"FAMOTIDINE (PEPCID) VIAL 10 MG/ML 2ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602555,"TRIMETHOBENZAMIDE HCL SUPP : 200 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602554,"PROCHLORPERAZINE (COMPAZINE) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602553,"PROCHLORPERAZINE (COMPAZINE) PR 25 MG-NF","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5602552,"PROCHLORPERAZINE SUPP  5 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602551,"PROCHLORPERAZINE VIAL 10 MG/2 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0780","PROCHLORPERAZINE INJECTION",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5602549,"MECLIZINE HCL TAB 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602547,"IPECAC SYRP : 30ML","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602546,"SORBITOL SOLUTION 70% SOLN : 480ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602545,"SENNA TAB 8.6 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602544,"PSYLLIUM-SODIUM BICARBONATE PACK : 1PACK","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602543,"MINERAL OIL OIL : 30ML","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602542,"MINERAL OIL 480ML","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602541,"MINERAL OIL (TOPICAL, STERILE) 25 ML","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602540,"MAGNESIUM HYDR/ALUM SUSP : 80 MEQ/30ML","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602539,"MAGNESIUM CITRATE SOLN 300ML","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602538,"MAGNESIUM CHLORIDE TBSA : 64 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602537,"GLYCERIN ADULT SUPPOSITORY","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602536,"ELECTROLYTE SOLN (GOLYTELY) : 4 LITER","CDM Code","IP/OP",259,"Drugs/Other","","",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[5602535,"DONEPEZIL (ARICEPT) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602534,"DOCUSATE (COLACE) 10MG/1ML 480ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602533,"DOCUSATE SODIUM (COLACE) 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602531,"CASTOR OIL - NF","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602529,"BISACODYL (DULCOLAX) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602528,"BISACODYL (DULCOLAX) SUPP 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602527,"SIMETHICONE CHEW TAB 80 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602526,"SIMETHICONE DROP 40 MG/0.6ML 30ML","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602525,"LOPERAMIDE LIQUID 1 MG/5ML 120ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602524,"LOPERAMIDE (IMODIUM) CAPSULE 2 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602523,"DIPHENOXYLATE-ATROP (LOMOTIL) TAB : (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602522,"BISMUTH SUBSALICYL SUSP : 262MG/15ML","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602521,"MAGNESIUM OXIDE (MAG-OX) TAB 400 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602520,"MILK OF MAGNESIUM:80MEQ/30ML","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602519,"MAG HYDROX-AL HYDROX-SIMETH SUSP : 360ML","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602518,"CALCIUM CARBONATE (TUMS) TABC 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602517,"ACTIVATED CHARCOAL W/ SORBITAL 120ML","CDM Code","IP/OP",259,"Drugs/Other","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5602516,"TRIETHANOLAMINE POLY OLEATE DROP : 6ML","CDM Code","IP/OP",259,"Drugs/Other","","",72,36,57.24,61.199999999999996,61.199999999999996,61.199999999999996,60.48,58.320000000000007,57.6,57.24,57.6]
[5602515,"TIMOLOL MALEATE 0.5% OPTH SOL","CDM Code","IP/OP",259,"Drugs/Other","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602514,"EYE WASH OPTH SOLUTION: 118ML","CDM Code","IP/OP",259,"Drugs/Other","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5602513,"BSS OPTHALMIC SOLN : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602512,"SODIUM CHLORIDE SPRY : 45ML","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602511,"BSS OPTHALMIC SOLN: 500ML","CDM Code","IP/OP",259,"Drugs/Other","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5602510,"SOD-POT-CAL-MAG,EYE STREAM SOL : 30ML","CDM Code","IP/OP",259,"Drugs/Other","","",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[5602509,"POLYVINYL ALCOHOL 1.4% OPHTH DROP : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602508,"EYE LUBRICANT (OPTH OINT) 3.5 GM","CDM Code","IP/OP",259,"Drugs/Other","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5602507,"LANOL-MINERA-PETRO OINT OPT(1GM TUBE) NF","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602506,"FLURBIPROFEN 0.03% OPHTH DROP : 2.5ML","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602505,"CARBAMIDE PEROXIDE 6.5% OTIC DROP : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5602504,"BRIMONIDINE 0.2% DROP : 15ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",852,426,677.34,724.19999999999993,724.19999999999993,724.19999999999993,715.68,690.12,681.6,677.34,681.6]
[5602503,"PHENYLEPHRINE 2.5% OPHTH DROP","CDM Code","IP/OP",259,"Drugs/Other","","",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[5602502,"PHENYLEPHRINE 2.5% OPTH - DON'T USE!","CDM Code","IP/OP",259,"Drugs/Other","","",358,179,284.61,304.3,304.3,304.3,300.71999999999997,289.98,286.40000000000003,284.61,286.40000000000003]
[5602501,"HYDROGEN PEROXIDE 3% SOLN : 480ML","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602500,"TROPICAMIDE 1% OPHTH DROP","CDM Code","IP/OP",259,"Drugs/Other","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5602499,"PHENYLEPHRINE-CYCLOPENTOLATE  : 2ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5602498,"PILOCARPINE HCL 2% DROP : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602497,"CARBACHOL 3% OPHTH DROP(ISOPTO) : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[5602496,"CARBACHOL OPHTH (MIOSTAT)0.01% 1.5ML-NF","CDM Code","IP/OP",259,"Drugs/Other","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5602495,"TETRACAINE HCL 0.5% OPHTH DROP - NF","CDM Code","IP/OP",259,"Drugs/Other","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5602494,"LIDOCAINE TOPICAL 4% SOLN 50 ML","CDM Code","IP/OP",259,"Drugs/Other","","",127,63.5,100.965,107.95,107.95,107.95,106.67999999999999,102.87,101.60000000000001,100.965,101.60000000000001]
[5602493,"LIDOCAINE VISCOUS 2% SOLN : 100ML","CDM Code","IP/OP",259,"Drugs/Other","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5602492,"COCAINE HCL 4% SOLN : 4ML","CDM Code","IP/OP",250,"Pharmacy","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5602491,"CETYLPYRIDINIUM (CEPACOL) LOZG : 2 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602490,"BENZOCAINE 20% SPRY BOT : 60ML","CDM Code","IP/OP",259,"Drugs/Other","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5602489,"ANTIPYRINE-BENZOCAINE OTIC DROP : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",56,28,44.52,47.6,47.6,47.6,47.04,45.36,44.800000000000004,44.52,44.800000000000004]
[5602488,"SOFT LENS ENZYMATIC CLEANSER EACH :","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602487,"SOFT LENS ADJUNCTIVE SOLUTIONS : 360ML","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602486,"ACETAZOLAMIDE (DIAMOX) VIAL 500 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1120","ACETAZOLAMID SODIUM INJECTIO",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[5602485,"ACETAZOLAMIDE (DIAMOX) TAB : 250 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602484,"PREDNISOLONE ACETATE 1% OPTH DROP","CDM Code","IP/OP",259,"Drugs/Other","","",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[5602483,"FLUTICASONE (FLONASE) NASAL SPRAY : 16GM","CDM Code","IP/OP",259,"Drugs/Other","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5602482,"FLUOROMETHOLONE DROP : 5ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602481,"BECLOMETHAS(BECONASE) 0.042% SPRA : 25GM","CDM Code","IP/OP",259,"Drugs/Other","","",136,68,108.12,115.6,115.6,115.6,114.24,110.16000000000001,108.80000000000001,108.12,108.80000000000001]
[5602480,"CIPROFLOXACIN 0.3% OPTH DROP:5ML","CDM Code","IP/OP",259,"Drugs/Other","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5602479,"CARBAMIDE PEROXIDE 10% SOLN : 15ML","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602478,"SULFACETAMIDE 10% OPHT OINT 3.5 GM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602477,"SULFACETAMIDE SODIUM 10% DROP 5 ML","CDM Code","IP/OP",259,"Drugs/Other","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[5602476,"TOBRAMYCIN-DEXAMET 0.3%-0.1% DROP","CDM Code","IP/OP",259,"Drugs/Other","","",292,146,232.14000000000001,248.2,248.2,248.2,245.28,236.52,233.60000000000002,232.14000000000001,233.60000000000002]
[5602475,"TOBRAMYCIN 0.3% OPTH OINT 3.5 GM (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[5602474,"TOBRAMYCIN SULFATE DROP : 5ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602473,"NEOMY-POLY-HC(CORTISPORIN)OTIC 10ML","CDM Code","IP/OP",259,"Drugs/Other","","",212,106,168.54000000000002,180.2,180.2,180.2,178.07999999999998,171.72,169.60000000000002,168.54000000000002,169.60000000000002]
[5602472,"GENTAMICIN SULFATE OPH OINT 3.5GM -NF","CDM Code","IP/OP",259,"Drugs/Other","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5602471,"GENTAMICIN OPTH DROP (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602470,"ERYTHROMYCIN OPHTH OINT 1 GM","CDM Code","IP/OP",259,"Drugs/Other","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5602469,"ERYTHROMYCIN OPHTH OINT 3.5GM","CDM Code","IP/OP",259,"Drugs/Other","","",56,28,44.52,47.6,47.6,47.6,47.04,45.36,44.800000000000004,44.52,44.800000000000004]
[5602468,"BACITRACIN OPHTHALMIC OINTMENT","CDM Code","IP/OP",259,"Drugs/Other","","",207,103.5,164.565,175.95,175.95,175.95,173.88,167.67000000000002,165.60000000000002,164.565,165.60000000000002]
[5602467,"acetylCYSTEINE INHALA(MUCOMYST) 20% - NF","CDM Code","IP/OP",250,"Pharmacy","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5602466,"GUAIFENESIN PLAIN SYRP : 100MG/5ML 120ML","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602465,"GUAIFENESIN PLAIN 200 MG/10 ML UD CUP","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602464,"GUAIFENESIN & DEXTROMETHORPHAN 120ML","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602462,"BENZONATATE (TESSALON) CAP 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602461,"HYALURONIDASE VIAL : 150 U","CDM Code","IP/OP",250,"Pharmacy","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5602460,"NS IRRIGATION BOTTLE 1.5 L","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5602459,"DEXTRAN 70-DEXTROSE 10%-WATER SOLI :","CDM Code","IP/OP",250,"Pharmacy","","",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[5602458,"SPIRONOLACTONE TAB 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602456,"TRIAMTERENE-HCTZ 37.5MG-25MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602455,"METOLAZONE (ZAROXOYLN) TAB 2.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602454,"MANNITOL 25% VIAL : 12.5 GM","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602452,"HYDROCHLOROTHIAZIDE (HCTZ) TAB 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602451,"FUROSEMIDE FOR IVP DOSES 41-80 MG","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602450,"FUROSEMIDE FOR IVP DOSES 21-40 MG","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602449,"FUROSEMIDE FOR IVP DOSES 1-20 MG","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602448,"FUROSEMIDE (LASIX) TAB 40 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602447,"FUROSEMIDE (LASIX) TAB 20 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602445,"FUROSEMIDE(LASIX)SOLN (NF):10 MG/ML 60ML","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602444,"ETHACRYNIC ACID TAB : 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602443,"ETHACRYNATE SODIUM VIAL : 50 MG (NF)","CDM Code","IP/OP",250,"Pharmacy","","",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[5602442,"CHLORTHALIDONE TAB 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602441,"CHLOROTHIAZIDE (DIURIL)(NF) VIAL :500 MG","CDM Code","IP/OP",250,"Pharmacy","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5602440,"BUMETANIDE 1 MG/4 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602439,"BUMETANIDE (BUMEX) TAB : 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602437,"LACTOSE-FREE FOOD-FIBER LIQU :","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602435,"LACTOSE-FREE FOOD LIQU :","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602434,"LACTOSE-FREE FOOD LIQU :","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602431,"GLUCOSE POLYMERS PWD :","CDM Code","IP/OP",259,"Drugs/Other","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602430,"D50% ABBOJECT : 50ML","CDM Code","IP/OP",250,"Pharmacy","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[5602429,"DEXTROSE 25% (INFANT) 10ML","CDM Code","IP/OP",250,"Pharmacy","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5602428,"SODIUM POLYSTY SULFONATE SUSP :15GM/60ML","CDM Code","IP/OP",259,"Drugs/Other","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5602425,"TRASTUZUMAB VIAL 440MG (CHEMO) - NF","CDM Code","IP/OP",636,"Drug/Detail Code","J9355","INJ TRASTUZUMAB EXCL BIOSIMI",8978,4489,7137.51,7631.3,7631.3,7631.3,7541.5199999999995,7272.18,7182.4000000000005,7137.51,7182.4000000000005]
[5602424,"CHROMIUM VIAL : 4 MCG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602423,"ZINC SULFATE VIAL : 1 MG/ML 10ML","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602422,"SELENIUM VIAL : 40 MCG/ML 10ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602421,"TRACE METALS VIAL","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602420,"NS VIAL 10ML","CDM Code","IP/OP",250,"Pharmacy","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602419,"SODIUM CHLOR VIAL (23.4%) 4 MEQ/ML 30ML","CDM Code","IP/OP",250,"Pharmacy","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602417,"POTASSIUM PHOSPHATE VIAL 3MMOL/ML 15ML","CDM Code","IP/OP",250,"Pharmacy","","",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[5602416,"POTASSIUM CHL 10% ELIX 20MEQ/15ML","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602415,"POTASSIUM CHL VIAL 40MEQ/20ML(NO IVPUSH)","CDM Code","IP/OP",250,"Pharmacy","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5602414,"POTASSIUM CHL (K-DUR) TAB 20 MEQ","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602413,"POTASSIUM CHLORIDE (K-DUR) TB : 10 MEQ","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602411,"HETASTARCH-NA CHLOR 0.9% PBAG :","CDM Code","IP/OP",250,"Pharmacy","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[5602410,"ELECTROLYTE SOLN (PEDIALYTE) 1 LITER","CDM Code","IP/OP",259,"Drugs/Other","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5602409,"CALCIUM GLUC 1GM/10ML VIAL FOR IVP","CDM Code","IP/OP",250,"Pharmacy","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5602408,"CALCIUM CHLORIDE 10% SYR : 1GM/10ML","CDM Code","IP/OP",250,"Pharmacy","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5602406,"CALCIUM ACETATE (PHOSLO) TAB 667 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602405,"LACTULOSE SYRP UD 20 GM/30ML","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602404,"LACTULOSE SYRUP 10GM/15ML 480ML","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5602403,"SODIUM CITRATE-CITRIC ACID SOLN :30ML","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602402,"SODIUM BICARBONATE 8.4% SYRINGE 50ML","CDM Code","IP/OP",250,"Pharmacy","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5602401,"SODIUM BICARBONATE 4% VIAL : 2.4 MEQ/5ML","CDM Code","IP/OP",250,"Pharmacy","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5602400,"SODIUM BICARBONATE 4.2% INFANT SYR: 10ML","CDM Code","IP/OP",250,"Pharmacy","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5602399,"TUBERCULIN PURIF PROT DERIV  VIAL : 5 U","CDM Code","IP/OP",250,"Pharmacy","","",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[5602398,"EDROPHONIUM CHLORIDE AMP : 10 MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5602397,"INDIGO CARMINE SOD 0.8% AMP : 5ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5602395,"FLUORESCEIN STRIP (FLUOR-I-STRIP)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602394,"CHLORHEXIDINE (PERIDEX) 480ML - NF","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602393,"SUMATRIPTAN (IMITREX) VIAL 6MG","CDM Code","IP/OP",636,"Drug/Detail Code","J3030","SUMATRIPTAN SUCCINATE / 6 MG",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5602392,"FLUMAZENIL VIAL : 0.1MG/ML 10ML","CDM Code","IP/OP",250,"Pharmacy","","",262,131,208.29000000000002,222.7,222.7,222.7,220.07999999999998,212.22000000000003,209.60000000000002,208.29000000000002,209.60000000000002]
[5602391,"FLUMAZENIL VIAL 0.1MG/ML","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602390,"PRAMIPEXOLE TAB 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602389,"CARBI-LEVO (SINEMET) 50-200 ER","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602388,"CARBI-LEVO (SINEMET) 25-250 IR TAB (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602387,"CARBIDOPA-LEVO (SINEMET) 25-100 IR TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602386,"AMANTADINE CAP 100 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602385,"LITHIUM CARBONATE CAP 300 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602384,"hydrOXYZINE HCL(VISTARIL):50MG/1ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5602383,"hydroXYZINE (VISTARIL) HCL TAB 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602382,"DROPERIDOL VIAL 5 MG/2 ML","CDM Code","IP/OP",250,"Pharmacy","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5602380,"BUSPIRONE HCL (BUSPAR) TAB (NF): 15 MG","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602379,"BUSPIRONE (BUSPAR) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602378,"TRIAZOLAM (HALCION) TAB 0.25 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5602376,"TEMAZEPAM CAP 15 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602375,"OXAZEPAM (SERAX) : 15 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602374,"OXAZEPAM (SERAX) : 10 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602373,"MIDAZOLAM 2 MG/2 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2250","INJ MIDAZOLAM HYDROCHLORIDE",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602372,"MIDAZOLAM 5MG/1ML INJ - AMBULANCE USE","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602371,"MIDAZOLAM ORAL SYRUP 5 MG/2.5 ML","CDM Code","IP/OP",250,"Pharmacy","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5602370,"ZOLPIDEM (AMBIEN) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602369,"LORAZEPAM (ATIVAN) TAB 0.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602365,"LORAZEPAM DRIP 1 MG/ML FINAL CONC","CDM Code","IP/OP",250,"Pharmacy","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5602364,"LORAZEPAM (ATIVAN) VIAL 2MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602362,"DIAZEPAM (VALIUM) INJ 5MG/ML 2ML","CDM Code","IP/OP",636,"Drug/Detail Code","J3360","DIAZEPAM INJECTION",88,44,69.960000000000008,74.8,74.8,74.8,73.92,71.28,70.400000000000006,69.960000000000008,70.400000000000006]
[5602361,"DIAZEPAM GEL 5 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",378,189,300.51,321.3,321.3,321.3,317.52,306.18,302.40000000000003,300.51,302.40000000000003]
[5602360,"DIAZEPAM (VALIUM) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602358,"CHLORDIAZEPOXIDE HCL AMP : 100 MG","CDM Code","IP/OP",250,"Pharmacy","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5602357,"ALPRAZOLAM (XANAX) TAB 0.5 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602356,"SCOPOLAMINE PATCH","CDM Code","IP/OP",259,"Drugs/Other","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5602355,"PHENOBARBITAL SODIUM VIAL 65MG/ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2560","PHENOBARBITAL SODIUM INJ",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[5602353,"PHENOBARBITAL ELIX : 20MG/5ML 480ML","CDM Code","IP/OP",259,"Drugs/Other","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5602352,"METHYLPHENIDATE (RITALIN) TAB 20 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602351,"METHYLPHENIDATE (RITALIN) TAB 5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602350,"METHYLPHENIDATE HCL (RITALIN)TAB : 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602349,"AMMONIA INHALATION","CDM Code","IP/OP",259,"Drugs/Other","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602347,"THIORIDAZINE HCL TAB 50 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602346,"RISPERIDONE TAB : 3 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5602345,"RISPERIDONE 1 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602344,"QUETIAPINE 25 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602343,"QUETIAPINE 100 MG TABLET - NF","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5602342,"OLANZAPINE (ZYPREXA) TAB : 2.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602341,"OLANZAPINE 2.5 MG TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602340,"OLANZAPINE (ZYPREXA) TAB : 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5602339,"HALOPERIDOL (HALDOL) VIAL 5MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5602338,"HALOPERIDOL (HALDOL) TAB 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602336,"CHLORPROMAZINE (THORAZINE) 25 MG TAB-NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602335,"CHLORPROMAZINE AMP :25MG/ML 2ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5602334,"VENLAFAXINE IMMED RELEASE 37.5 MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602333,"VENLAFAXINE IR : 25 MG TAB (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602330,"traZODONE HCL TAB 50 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602329,"SERTRALINE HCL (ZOLOFT) TAB 50 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602328,"SERTRALINE HCL (ZOLOFT) TAB : 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602326,"PAROXETINE (PAXIL) TAB 30 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602325,"PAROXETINE (PAXIL) TAB 20 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602322,"MIRTAZAPINE (REMERON) TAB 15MG","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602321,"MIRTAZAPINE (REMERON) TAB : 15 MG","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602319,"IMIPRAMINE (TOFRANIL) HCL TAB : 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602318,"CITALOPRAM HBR (CELEXA) TAB 20 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602317,"FLUOXETINE HCL (PROZAC) TAB : 20 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602309,"AMITRIPTYLINE HCL (ELAVIL) TAB 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602304,"MAGNESIUM SUL 4%(40mg/ml) 1L-OB use only","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5602303,"GABAPENTIN (NEURONTIN) CAP : 400 MG","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602298,"DIVALPROEX SOD (DEPAKOTE) TAB : 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602292,"PHENYTOIN (DILANTIN) CAP 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602287,"CLONAZEPAM (KLONIPIN) TAB : 1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602286,"PRIMIDONE TAB : 250 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602281,"ACETAMINOPHEN (TYLENOL EX) TAB 500 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602276,"ACETAMINOPHEN 160MG/5ML 120ML BOTTLE","CDM Code","IP/OP",259,"Drugs/Other","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602271,"PROPOXYPHENE--APAP (DARVOCET) TAB : (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602269,"oxyCODONE 5 MG TAB (IMMEDIATE RELEASE)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602264,"MORPHINE PCA 30 MG/30 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2270","MORPHINE SULFATE INJECTION",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5602259,"MORPHINE INJECTION 10 MG/ML 1 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602253,"MORPHINE SULFATE AMP : 10MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5602252,"MORPHINE/ASTRAMORPH 2MG AMP-anes only","CDM Code","IP/OP",250,"Pharmacy","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5602246,"MEPERIDINE HCL 30ML PCA : 10MG/ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5602240,"FENTANYL (DURAGESIC) 50MCG/HR PATC :","CDM Code","IP/OP",259,"Drugs/Other","","",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[5602235,"CODEINE SULFATE TAB : 30 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602234,"CODEINE-APAP (TYL #3) 300MG/30MG TAB","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602226,"KETOROLAC 30 MG/ML 1ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1885","KETOROLAC TROMETHAMINE INJ",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5602220,"IBUPROFEN (MOTRIN) TAB 400 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602214,"ROFECOXIB (VIOXX) TAB : 12.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602213,"CELECOXIB 200 MG CAP","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602207,"ASPIRIN 81 MG CHEWABLE TABLET","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602201,"PROPOFOL (DIPRIVAN) VIAL 10MG/ML 20ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2704","INJ, PROPOFOL, 10 MG",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5602196,"NITROGLYCERIN 0.4 MG/HR PATCH (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602195,"NITROGLYCERIN 0.2 MG/HR PATCH (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602190,"ISOSORBIDE MONO (IMDUR) ER TAB 60 MG","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602184,"RESERPINE TAB : 0.1 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602181,"LOSARTAN POTASSIUM (COZAAR) TAB 50 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602178,"LABETALOL SYRD : 5 MG (NF)","CDM Code","IP/OP",250,"Pharmacy","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5602173,"CLONIDINE HCL (CATAPRESS) PATC : 0.3 MG","CDM Code","IP/OP",259,"Drugs/Other","","",299,149.5,237.70500000000001,254.15,254.15,254.15,251.16,242.19000000000003,239.20000000000002,237.70500000000001,239.20000000000002]
[5602168,"SIMVASTATIN (ZOCOR) TAB 10 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602163,"VERAPAMIL VIAL 2.5MG/ML 2ML - NF","CDM Code","IP/OP",250,"Pharmacy","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5602162,"VERAPAMIL SR TBSA : 240 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602156,"QUINIDINE SULFATE TAB : 200 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602150,"PROCAINAMIDE VIAL 500MG/ML 2ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602143,"METOPROLOL (LOPRESSOR) VIAL 5 MG/5 ML","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5602142,"METOPROLOL SUCCINATE *ER* TAB 50 MG","CDM Code","IP/OP",259,"Drugs/Other","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602137,"LIDOCAINE 2% SYRD : 5ML","CDM Code","IP/OP",250,"Pharmacy","","",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[5602131,"DILTIAZEM 25 MG/5 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5602126,"DILTIAZEM ER (CARDIZEM) CAP 180 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602125,"DIGOXIN PEDIATRIC ELIX 0.05MG/ML (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602118,"ATENOLOL (TENORMIN) TAB 50 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602113,"STREPTOKINASE VIAL : 1.5 MU","CDM Code","IP/OP",636,"Drug/Detail Code","J2995","INJ STREPTOKINASE /250000 IU",1082,541,860.19,919.69999999999993,919.69999999999993,919.69999999999993,908.88,876.42000000000007,865.6,860.19,865.6]
[5602107,"GELATIN SPONGE,ABSORBABLE PWD :","CDM Code","IP/OP",259,"Drugs/Other","","",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[5602106,"AMINOCAPROIC(AMICAR) VL :250MG/ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5602101,"HEPARIN 5,000 UNITS/ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1644","INJ HEPARIN SODIUM PER 1000U",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5602096,"HEPARIN SOD PORCINE VIAL : 10U/ML 30ML","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602090,"FERROUS SULFATE TAB : 160 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602089,"FERROUS SULFATE TAB 325 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602084,"NICOTINE 14 MG/24 HR PATCH","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602078,"METHOCARBAMOL 750 MG TAB (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602073,"ATRACURIUM BESYLATE VIAL : 10MG/ML 10ML","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5602072,"DIHYDROERGOTAMINE (DHE) AMP : 1MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",266,133,211.47,226.1,226.1,226.1,223.44,215.46,212.8,211.47,212.8]
[5602066,"EPInephrine 1:10000 ABBO :0.1MG/ML 10ML","CDM Code","IP/OP",250,"Pharmacy","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5602059,"EPHEDrine INJ 50 MG/ML 1ML","CDM Code","IP/OP",250,"Pharmacy","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5602054,"ALBUTEROL 5MG/ML 20ML FOR CONT NEB","CDM Code","IP/OP",259,"Drugs/Other","","",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5602053,"ALBUTEROL(VENTOLIN)NEB : 2.5MG/3ML UD","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602047,"GLYCOPYRROLATE VIAL 0.2 MG/ML 2 ML","CDM Code","IP/OP",250,"Pharmacy","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602042,"BENZTROPINE (COGENTIN) TAB 0.5 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602037,"BETHANECHOL CHLORIDE TAB : 10 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5602032,"TAMOXIFEN CITRATE TAB 10 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5602019,"FLUTAMIDE (EULEXIN) CAP : 125 MG","CDM Code","IP/OP",259,"Drugs/Other","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5602007,"CISPLATIN VIAL (CHEMO): 1 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9060","CISPLATIN 10 MG INJECTION",1042,521,828.39,885.69999999999993,885.69999999999993,885.69999999999993,875.28,844.0200000000001,833.6,828.39,833.6]
[5602001,"BLEOMYCIN SULFATE (CHEMO)VIAL : 30 U","CDM Code","IP/OP",636,"Drug/Detail Code","J9040","BLEOMYCIN SULFATE INJECTION",171,85.5,135.94499999999999,145.35,145.35,145.35,143.63999999999999,138.51000000000002,136.80000000000001,135.94499999999999,136.80000000000001]
[5601998,"DAPSONE TAB 100 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601991,"NITROFURANTOIN MACRO CAP 50 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601986,"CIPROFLOXACIN (CIPRO) TAB 250 MG - NF","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601980,"VANCOMYCIN HCL VIAL 1 GM","CDM Code","IP/OP",636,"Drug/Detail Code","J3370","VANCOMYCIN HCL INJECTION",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5601979,"CLINDAMYCIN PHOS VIAL : 150MG/ML 6ML","CDM Code","IP/OP",250,"Pharmacy","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5601973,"TICARCILLIN-K CLAV 3.1 GM (NF)","CDM Code","IP/OP",250,"Pharmacy","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5601966,"PENICILLIN G PROCAINE SYR 600,000 U (NF)","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5601961,"OXACILLIN SODIUM VIAL : 2 GM","CDM Code","IP/OP",250,"Pharmacy","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5601960,"OXACILLIN SODIUM VIAL : 1 GM","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5601955,"AMPICILLIN VIAL FOR DOSES 251-500 MG","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5601948,"AMPICILLIN VIAL FOR DOSES 250 MG OR LESS","CDM Code","IP/OP",250,"Pharmacy","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5601943,"AMOXICILLIN-POTAS CLAVULANATE TAB : 500","CDM Code","IP/OP",259,"Drugs/Other","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5601942,"AMOXICILLIN TAB CHEWABLE: 250 MG (NF)","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601936,"ERYTHROMYCIN-SULFISOXAZOLE SUSP :","CDM Code","IP/OP",259,"Drugs/Other","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5601930,"CLARITHROMYCIN TAB 500 MG -NF","CDM Code","IP/OP",259,"Drugs/Other","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5601925,"IMIPENEM-CILASTATIN(PRIMAXIN) 500MG (NF)","CDM Code","IP/OP",636,"Drug/Detail Code","J0743","CILASTATIN SODIUM INJECTION",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[5601924,"CEFOTETAN DISODIUM (CEFOTAN) VIAL : 1 GM","CDM Code","IP/OP",250,"Pharmacy","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5601919,"CEPHALEXIN (KEFLEX) CAP 250 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601913,"CEFTRIAXONE ADD-VANTAGE VIAL : 1GM (NF)","CDM Code","IP/OP",250,"Pharmacy","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5601908,"CEFAZOLIN 1 GRAM VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0690","CEFAZOLIN SODIUM INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5601907,"CEFAZOLIN VIAL 500 MG","CDM Code","IP/OP",250,"Pharmacy","","",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[5601902,"CEFACLOR CAP : 250 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601897,"AMPHOTERICIN B VIAL : 50 MG/10ML","CDM Code","IP/OP",250,"Pharmacy","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5601893,"TOBRAMYCIN VIAL 40 MG/ML 2ML (NF)","CDM Code","IP/OP",250,"Pharmacy","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5601892,"GENTAMICIN 40 MG/ML 2ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5601887,"PROMETHAZINE (PHENERGAN) INJ 25 MG/1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2550","PROMETHAZINE HCL INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5601882,"DIPHENHYDRAMINE (BENADRYL) CAP 25 MG","CDM Code","IP/OP",259,"Drugs/Other","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5601600,"LIDOCAINE 2% JELLY 5ML","CDM Code","IP/OP",259,"Drugs/Other","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5601581,"VERSED INJ PER MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2250","INJ MIDAZOLAM HYDROCHLORIDE",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5600854,"MEPERIDINE TUBEX","CDM Code","IP/OP",250,"Pharmacy","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5600004,"ISOSULFAN BLUE 50 MG/5 ML VIAL","CDM Code","IP/OP",250,"Pharmacy","","",1945,972.5,1546.2750000000001,1653.25,1653.25,1653.25,1633.8,1575.45,1556,1546.2750000000001,1556]
[5508667,"DRESSG OPTILOCK 3X3","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5508666,"EPIFIX 7X7CM","CDM Code","IP/OP",250,"Pharmacy","Q4186","EPIFIX 1 SQ CM",3267,1633.5,2597.2650000000003,2776.95,2776.95,2776.95,2744.2799999999997,2646.27,2613.6000000000004,2597.2650000000003,2613.6000000000004]
[5508653,"SPECTRUM SU LOPRO S3 (SW)","CDM Code","IP/OP",272,"Sterile Supply","","",133,66.5,105.735,113.05,113.05,113.05,111.72,107.73,106.4,105.735,106.4]
[5508645,"PROX STAPLE RELOAD 60MM GRN","CDM Code","IP/OP",272,"Sterile Supply","","",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[5508640,"PILLOW GENTLE TOUCH RIGHT INTUB SLOT","CDM Code","IP/OP",272,"Sterile Supply","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5508639,"STAPLER ECS 29A","CDM Code","IP/OP",272,"Sterile Supply","","",368,184,292.56,312.8,312.8,312.8,309.12,298.08000000000004,294.40000000000003,292.56,294.40000000000003]
[5508634,"SET ITEM 58007212","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5508629,"SEE ITEM 58007211","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5508624,"SEE ITEM 58007637","CDM Code","IP/OP",272,"Sterile Supply","","",270,135,214.65,229.5,229.5,229.5,226.79999999999998,218.70000000000002,216,214.65,216]
[5508623,"DRESSING OPTILOCK 6.5X10","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5508617,"SEE ITEM 58007288","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5508612,"SEE ITEM 58007575","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5508607,"STAPLR 12MM HERNIA MULTI ENDO","CDM Code","IP/OP",272,"Sterile Supply","","",512,256,407.04,435.2,435.2,435.2,430.08,414.72,409.6,407.04,409.6]
[5508606,"MESH 3D MAX LRG RIGHT","CDM Code","IP/OP",278,"Supply/Implants","","",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[5508601,"RELOAD 60MM GREEN","CDM Code","IP/OP",272,"Sterile Supply","","",326,163,259.17,277.09999999999997,277.09999999999997,277.09999999999997,273.83999999999997,264.06,260.8,259.17,260.8]
[5508596,"GUN BIOPSY 18GX9CM QC 20MM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[5508591,"POST BI-CORTICAL 4.5X30MM","CDM Code","IP/OP",272,"Sterile Supply","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5508590,"POST BI-CORTICAL 4.5X27.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5508585,"PESSARY GELLHORN FLEX 2 3/4\"","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",193,96.5,153.435,164.04999999999998,164.04999999999998,164.04999999999998,162.12,156.33000000000001,154.4,153.435,154.4]
[5508580,"PESSARY GELLHORN FLEX 1 1/2\"","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5508575,"PESSARY DONUT 2\"","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5508574,"DIAPHRAM OMNIFLEX 65","CDM Code","IP/OP",272,"Sterile Supply","A4266","DIAPHRAGM",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5508567,"KIT MAGELLAN COMPLETE ONE SOURCE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",436,218,346.62,370.59999999999997,370.59999999999997,370.59999999999997,366.24,353.16,348.8,346.62,348.8]
[5508562,"SEE ITEM 58003700","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5508557,"DRESSG MEPILEX BORD 4X4","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5508556,"TRAY EPIDURAL BRAUN","CDM Code","IP/OP",272,"Sterile Supply","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[5508551,"SEE ITEM 58003302","CDM Code","IP/OP",270,"Med-Sur Supplies","","",277,138.5,220.215,235.45,235.45,235.45,232.67999999999998,224.37,221.60000000000002,220.215,221.60000000000002]
[5508545,"SEE ITEM 58007609","CDM Code","IP/OP",272,"Sterile Supply","","",244,122,193.98000000000002,207.4,207.4,207.4,204.95999999999998,197.64000000000001,195.20000000000002,193.98000000000002,195.20000000000002]
[5508540,"SEE ITEM 58007605","CDM Code","IP/OP",272,"Sterile Supply","","",329,164.5,261.55500000000001,279.64999999999998,279.64999999999998,279.64999999999998,276.36,266.49,263.2,261.55500000000001,263.2]
[5508539,"SEE ITEM 58007625","CDM Code","IP/OP",272,"Sterile Supply","","",461,230.5,366.495,391.84999999999997,391.84999999999997,391.84999999999997,387.24,373.41,368.8,366.495,368.8]
[5508534,"WIREGUIDE 3.2 THR ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[5508529,"SEE ITEM 58009580","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5508524,"BONE BIOPSY DEVICE TAPER SZ 2","CDM Code","IP/OP",272,"Sterile Supply","","",349,174.5,277.45500000000004,296.64999999999998,296.64999999999998,296.64999999999998,293.15999999999997,282.69,279.2,277.45500000000004,279.2]
[5508523,"CEMENT GUN BONE FILLER SISE 2","CDM Code","IP/OP",272,"Sterile Supply","","",585,292.5,465.07500000000005,497.25,497.25,497.25,491.4,473.85,468,465.07500000000005,468]
[5508518,"NEXPLANON","CDM Code","IP/OP",636,"Drug/Detail Code","J7307","ETONOGESTREL IMPLANT SYSTEM",1005,502.5,798.97500000000002,854.25,854.25,854.25,844.19999999999993,814.05000000000007,804,798.97500000000002,804]
[5508513,"DRESSG FOAM NON ADH 4X4","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5508508,"PROBE 23G INF CANN VITRECT","CDM Code","IP/OP",272,"Sterile Supply","","",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[5508507,"COHESIVE SM 2INCH 48MM EAKIN SEAL","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5508502,"TUBE TRACH CUFFLESS 6","CDM Code","IP/OP",272,"Sterile Supply","","",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[5508418,"CONCHA WTR & COLUMN","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5508411,"SEE ITEM 58002824","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5508410,"SEE ITEM 58006154","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5508405,"SEE ITEM 58007535","CDM Code","IP/OP",272,"Sterile Supply","","",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[5508400,"COLLINS KNIFE","CDM Code","IP/OP",272,"Sterile Supply","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5508224,"V+ SYRING KIT TRAUMCEM(TM)","CDM Code","IP/OP",272,"Sterile Supply","","",336,168,267.12,285.59999999999997,285.59999999999997,285.59999999999997,282.24,272.16000000000003,268.8,267.12,268.8]
[5508223,"V+ INJECT BONE CEMENT TRAUMACEM (TM)","CDM Code","IP/OP",278,"Supply/Implants","","",529,264.5,420.55500000000001,449.65,449.65,449.65,444.35999999999996,428.49,423.20000000000005,420.55500000000001,423.20000000000005]
[5508215,"TFNA FEN HELICAL BLADE 75MM","CDM Code","IP/OP",272,"Sterile Supply","","",783,391.5,622.48500000000001,665.55,665.55,665.55,657.72,634.23,626.40000000000009,622.48500000000001,626.40000000000009]
[5508209,"SEE  ITEM 58002921","CDM Code","IP/OP",272,"Sterile Supply","A4649","SURGICAL SUPPLIES",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5508204,"TFNA FEN HELICAL BLADE 115M","CDM Code","IP/OP",272,"Sterile Supply","","",783,391.5,622.48500000000001,665.55,665.55,665.55,657.72,634.23,626.40000000000009,622.48500000000001,626.40000000000009]
[5508203,"TFNA FEN HELICAL BLADE 110M","CDM Code","IP/OP",272,"Sterile Supply","","",783,391.5,622.48500000000001,665.55,665.55,665.55,657.72,634.23,626.40000000000009,622.48500000000001,626.40000000000009]
[5508155,"3D MAX LIGHT MESH LRG LEFT","CDM Code","IP/OP",278,"Supply/Implants","","",465,232.5,369.67500000000001,395.25,395.25,395.25,390.59999999999997,376.65000000000003,372,369.67500000000001,372]
[5508139,"ABSORBATACK FLEX SHORT","CDM Code","IP/OP",278,"Supply/Implants","","",450,225,357.75,382.5,382.5,382.5,378,364.5,360,357.75,360]
[5508115,"SYMBOTEX MESH 15CM","CDM Code","IP/OP",278,"Supply/Implants","","",578,289,459.51000000000005,491.3,491.3,491.3,485.52,468.18,462.40000000000003,459.51000000000005,462.40000000000003]
[5508109,"SYMBOTEX MESH 9CM","CDM Code","IP/OP",278,"Supply/Implants","","",383,191.5,304.48500000000001,325.55,325.55,325.55,321.71999999999997,310.23,306.40000000000003,304.48500000000001,306.40000000000003]
[5508025,"TI END CAP FOR TFNA 5MM","CDM Code","IP/OP",278,"Supply/Implants","","",360,180,286.2,306,306,306,302.39999999999998,291.60000000000002,288,286.2,288]
[5508020,"11MM/130DEG TI CANN TFNA 420MM RT","CDM Code","IP/OP",278,"Supply/Implants","","",2296,1148,1825.3200000000002,1951.6,1951.6,1951.6,1928.6399999999999,1859.7600000000002,1836.8000000000002,1825.3200000000002,1836.8000000000002]
[5508015,"11MM/130DEG TI CANN TFNA 360MM RT","CDM Code","IP/OP",278,"Supply/Implants","","",2296,1148,1825.3200000000002,1951.6,1951.6,1951.6,1928.6399999999999,1859.7600000000002,1836.8000000000002,1825.3200000000002,1836.8000000000002]
[5508014,"11MM/130DEG TI CANN TFNA 340MM LT","CDM Code","IP/OP",278,"Supply/Implants","","",2296,1148,1825.3200000000002,1951.6,1951.6,1951.6,1928.6399999999999,1859.7600000000002,1836.8000000000002,1825.3200000000002,1836.8000000000002]
[5508009,"11MM/130DEG TI CANN TFNA 300MM RT","CDM Code","IP/OP",278,"Supply/Implants","","",2296,1148,1825.3200000000002,1951.6,1951.6,1951.6,1928.6399999999999,1859.7600000000002,1836.8000000000002,1825.3200000000002,1836.8000000000002]
[5508004,"11MM/130DEG TI CANN TFNA 170MM","CDM Code","IP/OP",278,"Supply/Implants","","",1638,819,1302.21,1392.3,1392.3,1392.3,1375.9199999999998,1326.7800000000002,1310.4000000000001,1302.21,1310.4000000000001]
[5507583,"PLATE 3.5MM PROX HUM 5 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",1656,828,1316.52,1407.6,1407.6,1407.6,1391.04,1341.3600000000001,1324.8000000000002,1316.52,1324.8000000000002]
[5507582,"PLATE 3.5MM PROX HUM 3 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",1968,984,1564.5600000000002,1672.8,1672.8,1672.8,1653.12,1594.0800000000002,1574.4,1564.5600000000002,1574.4]
[5507577,"PLATE LCP 1/3 TUBULAR 6 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",406,203,322.77000000000004,345.09999999999997,345.09999999999997,345.09999999999997,341.03999999999996,328.86,324.8,322.77000000000004,324.8]
[5507572,"PLATE 3.5MM LCP T LT 3 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",475,237.5,377.625,403.75,403.75,403.75,399,384.75,380,377.625,380]
[5507567,"PLATE 3.5MM LCP T RT 6 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",491,245.5,390.34500000000003,417.34999999999997,417.34999999999997,417.34999999999997,412.44,397.71000000000004,392.8,390.34500000000003,392.8]
[5507566,"PLATE 3.5MM LCP T RT 4 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",490,245,389.55,416.5,416.5,416.5,411.59999999999997,396.90000000000003,392,389.55,392]
[5507561,"PLATE 3.5MM LCP RECON 10 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",717,358.5,570.01499999999999,609.44999999999993,609.44999999999993,609.44999999999993,602.28,580.77,573.6,570.01499999999999,573.6]
[5507556,"PLATE 3.5MM LCP 14 HOLES","CDM Code","IP/OP",278,"Supply/Implants","","",682,341,542.19000000000005,579.69999999999993,579.69999999999993,579.69999999999993,572.88,552.42000000000007,545.6,542.19000000000005,545.6]
[5507551,"PLATE 3.5MM LCP 6 HOLES","CDM Code","IP/OP",278,"Supply/Implants","","",417,208.5,331.51500000000004,354.45,354.45,354.45,350.28,337.77000000000004,333.6,331.51500000000004,333.6]
[5507550,"PLATE 3.5MM LCP 5 HOLES","CDM Code","IP/OP",278,"Supply/Implants","","",472,236,375.24,401.2,401.2,401.2,396.47999999999996,382.32000000000005,377.6,375.24,377.6]
[5507464,"SEE ITEM 58007801","CDM Code","IP/OP",278,"Supply/Implants","","",430,215,341.85,365.5,365.5,365.5,361.2,348.3,344,341.85,344]
[5507458,"SCREW 4.5 CORTEX SELF-TAP 68MM","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5507453,"SCREW 4.5 CORTEX SELF-TAP 58MM","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5507452,"SCREW 4.5 CORTEX SELF-TAP 56MM","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5507447,"SCREW 4.5 CORTEX SEL-TAP 46MM","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5507442,"SCREW 4.5 CORTEX SELF-TAP 36MM","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5507437,"SCREW 4.5 CORTEX SELF-TAP 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[5507436,"SCREW 4.5 CORTEX SELF-TAP 24MM","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5507431,"SCREW 4.5 CORTEX SELF-TAP 14MM","CDM Code","IP/OP",278,"Supply/Implants","","",92,46,73.14,78.2,78.2,78.2,77.28,74.52000000000001,73.600000000000009,73.14,73.600000000000009]
[5507426,"SCREW 3.5 LOCKING SELF TAP 40MM","CDM Code","IP/OP",278,"Supply/Implants","","",314,157,249.63000000000002,266.89999999999998,266.89999999999998,266.89999999999998,263.76,254.34,251.20000000000002,249.63000000000002,251.20000000000002]
[5507421,"SCREW 3.5 LOCKING SELF TAP 30MM","CDM Code","IP/OP",278,"Supply/Implants","","",314,157,249.63000000000002,266.89999999999998,266.89999999999998,266.89999999999998,263.76,254.34,251.20000000000002,249.63000000000002,251.20000000000002]
[5507420,"SCREW 3.5 LOCKING SELF TAP 28MM","CDM Code","IP/OP",278,"Supply/Implants","","",314,157,249.63000000000002,266.89999999999998,266.89999999999998,266.89999999999998,263.76,254.34,251.20000000000002,249.63000000000002,251.20000000000002]
[5507415,"SCREW 3.5 LOCKING SELF TAP 18MM","CDM Code","IP/OP",278,"Supply/Implants","","",324,162,257.58000000000004,275.39999999999998,275.39999999999998,275.39999999999998,272.15999999999997,262.44,259.2,257.58000000000004,259.2]
[5507411,"SCREW 3.5 LOCKING SELF TAP 10MM","CDM Code","IP/OP",278,"Supply/Implants","","",324,162,257.58000000000004,275.39999999999998,275.39999999999998,275.39999999999998,272.15999999999997,262.44,259.2,257.58000000000004,259.2]
[5507404,"SCREW 3.5 CORTEX SELF-TAP 45MM","CDM Code","IP/OP",278,"Supply/Implants","","",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[5507403,"SCREW 3.5 CORTEX SELF-TAP 32MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5507398,"SCREW 3.5 CORTEX SELF-TAP 22MM","CDM Code","IP/OP",278,"Supply/Implants","","",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[5507393,"SCREW 3.5 SHAFT 38MM","CDM Code","IP/OP",278,"Supply/Implants","","",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[5507388,"SCREW 3.5 SHAFT 28MM","CDM Code","IP/OP",278,"Supply/Implants","","",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[5507387,"SCREW 3.5 SHAFT 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[5507382,"SCREW 2.7 CORTEX SELF-TAP 50MM","CDM Code","IP/OP",278,"Supply/Implants","","",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5507377,"SCREW 2.7 CORTEX SELF-TAP 34MM","CDM Code","IP/OP",278,"Supply/Implants","","",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5507372,"SCREW 2.7 CORTEX SELF-TAP 24MM","CDM Code","IP/OP",278,"Supply/Implants","","",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[5507371,"SCREW 2.7 CORTEX SELF-TAP 22MM","CDM Code","IP/OP",278,"Supply/Implants","","",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5507366,"SCREW 2.7 CORTEX SELF-TAP 12MM","CDM Code","IP/OP",278,"Supply/Implants","","",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[5507361,"SCREW 5.0 LOCKING 85MM","CDM Code","IP/OP",278,"Supply/Implants","","",379,189.5,301.30500000000001,322.14999999999998,322.14999999999998,322.14999999999998,318.36,306.99,303.2,301.30500000000001,303.2]
[5507356,"SCREW 5.0 LOCKING 64MM","CDM Code","IP/OP",278,"Supply/Implants","","",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[5507355,"SCREW 5.0 LOCKING 60MM","CDM Code","IP/OP",278,"Supply/Implants","","",379,189.5,301.30500000000001,322.14999999999998,322.14999999999998,322.14999999999998,318.36,306.99,303.2,301.30500000000001,303.2]
[5507350,"SCREW 5.0 LOCKING 50MM","CDM Code","IP/OP",278,"Supply/Implants","","",332,166,263.94,282.2,282.2,282.2,278.88,268.92,265.60000000000002,263.94,265.60000000000002]
[5507345,"SCREW 5.0 LOCKING 40MM","CDM Code","IP/OP",278,"Supply/Implants","","",361,180.5,286.995,306.84999999999997,306.84999999999997,306.84999999999997,303.24,292.41000000000003,288.8,286.995,288.8]
[5507340,"SCREW 5.0 LOCKING 30MM","CDM Code","IP/OP",278,"Supply/Implants","","",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[5507339,"SCREW 5.0 LOCKING 28MM","CDM Code","IP/OP",278,"Supply/Implants","","",379,189.5,301.30500000000001,322.14999999999998,322.14999999999998,322.14999999999998,318.36,306.99,303.2,301.30500000000001,303.2]
[5507334,"SCREW 3.5 CANN PART THD 46MM","CDM Code","IP/OP",278,"Supply/Implants","","",394,197,313.23,334.9,334.9,334.9,330.96,319.14000000000004,315.20000000000005,313.23,315.20000000000005]
[5507329,"SCREW 3.5 CANN PART THD 36MM","CDM Code","IP/OP",278,"Supply/Implants","","",349,174.5,277.45500000000004,296.64999999999998,296.64999999999998,296.64999999999998,293.15999999999997,282.69,279.2,277.45500000000004,279.2]
[5507324,"SCREW 3.5 CANN PART THD 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",359,179.5,285.40500000000003,305.14999999999998,305.14999999999998,305.14999999999998,301.56,290.79000000000002,287.2,285.40500000000003,287.2]
[5507323,"SCREW 3.5 CANN PART THD 24MM","CDM Code","IP/OP",278,"Supply/Implants","","",394,197,313.23,334.9,334.9,334.9,330.96,319.14000000000004,315.20000000000005,313.23,315.20000000000005]
[5507318,"SCREW 3.5 CANN PART THD 14MM","CDM Code","IP/OP",278,"Supply/Implants","","",394,197,313.23,334.9,334.9,334.9,330.96,319.14000000000004,315.20000000000005,313.23,315.20000000000005]
[5507313,"SCREW 4.5 CANN PART THD 64MM","CDM Code","IP/OP",278,"Supply/Implants","","",328,164,260.76,278.8,278.8,278.8,275.52,265.68,262.40000000000003,260.76,262.40000000000003]
[5507308,"SCREW 4.5 CANN PART THD 50MM","CDM Code","IP/OP",278,"Supply/Implants","","",359,179.5,285.40500000000003,305.14999999999998,305.14999999999998,305.14999999999998,301.56,290.79000000000002,287.2,285.40500000000003,287.2]
[5507307,"SCREW 4.5 CANN PART THD 48MM","CDM Code","IP/OP",278,"Supply/Implants","","",384,192,305.28000000000003,326.39999999999998,326.39999999999998,326.39999999999998,322.56,311.04000000000002,307.20000000000005,305.28000000000003,307.20000000000005]
[5507302,"SCREW 4.5 CANN PART THD 38MM","CDM Code","IP/OP",278,"Supply/Implants","","",402,201,319.59000000000003,341.7,341.7,341.7,337.68,325.62,321.60000000000002,319.59000000000003,321.60000000000002]
[5507297,"SCREW 4.5 CANN PART THD 28MM","CDM Code","IP/OP",278,"Supply/Implants","","",416,208,330.72,353.59999999999997,353.59999999999997,353.59999999999997,349.44,336.96000000000004,332.8,330.72,332.8]
[5507292,"SCREW 7.3 CANN 32THR 150MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507291,"SCREW 7.3 CANN 32THR 145MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507287,"SCREW 7.3 CANN 32THR 125MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507282,"SCREW 7.3 CANN 32THR 100MM","CDM Code","IP/OP",278,"Supply/Implants","","",449,224.5,356.95500000000004,381.65,381.65,381.65,377.15999999999997,363.69,359.20000000000005,356.95500000000004,359.20000000000005]
[5507277,"SCREW 7.3 CANN 32THR 75MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507276,"SCREW 7.3 CANN 32THR 70MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507271,"SCREW 7.3 CANN 32THR 45MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507266,"SCREW 7.3 CANN 16THR 130MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507261,"SCREW 7.3 CANN 16 THR 105MM","CDM Code","IP/OP",278,"Supply/Implants","","",388,194,308.46000000000004,329.8,329.8,329.8,325.92,314.28000000000003,310.40000000000003,308.46000000000004,310.40000000000003]
[5507260,"SCREW 7.3 CANN 16THR 100MM","CDM Code","IP/OP",278,"Supply/Implants","","",449,224.5,356.95500000000004,381.65,381.65,381.65,377.15999999999997,363.69,359.20000000000005,356.95500000000004,359.20000000000005]
[5507255,"SCREW 7.3 CANN 16THR 70MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507250,"SCREW 7.3 CANN 16THR 45MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507245,"SCREW 6.5 CANN 32THR 145MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507244,"SCREW 6.5 CANN 32THR 140MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507239,"SCREW 6.5 CANN 32THR 115MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507234,"SCREW 6.5 CANN 32THR 90MM","CDM Code","IP/OP",278,"Supply/Implants","","",451,225.5,358.54500000000002,383.34999999999997,383.34999999999997,383.34999999999997,378.84,365.31,360.8,358.54500000000002,360.8]
[5507229,"SCREW 6.5 CANN 32THR 65MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507228,"SCREW 6.5 CANN 32THR 60MM","CDM Code","IP/OP",278,"Supply/Implants","","",422,211,335.49,358.7,358.7,358.7,354.47999999999996,341.82000000000005,337.6,335.49,337.6]
[5507223,"SCREW 6.5 CANN 16THR 145MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507218,"SCREW 6.5 CANN 16THR 120MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507213,"SCREW 6.5 CANN 16THR 95MM","CDM Code","IP/OP",278,"Supply/Implants","","",422,211,335.49,358.7,358.7,358.7,354.47999999999996,341.82000000000005,337.6,335.49,337.6]
[5507212,"SCREW 6.5 CANN 16THR 90MM","CDM Code","IP/OP",278,"Supply/Implants","","",422,211,335.49,358.7,358.7,358.7,354.47999999999996,341.82000000000005,337.6,335.49,337.6]
[5507207,"SCREW 6.5 CANN 16THR 65MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5507201,"SCREW 6.5 CANN 16THR 35MM","CDM Code","IP/OP",278,"Supply/Implants","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5506601,"VAPORIZATION BALL 24FR","CDM Code","IP/OP",272,"Sterile Supply","","",494,247,392.73,419.9,419.9,419.9,414.96,400.14000000000004,395.20000000000005,392.73,395.20000000000005]
[5506600,"PROSTATE LOOP 24/26FR .35MM","CDM Code","IP/OP",272,"Sterile Supply","","",488,244,387.96000000000004,414.8,414.8,414.8,409.91999999999996,395.28000000000003,390.40000000000003,387.96000000000004,390.40000000000003]
[5506595,"TROCAR Z THREAD 5 X 100MM","CDM Code","IP/OP",272,"Sterile Supply","","",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[5506590,"SLEEVE Z THREAD 5 X 100MM","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5506585,"RETRIEVAL BAG 10MM","CDM Code","IP/OP",272,"Sterile Supply","","",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[5506584,"CLIP APPLIER UNIVERSAL","CDM Code","IP/OP",272,"Sterile Supply","","",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[5506579,"PALACOS MV 80MG CEMENT","CDM Code","IP/OP",272,"Sterile Supply","","",338,169,268.71000000000004,287.3,287.3,287.3,283.92,273.78000000000003,270.40000000000003,268.71000000000004,270.40000000000003]
[5506574,"GRANEE NEEDLE","CDM Code","IP/OP",272,"Sterile Supply","","",162,81,128.79000000000002,137.69999999999999,137.69999999999999,137.69999999999999,136.07999999999998,131.22,129.6,128.79000000000002,129.6]
[5506572,"BLAKE DRAIN 10MM","CDM Code","IP/OP",272,"Sterile Supply","","",222,111,176.49,188.7,188.7,188.7,186.48,179.82000000000002,177.60000000000002,176.49,177.60000000000002]
[5506569,"BONE CEMENT 20G","CDM Code","IP/OP",272,"Sterile Supply","","",407,203.5,323.565,345.95,345.95,345.95,341.88,329.67,325.60000000000002,323.565,325.60000000000002]
[5506564,"CAST SYSTEM 4\" 5 SYS","CDM Code","IP/OP",270,"Med-Sur Supplies","","",285,142.5,226.57500000000002,242.25,242.25,242.25,239.39999999999998,230.85000000000002,228,226.57500000000002,228]
[5506559,"RELIATACK DEVICE W/29 DEEP PUR","CDM Code","IP/OP",272,"Sterile Supply","","",537,268.5,426.91500000000002,456.45,456.45,456.45,451.08,434.97,429.6,426.91500000000002,429.6]
[5506554,"CONTOUR URET STENT 6X26","CDM Code","IP/OP",272,"Sterile Supply","","",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[5506553,"CONTOUR URET STENT 6X24","CDM Code","IP/OP",272,"Sterile Supply","","",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[5506548,"PESSARY SHORT STEM 2-1/4","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",193,96.5,153.435,164.04999999999998,164.04999999999998,164.04999999999998,162.12,156.33000000000001,154.4,153.435,154.4]
[5506541,"PUREWICK FEMALE CATH","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5506536,"ALLOGRAFT KIT","CDM Code","IP/OP",272,"Sterile Supply","","",987,493.5,784.66500000000008,838.94999999999993,838.94999999999993,838.94999999999993,829.07999999999993,799.47,789.6,784.66500000000008,789.6]
[5506535,"AUTOGRAFT KIT","CDM Code","IP/OP",272,"Sterile Supply","","",714,357,567.63,606.9,606.9,606.9,599.76,578.34,571.20000000000005,567.63,571.20000000000005]
[5506530,"TEGA SACRAL FOAM SM","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5506525,"SEE ITEM 58007299","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[5506520,"SEE ITEM 58007302","CDM Code","IP/OP",272,"Sterile Supply","","",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[5506519,"SEE ITEM 58003703","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5506514,"SEE ITEM 58003708","CDM Code","IP/OP",270,"Med-Sur Supplies","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5506509,"PROCEDURAL O2 MASK","CDM Code","IP/OP",270,"Med-Sur Supplies","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5506504,"LAPAROSCOPY PACK","CDM Code","IP/OP",272,"Sterile Supply","","",334,167,265.53000000000003,283.89999999999998,283.89999999999998,283.89999999999998,280.56,270.54000000000002,267.2,265.53000000000003,267.2]
[5506503,"EXTREMITY PACK","CDM Code","IP/OP",272,"Sterile Supply","","",308,154,244.86,261.8,261.8,261.8,258.71999999999997,249.48000000000002,246.4,244.86,246.4]
[5506422,"GLIDESCOPE GVL 2.5 STAT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[5506417,"GLIDESCOPE GVL 0 STAT","CDM Code","IP/OP",272,"Sterile Supply","","",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[5506412,"PICO DRESSING 10CMX20CM","CDM Code","IP/OP",272,"Sterile Supply","","",380,190,302.10000000000002,323,323,323,319.2,307.8,304,302.10000000000002,304]
[5506411,"SHERIDAN LTS MICROLARYNGEAL ET TUBE","CDM Code","IP/OP",272,"Sterile Supply","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5506406,"DRAPE ORTHOMAX EXTREMITY","CDM Code","IP/OP",272,"Sterile Supply","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5506401,"LITHOVUE FLEXIBLE URETEROSCOPE","CDM Code","IP/OP",272,"Sterile Supply","","",1575,787.5,1252.125,1338.75,1338.75,1338.75,1323,1275.75,1260,1252.125,1260]
[5506396,"SEE ITEM 58002863","CDM Code","IP/OP",270,"Med-Sur Supplies","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5506395,"SEE ITEM 58003435","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5506390,"SEE ITEM 58003709","CDM Code","IP/OP",270,"Med-Sur Supplies","","",57,28.5,45.315000000000005,48.449999999999996,48.449999999999996,48.449999999999996,47.879999999999995,46.17,45.6,45.315000000000005,45.6]
[5506385,"BLACK STENT 7F 22CM","CDM Code","IP/OP",272,"Sterile Supply","","",293,146.5,232.935,249.04999999999998,249.04999999999998,249.04999999999998,246.12,237.33,234.4,232.935,234.4]
[5506377,"GUARDUS OVERTUBE","CDM Code","IP/OP",272,"Sterile Supply","","",419,209.5,333.10500000000002,356.15,356.15,356.15,351.96,339.39000000000004,335.20000000000005,333.10500000000002,335.20000000000005]
[5506376,"NAVIGATOR HD","CDM Code","IP/OP",272,"Sterile Supply","","",366,183,290.97000000000003,311.09999999999997,311.09999999999997,311.09999999999997,307.44,296.46000000000004,292.8,290.97000000000003,292.8]
[5506370,"SEE ITEM 58002600","CDM Code","IP/OP",272,"Sterile Supply","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5506367,"AMBU KING LTS-D SIZE 4","CDM Code","IP/OP",272,"Sterile Supply","","",99,49.5,78.704999999999998,84.149999999999991,84.149999999999991,84.149999999999991,83.16,80.190000000000012,79.2,78.704999999999998,79.2]
[5506362,"ATERIAL CATH KIT 20G","CDM Code","IP/OP",272,"Sterile Supply","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5506361,"BONE BIOPSY","CDM Code","IP/OP",272,"Sterile Supply","","",372,186,295.74,316.2,316.2,316.2,312.47999999999996,301.32,297.60000000000002,295.74,297.60000000000002]
[5506356,"AB THERA","CDM Code","IP/OP",272,"Sterile Supply","","",420,210,333.90000000000003,357,357,357,352.8,340.20000000000005,336,333.90000000000003,336]
[5506351,"EPIFIX 4X4CM","CDM Code","IP/OP",250,"Pharmacy","Q4186","EPIFIX 1 SQ CM",3267,1633.5,2597.2650000000003,2776.95,2776.95,2776.95,2744.2799999999997,2646.27,2613.6000000000004,2597.2650000000003,2613.6000000000004]
[5506346,"SEE ITEM 58003620","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5506345,"PROGRIP MESH 15X10CM","CDM Code","IP/OP",278,"Supply/Implants","","",484,242,384.78000000000003,411.4,411.4,411.4,406.56,392.04,387.20000000000005,384.78000000000003,387.20000000000005]
[5506340,"SEE ITEM 58002822","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5506335,"HYDROFERA BLUE FOAM 4X4 DRESSING","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5506330,"PRONTOSAN WOUND CLEANSER 350ML","CDM Code","IP/OP",272,"Sterile Supply","","",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[5506329,"FLUFF 6\" x 6.75\" STERILE","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5506324,"VENAFLOW CALF CUFF","CDM Code","IP/OP",272,"Sterile Supply","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5506319,"SMARTSET MV BONE CEMENT 40G","CDM Code","IP/OP",278,"Supply/Implants","","",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5506314,"SEE ITEM 58008100","CDM Code","IP/OP",272,"Sterile Supply","","",351,175.5,279.04500000000002,298.34999999999997,298.34999999999997,298.34999999999997,294.83999999999997,284.31,280.8,279.04500000000002,280.8]
[5506313,"FLANGE TIP YANKAUER","CDM Code","IP/OP",272,"Sterile Supply","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5506308,"WORD CATHETER","CDM Code","IP/OP",272,"Sterile Supply","","",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[5506303,"FAST FIX 360 CURVED","CDM Code","IP/OP",272,"Sterile Supply","","",555,277.5,441.22500000000002,471.75,471.75,471.75,466.2,449.55,444,441.22500000000002,444]
[5506298,"SEE ITEM 58006502","CDM Code","IP/OP",272,"Sterile Supply","","",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[5506297,"SEE ITEM 58007204","CDM Code","IP/OP",272,"Sterile Supply","","",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[5506292,"AQUAMARTYS 6.0 BIPOLAR SEALER","CDM Code","IP/OP",272,"Sterile Supply","","",800,400,636,680,680,680,672,648,640,636,640]
[5506287,"STIMULAN 5CC","CDM Code","IP/OP",272,"Sterile Supply","","",1292,646,1027.1400000000001,1098.2,1098.2,1098.2,1085.28,1046.52,1033.6000000000001,1027.1400000000001,1033.6000000000001]
[5506282,"SEE ITEM 58007206","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5506281,"SEE ITEM 58007233","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5506276,"LONE STAR RETRACTOR","CDM Code","IP/OP",272,"Sterile Supply","","",332,166,263.94,282.2,282.2,282.2,278.88,268.92,265.60000000000002,263.94,265.60000000000002]
[5506271,"ALTIS SLING","CDM Code","IP/OP",272,"Sterile Supply","","",1655,827.5,1315.7250000000001,1406.75,1406.75,1406.75,1390.2,1340.5500000000002,1324,1315.7250000000001,1324]
[5506266,"PESSARY DONUT 2-1/4\"","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5506265,"2-0 FIBER LOOP, KEITH NEEDLE","CDM Code","IP/OP",272,"Sterile Supply","","",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[5506260,"SEE ITEM 58002632","CDM Code","IP/OP",270,"Med-Sur Supplies","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[5506255,"ENDOCELL","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5506250,"UNIVERSAL SET W/CHLORAPREP","CDM Code","IP/OP",272,"Sterile Supply","","",548,274,435.66,465.8,465.8,465.8,460.32,443.88000000000005,438.40000000000003,435.66,438.40000000000003]
[5506247,"SHOE ORTHO WEDGE SM","CDM Code","IP/OP",274,"Prosth/Orth Dev","L3260","AMBULATORY SURGICAL BOOT EAC",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[5506245,"SHOE ORTHO WEDGE XL","CDM Code","IP/OP",274,"Prosth/Orth Dev","L3260","AMBULATORY SURGICAL BOOT EAC",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[5506240,"SEE ITEM 58007250","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5506235,"SEE ITEM 58007207","CDM Code","IP/OP",270,"Med-Sur Supplies","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5506234,"SEE ITEM 58007209","CDM Code","IP/OP",270,"Med-Sur Supplies","","",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[5506229,"SEE ITEM 58001280","CDM Code","IP/OP",270,"Med-Sur Supplies","E0560","HUMIDIFIER SUPPLEMENTAL W/ I",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5506224,"MEPILEX BORDER LITE 4X4.5 CM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5506219,"DRESSG TEGA  ABSORB 7.5\"X8\"","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5506218,"VERAFLO MEDIUM DRESSING KIT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",315,157.5,250.42500000000001,267.75,267.75,267.75,264.59999999999997,255.15,252,250.42500000000001,252]
[5506213,"WALLACH LOOP ELECTRODE 10MMX8MM SQUARE","CDM Code","IP/OP",272,"Sterile Supply","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5506208,"CHAMPION SLING SHOT 45 DEG RIGHT","CDM Code","IP/OP",272,"Sterile Supply","","",422,211,335.49,358.7,358.7,358.7,354.47999999999996,341.82000000000005,337.6,335.49,337.6]
[5506203,"DRESSG MEPILEX 4X8","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5506202,"TUB GASTRO 18F ADULT","CDM Code","IP/OP",272,"Sterile Supply","","",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[5506105,"DRESSING XTRASORB 4 X 5","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5506100,"HAMMERLOCK","CDM Code","IP/OP",276,"Intra Oc Lens","","",1234,617,981.03000000000009,1048.8999999999999,1048.8999999999999,1048.8999999999999,1036.56,999.54000000000008,987.2,981.03000000000009,987.2]
[5506059,"CATH COUD 14F TAPERED TIP","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5506058,"TRACH 4.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5506051,"SYS ENDO GASTROC RELEASE INTEGRA","CDM Code","IP/OP",270,"Med-Sur Supplies","","",1914,957,1521.63,1626.8999999999999,1626.8999999999999,1626.8999999999999,1607.76,1550.3400000000001,1531.2,1521.63,1531.2]
[5506021,"DRESSG MEPILEX BORD 4X4 AG","CDM Code","IP/OP",272,"Sterile Supply","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5506016,"DRESSG BIATAIN NON ADH 4X4","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5506015,"DRESSG FLEX 3 ACTICOAT 4X8","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5506010,"DRESSG MEPILEX BORD 3X3 AG","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5506004,"SEE ITEM 58005516","CDM Code","IP/OP",270,"Med-Sur Supplies","","",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5505830,"CYSTOGRAFIN 300ML","CDM Code","IP/OP",272,"Sterile Supply","","",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[5505828,"SUT MAXBRAID 3-0 BLUE","CDM Code","IP/OP",272,"Sterile Supply","","",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[5505823,"DILATOR COLONIC CRE 6-8MM","CDM Code","IP/OP",272,"Sterile Supply","","",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[5505818,"THUMB ORTHOSIS MED LEFT","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5505812,"SNAP DRESS KIT BRIDGE 14X11","CDM Code","IP/OP",272,"Sterile Supply","","",174,87,138.33000000000001,147.9,147.9,147.9,146.16,140.94,139.20000000000002,138.33000000000001,139.20000000000002]
[5505811,"THUNDERBEAT 5MM 35CM","CDM Code","IP/OP",272,"Sterile Supply","","",473,236.5,376.03500000000003,402.05,402.05,402.05,397.32,383.13000000000005,378.40000000000003,376.03500000000003,378.40000000000003]
[5505806,"KNIFE SLIT BEV 2.4","CDM Code","IP/OP",272,"Sterile Supply","","",165,82.5,131.17500000000001,140.25,140.25,140.25,138.6,133.65,132,131.17500000000001,132]
[5505801,"ARTHREX COOLCUT 45 ABLATOR SM JOINT","CDM Code","IP/OP",272,"Sterile Supply","","",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[5505796,"CATH 16FR FOL SILVER IMPREG","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5505795,"TRI LUMEN FILTERED TUBE SET","CDM Code","IP/OP",272,"Sterile Supply","","",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[5505790,"PLATE 3.5 LC-DCP 9 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",415,207.5,329.92500000000001,352.75,352.75,352.75,348.59999999999997,336.15000000000003,332,329.92500000000001,332]
[5505785,"PLATE 3.5 RECON 10 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",579,289.5,460.30500000000001,492.15,492.15,492.15,486.35999999999996,468.99,463.20000000000005,460.30500000000001,463.20000000000005]
[5505779,"NEBULIZER SYS ISO FILTERED","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5505778,"SET BONOPTY BIOPSY","CDM Code","IP/OP",272,"Sterile Supply","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5505773,"CUFF DISP 15X2.5 STER","CDM Code","IP/OP",272,"Sterile Supply","","",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[5505768,"STOMA WAFER NATURA 6X6 W/FLANGE","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5505763,"NEEDLE INJ WILLIAMS CYSTOSCOPIC","CDM Code","IP/OP",272,"Sterile Supply","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[5505762,"ENDOPATH SPATULA 5MMX34CM","CDM Code","IP/OP",272,"Sterile Supply","","",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[5505757,"NEEDLE TUOHY 18G 6\"","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5505752,"SEE ITEM 58003244","CDM Code","IP/OP",272,"Sterile Supply","","",65,32.5,51.675000000000004,55.25,55.25,55.25,54.6,52.650000000000006,52,51.675000000000004,52]
[5505747,"DRESSG RESTORE 2X2 FLEX","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5505746,"SEE ITEM 58006522","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5505741,"SUT VLOC WOUND CLOSER180 0/0 GR 9 GS-21","CDM Code","IP/OP",272,"Sterile Supply","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5505736,"SEE ITEM 58005533","CDM Code","IP/OP",270,"Med-Sur Supplies","","",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[5505730,"CURETT VAC CVD 11MM","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5505729,"SENSOR INF O2 18\" ADH MASIMO","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5505724,"PESSARY RING W/SUPPORT 2-3/4\"","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",200,100,159,170,170,170,168,162,160,159,160]
[5505719,"PESSARY DONUT 2-1/2\"","CDM Code","IP/OP",272,"Sterile Supply","A4562","PESSARY, NON RUBBER,ANY TYPE",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[5505714,"DRESS GENTLE BORDER FOAM 3.5X3.5","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5505712,"DRESSG MEPITEL 2X3","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5505706,"KIT BMA BONE MARROW ASPIRATION","CDM Code","IP/OP",272,"Sterile Supply","","",100,50,79.5,85,85,85,84,81,80,79.5,80]
[5505701,"POUCH SENSURA W/EASICLOSE 3/4X3\"","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5505696,"SEE ITEM 58003344","CDM Code","IP/OP",270,"Med-Sur Supplies","","",248,124,197.16,210.79999999999998,210.79999999999998,210.79999999999998,208.32,200.88000000000002,198.4,197.16,198.4]
[5505695,"TECA ELITE 1\" RED CON NEEDLE","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5505690,"INTRDUCER FROVA INTUBATING","CDM Code","IP/OP",272,"Sterile Supply","","",312,156,248.04000000000002,265.2,265.2,265.2,262.08,252.72000000000003,249.60000000000002,248.04000000000002,249.60000000000002]
[5505685,"SEE ITEM 58007632","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[5505680,"SEE ITEM 58003346","CDM Code","IP/OP",270,"Med-Sur Supplies","","",324,162,257.58000000000004,275.39999999999998,275.39999999999998,275.39999999999998,272.15999999999997,262.44,259.2,257.58000000000004,259.2]
[5505677,"SEE ITEM 58003349","CDM Code","IP/OP",270,"Med-Sur Supplies","","",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[5505674,"SNAP CARTRIDGE 125MMHG","CDM Code","IP/OP",272,"Sterile Supply","","",309,154.5,245.655,262.64999999999998,262.64999999999998,262.64999999999998,259.56,250.29000000000002,247.20000000000002,245.655,247.20000000000002]
[5505668,"DRESSG RESTORE 4X5 FLEX","CDM Code","IP/OP",272,"Sterile Supply","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5505663,"SEE ITEM 58005529","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5505662,"DRESSING ALLDRESS 6X6","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5505657,"SHEET ADH MEDIHONEY 4.5X4.5","CDM Code","IP/OP",272,"Sterile Supply","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5505652,"NDL 18X5 WEISS FIXED WING","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5505647,"SEE ITEM 58007538","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[5505646,"SEE ITEM 58006520","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5505641,"PLATE LOCKING LATERAL HOOK 7 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",460,230,365.70000000000005,391,391,391,386.4,372.6,368,365.70000000000005,368]
[5505636,"PLATE LOCKING THIRD TUBULAR 8 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",349,174.5,277.45500000000004,296.64999999999998,296.64999999999998,296.64999999999998,293.15999999999997,282.69,279.2,277.45500000000004,279.2]
[5505631,"PLATE LOCKING MEDIAL HOOK 7 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",521,260.5,414.19499999999999,442.84999999999997,442.84999999999997,442.84999999999997,437.64,422.01000000000005,416.8,414.19499999999999,416.8]
[5505630,"PLATE LOCKING MEDIAL HOOK 5 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",477,238.5,379.21500000000003,405.45,405.45,405.45,400.68,386.37,381.6,379.21500000000003,381.6]
[5505625,"PLATE LOCKING STRAIGHT 7 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",414,207,329.13,351.9,351.9,351.9,347.76,335.34000000000003,331.20000000000005,329.13,331.20000000000005]
[5505620,"PLATE LOCKING DIST FIB LFT 5 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",733,366.5,582.73500000000001,623.04999999999995,623.04999999999995,623.04999999999995,615.72,593.73,586.4,582.73500000000001,586.4]
[5505615,"PLATE LOCKING DIST FIB RT 4 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",621,310.5,493.69500000000005,527.85,527.85,527.85,521.64,503.01000000000005,496.8,493.69500000000005,496.8]
[5505614,"WASHER 7.0MM ARTHREX","CDM Code","IP/OP",278,"Supply/Implants","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[5505609,"SCREW 4.0 LP CANN LONG THR 40MM","CDM Code","IP/OP",278,"Supply/Implants","","",354,177,281.43,300.89999999999998,300.89999999999998,300.89999999999998,297.36,286.74,283.2,281.43,283.2]
[5505604,"SCREW 4.0 LP CANN SHT THR 50MM","CDM Code","IP/OP",278,"Supply/Implants","","",185,92.5,147.07500000000002,157.25,157.25,157.25,155.4,149.85000000000002,148,147.07500000000002,148]
[5505599,"SCREW 4.0 LP CANC 24MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505598,"SCREW 4.0 LP CANC 22MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505593,"SCREW 4.0 LP CANC 12MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505588,"SCREW 3.5 LP TM CORTEX 45MM","CDM Code","IP/OP",278,"Supply/Implants","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5505583,"SCREW 3.5 LP TM CORTEX 28MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505582,"SCREW 3.5 LP TM CORTEX 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505577,"SCREW 3.5 LP TM CORTEX 16MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505572,"SCREW 3.0 CANC FULL THR 28MM","CDM Code","IP/OP",278,"Supply/Implants","","",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[5505567,"SCREW 3.0 CANC FULL THR 18MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505566,"SCREW 3.0 CANC FULL THR 16MM","CDM Code","IP/OP",278,"Supply/Implants","","",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[5505561,"SCREW 3.5 LP LOCKING 18MM","CDM Code","IP/OP",278,"Supply/Implants","","",309,154.5,245.655,262.64999999999998,262.64999999999998,262.64999999999998,259.56,250.29000000000002,247.20000000000002,245.655,247.20000000000002]
[5505557,"SCREW 3.5 LP LOCKING 10MM","CDM Code","IP/OP",278,"Supply/Implants","","",309,154.5,245.655,262.64999999999998,262.64999999999998,262.64999999999998,259.56,250.29000000000002,247.20000000000002,245.655,247.20000000000002]
[5505552,"SCREW 2.7 LP LOCKING 18MM","CDM Code","IP/OP",278,"Supply/Implants","","",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[5505551,"SCREW 2.7 LP LOCKING 16MM","CDM Code","IP/OP",278,"Supply/Implants","","",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[5505546,"SEE ITEM 58003223","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5505541,"POST BI-CORTICAL 50MM","CDM Code","IP/OP",278,"Supply/Implants","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5505536,"POST BI-CORTICAL 37.5MM","CDM Code","IP/OP",278,"Supply/Implants","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5505535,"POST BI-CORTICAL 35MM","CDM Code","IP/OP",278,"Supply/Implants","","",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[5505530,"SEE ITEM 58007635","CDM Code","IP/OP",272,"Sterile Supply","","",376,188,298.92,319.59999999999997,319.59999999999997,319.59999999999997,315.83999999999997,304.56,300.8,298.92,300.8]
[5505525,"GAUZE SACKS W O RING","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5505520,"DRESSG FIBRACOL 2X2 PLUS","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5505519,"DRESSG PROMOGRAN MATRIX 4.34SQ IN","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5505513,"SEE ITEM 58005513","CDM Code","IP/OP",270,"Med-Sur Supplies","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5505508,"SEE ITEM 58005508","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5505500,"SEE ITEM 58005500","CDM Code","IP/OP",270,"Med-Sur Supplies","","",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5505459,"DRESS BIATAIN 4X4 ADH FOAM","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5505454,"DRESS MEPILEX FOAM LITE 4X4","CDM Code","IP/OP",270,"Med-Sur Supplies","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5505099,"TUB GASTRO 22F ADULT","CDM Code","IP/OP",272,"Sterile Supply","","",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[5505094,"CATH SET FANELLI CHOLANGIOGRAPHY 5FR","CDM Code","IP/OP",272,"Sterile Supply","","",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[5505093,"DEVICE XL TISSUE REMOVAL MYOSURE","CDM Code","IP/OP",272,"Sterile Supply","","",1089,544.5,865.755,925.65,925.65,925.65,914.76,882.09,871.2,865.755,871.2]
[5505088,"THUMB ORTHOSIS XS RIGHT","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5505083,"SEE ITEM 58009002","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5505078,"SCREW TENODESIS 6.25X15MM","CDM Code","IP/OP",278,"Supply/Implants","","",462,231,367.29,392.7,392.7,392.7,388.08,374.22,369.6,367.29,369.6]
[5505077,"SCREW TENODESIS 5.5X15MM","CDM Code","IP/OP",278,"Supply/Implants","","",463,231.5,368.08500000000004,393.55,393.55,393.55,388.91999999999996,375.03000000000003,370.40000000000003,368.08500000000004,370.40000000000003]
[5505072,"TUB GASTRO 12F LOW VOL","CDM Code","IP/OP",272,"Sterile Supply","","",108,54,85.86,91.8,91.8,91.8,90.72,87.48,86.4,85.86,86.4]
[5505067,"SEE ITEM 58007854","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[5505062,"SONO TAP CANNULA 22GX80MM","CDM Code","IP/OP",272,"Sterile Supply","","",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[5505061,"SHOULDER SPEEDBRIDGE","CDM Code","IP/OP",272,"Sterile Supply","","",1963,981.5,1560.585,1668.55,1668.55,1668.55,1648.9199999999998,1590.0300000000002,1570.4,1560.585,1570.4]
[5505056,"MEROCEL NASAL PACKING","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5505051,"TENSOPLAST 3\"","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5505045,"SEE ITEM 58007279","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5505044,"SEE ITEM 58003327","CDM Code","IP/OP",270,"Med-Sur Supplies","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5505040,"SEE ITEM 58003336","CDM Code","IP/OP",270,"Med-Sur Supplies","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5505034,"SEE ITEM 58003333","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5505029,"GRASPER MINILAP CLUTCH","CDM Code","IP/OP",272,"Sterile Supply","","",402,201,319.59000000000003,341.7,341.7,341.7,337.68,325.62,321.60000000000002,319.59000000000003,321.60000000000002]
[5505028,"SEE ITEM 58003308","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5505023,"SEE ITEM 58003311","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5505007,"SEE ITEM 58003317","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5505002,"SEE ITEM 58003337","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5505001,"SEE ITEM 58003328","CDM Code","IP/OP",270,"Med-Sur Supplies","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5504558,"SEE ITEM 58009505","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5504553,"VENTRIO ST HERNIA PATCH 27.4CM X 34.9CM","CDM Code","IP/OP",272,"Sterile Supply","","",2543,1271.5,2021.6850000000002,2161.5499999999997,2161.5499999999997,2161.5499999999997,2136.12,2059.83,2034.4,2021.6850000000002,2034.4]
[5504548,"SEE ITEM 58007540","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5504547,"BIMANUAL ULTRAFLOW","CDM Code","IP/OP",272,"Sterile Supply","","",86,43,68.37,73.099999999999994,73.099999999999994,73.099999999999994,72.239999999999995,69.660000000000011,68.8,68.37,68.8]
[5504542,"STAPLE LIGAMENT SPIKELESS 6X20","CDM Code","IP/OP",272,"Sterile Supply","","",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[5504537,"SEE ITEM 58007603","CDM Code","IP/OP",272,"Sterile Supply","","",330,165,262.35000000000002,280.5,280.5,280.5,277.2,267.3,264,262.35000000000002,264]
[5504532,"SEE ITEM 58009005","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5504531,"GEL HYPERGEL WOUND .17OZ","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5504526,"SEE ITEM 58002716","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5504520,"CUTTER LOOP RT ANGLE","CDM Code","IP/OP",272,"Sterile Supply","","",170,85,135.15,144.5,144.5,144.5,142.79999999999998,137.70000000000002,136,135.15,136]
[5504515,"NEEDLE BIO CORE 20GX15CM 20","CDM Code","IP/OP",272,"Sterile Supply","","",126,63,100.17,107.1,107.1,107.1,105.83999999999999,102.06,100.80000000000001,100.17,100.80000000000001]
[5504514,"NEEDLE BIO CORE 20GX15CM 10","CDM Code","IP/OP",272,"Sterile Supply","","",126,63,100.17,107.1,107.1,107.1,105.83999999999999,102.06,100.80000000000001,100.17,100.80000000000001]
[5504509,"LOCK TITE SECURE ET TUB","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5504504,"NEEDLE INSULATED 22G X 4 3/4","CDM Code","IP/OP",272,"Sterile Supply","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5504499,"CLIP MED LG HEMOLOK","CDM Code","IP/OP",272,"Sterile Supply","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[5504498,"TENDON PATELLAR 9 10MM","CDM Code","IP/OP",278,"Supply/Implants","","",4056,2028,3224.52,3447.6,3447.6,3447.6,3407.04,3285.36,3244.8,3224.52,3244.8]
[5504492,"NEEDLE GHIATAS BIO 20G 7CM MAMMO","CDM Code","IP/OP",272,"Sterile Supply","","",79,39.5,62.805,67.149999999999991,67.149999999999991,67.149999999999991,66.36,63.99,63.2,62.805,63.2]
[5504487,"GUN BIOPSY 20GX9CM QC 10MM","CDM Code","IP/OP",272,"Sterile Supply","","",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[5504481,"SEE ITEM 58009015","CDM Code","IP/OP",272,"Sterile Supply","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5504480,"FORCP CUT HALO 5MM","CDM Code","IP/OP",272,"Sterile Supply","","",701,350.5,557.29500000000007,595.85,595.85,595.85,588.84,567.81000000000006,560.80000000000007,557.29500000000007,560.80000000000007]
[5504472,"SEE ITEM 58003553","CDM Code","IP/OP",270,"Med-Sur Supplies","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5504467,"SEE ITEM 58003550","CDM Code","IP/OP",270,"Med-Sur Supplies","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5504465,"NEEDLE ENDOSCOPIC","CDM Code","IP/OP",272,"Sterile Supply","","",113,56.5,89.835000000000008,96.05,96.05,96.05,94.92,91.53,90.4,89.835000000000008,90.4]
[5504462,"CLIP FILSHIE","CDM Code","IP/OP",272,"Sterile Supply","","",303,151.5,240.88500000000002,257.55,257.55,257.55,254.51999999999998,245.43,242.4,240.88500000000002,242.4]
[5504457,"SET JEJUN FEED","CDM Code","IP/OP",272,"Sterile Supply","","",281,140.5,223.39500000000001,238.85,238.85,238.85,236.04,227.61,224.8,223.39500000000001,224.8]
[5504452,"WIREGUIDE CURVED .035X80CM","CDM Code","IP/OP",272,"Sterile Supply","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5504447,"NEEDLE BIO ASP CHIBA 21G","CDM Code","IP/OP",272,"Sterile Supply","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5504446,"NEEDLE PERCUT ENTRY THIN 18GX7CM","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5504441,"DILATOR STD 10F 15CM","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5504436,"SEE ITEM 58003227","CDM Code","IP/OP",272,"Sterile Supply","","",252,126,200.34,214.2,214.2,214.2,211.67999999999998,204.12,201.60000000000002,200.34,201.60000000000002]
[5504431,"NEEDLE BONE BIO COAXIAL 13GX10CM","CDM Code","IP/OP",272,"Sterile Supply","","",282,141,224.19,239.7,239.7,239.7,236.88,228.42000000000002,225.60000000000002,224.19,225.60000000000002]
[5504430,"SEE ITEM 58003711","CDM Code","IP/OP",270,"Med-Sur Supplies","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5504425,"MARK BIO SITE SUPERFICIAL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[5504420,"DRESSG TEGA ALGI ROPE 12IN","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5504414,"DRESSG SILVEASORB PERF 4.25X4.25","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5504412,"DRESSG TEGA FOAM 4X4.5","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5504404,"DRESSG TEGA ALGINATE 2X2","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5504328,"WRAP COBAN 3 LF STRL","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5504323,"SEE ITEM 58007922","CDM Code","IP/OP",272,"Sterile Supply","","",98,49,77.910000000000011,83.3,83.3,83.3,82.32,79.38000000000001,78.400000000000006,77.910000000000011,78.400000000000006]
[5504322,"SEE ITEM 58007923","CDM Code","IP/OP",272,"Sterile Supply","","",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[5504317,"WIREGUIDE 4.0 THR ASNIS","CDM Code","IP/OP",272,"Sterile Supply","","",273,136.5,217.03500000000003,232.04999999999998,232.04999999999998,232.04999999999998,229.32,221.13000000000002,218.4,217.03500000000003,218.4]
[5504312,"WRAP ICE KNEE","CDM Code","IP/OP",272,"Sterile Supply","","",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[5504307,"WIREGUIDE BENTS .035","CDM Code","IP/OP",272,"Sterile Supply","","",53,26.5,42.135000000000005,45.05,45.05,45.05,44.519999999999996,42.93,42.400000000000006,42.135000000000005,42.400000000000006]
[5504306,"WIREGLIDE ST 038X150","CDM Code","IP/OP",272,"Sterile Supply","","",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[5504301,"SEE ITEM 58007917","CDM Code","IP/OP",278,"Supply/Implants","","",105,52.5,83.475000000000009,89.25,89.25,89.25,88.2,85.050000000000011,84,83.475000000000009,84]
[5504296,"SEE ITEM 58007912","CDM Code","IP/OP",278,"Supply/Implants","","",105,52.5,83.475000000000009,89.25,89.25,89.25,88.2,85.050000000000011,84,83.475000000000009,84]
[5504291,"SEE ITEM 58007751","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5504290,"SEE ITEM 58007753","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5504285,"WASHER 10.0MM FOR 4.5 SET","CDM Code","IP/OP",278,"Supply/Implants","","",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[5504277,"* SERFAS ENERGY 2.5MM MICRO","CDM Code","IP/OP",272,"Sterile Supply","","",359,179.5,285.40500000000003,305.14999999999998,305.14999999999998,305.14999999999998,301.56,290.79000000000002,287.2,285.40500000000003,287.2]
[5504271,"VISCOADHERENT","CDM Code","IP/OP",272,"Sterile Supply","","",173,86.5,137.535,147.04999999999998,147.04999999999998,147.04999999999998,145.32,140.13,138.4,137.535,138.4]
[5504269,"VISCRA RETAINER FISH","CDM Code","IP/OP",272,"Sterile Supply","","",81,40.5,64.39500000000001,68.849999999999994,68.849999999999994,68.849999999999994,68.039999999999992,65.61,64.8,64.39500000000001,64.8]
[5504261,"TUB TRACH 6 L PRES CUF","CDM Code","IP/OP",270,"Med-Sur Supplies","","",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[5504258,"SEE ITEM 58002853","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5504253,"SEE ITEM 58002854","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5504252,"TUBE SET FLOSTEADY ARTHO PUMP","CDM Code","IP/OP",272,"Sterile Supply","","",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[5504247,"TUB 4 LUMN 18 BLAKEMORE","CDM Code","IP/OP",272,"Sterile Supply","","",413,206.5,328.33500000000004,351.05,351.05,351.05,346.91999999999996,334.53000000000003,330.40000000000003,328.33500000000004,330.40000000000003]
[5504240,"TROCR CATH 24F","CDM Code","IP/OP",272,"Sterile Supply","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5504235,"TROCR CATH 12F","CDM Code","IP/OP",272,"Sterile Supply","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5504234,"TROCR CATH 10F","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5504229,"SEE ITEM 58008405","CDM Code","IP/OP",272,"Sterile Supply","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[5504220,"FISCHER CONE BIOPSY EXCISOR MED","CDM Code","IP/OP",272,"Sterile Supply","","",86,43,68.37,73.099999999999994,73.099999999999994,73.099999999999994,72.239999999999995,69.660000000000011,68.8,68.37,68.8]
[5504214,"TRAY PREP LG DISP","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5504213,"SEE ITEM 58004213","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5504208,"TRAY LUMBR PUNC PED","CDM Code","IP/OP",272,"Sterile Supply","","",30,15,23.85,25.5,25.5,25.5,25.2,24.3,24,23.85,24]
[5504203,"TRAY IRRIG ASEPTO","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5504198,"TRAP FING STER L","CDM Code","IP/OP",272,"Sterile Supply","","",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[5504197,"SEE ITEM 58003630","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5504192,"SEE ITEM 58003470","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5504187,"SEE ITEM 58003645","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5504181,"SEE ITEM 58003455","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5504180,"SEE ITEM 58003660","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5504165,"TAMPON NASAL","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5504158,"SYRG ENDO GUN","CDM Code","IP/OP",272,"Sterile Supply","","",110,55,87.45,93.5,93.5,93.5,92.399999999999991,89.100000000000009,88,87.45,88]
[5504153,"SEE ITEM 58007221","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5504152,"SEE ITEM 58006511","CDM Code","IP/OP",272,"Sterile Supply","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5504146,"SEE ITEM 58007231","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5504139,"SUT ACCU PASS LT","CDM Code","IP/OP",272,"Sterile Supply","","",290,145,230.55,246.5,246.5,246.5,243.6,234.9,232,230.55,232]
[5504134,"SEE ITEM 58006541","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5504133,"SEE ITEM 58004133","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5504128,"SEE ITEM 58004128","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5504122,"SEE ITEM 58007258","CDM Code","IP/OP",272,"Sterile Supply","","",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[5504117,"SEE ITEM 58004117","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5504113,"SEE ITEM 58007275","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5504111,"SEE ITEM 58007273","CDM Code","IP/OP",272,"Sterile Supply","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5504104,"SEE ITEM 58004104","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5504092,"SEE ITEM 58007254","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5504091,"SEE ITEM 58004091","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5504083,"SEE ITEM 58004083","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5504076,"SEE ITEM 58004076","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5504062,"SEE ITEM 58004062","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5504061,"SEE ITEM 58004061","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5504050,"SEE ITEM 58007235","CDM Code","IP/OP",272,"Sterile Supply","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[5504035,"SEE ITEM 58007228","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5504029,"SEE ITEM 58007224","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5504028,"SEE ITEM 58006514","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5504017,"SEE ITEM 58007216","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5504008,"SEE ITEM 58006506","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5504001,"SEE ITEM 58006524","CDM Code","IP/OP",272,"Sterile Supply","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5504000,"SEE ITEM 58007238","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5503990,"SEE ITEM 58007269","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5503981,"SEE ITEM 58006516","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5503974,"SEE ITEM 58007278","CDM Code","IP/OP",272,"Sterile Supply","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5503973,"SEE ITEM 58007286","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5503962,"SEE ITEM 58006530","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5503955,"SUT FIBERWIRE 2 T5","CDM Code","IP/OP",272,"Sterile Supply","","",83,41.5,65.984999999999999,70.55,70.55,70.55,69.72,67.23,66.400000000000006,65.984999999999999,66.400000000000006]
[5503943,"SUT ULTRABRAID 2 COBRAID","CDM Code","IP/OP",272,"Sterile Supply","","",61,30.5,48.495000000000005,51.85,51.85,51.85,51.239999999999995,49.410000000000004,48.800000000000004,48.495000000000005,48.800000000000004]
[5503941,"SEE ITEM 58006523","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5503934,"SUT FORCE FIBER 5 38 STD W NEEDLE","CDM Code","IP/OP",272,"Sterile Supply","","",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[5503814,"SEE ITEM 58006544","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5503809,"STAPLR RELOAD ENDO ETS45","CDM Code","IP/OP",272,"Sterile Supply","","",277,138.5,220.215,235.45,235.45,235.45,232.67999999999998,224.37,221.60000000000002,220.215,221.60000000000002]
[5503808,"SEE ITEM 58003968","CDM Code","IP/OP",270,"Med-Sur Supplies","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5503801,"SEE ITEM 58003966","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5503796,"* STYLET COUNCIL 6F","CDM Code","IP/OP",272,"Sterile Supply","","",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[5503789,"SEE ITEM 58003963","CDM Code","IP/OP",270,"Med-Sur Supplies","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5503788,"SEE ITEM 58003960","CDM Code","IP/OP",270,"Med-Sur Supplies","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5503782,"SEE ITEM 58009541","CDM Code","IP/OP",270,"Med-Sur Supplies","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5503776,"STENT MULTIFLX 6X26","CDM Code","IP/OP",272,"Sterile Supply","","",376,188,298.92,319.59999999999997,319.59999999999997,319.59999999999997,315.83999999999997,304.56,300.8,298.92,300.8]
[5503767,"STAPLR SKIN 35W","CDM Code","IP/OP",272,"Sterile Supply","","",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[5503765,"STAPLR LINEAR 100MM","CDM Code","IP/OP",272,"Sterile Supply","","",273,136.5,217.03500000000003,232.04999999999998,232.04999999999998,232.04999999999998,229.32,221.13000000000002,218.4,217.03500000000003,218.4]
[5503758,"STAPLR ACCESS CS40G","CDM Code","IP/OP",272,"Sterile Supply","","",444,222,352.98,377.4,377.4,377.4,372.96,359.64000000000004,355.20000000000005,352.98,355.20000000000005]
[5503744,"SCREW 3.0 CANN LONG 34MM","CDM Code","IP/OP",278,"Supply/Implants","","",383,191.5,304.48500000000001,325.55,325.55,325.55,321.71999999999997,310.23,306.40000000000003,304.48500000000001,306.40000000000003]
[5503739,"SCREW 3.0 CANN LONG 27MM","CDM Code","IP/OP",278,"Supply/Implants","","",399,199.5,317.20500000000004,339.15,339.15,339.15,335.15999999999997,323.19,319.20000000000005,317.20500000000004,319.20000000000005]
[5503738,"SCREW 3.0 CANN LONG 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",399,199.5,317.20500000000004,339.15,339.15,339.15,335.15999999999997,323.19,319.20000000000005,317.20500000000004,319.20000000000005]
[5503733,"SCREW 3.0 CANN LONG 21MM","CDM Code","IP/OP",278,"Supply/Implants","","",399,199.5,317.20500000000004,339.15,339.15,339.15,335.15999999999997,323.19,319.20000000000005,317.20500000000004,319.20000000000005]
[5503728,"SPRAY DERMAGRAM","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5503722,"SEE ITEM 58002722","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5503721,"SPONG PEANUT KITNR","CDM Code","IP/OP",272,"Sterile Supply","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5503716,"SEE ITEM 58003941","CDM Code","IP/OP",270,"Med-Sur Supplies","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5503705,"SEE ITEM 58003945","CDM Code","IP/OP",270,"Med-Sur Supplies","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5503699,"SEE ITEM 58005540","CDM Code","IP/OP",270,"Med-Sur Supplies","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5503698,"SEE ITEM 58005538","CDM Code","IP/OP",270,"Med-Sur Supplies","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5503689,"BALLOON DISSECTION","CDM Code","IP/OP",272,"Sterile Supply","","",515,257.5,409.42500000000001,437.75,437.75,437.75,432.59999999999997,417.15000000000003,412,409.42500000000001,412]
[5503679,"SNARE PED PROFILE","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5503672,"SLING ULTRA S","CDM Code","IP/OP",270,"Med-Sur Supplies","","",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[5503671,"SLING XL SHDLR ADUL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5503666,"SEE ITEM 58003926","CDM Code","IP/OP",270,"Med-Sur Supplies","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5503654,"SEE ITEM 58003297","CDM Code","IP/OP",270,"Med-Sur Supplies","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5503646,"SCREW 3.0 CANN LONG 40MM","CDM Code","IP/OP",278,"Supply/Implants","","",367,183.5,291.76499999999999,311.95,311.95,311.95,308.27999999999997,297.27000000000004,293.60000000000002,291.76499999999999,293.60000000000002]
[5503644,"SET CATH NEPH","CDM Code","IP/OP",272,"Sterile Supply","","",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[5503635,"SET ANES MICRBORE","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5503629,"SCREW 3.0 CANN SHORT 34MM","CDM Code","IP/OP",278,"Supply/Implants","","",374,187,297.33000000000004,317.89999999999998,317.89999999999998,317.89999999999998,314.15999999999997,302.94,299.2,297.33000000000004,299.2]
[5503624,"SCREW 3.0 CANN SHORT 27MM","CDM Code","IP/OP",278,"Supply/Implants","","",374,187,297.33000000000004,317.89999999999998,317.89999999999998,317.89999999999998,314.15999999999997,302.94,299.2,297.33000000000004,299.2]
[5503622,"SCREW 3.0 CANN SHORT 25MM","CDM Code","IP/OP",278,"Supply/Implants","","",387,193.5,307.66500000000002,328.95,328.95,328.95,325.08,313.47000000000003,309.60000000000002,307.66500000000002,309.60000000000002]
[5503619,"SCREW 3.0 CANN SHORT 22MM","CDM Code","IP/OP",278,"Supply/Implants","","",383,191.5,304.48500000000001,325.55,325.55,325.55,321.71999999999997,310.23,306.40000000000003,304.48500000000001,306.40000000000003]
[5503609,"SCREW 6.5 ASNIS CANN 45MM","CDM Code","IP/OP",278,"Supply/Implants","","",459,229.5,364.90500000000003,390.15,390.15,390.15,385.56,371.79,367.20000000000005,364.90500000000003,367.20000000000005]
[5503588,"SCREW 6.5 CANC FULL THR 30MM","CDM Code","IP/OP",278,"Supply/Implants","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5503587,"SCREW 6.5 CANC FULL THR 25MM","CDM Code","IP/OP",278,"Supply/Implants","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5503582,"SCREW 6.5 CANC 32 THR 75MM","CDM Code","IP/OP",278,"Supply/Implants","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5503577,"SCREW 6.5 CANC 32 THR 50MM","CDM Code","IP/OP",278,"Supply/Implants","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5503572,"SCREW 6.5 CANC 16 THR  90MM","CDM Code","IP/OP",278,"Supply/Implants","","",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[5503571,"SCREW 6.5 CANC 16 THR  85MM","CDM Code","IP/OP",278,"Supply/Implants","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[5503566,"SCREW 6.5 CANC 16 THR  60MM","CDM Code","IP/OP",278,"Supply/Implants","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5503561,"SCREW 6.5 CANC 16 THR 30MM","CDM Code","IP/OP",278,"Supply/Implants","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5503556,"SCREW 6.5 ASNIS CANN 90MM","CDM Code","IP/OP",278,"Supply/Implants","","",459,229.5,364.90500000000003,390.15,390.15,390.15,385.56,371.79,367.20000000000005,364.90500000000003,367.20000000000005]
[5503555,"SCREW 6.5 ASNIS CANN 85MM","CDM Code","IP/OP",278,"Supply/Implants","","",459,229.5,364.90500000000003,390.15,390.15,390.15,385.56,371.79,367.20000000000005,364.90500000000003,367.20000000000005]
[5503550,"SCREW 6.5 ASNIS CANN 60MM","CDM Code","IP/OP",278,"Supply/Implants","","",333,166.5,264.73500000000001,283.05,283.05,283.05,279.71999999999997,269.73,266.40000000000003,264.73500000000001,266.40000000000003]
[5503545,"SCREW 6.5 ASNIS CANN 105MM","CDM Code","IP/OP",278,"Supply/Implants","","",422,211,335.49,358.7,358.7,358.7,354.47999999999996,341.82000000000005,337.6,335.49,337.6]
[5503540,"SCREW 3.0 CANN SHORT 16MM","CDM Code","IP/OP",278,"Supply/Implants","C1713","ANCHOR/SCREW BN/BN,TIS/BN",410,205,325.95,348.5,348.5,348.5,344.4,332.1,328,325.95,328]
[5503539,"SCREW 3.0 CANN SHORT 15MM","CDM Code","IP/OP",278,"Supply/Implants","","",383,191.5,304.48500000000001,325.55,325.55,325.55,321.71999999999997,310.23,306.40000000000003,304.48500000000001,306.40000000000003]
[5503534,"SCREW 3.0 CANN SHORT 10MM","CDM Code","IP/OP",278,"Supply/Implants","","",383,191.5,304.48500000000001,325.55,325.55,325.55,321.71999999999997,310.23,306.40000000000003,304.48500000000001,306.40000000000003]
[5503529,"SCREW 4.5 MALLEOLAR 60MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503524,"SCREW 4.5 MALLEOLAR 35MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503523,"SCREW 4.5 MALLEOLAR 30MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503504,"SCREW 4.5 CORTEX 60MM","CDM Code","IP/OP",278,"Supply/Implants","","",53,26.5,42.135000000000005,45.05,45.05,45.05,44.519999999999996,42.93,42.400000000000006,42.135000000000005,42.400000000000006]
[5503499,"SCREW 4.5 CORTEX 50MM","CDM Code","IP/OP",278,"Supply/Implants","C1713","ANCHOR/SCREW BN/BN,TIS/BN",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5503494,"SCREW 4.5 CORTEX 40MM","CDM Code","IP/OP",278,"Supply/Implants","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5503493,"SCREW 4.5 CORTEX 36MM","CDM Code","IP/OP",278,"Supply/Implants","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5503488,"SCREW 4.5 CORTEX 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5503483,"SCREW 4.5 CORTEX 16MM","CDM Code","IP/OP",278,"Supply/Implants","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5503478,"SCREW 4.0 ASNIS CANN 36MM","CDM Code","IP/OP",278,"Supply/Implants","","",417,208.5,331.51500000000004,354.45,354.45,354.45,350.28,337.77000000000004,333.6,331.51500000000004,333.6]
[5503477,"SCREW 4.0 ASNIS CANN 34MM","CDM Code","IP/OP",278,"Supply/Implants","","",303,151.5,240.88500000000002,257.55,257.55,257.55,254.51999999999998,245.43,242.4,240.88500000000002,242.4]
[5503472,"SCREW 4.0 ASNIS CANN 24MM","CDM Code","IP/OP",278,"Supply/Implants","","",303,151.5,240.88500000000002,257.55,257.55,257.55,254.51999999999998,245.43,242.4,240.88500000000002,242.4]
[5503466,"SCREW 4.0 CANC PART THR 35MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503463,"SCREW 4.0 CANC PART THR 26MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503461,"SCREW 4.0 CANC PART THR 22MM","CDM Code","IP/OP",278,"Supply/Implants","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5503456,"SCREW 4.0 CANC PART THR 12MM","CDM Code","IP/OP",278,"Supply/Implants","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5503450,"SCREW 4.0 CANC FULL THR 24MM","CDM Code","IP/OP",278,"Supply/Implants","","",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[5503445,"SCR 4.0 CANC FULL THR 14MM","CDM Code","IP/OP",278,"Supply/Implants","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[5503444,"SCREW 4.0 CANC FULL THR 12MM","CDM Code","IP/OP",278,"Supply/Implants","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5503438,"SCREW 3.5 CORTEX SELF-TAP 16MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503432,"SCREW 3.5 CORTEX SELF-TAP 34MM","CDM Code","IP/OP",278,"Supply/Implants","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5503427,"SCREW 2.7 CORT 20MM","CDM Code","IP/OP",278,"Supply/Implants","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5503426,"SCREW 2.7 CORT 18MM","CDM Code","IP/OP",278,"Supply/Implants","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5503414,"SCREW 4.0 ASNIS CANN 14MM","CDM Code","IP/OP",278,"Supply/Implants","","",303,151.5,240.88500000000002,257.55,257.55,257.55,254.51999999999998,245.43,242.4,240.88500000000002,242.4]
[5503409,"SCREW 4.0 ASNIS CANN 44MM","CDM Code","IP/OP",278,"Supply/Implants","","",380,190,302.10000000000002,323,323,323,319.2,307.8,304,302.10000000000002,304]
[5503404,"SCREW 4.0 ASNIS CANN 60MM","CDM Code","IP/OP",278,"Supply/Implants","","",303,151.5,240.88500000000002,257.55,257.55,257.55,254.51999999999998,245.43,242.4,240.88500000000002,242.4]
[5503403,"SCREW 4.0 ASNIS CANN 65MM","CDM Code","IP/OP",278,"Supply/Implants","","",314,157,249.63000000000002,266.89999999999998,266.89999999999998,266.89999999999998,263.76,254.34,251.20000000000002,249.63000000000002,251.20000000000002]
[5503398,"SCREW LP CORTICAL 2.3X27MM","CDM Code","IP/OP",278,"Supply/Implants","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[5503393,"SCREW LP CORTICAL 2.3X22MM","CDM Code","IP/OP",278,"Supply/Implants","","",209,104.5,166.155,177.65,177.65,177.65,175.56,169.29000000000002,167.20000000000002,166.155,167.20000000000002]
[5503388,"SCREW LP CORTICAL 2.3X17MM","CDM Code","IP/OP",278,"Supply/Implants","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[5503387,"SCREW LP CORTICAL 2.3X16MM","CDM Code","IP/OP",278,"Supply/Implants","","",209,104.5,166.155,177.65,177.65,177.65,175.56,169.29000000000002,167.20000000000002,166.155,167.20000000000002]
[5503382,"SCR AR CORT 2.3X11","CDM Code","IP/OP",278,"Supply/Implants","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[5503267,"SYS W TRACT FORCE INDI KIWI","CDM Code","IP/OP",272,"Sterile Supply","","",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[5503262,"RESERVOIR CONSTAVAC","CDM Code","IP/OP",272,"Sterile Supply","","",305,152.5,242.47500000000002,259.25,259.25,259.25,256.2,247.05,244,242.47500000000002,244]
[5503259,"RETRV PED FORGN BODY","CDM Code","IP/OP",272,"Sterile Supply","","",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[5503252,"RESUSCIT DISP NEONATE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5503243,"RELD STAPL TR45W","CDM Code","IP/OP",272,"Sterile Supply","","",274,137,217.83,232.9,232.9,232.9,230.16,221.94000000000003,219.20000000000002,217.83,219.20000000000002]
[5503234,"SEE ITEM 58007860","CDM Code","IP/OP",272,"Sterile Supply","","",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[5503232,"RASP LG COTTLE","CDM Code","IP/OP",272,"Sterile Supply","","",333,166.5,264.73500000000001,283.05,283.05,283.05,279.71999999999997,269.73,266.40000000000003,264.73500000000001,266.40000000000003]
[5503227,"RETRACT PRO WOUND MED 5X9 INC","CDM Code","IP/OP",272,"Sterile Supply","","",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[5503218,"OMNI HFX 7 132","CDM Code","IP/OP",278,"Supply/Implants","","",1392,696,1106.6400000000001,1183.2,1183.2,1183.2,1169.28,1127.52,1113.6000000000001,1106.6400000000001,1113.6000000000001]
[5503213,"UNI 14MM DIS CEM SP","CDM Code","IP/OP",278,"Supply/Implants","","",209,104.5,166.155,177.65,177.65,177.65,175.56,169.29000000000002,167.20000000000002,166.155,167.20000000000002]
[5503212,"UNI 13MM DIS CEM SP","CDM Code","IP/OP",278,"Supply/Implants","","",352,176,279.84000000000003,299.2,299.2,299.2,295.68,285.12,281.60000000000002,279.84000000000003,281.60000000000002]
[5503208,"UNI 8MM DIS CEM SP","CDM Code","IP/OP",278,"Supply/Implants","","",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[5503203,"PROS HD UH1 58 OSTEO","CDM Code","IP/OP",278,"Supply/Implants","","",1679,839.5,1334.8050000000001,1427.1499999999999,1427.1499999999999,1427.1499999999999,1410.36,1359.99,1343.2,1334.8050000000001,1343.2]
[5503198,"PROS HD UH1 52 OSTEO","CDM Code","IP/OP",278,"Supply/Implants","","",1199,599.5,953.20500000000004,1019.15,1019.15,1019.15,1007.16,971.19,959.2,953.20500000000004,959.2]
[5503197,"PROS HD UH1 51 OSTEO","CDM Code","IP/OP",278,"Supply/Implants","","",811,405.5,644.745,689.35,689.35,689.35,681.24,656.91000000000008,648.80000000000007,644.745,648.80000000000007]
[5503192,"PROS HD UH1 46 OSTEO","CDM Code","IP/OP",278,"Supply/Implants","","",736,368,585.12,625.6,625.6,625.6,618.24,596.16000000000008,588.80000000000007,585.12,588.80000000000007]
[5503187,"PROS HD UH1 41 OSTEO","CDM Code","IP/OP",278,"Supply/Implants","","",949,474.5,754.45500000000004,806.65,806.65,806.65,797.16,768.69,759.2,754.45500000000004,759.2]
[5503179,"PROBE DART MRASURE","CDM Code","IP/OP",272,"Sterile Supply","","",170,85,135.15,144.5,144.5,144.5,142.79999999999998,137.70000000000002,136,135.15,136]
[5503176,"PROBE 21G INF CANN VITRECT","CDM Code","IP/OP",272,"Sterile Supply","","",338,169,268.71000000000004,287.3,287.3,287.3,283.92,273.78000000000003,270.40000000000003,268.71000000000004,270.40000000000003]
[5503115,"TUB SALEM SUMP SILICONE 16F","CDM Code","IP/OP",272,"Sterile Supply","","",401,200.5,318.79500000000002,340.84999999999997,340.84999999999997,340.84999999999997,336.84,324.81,320.8,318.79500000000002,320.8]
[5503110,"PLATE LATERAL TIB BUTTRESS LT 9HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",508,254,403.86,431.8,431.8,431.8,426.71999999999997,411.48,406.40000000000003,403.86,406.40000000000003]
[5503105,"PLATE T 4 HOLES","CDM Code","IP/OP",278,"Supply/Implants","","",379,189.5,301.30500000000001,322.14999999999998,322.14999999999998,322.14999999999998,318.36,306.99,303.2,301.30500000000001,303.2]
[5503101,"PLATE SPOON 5 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",339,169.5,269.505,288.14999999999998,288.14999999999998,288.14999999999998,284.76,274.59000000000003,271.2,269.505,271.2]
[5503084,"PLATE 1/3 TUBULAR 7 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",206,103,163.77000000000001,175.1,175.1,175.1,173.04,166.86,164.8,163.77000000000001,164.8]
[5503079,"PLATE L-BUTTRESS RT 4 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",401,200.5,318.79500000000002,340.84999999999997,340.84999999999997,340.84999999999997,336.84,324.81,320.8,318.79500000000002,320.8]
[5503074,"PLATE SM T OBLIQUE 3/3 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[5503073,"PLATE SM T RT ANGLE 3/3 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",212,106,168.54000000000002,180.2,180.2,180.2,178.07999999999998,171.72,169.60000000000002,168.54000000000002,169.60000000000002]
[5503068,"PLATE 4.5 NARROW DCP 5 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",253,126.5,201.13500000000002,215.04999999999998,215.04999999999998,215.04999999999998,212.51999999999998,204.93,202.4,201.13500000000002,202.4]
[5503063,"PLATE 4.5 BROAD DCP 8 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",336,168,267.12,285.59999999999997,285.59999999999997,285.59999999999997,282.24,272.16000000000003,268.8,267.12,268.8]
[5503058,"PLATE 3.5 RECON 6 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",285,142.5,226.57500000000002,242.25,242.25,242.25,239.39999999999998,230.85000000000002,228,226.57500000000002,228]
[5503057,"PLATE 3.5 LC-DCP 8 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",395,197.5,314.02500000000003,335.75,335.75,335.75,331.8,319.95000000000005,316,314.02500000000003,316]
[5503052,"PLATE 1/3 TUBULAR 5 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",244,122,193.98000000000002,207.4,207.4,207.4,204.95999999999998,197.64000000000001,195.20000000000002,193.98000000000002,195.20000000000002]
[5503047,"PLATE 1/3 TUBULAR 6 HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",192,96,152.64000000000001,163.19999999999999,163.19999999999999,163.19999999999999,161.28,155.52000000000001,153.60000000000002,152.64000000000001,153.60000000000002]
[5503042,"PLATE LP MET WEDGE 4MM RT","CDM Code","IP/OP",278,"Supply/Implants","","",475,237.5,377.625,403.75,403.75,403.75,399,384.75,380,377.625,380]
[5503041,"PLATE LP MET WEDGE 4MM LT","CDM Code","IP/OP",278,"Supply/Implants","","",503,251.5,399.88500000000005,427.55,427.55,427.55,422.52,407.43,402.40000000000003,399.88500000000005,402.40000000000003]
[5503030,"PLATE LP MET WEDGE 5.5MM LT","CDM Code","IP/OP",272,"Sterile Supply","C1713","ANCHOR/SCREW BN/BN,TIS/BN",896,448,712.32,761.6,761.6,761.6,752.64,725.76,716.80000000000007,712.32,716.80000000000007]
[5503025,"PLATE LP MET WEDGE 7MM RT","CDM Code","IP/OP",278,"Supply/Implants","","",896,448,712.32,761.6,761.6,761.6,752.64,725.76,716.80000000000007,712.32,716.80000000000007]
[5503001,"PAD HEEL W H 2 5 16 FELT","CDM Code","IP/OP",270,"Med-Sur Supplies","L3485","SHOE HEEL PAD REMOVABLE FOR",72,36,57.24,61.199999999999996,61.199999999999996,61.199999999999996,60.48,58.320000000000007,57.6,57.24,57.6]
[5502996,"PIN STEIN 9/64 X 9 THRD","CDM Code","IP/OP",278,"Supply/Implants","","",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[5502991,"PIN STEIN 3/16 X 9 THRD","CDM Code","IP/OP",278,"Supply/Implants","","",203,101.5,161.38500000000002,172.54999999999998,172.54999999999998,172.54999999999998,170.51999999999998,164.43,162.4,161.38500000000002,162.4]
[5502986,"PIN STEIN .156 X 9","CDM Code","IP/OP",278,"Supply/Implants","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[5502984,"PIN STEIN .188 X 9","CDM Code","IP/OP",278,"Supply/Implants","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5502953,"HOOD INFANT SMALL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5502943,"PAD SCRATCH STERILE","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5502935,"PACK CYSTO IV","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5502929,"PACK LAPCHOLE","CDM Code","IP/OP",272,"Sterile Supply","","",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[5502928,"PACK LAP PELVISCOPY III","CDM Code","IP/OP",272,"Sterile Supply","","",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[5502921,"PACKING NASAL RHINO 5.5","CDM Code","IP/OP",272,"Sterile Supply","","",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[5502916,"KIT BICEPTOR 7X25","CDM Code","IP/OP",272,"Sterile Supply","","",458,229,364.11,389.3,389.3,389.3,384.71999999999997,370.98,366.40000000000003,364.11,366.40000000000003]
[5502911,"KIT BICEPTOR 8X15","CDM Code","IP/OP",272,"Sterile Supply","","",458,229,364.11,389.3,389.3,389.3,384.71999999999997,370.98,366.40000000000003,364.11,366.40000000000003]
[5502910,"KIT BICEPTOR 7X15","CDM Code","IP/OP",272,"Sterile Supply","","",458,229,364.11,389.3,389.3,389.3,384.71999999999997,370.98,366.40000000000003,364.11,366.40000000000003]
[5502899,"SEE ITEM 58008006","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5502893,"SEE ITEM 58002930","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5502883,"SEE ITEM 58002944","CDM Code","IP/OP",272,"Sterile Supply","","",368,184,292.56,312.8,312.8,312.8,309.12,298.08000000000004,294.40000000000003,292.56,294.40000000000003]
[5502882,"SEE ITEM 58002946","CDM Code","IP/OP",272,"Sterile Supply","","",367,183.5,291.76499999999999,311.95,311.95,311.95,308.27999999999997,297.27000000000004,293.60000000000002,291.76499999999999,293.60000000000002]
[5502876,"NEEDLE MAYO HALF CIRC 4D","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5502870,"VENTRALEX ST MED CIRCLE","CDM Code","IP/OP",278,"Supply/Implants","","",550,275,437.25,467.5,467.5,467.5,462,445.50000000000006,440,437.25,440]
[5502865,"SEE ITEM 58003190","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5502864,"NEBULIZER HOPE","CDM Code","IP/OP",272,"Sterile Supply","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5502858,"METER PEAK FLOW LOW","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5502853,"MESH SOFT FLAT 6X6","CDM Code","IP/OP",278,"Supply/Implants","","",199,99.5,158.20500000000001,169.15,169.15,169.15,167.16,161.19,159.20000000000002,158.20500000000001,159.20000000000002]
[5502848,"LENS ACRYSOF TORIC SV25TO","CDM Code","IP/OP",276,"Intra Oc Lens","","",1009,504.5,802.15500000000009,857.65,857.65,857.65,847.56,817.29000000000008,807.2,802.15500000000009,807.2]
[5502847,"MASK MULTI VENT PEDI","CDM Code","IP/OP",270,"Med-Sur Supplies","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5502836,"KNEE CUTTING BLOCK OTIS","CDM Code","IP/OP",272,"Sterile Supply","","",1690,845,1343.55,1436.5,1436.5,1436.5,1419.6,1368.9,1352,1343.55,1352]
[5502831,"SEE ITEM 58009500","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502826,"LENS CRYS AT50AO/AT52SE","CDM Code","IP/OP",276,"Intra Oc Lens","","",1009,504.5,802.15500000000009,857.65,857.65,857.65,847.56,817.29000000000008,807.2,802.15500000000009,807.2]
[5502825,"LENS IOL STD SN60WF","CDM Code","IP/OP",276,"Intra Oc Lens","","",368,184,292.56,312.8,312.8,312.8,309.12,298.08000000000004,294.40000000000003,292.56,294.40000000000003]
[5502815,"KNIFE DISP COLD","CDM Code","IP/OP",272,"Sterile Supply","","",289,144.5,229.75500000000002,245.65,245.65,245.65,242.76,234.09,231.20000000000002,229.75500000000002,231.20000000000002]
[5502805,"KIT CEMNT MIX ADVAN","CDM Code","IP/OP",272,"Sterile Supply","","",288,144,228.96,244.79999999999998,244.79999999999998,244.79999999999998,241.92,233.28000000000003,230.4,228.96,230.4]
[5502796,"IV D5 NS .9% 1000ml","CDM Code","IP/OP",258,"IV Solutions","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502795,"IV D5 NS .45% 1000ml","CDM Code","IP/OP",258,"IV Solutions","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502789,"IV LR INJ 1000ML","CDM Code","IP/OP",636,"Drug/Detail Code","J7120","RINGERS LACTATE INFUSION",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5502786,"IV LR 3000ML","CDM Code","IP/OP",258,"IV Solutions","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5502781,"IV D10 INJ 500ml","CDM Code","IP/OP",258,"IV Solutions","","",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[5502780,"KIT ORAL CARE Q-2HR","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5502775,"IRRIG WATER 1500ML","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5502769,"PULSE LAVAGE","CDM Code","IP/OP",272,"Sterile Supply","","",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[5502760,"SEE ITEM 58003924","CDM Code","IP/OP",270,"Med-Sur Supplies","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5502759,"SEE ITEM 58003919","CDM Code","IP/OP",270,"Med-Sur Supplies","","",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[5502754,"HEALON 5","CDM Code","IP/OP",272,"Sterile Supply","","",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[5502744,"IV GASTROGRAFIN","CDM Code","IP/OP",636,"Drug/Detail Code","Q9963","HOCM 350-399MG/ML IODINE,1ML",37,18.5,29.415000000000003,31.45,31.45,31.45,31.08,29.970000000000002,29.6,29.415000000000003,29.6]
[5502736,"GAUZE IODOFORM 1/4\" 5% PACKG","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502735,"GAUZE IODOFORM 1/2 PACKG","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502728,"INSTR HARMONIC FOCUS","CDM Code","IP/OP",272,"Sterile Supply","","",522,261,414.99,443.7,443.7,443.7,438.47999999999996,422.82000000000005,417.6,414.99,417.6]
[5502722,"FORCP BX L CLD 240CM","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5502715,"FOLLR CATH URET 24F","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[5502714,"FOLLR CATH URET 22F","CDM Code","IP/OP",272,"Sterile Supply","","",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[5502709,"FOLLR CATH URET 12F","CDM Code","IP/OP",272,"Sterile Supply","","",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[5502698,"HEAD 28MM C-TAPER +0","CDM Code","IP/OP",278,"Supply/Implants","","",695,347.5,552.52499999999998,590.75,590.75,590.75,583.79999999999995,562.95000000000005,556,552.52499999999998,556]
[5502693,"SEE ITEM 58001272","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5502691,"KNIFE MVR 20G","CDM Code","IP/OP",272,"Sterile Supply","","",99,49.5,78.704999999999998,84.149999999999991,84.149999999999991,84.149999999999991,83.16,80.190000000000012,79.2,78.704999999999998,79.2]
[5502673,"ELECTRIC PEN HAND DISP","CDM Code","IP/OP",272,"Sterile Supply","","",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[5502659,"ELECTRD COAG 27F","CDM Code","IP/OP",272,"Sterile Supply","","",276,138,219.42000000000002,234.6,234.6,234.6,231.84,223.56,220.8,219.42000000000002,220.8]
[5502650,"SEE ITEM 58007638","CDM Code","IP/OP",272,"Sterile Supply","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[5502649,"DRILL SIDE CUT 2.1","CDM Code","IP/OP",272,"Sterile Supply","","",149,74.5,118.45500000000001,126.64999999999999,126.64999999999999,126.64999999999999,125.16,120.69000000000001,119.2,118.45500000000001,119.2]
[5502635,"SEE ITEM 58007630","CDM Code","IP/OP",272,"Sterile Supply","","",569,284.5,452.35500000000002,483.65,483.65,483.65,477.96,460.89000000000004,455.20000000000005,452.35500000000002,455.20000000000005]
[5502630,"SEE ITEM 58007612","CDM Code","IP/OP",270,"Med-Sur Supplies","","",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[5502619,"DRESSG COVRSITE 4","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5502618,"DRESSG XERFM 5X9","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5502609,"DRESSG ADAPT 3X3","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5502604,"DRESSG SENSA MED BLK TRAC","CDM Code","IP/OP",272,"Sterile Supply","","",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[5502597,"BAN FILTERED MOUTHPIECE","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5502594,"CATHETER MALECOT 14F","CDM Code","IP/OP",272,"Sterile Supply","","",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[5502591,"CATHETER MALECOT 18F","CDM Code","IP/OP",272,"Sterile Supply","","",118,59,93.81,100.3,100.3,100.3,99.11999999999999,95.580000000000013,94.4,93.81,94.4]
[5502576,"DISTRCT AKL FOOT STRAP","CDM Code","IP/OP",272,"Sterile Supply","","",117,58.5,93.015000000000001,99.45,99.45,99.45,98.28,94.77000000000001,93.600000000000009,93.015000000000001,93.600000000000009]
[5502571,"DILATR BAL 15","CDM Code","IP/OP",272,"Sterile Supply","","",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[5502570,"DILATR URET 7F BALN","CDM Code","IP/OP",272,"Sterile Supply","","",297,148.5,236.11500000000001,252.45,252.45,252.45,249.48,240.57000000000002,237.60000000000002,236.11500000000001,237.60000000000002]
[5502565,"DILATR BAL 18","CDM Code","IP/OP",272,"Sterile Supply","","",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[5502557,"DETECTOR PEDI CO2","CDM Code","IP/OP",272,"Sterile Supply","","",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[5502550,"CURETT VAC F TIP 8MM","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5502549,"SEE ITEM 58009555 & 9556","CDM Code","IP/OP",272,"Sterile Supply","","",127,63.5,100.965,107.95,107.95,107.95,106.67999999999999,102.87,101.60000000000001,100.965,101.60000000000001]
[5502543,"CURETT VAC CVD 8MM","CDM Code","IP/OP",272,"Sterile Supply","","",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[5502518,"SEE ITEM 58003904","CDM Code","IP/OP",270,"Med-Sur Supplies","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5502513,"SEE ITEM 58003906","CDM Code","IP/OP",270,"Med-Sur Supplies","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5502512,"SEE ITEM 58003905","CDM Code","IP/OP",270,"Med-Sur Supplies","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5502499,"CLIP ENDO MULTI M","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5502492,"VENTRALIGHT ST W/ECHO PS 15CM","CDM Code","IP/OP",278,"Supply/Implants","","",931,465.5,740.14499999999998,791.35,791.35,791.35,782.04,754.11,744.80000000000007,740.14499999999998,744.80000000000007]
[5502487,"CIRCUIT ANES INFANT","CDM Code","IP/OP",272,"Sterile Supply","","",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[5502486,"CIRCUIT ANES ADULT LF","CDM Code","IP/OP",272,"Sterile Supply","","",13,6.5,10.335000000000001,11.049999999999999,11.049999999999999,11.049999999999999,10.92,10.530000000000001,10.4,10.335000000000001,10.4]
[5502479,"CAPS TEN CTS TYPE 6E 10.16","CDM Code","IP/OP",272,"Sterile Supply","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[5502474,"SEE ITEM 58003234","CDM Code","IP/OP",272,"Sterile Supply","","",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[5502468,"SEE ITEM 58002610","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5502467,"CAUT CORD BIPOL DISP","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502460,"CATH VESSEL UMBIL 3.5FR","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5502450,"SEE ITEM 58003218","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5502442,"SEE ITEM 58003232","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5502438,"KIT PICC DOUBLE LUMEN 5FR","CDM Code","IP/OP",272,"Sterile Supply","","",269,134.5,213.85500000000002,228.65,228.65,228.65,225.95999999999998,217.89000000000001,215.20000000000002,213.85500000000002,215.20000000000002]
[5502431,"SEE ITEM 58002922","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502426,"SEE ITEM 58006754","CDM Code","IP/OP",272,"Sterile Supply","","",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[5502418,"SEE ITEM 58003213","CDM Code","IP/OP",272,"Sterile Supply","","",38,19,30.21,32.299999999999997,32.299999999999997,32.299999999999997,31.919999999999998,30.78,30.400000000000002,30.21,30.400000000000002]
[5502417,"SEE ITEM 58003235","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5502411,"SEE ITEM 58006752","CDM Code","IP/OP",272,"Sterile Supply","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5502401,"SEE ITEM 58003216","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5502394,"SEE ITEM 58003243","CDM Code","IP/OP",272,"Sterile Supply","","",72,36,57.24,61.199999999999996,61.199999999999996,61.199999999999996,60.48,58.320000000000007,57.6,57.24,57.6]
[5502392,"SEE ITEM 58003238","CDM Code","IP/OP",272,"Sterile Supply","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[5502386,"SEE ITEM 58003206","CDM Code","IP/OP",272,"Sterile Supply","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5502378,"CATH URET D3.5 L82 KOALA","CDM Code","IP/OP",272,"Sterile Supply","","",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[5502373,"KIT INTRO SHEATH PERCUT 9FR","CDM Code","IP/OP",272,"Sterile Supply","","",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[5502372,"SEE ITEM 58003720","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5502246,"CABLE SLEEVE 2.0 BEADED","CDM Code","IP/OP",278,"Supply/Implants","","",534,267,424.53000000000003,453.9,453.9,453.9,448.56,432.54,427.20000000000005,424.53000000000003,427.20000000000005]
[5502241,"CANN INNER DISP 8 SHILEY","CDM Code","IP/OP",270,"Med-Sur Supplies","","",11,5.5,8.745000000000001,9.35,9.35,9.35,9.24,8.91,8.8000000000000007,8.745000000000001,8.8000000000000007]
[5502234,"SEE ITEM 58003144","CDM Code","IP/OP",270,"Med-Sur Supplies","","",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[5502233,"SEE ITEM 58003134","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5502228,"SEE ITEM 58003005","CDM Code","IP/OP",270,"Med-Sur Supplies","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502223,"SEE ITEM 58003104","CDM Code","IP/OP",270,"Med-Sur Supplies","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[5502209,"CANN 19GA","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5502205,"CANN TWIST 7X75","CDM Code","IP/OP",272,"Sterile Supply","","",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[5502198,"SEE ITEM 58007001","CDM Code","IP/OP",272,"Sterile Supply","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5502183,"SEE ITEM 58007008","CDM Code","IP/OP",272,"Sterile Supply","","",275,137.5,218.625,233.75,233.75,233.75,231,222.75000000000003,220,218.625,220]
[5502175,"SEE ITEM 58003340","CDM Code","IP/OP",270,"Med-Sur Supplies","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5502173,"SEE ITEM 58007503","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[5502152,"SEE ITEM 58007527","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[5502145,"SEE ITEM 58007519","CDM Code","IP/OP",272,"Sterile Supply","","",94,47,74.73,79.899999999999991,79.899999999999991,79.899999999999991,78.959999999999994,76.14,75.2,74.73,75.2]
[5502139,"SEE ITEM 58007510","CDM Code","IP/OP",272,"Sterile Supply","","",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[5502131,"SEE ITEM 58007545","CDM Code","IP/OP",272,"Sterile Supply","","",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[5502126,"SEE ITEM 58007525","CDM Code","IP/OP",272,"Sterile Supply","","",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[5502120,"SEE ITEM 58007514","CDM Code","IP/OP",272,"Sterile Supply","","",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[5502114,"SEE ITEM 58007547","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5502113,"SEE ITEM 58002613","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[5502084,"SEE ITEM 58003902","CDM Code","IP/OP",270,"Med-Sur Supplies","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5502076,"STIMUBLAST PUTTY 5CC","CDM Code","IP/OP",278,"Supply/Implants","","",901,450.5,716.29500000000007,765.85,765.85,765.85,756.83999999999992,729.81000000000006,720.80000000000007,716.29500000000007,720.80000000000007]
[5502070,"BASKT ST 3F URET","CDM Code","IP/OP",272,"Sterile Supply","","",346,173,275.07,294.09999999999997,294.09999999999997,294.09999999999997,290.64,280.26,276.8,275.07,276.8]
[5502063,"SEE ITEM 58007404","CDM Code","IP/OP",272,"Sterile Supply","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5502060,"SEE ITEM 58002713","CDM Code","IP/OP",270,"Med-Sur Supplies","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5502054,"SEE ITEM 58002712","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5502049,"SEE ITEM 58002718","CDM Code","IP/OP",272,"Sterile Supply","","",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[5502048,"BAND FALOPE RING","CDM Code","IP/OP",272,"Sterile Supply","","",280,140,222.60000000000002,238,238,238,235.2,226.8,224,222.60000000000002,224]
[5502027,"SEE ITEM 58003201","CDM Code","IP/OP",270,"Med-Sur Supplies","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5502021,"SEE ITEM 58009006","CDM Code","IP/OP",272,"Sterile Supply","","",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[5502016,"SEE ITEM 58002826","CDM Code","IP/OP",272,"Sterile Supply","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5502015,"SEE ITEM 58009014","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5502010,"SEE ITEM 58009009","CDM Code","IP/OP",272,"Sterile Supply","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[5502002,"ANCHOR 6.5 HEALIX BR","CDM Code","IP/OP",272,"Sterile Supply","","",586,293,465.87,498.09999999999997,498.09999999999997,498.09999999999997,492.24,474.66,468.8,465.87,468.8]
[5501565,"DRESS AG ROPE AQUACEL","CDM Code","IP/OP",272,"Sterile Supply","","",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[5501564,"DRESS 2X2 AG AQUA EXTRA","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5501559,"REGULAR LENS","CDM Code","IP/OP",276,"Intra Oc Lens","V2632","POST CHMBR INTRAOCULAR LENS",587,293.5,466.66500000000002,498.95,498.95,498.95,493.08,475.47,469.6,466.66500000000002,469.6]
[5501536,"SHOE LIFTS TAPERED TO ONE-HA","CDM Code","IP/OP",274,"Prosth/Orth Dev","L3332","SHOE LIFTS TAPERED TO ONE-HA",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5501499,"VASCULAR PATCH GORTEX","CDM Code","IP/OP",272,"Sterile Supply","","",356,178,283.02000000000004,302.59999999999997,302.59999999999997,302.59999999999997,299.03999999999996,288.36,284.8,283.02000000000004,284.8]
[5501498,"SUTURE GORTEX","CDM Code","IP/OP",272,"Sterile Supply","","",575,287.5,457.125,488.75,488.75,488.75,483,465.75000000000006,460,457.125,460]
[5501493,"TUBE-ENDOTRACHEAL 5.5M","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5501488,"SCREW-LG CARTICAL SELFTAP","CDM Code","IP/OP",278,"Supply/Implants","","",117,58.5,93.015000000000001,99.45,99.45,99.45,98.28,94.77000000000001,93.600000000000009,93.015000000000001,93.600000000000009]
[5501483,"HOLDER FOLEY CATHETER","CDM Code","IP/OP",272,"Sterile Supply","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5501482,"POUCH DRAINABLE 2 1/2 INCH","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5501477,"H2O IRRIGATION","CDM Code","IP/OP",272,"Sterile Supply","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[5501472,"ARTHRO WAND COVAC 50","CDM Code","IP/OP",272,"Sterile Supply","","",552,276,438.84000000000003,469.2,469.2,469.2,463.68,447.12,441.6,438.84000000000003,441.6]
[5501467,"ARTHREX 14MM MENISCAL DARTS","CDM Code","IP/OP",272,"Sterile Supply","","",329,164.5,261.55500000000001,279.64999999999998,279.64999999999998,279.64999999999998,276.36,266.49,263.2,261.55500000000001,263.2]
[5501466,"ARTHREX 12 MM MENISCAL DARTS","CDM Code","IP/OP",272,"Sterile Supply","","",329,164.5,261.55500000000001,279.64999999999998,279.64999999999998,279.64999999999998,276.36,266.49,263.2,261.55500000000001,263.2]
[5501456,"DILATOR 16MMX8CM 48F","CDM Code","IP/OP",272,"Sterile Supply","","",750,375,596.25,637.5,637.5,637.5,630,607.5,600,596.25,600]
[5501448,"GUIDEWIRE 3 CM FLEX","CDM Code","IP/OP",272,"Sterile Supply","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[5501443,"TIP VCRTTS F TIP 7MM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",250,125,198.75,212.5,212.5,212.5,210,202.5,200,198.75,200]
[5501439,"DRILL-BIT 3.2X145MM","CDM Code","IP/OP",272,"Sterile Supply","","",299,149.5,237.70500000000001,254.15,254.15,254.15,251.16,242.19000000000003,239.20000000000002,237.70500000000001,239.20000000000002]
[5501434,"SET-DELIVERY OB VAC","CDM Code","IP/OP",272,"Sterile Supply","","",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[5501429,"PROBE ELEC HYD 1.6FR","CDM Code","IP/OP",272,"Sterile Supply","","",817,408.5,649.51499999999999,694.44999999999993,694.44999999999993,694.44999999999993,686.28,661.7700000000001,653.6,649.51499999999999,653.6]
[5501426,"CTH FLY 18FR 30CC 3W","CDM Code","IP/OP",272,"Sterile Supply","","",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[5501419,"TUBE ENDOTRACH 5.0MM","CDM Code","IP/OP",272,"Sterile Supply","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5501408,"KIT LAPAROSCOPIC ACC","CDM Code","IP/OP",272,"Sterile Supply","","",424,212,337.08000000000004,360.4,360.4,360.4,356.15999999999997,343.44,339.20000000000005,337.08000000000004,339.20000000000005]
[5501399,"BARRIER-SKIN 2.75 W FL","CDM Code","IP/OP",272,"Sterile Supply","","",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[5501392,"FILTER JUGULAR SST","CDM Code","IP/OP",272,"Sterile Supply","","",3172,1586,2521.7400000000002,2696.2,2696.2,2696.2,2664.48,2569.3200000000002,2537.6000000000004,2521.7400000000002,2537.6000000000004]
[5501391,"FILTER FEMORAL SST","CDM Code","IP/OP",272,"Sterile Supply","","",2915,1457.5,2317.4250000000002,2477.75,2477.75,2477.75,2448.6,2361.15,2332,2317.4250000000002,2332]
[5501383,"BANDAGE COVAN 5X5YD\"","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5501378,"AMINOSYN W/ELECTRO","CDM Code","IP/OP",270,"Med-Sur Supplies","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5501372,"BIPAP MASK NASL MDSM","CDM Code","IP/OP",270,"Med-Sur Supplies","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5501370,"BIPAP CIRCUITS SGLPT","CDM Code","IP/OP",270,"Med-Sur Supplies","","",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[5501351,"KIT CATHETER FEMALE","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5501343,"PLATE BASE TIBIAL","CDM Code","IP/OP",278,"Supply/Implants","","",3715,1857.5,2953.4250000000002,3157.75,3157.75,3157.75,3120.6,3009.15,2972,2953.4250000000002,2972]
[5501334,"VORTEX-PORT 9.6FR","CDM Code","IP/OP",270,"Med-Sur Supplies","","",1322,661,1050.99,1123.7,1123.7,1123.7,1110.48,1070.8200000000002,1057.6000000000001,1050.99,1057.6000000000001]
[5501333,"DRAINBAG-URINE 4L","CDM Code","IP/OP",272,"Sterile Supply","","",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[5501328,"SUTURE-VICRYL ENDLO","CDM Code","IP/OP",272,"Sterile Supply","","",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[5501318,"SUTURE-VICRYL 10-0","CDM Code","IP/OP",272,"Sterile Supply","","",237,118.5,188.41500000000002,201.45,201.45,201.45,199.07999999999998,191.97,189.60000000000002,188.41500000000002,189.60000000000002]
[5501306,"SUTURE-CHROMIC 4-0","CDM Code","IP/OP",272,"Sterile Supply","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5501302,"SET-TUBING HYDROVALV","CDM Code","IP/OP",272,"Sterile Supply","","",501,250.5,398.29500000000002,425.84999999999997,425.84999999999997,425.84999999999997,420.84,405.81,400.8,398.29500000000002,400.8]
[5501288,"LAP-SUCT IRRIG SYS","CDM Code","IP/OP",272,"Sterile Supply","","",430,215,341.85,365.5,365.5,365.5,361.2,348.3,344,341.85,344]
[5501280,"KNEE-STABILIZER INSERT","CDM Code","IP/OP",278,"Supply/Implants","","",3129,1564.5,2487.5550000000003,2659.65,2659.65,2659.65,2628.36,2534.4900000000002,2503.2000000000003,2487.5550000000003,2503.2000000000003]
[5501275,"HIP-DEFINITION HIP STERR","CDM Code","IP/OP",278,"Supply/Implants","","",8576,4288,6817.92,7289.5999999999995,7289.5999999999995,7289.5999999999995,7203.84,6946.56,6860.8,6817.92,6860.8]
[5501274,"HIP-FEMORAL HEAD","CDM Code","IP/OP",278,"Supply/Implants","","",1664,832,1322.88,1414.3999999999999,1414.3999999999999,1414.3999999999999,1397.76,1347.8400000000001,1331.2,1322.88,1331.2]
[5501269,"HIP-ACETABULAR SHELL","CDM Code","IP/OP",278,"Supply/Implants","","",4043,2021.5,3214.1849999999999,3436.5499999999997,3436.5499999999997,3436.5499999999997,3396.12,3274.8300000000004,3234.4,3214.1849999999999,3234.4]
[5501264,"HIP-SUPRA CONDYLAR PLATE","CDM Code","IP/OP",278,"Supply/Implants","","",1554,777,1235.43,1320.8999999999999,1320.8999999999999,1320.8999999999999,1305.3599999999999,1258.74,1243.2,1235.43,1243.2]
[5501259,"EXTFIX-PINS","CDM Code","IP/OP",278,"Supply/Implants","","",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[5501258,"EXTFIX-BALL JOINT","CDM Code","IP/OP",278,"Supply/Implants","","",1093,546.5,868.93500000000006,929.05,929.05,929.05,918.12,885.33,874.40000000000009,868.93500000000006,874.40000000000009]
[5501252,"PEN-MARK FINE PT/OR","CDM Code","IP/OP",272,"Sterile Supply","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5501240,"SCREW-ASNIS 6.5X70MM","CDM Code","IP/OP",272,"Sterile Supply","","",964,482,766.38,819.4,819.4,819.4,809.76,780.84,771.2,766.38,771.2]
[5501223,"TUBE TRACH DIR 7.5","CDM Code","IP/OP",272,"Sterile Supply","","",72,36,57.24,61.199999999999996,61.199999999999996,61.199999999999996,60.48,58.320000000000007,57.6,57.24,57.6]
[5501222,"TUBE TRACH DIR 7.0","CDM Code","IP/OP",272,"Sterile Supply","","",72,36,57.24,61.199999999999996,61.199999999999996,61.199999999999996,60.48,58.320000000000007,57.6,57.24,57.6]
[5501218,"TUBE TRACH DIR 5.0","CDM Code","IP/OP",272,"Sterile Supply","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5501205,"STYLET-INTUB 14FR","CDM Code","IP/OP",272,"Sterile Supply","","",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[5501200,"STOCKINET-IMPRV12X48","CDM Code","IP/OP",272,"Sterile Supply","","",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[5501198,"RETRACTOR BALLOON","CDM Code","IP/OP",272,"Sterile Supply","","",571,285.5,453.94500000000005,485.34999999999997,485.34999999999997,485.34999999999997,479.64,462.51000000000005,456.8,453.94500000000005,456.8]
[5501192,"BLADE-ARTH 5MM SCLOP","CDM Code","IP/OP",272,"Sterile Supply","","",623,311.5,495.28500000000003,529.54999999999995,529.54999999999995,529.54999999999995,523.31999999999994,504.63000000000005,498.40000000000003,495.28500000000003,498.40000000000003]
[5501185,"SCREW-LAG 125MM","CDM Code","IP/OP",272,"Sterile Supply","","",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[5501178,"ELECTRODE DISP 50X50","CDM Code","IP/OP",272,"Sterile Supply","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5501174,"SUTUR-VICRYL 3-0","CDM Code","IP/OP",272,"Sterile Supply","","",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[5501169,"SUTURE-ETHICON 5-0","CDM Code","IP/OP",272,"Sterile Supply","","",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[5501159,"SUTUR-PROLENE 4-0 SH","CDM Code","IP/OP",272,"Sterile Supply","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5501149,"SUTURE-PRLN BL 10-0","CDM Code","IP/OP",272,"Sterile Supply","","",205,102.5,162.97499999999999,174.25,174.25,174.25,172.2,166.05,164,162.97499999999999,164]
[5501148,"SUTUR-PRLN BL MONO70","CDM Code","IP/OP",272,"Sterile Supply","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5501141,"SUTURE-VICRYL3-0 PC5","CDM Code","IP/OP",272,"Sterile Supply","","",53,26.5,42.135000000000005,45.05,45.05,45.05,44.519999999999996,42.93,42.400000000000006,42.135000000000005,42.400000000000006]
[5501134,"ARM BAND","CDM Code","IP/OP",270,"Med-Sur Supplies","","",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[5501128,"SUTURE-O PROLENE","CDM Code","IP/OP",272,"Sterile Supply","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5501127,"IV-SOD CHBR 3%500ML","CDM Code","IP/OP",258,"IV Solutions","","",74,37,58.830000000000005,62.9,62.9,62.9,62.16,59.940000000000005,59.2,58.830000000000005,59.2]
[5501119,"SUTURE-VICRYL 2-0","CDM Code","IP/OP",272,"Sterile Supply","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5501113,"WIREGUIDE SUPRA XCHG","CDM Code","IP/OP",272,"Sterile Supply","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5501104,"TROCAR-ENDO 5X100MM","CDM Code","IP/OP",272,"Sterile Supply","","",589,294.5,468.255,500.65,500.65,500.65,494.76,477.09000000000003,471.20000000000005,468.255,471.20000000000005]
[5501103,"SUTURE-ETHIBOND X BR","CDM Code","IP/OP",272,"Sterile Supply","","",136,68,108.12,115.6,115.6,115.6,114.24,110.16000000000001,108.80000000000001,108.12,108.80000000000001]
[5501098,"KIT-NORPLANT","CDM Code","IP/OP",272,"Sterile Supply","","",1442,721,1146.3900000000001,1225.7,1225.7,1225.7,1211.28,1168.02,1153.6000000000001,1146.3900000000001,1153.6000000000001]
[5501091,"PUNCH BIOPSY 3MM DIS","CDM Code","IP/OP",272,"Sterile Supply","","",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[5501086,"LOCATOR-NERVE VERIS3","CDM Code","IP/OP",272,"Sterile Supply","","",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[5501085,"DRESSING ADAPTIC 3X16","CDM Code","IP/OP",272,"Sterile Supply","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5501072,"INST-BIOPSY MONOPTY","CDM Code","IP/OP",272,"Sterile Supply","","",295,147.5,234.52500000000001,250.75,250.75,250.75,247.79999999999998,238.95000000000002,236,234.52500000000001,236]
[5501067,"SCREW COMPR 110MM","CDM Code","IP/OP",278,"Supply/Implants","","",971,485.5,771.94500000000005,825.35,825.35,825.35,815.64,786.5100000000001,776.80000000000007,771.94500000000005,776.80000000000007]
[5501062,"CATH-SILASTIC 20FR 5","CDM Code","IP/OP",272,"Sterile Supply","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5501061,"CATH-SILASTIC 18FR 5","CDM Code","IP/OP",272,"Sterile Supply","","",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[5501056,"CATH-COUDE 18FR 5CC","CDM Code","IP/OP",272,"Sterile Supply","","",101,50.5,80.295000000000002,85.85,85.85,85.85,84.84,81.81,80.800000000000011,80.295000000000002,80.800000000000011]
[5501046,"CATH-ALL PURPOSE 12F","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5501044,"PASTE-KARAYA REG","CDM Code","IP/OP",272,"Sterile Supply","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5501037,"SOLUTION-IRRIG STERI","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5501025,"STERI STRIPS","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5501017,"PLUG INTRAMED","CDM Code","IP/OP",272,"Sterile Supply","","",662,331,526.29000000000008,562.69999999999993,562.69999999999993,562.69999999999993,556.07999999999993,536.22,529.6,526.29000000000008,529.6]
[5501012,"LENS INTRAOC ANTER","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5501011,"LENS INTRAOC POSTER","CDM Code","IP/OP",276,"Intra Oc Lens","","",926,463,736.17000000000007,787.1,787.1,787.1,777.83999999999992,750.06000000000006,740.80000000000007,736.17000000000007,740.80000000000007]
[5501004,"LENS-I/O JFILRU 21X","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5500997,"LENS-I/O JFILRU 23.5","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5500992,"LENS-I/O JF1LRU 18.5","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5500991,"LENS-I/O JF1LRU 17.5","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5500986,"LENS-I/O S16BLRU 20X","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5500981,"LENS-I/O MT-4 21.5X","CDM Code","IP/OP",276,"Intra Oc Lens","","",950,475,755.25,807.5,807.5,807.5,798,769.5,760,755.25,760]
[5500975,"CAUTERY-SURETEMP EYE","CDM Code","IP/OP",272,"Sterile Supply","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[5500974,"SUTURE-ALCON 2020-01","CDM Code","IP/OP",272,"Sterile Supply","","",201,100.5,159.79500000000002,170.85,170.85,170.85,168.84,162.81,160.80000000000001,159.79500000000002,160.80000000000001]
[5500968,"SEAL-8MM SLIMLINE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5500961,"TUBE-ENDOTRACH 7MM","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5500956,"TRACH TUBE-8 FEN","CDM Code","IP/OP",272,"Sterile Supply","","",531,265.5,422.14500000000004,451.34999999999997,451.34999999999997,451.34999999999997,446.03999999999996,430.11,424.8,422.14500000000004,424.8]
[5500955,"TRACH TUBE-6 FEN","CDM Code","IP/OP",272,"Sterile Supply","","",488,244,387.96000000000004,414.8,414.8,414.8,409.91999999999996,395.28000000000003,390.40000000000003,387.96000000000004,390.40000000000003]
[5500950,"TRACH TUBE PEDI 1","CDM Code","IP/OP",272,"Sterile Supply","","",382,191,303.69,324.7,324.7,324.7,320.88,309.42,305.60000000000002,303.69,305.60000000000002]
[5500936,"VACURETTE-FLEX 7MM","CDM Code","IP/OP",272,"Sterile Supply","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5500922,"HEMOVAC-SNYDER OTUBE","CDM Code","IP/OP",272,"Sterile Supply","","",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[5500920,"CIRCUIT-ANES ARTEC","CDM Code","IP/OP",272,"Sterile Supply","","",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[5500912,"BANDAGE-WEBRIL 6\"","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5500902,"TRAY-SPINAL 25G ANES","CDM Code","IP/OP",272,"Sterile Supply","","",159,79.5,126.405,135.15,135.15,135.15,133.56,128.79000000000002,127.2,126.405,127.2]
[5500895,"DRESSING-UNIFLEX IV","CDM Code","IP/OP",270,"Med-Sur Supplies","","",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[5500893,"CANNULA-INFANT OXYG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5500882,"SCREW-CANNULATE 105M","CDM Code","IP/OP",278,"Supply/Implants","","",711,355.5,565.245,604.35,604.35,604.35,597.24,575.91000000000008,568.80000000000007,565.245,568.80000000000007]
[5500877,"SCREW-CANNULATE 80MM","CDM Code","IP/OP",278,"Supply/Implants","","",711,355.5,565.245,604.35,604.35,604.35,597.24,575.91000000000008,568.80000000000007,565.245,568.80000000000007]
[5500872,"DRESSING-TRANSPAR L","CDM Code","IP/OP",272,"Sterile Supply","","",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[5500869,"TRAY-LUMBAR ADULT","CDM Code","IP/OP",272,"Sterile Supply","","",112,56,89.04,95.2,95.2,95.2,94.08,90.72,89.600000000000009,89.04,89.600000000000009]
[5500863,"WIRE-KIRSCHNER 9\"","CDM Code","IP/OP",278,"Supply/Implants","","",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[5500860,"SCREW-CANCEL 217 SER","CDM Code","IP/OP",278,"Supply/Implants","","",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[5500854,"SCREW-COMPSNG 28.5MM","CDM Code","IP/OP",278,"Supply/Implants","","",183,91.5,145.48500000000001,155.54999999999998,155.54999999999998,155.54999999999998,153.72,148.23000000000002,146.4,145.48500000000001,146.4]
[5500853,"PIN-STNMN THRD 5/64\"","CDM Code","IP/OP",278,"Supply/Implants","","",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[5500847,"WIRE-KIRSCHNER.028","CDM Code","IP/OP",278,"Supply/Implants","","",253,126.5,201.13500000000002,215.04999999999998,215.04999999999998,215.04999999999998,212.51999999999998,204.93,202.4,201.13500000000002,202.4]
[5500842,"STAPLE-OSTEOTOMY FIX","CDM Code","IP/OP",272,"Sterile Supply","","",458,229,364.11,389.3,389.3,389.3,384.71999999999997,370.98,366.40000000000003,364.11,366.40000000000003]
[5500837,"TUBE-ENDOTRACH 7.5MM","CDM Code","IP/OP",272,"Sterile Supply","","",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[5500836,"NAIL HIP 80MM ZICKII","CDM Code","IP/OP",278,"Supply/Implants","","",817,408.5,649.51499999999999,694.44999999999993,694.44999999999993,694.44999999999993,686.28,661.7700000000001,653.6,649.51499999999999,653.6]
[5500831,"SCREW-KEY LOCK LAG","CDM Code","IP/OP",278,"Supply/Implants","","",934,467,742.53000000000009,793.9,793.9,793.9,784.56,756.54000000000008,747.2,742.53000000000009,747.2]
[5500826,"SCREW COMPR 85MM","CDM Code","IP/OP",278,"Supply/Implants","","",796,398,632.82000000000005,676.6,676.6,676.6,668.64,644.76,636.80000000000007,632.82000000000005,636.80000000000007]
[5500821,"PIN HOFFMAN SMALL HF","CDM Code","IP/OP",270,"Med-Sur Supplies","","",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[5500820,"PLATE SUPRACONDYLAR","CDM Code","IP/OP",278,"Supply/Implants","","",1195,597.5,950.02500000000009,1015.75,1015.75,1015.75,1003.8,967.95,956,950.02500000000009,956]
[5500815,"PLATE HIP CMP 12S135","CDM Code","IP/OP",278,"Supply/Implants","","",1358,679,1079.6100000000001,1154.3,1154.3,1154.3,1140.72,1099.98,1086.4000000000001,1079.6100000000001,1086.4000000000001]
[5500810,"STRIPPER-VEIN","CDM Code","IP/OP",272,"Sterile Supply","","",163,81.5,129.58500000000001,138.54999999999998,138.54999999999998,138.54999999999998,136.91999999999999,132.03,130.4,129.58500000000001,130.4]
[5500805,"SCREW-FEM DIAG 70MM","CDM Code","IP/OP",278,"Supply/Implants","","",446,223,354.57,379.09999999999997,379.09999999999997,379.09999999999997,374.64,361.26000000000005,356.8,354.57,356.8]
[5500804,"SCREW-FEMORAL DIAGON","CDM Code","IP/OP",278,"Supply/Implants","","",427,213.5,339.46500000000003,362.95,362.95,362.95,358.68,345.87,341.6,339.46500000000003,341.6]
[5500798,"PLATE-HIP COMP 15SLO","CDM Code","IP/OP",278,"Supply/Implants","","",1123,561.5,892.78500000000008,954.55,954.55,954.55,943.31999999999994,909.63000000000011,898.40000000000009,892.78500000000008,898.40000000000009]
[5500790,"PIN-GUIDE THREAD TIP","CDM Code","IP/OP",278,"Supply/Implants","","",73,36.5,58.035000000000004,62.05,62.05,62.05,61.32,59.13,58.400000000000006,58.035000000000004,58.400000000000006]
[5500785,"PIN-STEINMAN 1/8X9","CDM Code","IP/OP",278,"Supply/Implants","","",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[5500784,"PIN-STEINMAN 7/64","CDM Code","IP/OP",278,"Supply/Implants","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5500779,"SCREW-FEMORAL DIAGN","CDM Code","IP/OP",278,"Supply/Implants","","",723,361.5,574.78500000000008,614.54999999999995,614.54999999999995,614.54999999999995,607.31999999999994,585.63,578.4,574.78500000000008,578.4]
[5500772,"SCREW-MALLEOLAR","CDM Code","IP/OP",278,"Supply/Implants","","",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[5500767,"SCREW-CANE 6.5MMX65M","CDM Code","IP/OP",278,"Supply/Implants","","",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[5500766,"SCREW-CANC 6.5X55MM","CDM Code","IP/OP",278,"Supply/Implants","","",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[5500761,"CEMENT - 1/2 DOSE","CDM Code","IP/OP",278,"Supply/Implants","","",460,230,365.70000000000005,391,391,391,386.4,372.6,368,365.70000000000005,368]
[5500753,"SET CATH IRRIG/CLAMP","CDM Code","IP/OP",272,"Sterile Supply","","",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[5500746,"KIT-INTRODUCER/SHEATH","CDM Code","IP/OP",272,"Sterile Supply","","",305,152.5,242.47500000000002,259.25,259.25,259.25,256.2,247.05,244,242.47500000000002,244]
[5500745,"KIT-CATH RADIAL ART","CDM Code","IP/OP",272,"Sterile Supply","","",333,166.5,264.73500000000001,283.05,283.05,283.05,279.71999999999997,269.73,266.40000000000003,264.73500000000001,266.40000000000003]
[5500740,"TRANSDUCER ADULT","CDM Code","IP/OP",272,"Sterile Supply","","",210,105,166.95000000000002,178.5,178.5,178.5,176.4,170.10000000000002,168,166.95000000000002,168]
[5500731,"METER-PEAK FLOW/DISP","CDM Code","IP/OP",272,"Sterile Supply","","",215,107.5,170.92500000000001,182.75,182.75,182.75,180.6,174.15,172,170.92500000000001,172]
[5500725,"KIT-JACKSON PRATT","CDM Code","IP/OP",272,"Sterile Supply","","",298,149,236.91000000000003,253.29999999999998,253.29999999999998,253.29999999999998,250.32,241.38000000000002,238.4,236.91000000000003,238.4]
[5500722,"FIBERGLASS CAST S LE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5500720,"FIBERGLASS CAST S AR","CDM Code","IP/OP",270,"Med-Sur Supplies","","",178,89,141.51000000000002,151.29999999999998,151.29999999999998,151.29999999999998,149.51999999999998,144.18,142.4,141.51000000000002,142.4]
[5500715,"PLASTER SPLINT LEG","CDM Code","IP/OP",270,"Med-Sur Supplies","","",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[5500710,"KIT-EYE CARE SS","CDM Code","IP/OP",272,"Sterile Supply","","",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[5500709,"SUTUERS-VICRYL J574G","CDM Code","IP/OP",272,"Sterile Supply","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5500704,"VENODYNE SLEEVE 14\"","CDM Code","IP/OP",272,"Sterile Supply","","",210,105,166.95000000000002,178.5,178.5,178.5,176.4,170.10000000000002,168,166.95000000000002,168]
[5500697,"SUTURE PROL O CT","CDM Code","IP/OP",272,"Sterile Supply","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5500691,"DRAIN-EYE 80CC","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5500689,"TUBE GOOD T BIOLIT R","CDM Code","IP/OP",272,"Sterile Supply","","",482,241,383.19,409.7,409.7,409.7,404.88,390.42,385.6,383.19,385.6]
[5500669,"BANDAGE COBAN 1X5 YDS","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5500663,"TROCAR-ENDO REDUCER","CDM Code","IP/OP",272,"Sterile Supply","","",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[5500658,"WATER-STER SUCTION","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5500657,"SUTURE-PROLN 2-0 LR","CDM Code","IP/OP",272,"Sterile Supply","","",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[5500648,"DUODERM 8X8","CDM Code","IP/OP",272,"Sterile Supply","","",137,68.5,108.91500000000001,116.45,116.45,116.45,115.08,110.97000000000001,109.60000000000001,108.91500000000001,109.60000000000001]
[5500642,"SUTURE 3-0 VCRYL CT1","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5500637,"STR-ETHLN BL MON 4-0","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5500636,"HEMOVAC DRAIN-FL/TRO","CDM Code","IP/OP",272,"Sterile Supply","","",197,98.5,156.61500000000001,167.45,167.45,167.45,165.48,159.57000000000002,157.60000000000002,156.61500000000001,157.60000000000002]
[5500631,"ELECTRODE-CUTTING YE","CDM Code","IP/OP",272,"Sterile Supply","","",511,255.5,406.245,434.34999999999997,434.34999999999997,434.34999999999997,429.24,413.91,408.8,406.245,408.8]
[5500621,"KIT-TRACH CLEANING","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5500616,"PENCIL-SKIN MARKING","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500608,"SCREW-CORTEX 4.5X64MM","CDM Code","IP/OP",278,"Supply/Implants","","",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[5500603,"SCREW-CORTEX 4.5MX32","CDM Code","IP/OP",278,"Supply/Implants","","",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[5500596,"SCREW-CANC 3.5MX20MM","CDM Code","IP/OP",278,"Supply/Implants","","",79,39.5,62.805,67.149999999999991,67.149999999999991,67.149999999999991,66.36,63.99,63.2,62.805,63.2]
[5500591,"SCREW-CORTEX 2.7X16","CDM Code","IP/OP",278,"Supply/Implants","","",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[5500590,"SCREW-CORTEX 2.7X6","CDM Code","IP/OP",278,"Supply/Implants","","",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[5500584,"PLATE-DYN COMP 5HOLE","CDM Code","IP/OP",278,"Supply/Implants","","",524,262,416.58000000000004,445.4,445.4,445.4,440.15999999999997,424.44000000000005,419.20000000000005,416.58000000000004,419.20000000000005]
[5500579,"PLATE 1/3 TUBULAR 4H","CDM Code","IP/OP",278,"Supply/Implants","","",298,149,236.91000000000003,253.29999999999998,253.29999999999998,253.29999999999998,250.32,241.38000000000002,238.4,236.91000000000003,238.4]
[5500574,"PLATE-BONE 7H 119MM","CDM Code","IP/OP",278,"Supply/Implants","","",684,342,543.78,581.4,581.4,581.4,574.55999999999995,554.04000000000008,547.20000000000005,543.78,547.20000000000005]
[5500573,"PLATE-BONE 6H 103MM","CDM Code","IP/OP",278,"Supply/Implants","","",684,342,543.78,581.4,581.4,581.4,574.55999999999995,554.04000000000008,547.20000000000005,543.78,547.20000000000005]
[5500568,"PLATE-BONE 7H/119MM","CDM Code","IP/OP",278,"Supply/Implants","","",684,342,543.78,581.4,581.4,581.4,574.55999999999995,554.04000000000008,547.20000000000005,543.78,547.20000000000005]
[5500563,"BANDAGE WEBRIL 3\"","CDM Code","IP/OP",272,"Sterile Supply","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5500548,"PADS-ANAL VAGINAL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[5500547,"STENT-DOUBLE J URETH","CDM Code","IP/OP",272,"Sterile Supply","","",951,475.5,756.04500000000007,808.35,808.35,808.35,798.83999999999992,770.31000000000006,760.80000000000007,756.04500000000007,760.80000000000007]
[5500538,"FOLEY CATHETER 22 FR","CDM Code","IP/OP",272,"Sterile Supply","","",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[5500529,"CATHETER-NELATION 12F","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5500514,"CATHETERFOLEY20FR5CC","CDM Code","IP/OP",272,"Sterile Supply","","",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[5500513,"CATHETER-FOLEY 18FR","CDM Code","IP/OP",272,"Sterile Supply","","",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5500507,"DRAIN-MALECOT 28FR","CDM Code","IP/OP",272,"Sterile Supply","","",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[5500500,"TRAY IRRIG/PISTON","CDM Code","IP/OP",272,"Sterile Supply","","",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[5500493,"CATH FOGARTY 6FR","CDM Code","IP/OP",272,"Sterile Supply","","",455,227.5,361.72500000000002,386.75,386.75,386.75,382.2,368.55,364,361.72500000000002,364]
[5500492,"BRACE-KNEE HINGED SM","CDM Code","IP/OP",274,"Prosth/Orth Dev","","",340,170,270.3,289,289,289,285.59999999999997,275.40000000000003,272,270.3,272]
[5500484,"TUB-TRACHEAL 3.0MM","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500478,"SIGMOIDOSCOPE","CDM Code","IP/OP",272,"Sterile Supply","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5500473,"CATH-TROCAR 12FR 9","CDM Code","IP/OP",272,"Sterile Supply","","",128,64,101.76,108.8,108.8,108.8,107.52,103.68,102.4,101.76,102.4]
[5500472,"CATH-TROCAR 10FR 9","CDM Code","IP/OP",272,"Sterile Supply","","",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[5500467,"AIRWAY ORAL 50MM BLU","CDM Code","IP/OP",270,"Med-Sur Supplies","","",9,4.5,7.1550000000000002,7.6499999999999995,7.6499999999999995,7.6499999999999995,7.56,7.2900000000000009,7.2,7.1550000000000002,7.2]
[5500460,"SUTURE 60 P1 PROLENE","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5500455,"BANDAGE COBAN 2X5YDS","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500454,"BLADE4 SLIT KNIFE 2.5","CDM Code","IP/OP",272,"Sterile Supply","","",183,91.5,145.48500000000001,155.54999999999998,155.54999999999998,155.54999999999998,153.72,148.23000000000002,146.4,145.48500000000001,146.4]
[5500445,"SUTURE-VICRYL4-0 PC-5","CDM Code","IP/OP",272,"Sterile Supply","","",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[5500436,"SCALEL-DIPOSBL #15","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5500427,"DRAIN-DEAVER T-18FR","CDM Code","IP/OP",272,"Sterile Supply","","",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[5500426,"DRAIN DEAVER T 16FR","CDM Code","IP/OP",272,"Sterile Supply","","",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5500420,"CATH-FOLEY24FR5CC","CDM Code","IP/OP",272,"Sterile Supply","","",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[5500415,"BOOT-CAST SM CL TOE","CDM Code","IP/OP",270,"Med-Sur Supplies","","",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[5500410,"SCREW-HIP 4","CDM Code","IP/OP",278,"Supply/Implants","","",379,189.5,301.30500000000001,322.14999999999998,322.14999999999998,322.14999999999998,318.36,306.99,303.2,301.30500000000001,303.2]
[5500409,"SCREW-HIP 3 3/4","CDM Code","IP/OP",278,"Supply/Implants","","",361,180.5,286.995,306.84999999999997,306.84999999999997,306.84999999999997,303.24,292.41000000000003,288.8,286.995,288.8]
[5500404,"SCREW-BONE 1 3/4","CDM Code","IP/OP",278,"Supply/Implants","","",113,56.5,89.835000000000008,96.05,96.05,96.05,94.92,91.53,90.4,89.835000000000008,90.4]
[5500384,"IOBAN 2PT ISOL SYS","CDM Code","IP/OP",272,"Sterile Supply","","",195,97.5,155.02500000000001,165.75,165.75,165.75,163.79999999999998,157.95000000000002,156,155.02500000000001,156]
[5500376,"STAPLER CVD ILS 33MM","CDM Code","IP/OP",272,"Sterile Supply","","",974,487,774.33,827.9,827.9,827.9,818.16,788.94,779.2,774.33,779.2]
[5500375,"DRESSING ADAPTIC 3X3","CDM Code","IP/OP",272,"Sterile Supply","","",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[5500369,"TUB-ART PRESS M/M48","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500365,"CATH-4LUM 7.5FR","CDM Code","IP/OP",272,"Sterile Supply","","",811,405.5,644.745,689.35,689.35,689.35,681.24,656.91000000000008,648.80000000000007,644.745,648.80000000000007]
[5500358,"SUTURE-PROLENE 3-0","CDM Code","IP/OP",272,"Sterile Supply","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5500356,"TUBE-FEED 8FR/STYLET","CDM Code","IP/OP",272,"Sterile Supply","","",119,59.5,94.605000000000004,101.14999999999999,101.14999999999999,101.14999999999999,99.96,96.39,95.2,94.605000000000004,95.2]
[5500344,"POUCH-POST OR OSTOMY","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500330,"SUTURE-PROLENE 2-0","CDM Code","IP/OP",272,"Sterile Supply","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[5500323,"POUCH STOMA 1 1/2","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500322,"POUCH-STOMA 1 1/4","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500316,"STENT-DBL J URETERAL","CDM Code","IP/OP",272,"Sterile Supply","","",951,475.5,756.04500000000007,808.35,808.35,808.35,798.83999999999992,770.31000000000006,760.80000000000007,756.04500000000007,760.80000000000007]
[5500309,"TUBE LAVACUATOR 28FR","CDM Code","IP/OP",272,"Sterile Supply","","",108,54,85.86,91.8,91.8,91.8,90.72,87.48,86.4,85.86,86.4]
[5500300,"TUBE TRACHEAL 8.0","CDM Code","IP/OP",272,"Sterile Supply","","",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[5500299,"COLLAR LOW CONTOUR M","CDM Code","IP/OP",270,"Med-Sur Supplies","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[5500292,"TUBE TRACHEAL 6.5","CDM Code","IP/OP",272,"Sterile Supply","","",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[5500284,"TUBE LEVIN STOM 14FR","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500276,"IV BUTTERFLY 23X3/4","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500275,"TUBE FEEDING 8FR 15","CDM Code","IP/OP",272,"Sterile Supply","","",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[5500269,"TRAY LUMBAR PUN PEDI","CDM Code","IP/OP",270,"Med-Sur Supplies","","",101,50.5,80.295000000000002,85.85,85.85,85.85,84.84,81.81,80.800000000000011,80.295000000000002,80.800000000000011]
[5500264,"TRAY IRRIG TURY","CDM Code","IP/OP",272,"Sterile Supply","","",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[5500258,"AQUAPLAST 3X3/32 SPL","CDM Code","IP/OP",272,"Sterile Supply","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5500257,"AQUAPLAST 3X1/16 SPL","CDM Code","IP/OP",272,"Sterile Supply","","",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[5500122,"AQUAPAK HUMIDIFIER","CDM Code","IP/OP",270,"Med-Sur Supplies","","",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[5500116,"CATH.FOGARTY 5FR","CDM Code","IP/OP",272,"Sterile Supply","","",496,248,394.32,421.59999999999997,421.59999999999997,421.59999999999997,416.64,401.76000000000005,396.8,394.32,396.8]
[5500109,"CATHETER10FR3CCFOLEY","CDM Code","IP/OP",272,"Sterile Supply","","",68,34,54.06,57.8,57.8,57.8,57.12,55.080000000000005,54.400000000000006,54.06,54.400000000000006]
[5500108,"GUIDE WIRE 0.038","CDM Code","IP/OP",272,"Sterile Supply","","",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[5500102,"SPONGE/BRUSH HIB","CDM Code","IP/OP",272,"Sterile Supply","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[5500095,"STENT DBL J DUAL 6FR","CDM Code","IP/OP",272,"Sterile Supply","","",1076,538,855.42000000000007,914.6,914.6,914.6,903.83999999999992,871.56000000000006,860.80000000000007,855.42000000000007,860.80000000000007]
[5500086,"AIRWAY ORAL 90MM YEL","CDM Code","IP/OP",270,"Med-Sur Supplies","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5500085,"AIRWAY ORAL 80MM GRN","CDM Code","IP/OP",270,"Med-Sur Supplies","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[5500075,"COLLAR EXT BABY NONK","CDM Code","IP/OP",270,"Med-Sur Supplies","","",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[5300072,"*ECHO COMP W CONTRAST","CDM Code","IP/OP",480,"Cardiology","C8929","TTE W OR WO FOL WCON,DOPPLER",2364,1182,1879.38,2009.3999999999999,2009.3999999999999,2009.3999999999999,1985.76,1914.8400000000001,1891.2,1879.38,1891.2]
[5300068,"ZIO INTERPRETATION 3 DAYS- 7 DAYS","CDM Code","Pro",510,"Clinic",93244,"EXT ECG>48HR<7D REV&INTERPJ",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[5300066,"EEG AWAKE AND ASLEEP 95819","CDM Code","IP/OP",740,"EEG",95819,"EEG AWAKE AND ASLEEP",1492,746,1186.1400000000001,1268.2,1268.2,1268.2,1253.28,1208.52,1193.6000000000001,1186.1400000000001,1193.6000000000001]
[5300058,"HOLTER MONITOR HOOKUP","CDM Code","IP/OP",731,"Holter Mont",93225,"ECG MONIT/REPRT UP TO 48 HRS",585,292.5,465.07500000000005,497.25,497.25,497.25,491.4,473.85,468,465.07500000000005,468]
[5300053,"*ECHO TRANSTHORACIC LIMITED","CDM Code","IP/OP",480,"Cardiology",93308,"TTE F-UP OR LMTD",1229,614.5,977.05500000000006,1044.6499999999999,1044.6499999999999,1044.6499999999999,1032.3599999999999,995.49,983.2,977.05500000000006,983.2]
[5300039,"SHORT LATENCY SOMATOSENSORY PERIPH NERVE","CDM Code","IP/OP",922,"Other Diagnostic Services: Electromyelogram",95925,"SOMATOSENSORY TESTING",1360,680,1081.2,1156,1156,1156,1142.3999999999999,1101.6000000000001,1088,1081.2,1088]
[5300038,"STRESS ECHO TRANSTHORACIC","CDM Code","IP/OP",480,"Cardiology",93350,"STRESS TTE ONLY",2608,1304,2073.36,2216.7999999999997,2216.7999999999997,2216.7999999999997,2190.7199999999998,2112.48,2086.4,2073.36,2086.4]
[5300028,"EEG-REGULAR","CDM Code","IP/OP",740,"EEG",95816,"EEG AWAKE AND DROWSY",1490,745,1184.55,1266.5,1266.5,1266.5,1251.5999999999999,1206.9000000000001,1192,1184.55,1192]
[5300015,"CARTOID DUP SCAN LMT","CDM Code","IP/OP",921,"Peri Vascul Lab",93882,"EXTRACRANIAL UNI/LTD STUDY",710,355,564.45000000000005,603.5,603.5,603.5,596.4,575.1,568,564.45000000000005,568]
[5300007,"EKG LONG LEAD","CDM Code","IP/OP",730,"EKG/ECG",93005,"ELECTROCARDIOGRAM TRACING",280,140,222.60000000000002,238,238,238,235.2,226.8,224,222.60000000000002,224]
[5300006,"CARDIOVERSION","CDM Code","IP/OP",480,"Cardiology",92960,"CARDIOVERSION ELECTRIC EXT",762,381,605.79000000000008,647.69999999999993,647.69999999999993,647.69999999999993,640.07999999999993,617.22,609.6,605.79000000000008,609.6]
[5200032,"ST ONLINE 21-","CDM Code","IP/OP",440,"Speech Therapy","G2063","QUAL NONMD EST PT 21>MIN",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5200027,"ST VOICE AND RESONANCE 92524","CDM Code","IP/OP",440,"Speech Therapy",92524,"BEHAVRAL QUALIT ANALYS VOICE",567,283.5,450.76500000000004,481.95,481.95,481.95,476.28,459.27000000000004,453.6,450.76500000000004,453.6]
[5200022,"ST THERAPIST HOURLY","CDM Code","IP/OP",440,"Speech Therapy","","",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[5200020,"ST DEVELOP TEST LIMITED","CDM Code","IP/OP",440,"Speech Therapy",96110,"DEVELOPMENTAL SCREEN W/SCORE",701,350.5,557.29500000000007,595.85,595.85,595.85,588.84,567.81000000000006,560.80000000000007,557.29500000000007,560.80000000000007]
[5200006,"ST EVAL SPEECH GEN AUG DEV 1HR","CDM Code","IP/OP",440,"Speech Therapy",92607,"EX FOR SPEECH DEVICE RX 1HR",721,360.5,573.19500000000005,612.85,612.85,612.85,605.64,584.01,576.80000000000007,573.19500000000005,576.80000000000007]
[5100060,"OT ONLINE 21-OVER","CDM Code","IP/OP",430,"Occupational Ther","G2063","QUAL NONMD EST PT 21>MIN",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5100054,"OT EVAL HIGH COMPLEXITY","CDM Code","IP/OP",430,"Occupational Ther",97167,"OT EVAL HIGH COMPLEX 60 MIN",354,177,281.43,300.89999999999998,300.89999999999998,300.89999999999998,297.36,286.74,283.2,281.43,283.2]
[5100053,"OT EVAL MODERATE COMPLEXITY","CDM Code","IP/OP",430,"Occupational Ther",97166,"OT EVAL MOD COMPLEX 45 MIN",336,168,267.12,285.59999999999997,285.59999999999997,285.59999999999997,282.24,272.16000000000003,268.8,267.12,268.8]
[5100046,"OT GMC EMPLOYEE ERGONOMIC EVALS","CDM Code","IP/OP",430,"Occupational Ther","","",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[5100038,"OT ULTRASOUND","CDM Code","IP/OP",430,"Occupational Ther",97035,"ULTRASOUND THERAPY",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[5100032,"OT FCE (EACH 15 MIN)","CDM Code","IP/OP",430,"Occupational Ther",97750,"PHYSICAL PERFORMANCE TEST",160,80,127.2,136,136,136,134.4,129.60000000000002,128,127.2,128]
[5100030,"OT WOUND CARE SELECTIVE LESS THAN 20SQCM","CDM Code","IP/OP",430,"Occupational Ther",97597,"RMVL DEVITAL TIS 20 CM/<",248,124,197.16,210.79999999999998,210.79999999999998,210.79999999999998,208.32,200.88000000000002,198.4,197.16,198.4]
[5100025,"OT ORTHOTIC TRAINING","CDM Code","IP/OP",430,"Occupational Ther",97760,"ORTHOTIC MGMT&TRAING 1ST ENC",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[5100018,"OT WHEELCHAIR MGMT 15'","CDM Code","IP/OP",430,"Occupational Ther",97542,"WHEELCHAIR MNGMENT TRAINING",212,106,168.54000000000002,180.2,180.2,180.2,178.07999999999998,171.72,169.60000000000002,168.54000000000002,169.60000000000002]
[5100013,"OT ORTOOTCS FTTNG/TRAIN","CDM Code","IP/OP",430,"Occupational Ther",97760,"ORTHOTIC MGMT&TRAING 1ST ENC",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[5100012,"OT JOINT MOBILIZATION","CDM Code","IP/OP",430,"Occupational Ther",97140,"MANUAL THERAPY 1/> REGIONS",205,102.5,162.97499999999999,174.25,174.25,174.25,172.2,166.05,164,162.97499999999999,164]
[5100007,"OT ROM TEST EXTREM TRNK","CDM Code","IP/OP",430,"Occupational Ther",95851,"RANGE OF MOTION MEASUREMENTS",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[5000096,"PT ONLINE 21-MORE  MIN","CDM Code","IP/OP",420,"Physical Therp","G2063","QUAL NONMD EST PT 21>MIN",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[5000090,"PT EVAL MODERATE COMPLEXITY","CDM Code","IP/OP",420,"Physical Therp",97162,"PT EVAL MOD COMPLEX 30 MIN",341,170.5,271.09500000000003,289.84999999999997,289.84999999999997,289.84999999999997,286.44,276.21000000000004,272.8,271.09500000000003,272.8]
[5000089,"PT EVAL LOW COMPLEXITY","CDM Code","IP/OP",420,"Physical Therp",97161,"PT EVAL LOW COMPLEX 20 MIN",326,163,259.17,277.09999999999997,277.09999999999997,277.09999999999997,273.83999999999997,264.06,260.8,259.17,260.8]
[5000082,"PT COMPUTERIZED DYNAMIC POSTUROGRAPHY","CDM Code","IP/OP",420,"Physical Therp",92548,"CDP-SOT 6 COND W/I&R",1306,653,1038.27,1110.0999999999999,1110.0999999999999,1110.0999999999999,1097.04,1057.8600000000001,1044.8,1038.27,1044.8]
[5000044,"PT WOUND CARE SELECTIVE LESS THAN 20SQCM","CDM Code","IP/OP",420,"Physical Therp",97597,"RMVL DEVITAL TIS 20 CM/<",248,124,197.16,210.79999999999998,210.79999999999998,210.79999999999998,208.32,200.88000000000002,198.4,197.16,198.4]
[5000036,"PT THERAPEUTIC ACTVITIES EA 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97530,"THERAPEUTIC ACTIVITIES",172,86,136.74,146.19999999999999,146.19999999999999,146.19999999999999,144.47999999999999,139.32000000000002,137.6,136.74,137.6]
[5000035,"PT PROSTHETIC TRAINING EA 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97761,"PROSTHETIC TRAING 1ST ENC",185,92.5,147.07500000000002,157.25,157.25,157.25,155.4,149.85000000000002,148,147.07500000000002,148]
[5000030,"PT TRACTION MANUAL EA 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97140,"MANUAL THERAPY 1/> REGIONS",181,90.5,143.89500000000001,153.85,153.85,153.85,152.04,146.61000000000001,144.80000000000001,143.89500000000001,144.80000000000001]
[5000019,"PT NEUROMUSCULAR REEDUCATION EA 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97112,"NEUROMUSCULAR REEDUCATION",127,63.5,100.965,107.95,107.95,107.95,106.67999999999999,102.87,101.60000000000001,100.965,101.60000000000001]
[5000013,"PT ELECTRICAL STIMULATION MANUAL 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97032,"ELECTRICAL STIMULATION",110,55,87.45,93.5,93.5,93.5,92.399999999999991,89.100000000000009,88,87.45,88]
[5000012,"PT WHIRLPOOL","CDM Code","IP/OP",420,"Physical Therp",97022,"WHIRLPOOL THERAPY",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[5000005,"PT ROM TEST HAND","CDM Code","IP/OP",420,"Physical Therp",95852,"RANGE OF MOTION MEASUREMENTS",98,49,77.910000000000011,83.3,83.3,83.3,82.32,79.38000000000001,78.400000000000006,77.910000000000011,78.400000000000006]
[4900079,"NOCTURNAL CPAP","CDM Code","IP/OP",410,"Respiratory Svc",94660,"POS AIRWAY PRESSURE CPAP",435,217.5,345.82500000000005,369.75,369.75,369.75,365.4,352.35,348,345.82500000000005,348]
[4900073,"NEWBORN HEARING SCREENING OAE","CDM Code","IP/OP",471,"Audiology/Dx",92558,"EVOKED AUDITORY TEST QUAL",195,97.5,155.02500000000001,165.75,165.75,165.75,163.79999999999998,157.95000000000002,156,155.02500000000001,156]
[4900072,"PFT DIFFUSING CAPACITY 94729","CDM Code","IP/OP",460,"Pulmonary Func",94729,"CO/MEMBANE DIFFUSE CAPACITY",400,200,318,340,340,340,336,324,320,318,320]
[4900062,"CONT INHALATION TX W AEROSOL MED EA ADD","CDM Code","IP/OP",410,"Respiratory Svc",94645,"CBT EACH ADDL HOUR",247,123.5,196.36500000000001,209.95,209.95,209.95,207.48,200.07000000000002,197.60000000000002,196.36500000000001,197.60000000000002]
[4900052,"HHN IPPB MDI SUBSEQUENT TX 4","CDM Code","IP/OP",410,"Respiratory Svc",94640,"AIRWAY INHALATION TREATMENT",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[4900035,"NASOTRACHEAL SUCTION","CDM Code","IP/OP",410,"Respiratory Svc",31720,"CLEARANCE OF AIRWAYS",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[4900032,"CO2 DETERMINATION","CDM Code","IP/OP",460,"Pulmonary Func",94770,"EXHALED CARBON DIOXIDE TEST",323,161.5,256.78500000000003,274.55,274.55,274.55,271.32,261.63,258.40000000000003,256.78500000000003,258.40000000000003]
[4900026,"CPT PD OR COUGH ASSIST INITIAL TX","CDM Code","IP/OP",410,"Respiratory Svc",94667,"CHEST WALL MANIPULATION",237,118.5,188.41500000000002,201.45,201.45,201.45,199.07999999999998,191.97,189.60000000000002,188.41500000000002,189.60000000000002]
[4900020,"HHN INITIAL TREATMENT","CDM Code","IP/OP",410,"Respiratory Svc",94640,"AIRWAY INHALATION TREATMENT",266,133,211.47,226.1,226.1,226.1,223.44,215.46,212.8,211.47,212.8]
[4900007,"PFT METHACHOLINE CHALLENGE","CDM Code","IP/OP",460,"Pulmonary Func",94070,"EVALUATION OF WHEEZING",1429,714.5,1136.0550000000001,1214.6499999999999,1214.6499999999999,1214.6499999999999,1200.3599999999999,1157.49,1143.2,1136.0550000000001,1143.2]
[4900006,"PFT AP BRONCHODILATORS","CDM Code","IP/OP",460,"Pulmonary Func",94060,"EVALUATION OF WHEEZING",1115,557.5,886.42500000000007,947.75,947.75,947.75,936.59999999999991,903.15000000000009,892,886.42500000000007,892]
[4700049,"BB PLATELET PR","CDM Code","IP/OP",391,"Blood/Admin","P9073","PLATELETS PHERESIS PATH REDU",983,491.5,781.48500000000001,835.55,835.55,835.55,825.71999999999991,796.23,786.40000000000009,781.48500000000001,786.40000000000009]
[4700044,"BB 25% ALBUMIN-50ML","CDM Code","IP/OP",390,"Blood/Admin/Stor","P9047","ALBUMIN (HUMAN), 25%, 50ML",412,206,327.54000000000002,350.2,350.2,350.2,346.08,333.72,329.6,327.54000000000002,329.6]
[4700035,"BB FRESH FROZEN PLASMA","CDM Code","IP/OP",390,"Blood/Admin/Stor","","",385,192.5,306.07499999999999,327.25,327.25,327.25,323.39999999999998,311.85000000000002,308,306.07499999999999,308]
[4700031,"BB RHO(D)IMMUME GLOBULIN IM","CDM Code","IP/OP",636,"Drug/Detail Code",90384,"RH IG FULL-DOSE IM",321,160.5,255.19500000000002,272.84999999999997,272.84999999999997,272.84999999999997,269.64,260.01,256.8,255.19500000000002,256.8]
[4600073,"BB RBC ANTIGEN TEST EACH ANTIGEN","CDM Code","IP/OP",300,"Lab",86902,"BLOOD TYPE ANTIGEN DONOR EA",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[4600047,"BB CROSSMATCH AHG","CDM Code","IP/OP",300,"Lab",86922,"COMPATIBILITY TEST ANTIGLOB",204,102,162.18,173.4,173.4,173.4,171.35999999999999,165.24,163.20000000000002,162.18,163.20000000000002]
[4600022,"ANTIBODY ID","CDM Code","IP/OP",300,"Lab",86870,"RBC ANTIBODY IDENTIFICATION",477,238.5,379.21500000000003,405.45,405.45,405.45,400.68,386.37,381.6,379.21500000000003,381.6]
[4600019,"BB ANTIBODY SCREEN","CDM Code","IP/OP",300,"Lab",86850,"RBC ANTIBODY SCREEN",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[4500051,"ONCOLOGY ROOM PROCEDURE PER MINUTE","CDM Code","IP/OP",361,"OR/Minor","","",100,50,79.5,85,85,85,84,81,80,79.5,80]
[4500045,"CHEMO INTRA ARTERIAL PUSH TECHNIQUE","CDM Code","IP/OP",331,"Rad-Chemo-Inject",96420,"CHEMO IA PUSH TECNIQUE",554,277,440.43,470.9,470.9,470.9,465.35999999999996,448.74,443.20000000000005,440.43,443.20000000000005]
[4500043,"CHEMO ADMIN SQ OR IM NON HORMONAL ANTI N","CDM Code","IP/OP",331,"Rad-Chemo-Inject",96401,"CHEMO ANTI-NEOPL SQ/IM",293,146.5,232.935,249.04999999999998,249.04999999999998,249.04999999999998,246.12,237.33,234.4,232.935,234.4]
[4500040,"IV PUSH NON CHEMO EA ADDTL SEQ SUBSTANCE","CDM Code","IP/OP",940,"Other Rx Svcs",96375,"TX/PRO/DX INJ NEW DRUG ADDON",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[4500035,"CHEMO IV INF PROLONGED 8+HOURS REQ PUMP","CDM Code","IP/OP",335,"Rad-Chemo-IV",96416,"CHEMO PROLONG INFUSE W/PUMP",1519,759.5,1207.605,1291.1499999999999,1291.1499999999999,1291.1499999999999,1275.96,1230.3900000000001,1215.2,1207.605,1215.2]
[4500030,"INFUSION THERAPY OR PROPHYLAXIS EA ADDTL","CDM Code","IP/OP",260,"IV Therapy",96366,"THER/PROPH/DIAG IV INF ADDON",283,141.5,224.98500000000001,240.54999999999998,240.54999999999998,240.54999999999998,237.72,229.23000000000002,226.4,224.98500000000001,226.4]
[4500015,"CHEMO ADMIN IV PUSH UP TO 15 MIN","CDM Code","IP/OP",331,"Rad-Chemo-Inject",96409,"CHEMO IV PUSH SNGL DRUG",374,187,297.33000000000004,317.89999999999998,317.89999999999998,317.89999999999998,314.15999999999997,302.94,299.2,297.33000000000004,299.2]
[4500009,"NON-COVERED VENIPUNCTURE","CDM Code","IP/OP",300,"Lab",36415,"ROUTINE VENIPUNCTURE",19,9.5,15.105,16.149999999999999,16.149999999999999,16.149999999999999,15.959999999999999,15.39,15.200000000000001,15.105,15.200000000000001]
[4500003,"BLOOD TRANSFUSION 4-6 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1131,565.5,899.1450000000001,961.35,961.35,961.35,950.04,916.11,904.80000000000007,899.1450000000001,904.80000000000007]
[4402650,"BLASTOMYCES AG QUANT UR RANDOM","CDM Code","IP/OP",300,"Lab",87449,"NOS EACH ORGANISM AG IA",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[4402645,"HEPATITIS B SURFACE AB QUAL QUANT SERUM","CDM Code","IP/OP",300,"Lab",86706,"HEP B SURFACE ANTIBODY",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[4402643,"THC CONFIRMATION URINE RANDOM","CDM Code","IP/OP",300,"Lab",80349,"CANNABINOIDS NATURAL",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[4402638,"*P TAU ABETA 42","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",440,220,349.8,374,374,374,369.59999999999997,356.40000000000003,352,349.8,352]
[4402633,"HIV1 GENOTYPE DRUG RESISTANT","CDM Code","IP/OP",300,"Lab","0219U","NFCT AGT HIV GNRJ SEQ ALYS",435,217.5,345.82500000000005,369.75,369.75,369.75,365.4,352.35,348,345.82500000000005,348]
[4402628,"EVEROLIMUS BLOOD","CDM Code","IP/OP",300,"Lab",80169,"DRUG ASSAY EVEROLIMUS",51,25.5,40.545000000000002,43.35,43.35,43.35,42.839999999999996,41.31,40.800000000000004,40.545000000000002,40.800000000000004]
[4402627,"NMO AQP4 FACS","CDM Code","IP/OP",300,"Lab",86053,"AQAPRN-4 ANTB FLO CYTMTRY EA",350,175,278.25,297.5,297.5,297.5,294,283.5,280,278.25,280]
[4402622,"*EHRLICHIA CHAFFEENSIS","CDM Code","IP/OP",300,"Lab",87484,"EHRLICHA CHAFFEENSIS AMP PRB",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[4402617,"CV19 FLU","CDM Code","IP/OP",300,"Lab","0240U","NFCT DS VIR RESP RNA 3 TRGT",143,71.5,113.685,121.55,121.55,121.55,120.11999999999999,115.83000000000001,114.4,113.685,114.4]
[4402612,"*CIB IgM","CDM Code","IP/OP",300,"Lab",88350,"IMMUNOFLUOR ANTB ADDL STAIN",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[4402611,"*CIB IgG4","CDM Code","IP/OP",300,"Lab",88350,"IMMUNOFLUOR ANTB ADDL STAIN",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[4402606,"*ID MALTI ANO2 MASS SPEC","CDM Code","IP/OP",300,"Lab",87076,"CULTURE ANAEROBE IDENT EACH",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[4402601,"COMPLEMENT C1Q SERUM","CDM Code","IP/OP",300,"Lab",86160,"COMPLEMENT ANTIGEN",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[4402596,"POLYSUBSTANCE DRUG PANEL URINE","CDM Code","IP/OP",300,"Lab",80307,"DRUG TEST PRSMV CHEM ANLYZR",129,64.5,102.55500000000001,109.64999999999999,109.64999999999999,109.64999999999999,108.36,104.49000000000001,103.2,102.55500000000001,103.2]
[4402595,"*FUNGAL SMEAR","CDM Code","IP/OP",300,"Lab",87206,"SMEAR FLUORESCENT/ACID STAI",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[4402590,"*OXYCODONE","CDM Code","IP/OP",300,"Lab",80365,"DRUG SCREENING OXYCODONE",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[4402585,"HEPATITIS C AB W REFLEX","CDM Code","IP/OP",300,"Lab",86803,"HEPATITIS C AB TEST",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[4402580,"*MALARIA BINEX NOW","CDM Code","IP/OP",300,"Lab",87899,"AGENT NOS ASSAY W/OPTIC",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[4402578,"VON WILLEBRAND FACTOR ACTIVITY W REFLEX","CDM Code","IP/OP",300,"Lab",85397,"CLOTTING FUNCT ACTIVITY",361,180.5,286.995,306.84999999999997,306.84999999999997,306.84999999999997,303.24,292.41000000000003,288.8,286.995,288.8]
[4402573,"MULTIPLEX IMMUNO STAIN","CDM Code","IP/OP",300,"Lab",88344,"IMMUNOHISTO ANTIBODY SLIDE",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[4402567,"MYELIN ASSOCIATED GLYCOPROTEIN","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",156,78,124.02000000000001,132.6,132.6,132.6,131.04,126.36000000000001,124.80000000000001,124.02000000000001,124.80000000000001]
[4402562,"*OXALATE UR 24","CDM Code","IP/OP",300,"Lab",83945,"ASSAY OF OXALATE",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[4402561,"*SULFATE UR 24","CDM Code","IP/OP",300,"Lab",84392,"ASSAY OF URINE SULFATE",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[4402556,"*CALCIUM UR 24","CDM Code","IP/OP",300,"Lab",82340,"ASSAY OF CALCIUM IN URINE",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[4402553,"*OSMOLALITY URINE 24","CDM Code","IP/OP",300,"Lab",83935,"ASSAY OF URINE OSMOLALITY",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[4402547,"ID ANAEROBIC BACTERIA","CDM Code","IP/OP",300,"Lab",87076,"CULTURE ANAEROBE IDENT EACH",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[4402546,"*R MYCOBACTERIUM TB PCR","CDM Code","IP/OP",300,"Lab",87556,"M.TUBERCULO DNA AMP PROBE",317,158.5,252.01500000000001,269.45,269.45,269.45,266.27999999999997,256.77000000000004,253.60000000000002,252.01500000000001,253.60000000000002]
[4402540,"TRANSGLUTAMINASE TISSUE IGA","CDM Code","IP/OP",300,"Lab",86364,"TISS TRNSGLTMNASE EA IG CLAS",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[4402532,"ACID SPHINGOMYELINASE LEUKOCYTES","CDM Code","IP/OP",300,"Lab",82657,"ENZYME CELL ACTIVITY",472,236,375.24,401.2,401.2,401.2,396.47999999999996,382.32000000000005,377.6,375.24,377.6]
[4402527,"GROUP A STREP PCR","CDM Code","IP/OP",300,"Lab",87651,"STREP A DNA AMP PROBE",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[4402526,"ANCA","CDM Code","IP/OP",300,"Lab",86036,"ANCA SCREEN EACH ANTIBODY",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[4402521,"GALACTOSE 1 PHOSPHATE URIDYLTRANSFERASE","CDM Code","IP/OP",300,"Lab",82775,"ASSAY GALACTOSE TRANSFERASE",79,39.5,62.805,67.149999999999991,67.149999999999991,67.149999999999991,66.36,63.99,63.2,62.805,63.2]
[4402516,"FACTOR 9 ASSAY","CDM Code","IP/OP",300,"Lab",85250,"CLOT FACTOR IX PTC/CHRSTMAS",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[4402511,"*GENE PANEL HEME","CDM Code","IP/OP",300,"Lab",81455,"TGSAP SO/HL 51/> DNA/DNA&RNA",2426,1213,1928.67,2062.1,2062.1,2062.1,2037.84,1965.0600000000002,1940.8000000000002,1928.67,1940.8000000000002]
[4402510,"*ANALYZE 20-25 CELLS","CDM Code","IP/OP",300,"Lab",88264,"CHROMOSOME ANALYSIS 20-25",542,271,430.89000000000004,460.7,460.7,460.7,455.28,439.02000000000004,433.6,430.89000000000004,433.6]
[4402504,"*R ACH RECEPTOR MODULATING AB","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",154,77,122.43,130.9,130.9,130.9,129.35999999999999,124.74000000000001,123.2,122.43,123.2]
[4402499,"MAGNESIUM URINE RANDOM","CDM Code","IP/OP",300,"Lab",83735,"ASSAY OF MAGNESIUM",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[4402494,"ASPERGILLUS IGE","CDM Code","IP/OP",300,"Lab",86003,"ALLG SPEC IGE CRUDE XTRC EA",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[4402493,"NASH FIBROTEST","CDM Code","IP/OP",300,"Lab","0003M","LIVER DIS 10 ASSAYS W/NASH",469,234.5,372.85500000000002,398.65,398.65,398.65,393.96,379.89000000000004,375.20000000000005,372.85500000000002,375.20000000000005]
[4402487,"*OXALATE URINE RANDOM","CDM Code","IP/OP",300,"Lab",83945,"ASSAY OF OXALATE",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[4402482,"*R MPL","CDM Code","IP/OP",300,"Lab",81339,"MPL GENE SEQ ALYS EXON 10",607,303.5,482.565,515.94999999999993,515.94999999999993,515.94999999999993,509.88,491.67,485.6,482.565,485.6]
[4402477,"*HSV 2 PCR CSF","CDM Code","IP/OP",300,"Lab",87529,"HSV DNA AMP PROBE",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[4402476,"COCCIDIOIDES AB SCREEN W REFLEX","CDM Code","IP/OP",300,"Lab",86635,"COCCIDIOIDES ANTIBODY",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[4402471,"FIBROBLAST GROWTH FACTOR 23","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[4402465,"INTERLEUKIN 1 BETA","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",286,143,227.37,243.1,243.1,243.1,240.23999999999998,231.66000000000003,228.8,227.37,228.8]
[4402460,"*THYROXINE TOTAL","CDM Code","IP/OP",300,"Lab",84436,"ASSAY OF TOTAL THYROXINE",27,13.5,21.465,22.95,22.95,22.95,22.68,21.87,21.6,21.465,21.6]
[4402459,"*THYROXINE BINDING CAPACITY","CDM Code","IP/OP",300,"Lab",84479,"ASSAY OF THYROID (T3 OR T4)",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[4402452,"SARS CV2 NUCLEOCAPSI AB SERUM","CDM Code","IP/OP",300,"Lab",86769,"SARS-COV-2 COVID-19 ANTIBODY",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[4402446,"PREGABALIN LYRICA","CDM Code","IP/OP",300,"Lab",80366,"DRUG SCREENING PREGABALIN",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[4402441,"2C9 GENOTYPE","CDM Code","IP/OP",300,"Lab",81227,"CYP2C9 GENE COM VARIANTS",660,330,524.70000000000005,561,561,561,554.4,534.6,528,524.70000000000005,528]
[4402440,"CV19 FLU RSV","CDM Code","IP/OP",300,"Lab","0241U","NFCT DS VIR RESP RNA 4 TRGT",170,85,135.15,144.5,144.5,144.5,142.79999999999998,137.70000000000002,136,135.15,136]
[4402431,"*MYCOPLASMA PNEUMONIAE","CDM Code","IP/OP",300,"Lab",87581,"M.PNEUMON DNA AMP PROBE",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[4402426,"*ANTIUSTEKINUMAB","CDM Code","IP/OP",300,"Lab",82397,"CHEMILUMINESCENT ASSAY",127,63.5,100.965,107.95,107.95,107.95,106.67999999999999,102.87,101.60000000000001,100.965,101.60000000000001]
[4402421,"CLOBAZAM METABOLITE SERUM","CDM Code","IP/OP",300,"Lab",80339,"ANTIEPILEPTICS NOS 1-3",106,53,84.27000000000001,90.1,90.1,90.1,89.039999999999992,85.86,84.800000000000011,84.27000000000001,84.800000000000011]
[4402418,"HTLV I II AB S","CDM Code","IP/OP",300,"Lab",86689,"HTLV/HIV CONFIRMJ ANTIBODY",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[4402416,"INFLIXIMAB QUANT WITH AB REFLEX","CDM Code","IP/OP",300,"Lab",80230,"DRUG ASSAY INFLIXIMAB",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[4402411,"LEPTIN","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",124,62,98.58,105.39999999999999,105.39999999999999,105.39999999999999,104.16,100.44000000000001,99.2,98.58,99.2]
[4402406,"*CYTOMOLECULAR REPORT","CDM Code","IP/OP",300,"Lab",88291,"CYTO/MOLECULAR REPORT",141,70.5,112.095,119.85,119.85,119.85,118.44,114.21000000000001,112.80000000000001,112.095,112.80000000000001]
[4402405,"*CYTOGENETICS 100-300","CDM Code","IP/OP",300,"Lab",88275,"CYTOGENETICS 100-300",257,128.5,204.315,218.45,218.45,218.45,215.88,208.17000000000002,205.60000000000002,204.315,205.60000000000002]
[4402399,"D LACTATE PLASMA","CDM Code","IP/OP",300,"Lab",83605,"ASSAY OF LACTIC ACID",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[4402394,"*GM 1 DIASIALO IGG","CDM Code","IP/OP",300,"Lab",83516,"IMMUNOASSAY NONANTIBODY",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[4402389,"CV19 PCR SEND OUT","CDM Code","IP/OP",300,"Lab","U0003","COV-19 AMP PRB HGH THRUPUT",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[4402388,"*GLUCOSE URINE","CDM Code","IP/OP",300,"Lab",82945,"GLUCOSE OTHER FLUID",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[4402382,"ETHYLENE GLYCOL","CDM Code","IP/OP",300,"Lab",82693,"ASSAY OF ETHYLENE GLYCOL",61,30.5,48.495000000000005,51.85,51.85,51.85,51.239999999999995,49.410000000000004,48.800000000000004,48.495000000000005,48.800000000000004]
[4402375,"*R MVISTA HISTO AG QUANT","CDM Code","IP/OP",300,"Lab",87385,"HISTOPLASMA CAPSUL AG IA",128,64,101.76,108.8,108.8,108.8,107.52,103.68,102.4,101.76,102.4]
[4402369,"AFP PERITONEAL FLUID","CDM Code","IP/OP",300,"Lab",86316,"IMMUNOASSAY TUMOR OTHER",85,42.5,67.575000000000003,72.25,72.25,72.25,71.399999999999991,68.850000000000009,68,67.575000000000003,68]
[4402366,"HEMOSIDERIN URINE","CDM Code","IP/OP",300,"Lab",83070,"ASSAY OF HEMOSIDERIN QUAL",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[4402361,"*CHIKUNGUNYA IGG AB","CDM Code","IP/OP",300,"Lab",86790,"VIRUS ANTIBODY NOS",124,62,98.58,105.39999999999999,105.39999999999999,105.39999999999999,104.16,100.44000000000001,99.2,98.58,99.2]
[4402356,"ANTI USTEKINUMAB ANTIBODY","CDM Code","IP/OP",300,"Lab",80299,"QUANTITATIVE ASSAY DRUG",156,78,124.02000000000001,132.6,132.6,132.6,131.04,126.36000000000001,124.80000000000001,124.02000000000001,124.80000000000001]
[4402351,"FECAL BACTERIAL PATHOGENS BY PCR","CDM Code","IP/OP",300,"Lab",87505,"NFCT AGENT DETECTION GI",519,259.5,412.60500000000002,441.15,441.15,441.15,435.96,420.39000000000004,415.20000000000005,412.60500000000002,415.20000000000005]
[4402348,"BILE ACID TOTAL AND FRACTIONATED","CDM Code","IP/OP",300,"Lab",82542,"COL CHROMOTOGRAPHY QUAL/QUAN",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[4402343,"COPEPTIN PROAVP","CDM Code","IP/OP",300,"Lab",84588,"ASSAY OF VASOPRESSIN",148,74,117.66000000000001,125.8,125.8,125.8,124.32,119.88000000000001,118.4,117.66000000000001,118.4]
[4402335,"LEGIONELLA AB SERUM","CDM Code","IP/OP",300,"Lab",86713,"LEGIONELLA ANTIBODY",68,34,54.06,57.8,57.8,57.8,57.12,55.080000000000005,54.400000000000006,54.06,54.400000000000006]
[4402330,"EOSINOPHILS URINE","CDM Code","IP/OP",300,"Lab",85999,"UNLISTED HEMATOLOGY&COAGJ PX",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[4402329,"PROTOPORPHRYNS OCCUPATIONAL","CDM Code","IP/OP",300,"Lab",82542,"COL CHROMOTOGRAPHY QUAL/QUAN",163,81.5,129.58500000000001,138.54999999999998,138.54999999999998,138.54999999999998,136.91999999999999,132.03,130.4,129.58500000000001,130.4]
[4402324,"*TISSUE CULTURE SKIN BIOPSY","CDM Code","IP/OP",300,"Lab",88233,"TISSUE CULTURE SKIN/BIOPSY",637,318.5,506.41500000000002,541.44999999999993,541.44999999999993,541.44999999999993,535.07999999999993,515.97,509.6,506.41500000000002,509.6]
[4402319,"*ASSAY OF GGT","CDM Code","IP/OP",300,"Lab",82977,"ASSAY OF GGT",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[4402314,"RESPIRATORY VIRAL PANEL EXP","CDM Code","IP/OP",300,"Lab",87632,"RESP VIRUS 6-11 TARGETS",644,322,511.98,547.4,547.4,547.4,540.96,521.64,515.20000000000005,511.98,515.20000000000005]
[4402313,"*EHRLICHIA MURIS","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",125,62.5,99.375,106.25,106.25,106.25,105,101.25,100,99.375,100]
[4402307,"D LACTATE URINE","CDM Code","IP/OP",300,"Lab",83605,"ASSAY OF LACTIC ACID",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[4402302,"MOG FACS","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",483,241.5,383.98500000000001,410.55,410.55,410.55,405.71999999999997,391.23,386.40000000000003,383.98500000000001,386.40000000000003]
[4402295,"ZIKA PCR SERUM","CDM Code","IP/OP",300,"Lab",87662,"ZIKA VIRUS DNA/RNA AMP PROBE",279,139.5,221.80500000000001,237.15,237.15,237.15,234.35999999999999,225.99,223.20000000000002,221.80500000000001,223.20000000000002]
[4402294,"S CEREVISIAE IGG","CDM Code","IP/OP",300,"Lab",86671,"FUNGUS NES ANTIBODY",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[4402289,"*COCAINE REFLEX WB","CDM Code","IP/OP",300,"Lab",80353,"DRUG SCREENING COCAINE",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[4402284,"SHOX DNA","CDM Code","IP/OP",300,"Lab",81479,"UNLISTED MOLECULAR PATHOLOGY",604,302,480.18,513.4,513.4,513.4,507.35999999999996,489.24,483.20000000000005,480.18,483.20000000000005]
[4402280,"*R LG1CS","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",286,143,227.37,243.1,243.1,243.1,240.23999999999998,231.66000000000003,228.8,227.37,228.8]
[4402279,"QUETIAPINE SEROQUEL","CDM Code","IP/OP",300,"Lab",80342,"ANTIPSYCHOTICS NOS 1-3",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[4402273,"INFLUENZA A B PCR","CDM Code","IP/OP",300,"Lab",87631,"RESP VIRUS 3-5 TARGETS",458,229,364.11,389.3,389.3,389.3,384.71999999999997,370.98,366.40000000000003,364.11,366.40000000000003]
[4402268,"RHD GENE ANALYSIS","CDM Code","IP/OP",300,"Lab",81403,"MOPATH PROCEDURE LEVEL 4",540,270,429.3,459,459,459,453.59999999999997,437.40000000000003,432,429.3,432]
[4402262,"*POLIOVIRUS 1 AB","CDM Code","IP/OP",300,"Lab",86382,"NEUTRALIZATION TEST VIRAL",244,122,193.98000000000002,207.4,207.4,207.4,204.95999999999998,197.64000000000001,195.20000000000002,193.98000000000002,195.20000000000002]
[4402260,"*OPIATES MECONIUM","CDM Code","IP/OP",300,"Lab",80361,"OPIATES 1 OR MORE",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[4402255,"*R THC MECONIUM CONFIRM","CDM Code","IP/OP",300,"Lab",80349,"CANNABINOIDS NATURAL",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[4402250,"*BVAB 2","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[4402243,"*BURGDORFERI PCR","CDM Code","IP/OP",300,"Lab",87476,"LYME DIS DNA AMP PROBE",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[4402242,"*ID OTHER AER MML","CDM Code","IP/OP",300,"Lab",87077,"CULTURE AEROBIC IDENTIFY",101,50.5,80.295000000000002,85.85,85.85,85.85,84.84,81.81,80.800000000000011,80.295000000000002,80.800000000000011]
[4402237,"COMPLEMENT C4A","CDM Code","IP/OP",300,"Lab",86160,"COMPLEMENT ANTIGEN",173,86.5,137.535,147.04999999999998,147.04999999999998,147.04999999999998,145.32,140.13,138.4,137.535,138.4]
[4402230,"PROSTATE HEALTH INDEX","CDM Code","IP/OP",300,"Lab",84153,"ASSAY OF PSA TOTAL",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[4402186,"CULTURE FUNGAL HAIR NAIL SKIN","CDM Code","IP/OP",300,"Lab",87101,"SKIN FUNGI CULTURE",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[4402185,"BCR ABL 1 TKI MUTATION","CDM Code","IP/OP",300,"Lab",81170,"ABL1 GENE",1125,562.5,894.375,956.25,956.25,956.25,945,911.25000000000011,900,894.375,900]
[4402180,"*DENGUE NS1 AG","CDM Code","IP/OP",300,"Lab",86790,"VIRUS ANTIBODY NOS",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[4402174,"*RAF1","CDM Code","IP/OP",300,"Lab",81406,"MOPATH PROCEDURE LEVEL 7",318,159,252.81,270.3,270.3,270.3,267.12,257.58000000000004,254.4,252.81,254.4]
[4402169,"*SHOC2","CDM Code","IP/OP",300,"Lab",81405,"MOPATH PROCEDURE LEVEL 6",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[4402168,"*KRAS","CDM Code","IP/OP",300,"Lab",81405,"MOPATH PROCEDURE LEVEL 6",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[4402159,"*TRICHOMONAS UVM","CDM Code","IP/OP",300,"Lab",87808,"TRICHOMONAS ASSAY W/OPTIC",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[4402152,"UDS PRESCRIPTION OTC","CDM Code","IP/OP",300,"Lab",80307,"DRUG TEST PRSMV CHEM ANLYZR",351,175.5,279.04500000000002,298.34999999999997,298.34999999999997,298.34999999999997,294.83999999999997,284.31,280.8,279.04500000000002,280.8]
[4402147,"ALCOHOL BIOMARKERS SCREEN REFLEX","CDM Code","IP/OP",300,"Lab",80307,"DRUG TEST PRSMV CHEM ANLYZR",350,175,278.25,297.5,297.5,297.5,294,283.5,280,278.25,280]
[4402146,"*STAT3 SNP","CDM Code","IP/OP",300,"Lab",81479,"UNLISTED MOLECULAR PATHOLOGY",572,286,454.74,486.2,486.2,486.2,480.47999999999996,463.32000000000005,457.6,454.74,457.6]
[4402141,"*IBD SPECIFIC PANCA IFA PERINUCLEAR PATT","CDM Code","IP/OP",300,"Lab",88346,"IMMUNOFLUOR ANTB 1ST STAIN",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[4402136,"*ANTI CBIR1 IGG ELISA","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[4402131,"*VCAM","CDM Code","IP/OP",300,"Lab",82397,"CHEMILUMINESCENT ASSAY",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[4402130,"*ICAM","CDM Code","IP/OP",300,"Lab",82397,"CHEMILUMINESCENT ASSAY",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[4402125,"*BP 180","CDM Code","IP/OP",300,"Lab",83516,"IMMUNOASSAY NONANTIBODY",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[4402119,"ADENOVIRUS ANTIBODY","CDM Code","IP/OP",300,"Lab",86603,"ADENOVIRUS ANTIBODY",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[4402113,"JAK2 V617F MUTATION","CDM Code","IP/OP",300,"Lab",81270,"JAK2 GENE",530,265,421.35,450.5,450.5,450.5,445.2,429.3,424,421.35,424]
[4402112,"URIC ACID BODY FLUID","CDM Code","IP/OP",300,"Lab",84560,"ASSAY OF URINE/URIC ACID",56,28,44.52,47.6,47.6,47.6,47.04,45.36,44.800000000000004,44.52,44.800000000000004]
[4402106,"*PCA TR","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[4402102,"*ANNA 3","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[4402097,"HERPESVIRUS 6 A B PCR","CDM Code","IP/OP",300,"Lab",87533,"HHV-6 DNA QUANT",786,393,624.87,668.1,668.1,668.1,660.24,636.66000000000008,628.80000000000007,624.87,628.80000000000007]
[4402096,"*HSV 1 PCR CSF","CDM Code","IP/OP",300,"Lab",87529,"HSV DNA AMP PROBE",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[4402090,"*ECHOVIRUS 30 AB","CDM Code","IP/OP",300,"Lab",86658,"ENTEROVIRUS ANTIBODY",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[4402085,"BACTERIAL VAGINOSIS GRAM STAIN","CDM Code","IP/OP",300,"Lab",87205,"SMEAR GRAM STAIN",165,82.5,131.17500000000001,140.25,140.25,140.25,138.6,133.65,132,131.17500000000001,132]
[4402080,"WEST NILE PCR CSF","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",173,86.5,137.535,147.04999999999998,147.04999999999998,147.04999999999998,145.32,140.13,138.4,137.535,138.4]
[4402079,"SHIGA TOXIN PCR","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",171,85.5,135.94499999999999,145.35,145.35,145.35,143.63999999999999,138.51000000000002,136.80000000000001,135.94499999999999,136.80000000000001]
[4402074,"HISTAMINE PLASMA","CDM Code","IP/OP",300,"Lab",83088,"ASSAY OF HISTAMINE",181,90.5,143.89500000000001,153.85,153.85,153.85,152.04,146.61000000000001,144.80000000000001,143.89500000000001,144.80000000000001]
[4402067,"TRICHLOROETHYLENE","CDM Code","IP/OP",300,"Lab",82441,"TEST FOR CHLOROHYDROCARBONS",184,92,146.28,156.4,156.4,156.4,154.56,149.04000000000002,147.20000000000002,146.28,147.20000000000002]
[4402062,"HEPATITIS E IGG","CDM Code","IP/OP",300,"Lab",86790,"VIRUS ANTIBODY NOS",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[4402061,"ENDOMYSIAL AB","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",81,40.5,64.39500000000001,68.849999999999994,68.849999999999994,68.849999999999994,68.039999999999992,65.61,64.8,64.39500000000001,64.8]
[4402056,"CHOLESTEROL BODY FLUID","CDM Code","IP/OP",300,"Lab",84311,"SPECTROPHOTOMETRY",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[4402051,"*BCR ABL1 GENE OTHER BP","CDM Code","IP/OP",300,"Lab",81208,"BCR/ABL1 GENE OTHER BP",223,111.5,177.285,189.54999999999998,189.54999999999998,189.54999999999998,187.32,180.63000000000002,178.4,177.285,178.4]
[4402045,"ANTIDEPRESSANTS CLASS 3-5","CDM Code","IP/OP",300,"Lab",80333,"ANTIDEPRESSANTS CLASS 3-5",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[4402044,"FUNGITELL SERUM","CDM Code","IP/OP",300,"Lab",87449,"NOS EACH ORGANISM AG IA",163,81.5,129.58500000000001,138.54999999999998,138.54999999999998,138.54999999999998,136.91999999999999,132.03,130.4,129.58500000000001,130.4]
[4402039,"PROCALCITONIN PLASMA","CDM Code","IP/OP",300,"Lab",84145,"PROCALCITONIN (PCT)",202,101,160.59,171.7,171.7,171.7,169.68,163.62,161.60000000000002,160.59,161.60000000000002]
[4402033,"ALLERGEN SPECIFIC IGG EACH TEST","CDM Code","IP/OP",300,"Lab",86001,"ALLERGEN SPECIFIC IGG",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[4402027,"*NMDAR-Ab CSF","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",174,87,138.33000000000001,147.9,147.9,147.9,146.16,140.94,139.20000000000002,138.33000000000001,139.20000000000002]
[4402026,"*GABAR-Ab CSF","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",174,87,138.33000000000001,147.9,147.9,147.9,146.16,140.94,139.20000000000002,138.33000000000001,139.20000000000002]
[4402014,"NICKEL RANDOM URINE","CDM Code","IP/OP",300,"Lab",83885,"ASSAY OF NICKEL",165,82.5,131.17500000000001,140.25,140.25,140.25,138.6,133.65,132,131.17500000000001,132]
[4402009,"*AMPHETAMINE SCREEN","CDM Code","IP/OP",300,"Lab",80324,"DRUG SCREEN AMPHETAMINES 1/2",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[4402001,"AMITRIPTYLINE NORTRIPTYLINE","CDM Code","IP/OP",300,"Lab",80335,"ANTIDEPRESSANT TRICYCLIC 1/2",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[4402000,"CLONAZEPAM SERUM","CDM Code","IP/OP",300,"Lab",80346,"BENZODIAZEPINES1-12",51,25.5,40.545000000000002,43.35,43.35,43.35,42.839999999999996,41.31,40.800000000000004,40.545000000000002,40.800000000000004]
[4401993,"*R BENZODIAZEPINE CONFIRM URINE","CDM Code","IP/OP",300,"Lab",80346,"BENZODIAZEPINES1-12",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[4401986,"*COXIELLA BURNETII PCR","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",504,252,400.68,428.4,428.4,428.4,423.35999999999996,408.24,403.20000000000005,400.68,403.20000000000005]
[4401977,"GAA EXON 18 DELETION","CDM Code","IP/OP",300,"Lab",81403,"MOPATH PROCEDURE LEVEL 4",537,268.5,426.91500000000002,456.45,456.45,456.45,451.08,434.97,429.6,426.91500000000002,429.6]
[4401976,"FECAL LACTOFERRIN","CDM Code","IP/OP",300,"Lab",83630,"LACTOFERRIN FECAL (QUAL)",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[4401963,"IMMUNOGLOBULIN D (IgD)","CDM Code","IP/OP",300,"Lab",82784,"ASSAY IGA/IGD/IGG/IGM EACH",86,43,68.37,73.099999999999994,73.099999999999994,73.099999999999994,72.239999999999995,69.660000000000011,68.8,68.37,68.8]
[4401956,"*PHOSPHORUS F","CDM Code","IP/OP",300,"Lab",84100,"ASSAY OF PHOSPHORUS",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[4401953,"*CHLORIDE F","CDM Code","IP/OP",300,"Lab",82438,"ASSAY OTHER FLUID CHLORIDES",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[4401951,"*SODIUM F","CDM Code","IP/OP",300,"Lab",84302,"ASSAY OF SWEAT SODIUM",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[4401934,"COMPLEMENT C4 SERUM","CDM Code","IP/OP",300,"Lab",86160,"COMPLEMENT ANTIGEN",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[4401920,"*SEROTYPE 19A (57)","CDM Code","IP/OP",300,"Lab",86317,"IMMUNOASSAY INFECTIOUS AGENT",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[4401915,"*SEROTYPE 10A (34)","CDM Code","IP/OP",300,"Lab",86317,"IMMUNOASSAY INFECTIOUS AGENT",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[4401914,"*SEROTYPE 6B (26)","CDM Code","IP/OP",300,"Lab",86317,"IMMUNOASSAY INFECTIOUS AGENT",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[4401909,"*SEROTYPE 17F (17)","CDM Code","IP/OP",300,"Lab",86317,"IMMUNOASSAY INFECTIOUS AGENT",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[4401904,"*SEROTYPE 5 (5)","CDM Code","IP/OP",300,"Lab",86317,"IMMUNOASSAY INFECTIOUS AGENT",15,7.5,11.925000000000001,12.75,12.75,12.75,12.6,12.15,12,11.925000000000001,12]
[4401899,"MuSK ANTIBODY","CDM Code","IP/OP",300,"Lab",83519,"RIA NONANTIBODY",572,286,454.74,486.2,486.2,486.2,480.47999999999996,463.32000000000005,457.6,454.74,457.6]
[4401898,"*R HIV REFLEX HVCOP","CDM Code","IP/OP",300,"Lab",87389,"HIV-1 AG W/HIV-1&-2 AB AG IA",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[4401893,"*CHROMOSOMAL MICROARRAY","CDM Code","IP/OP",300,"Lab",81229,"CYTOG ALYS CHRML ABNR SNPCGH",2091,1045.5,1662.345,1777.35,1777.35,1777.35,1756.4399999999998,1693.71,1672.8000000000002,1662.345,1672.8000000000002]
[4401875,"*INTERLEUKIN 6","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[4401870,"*INTERLEUKIN 4","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[4401869,"*INTERFERON GAMMA","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[4401864,"MYCOPHENOLIC ACID","CDM Code","IP/OP",300,"Lab",80180,"DRUG SCRN QUAN MYCOPHENOLATE",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[4401857,"KEPPRA","CDM Code","IP/OP",300,"Lab",80177,"DRUG SCRN QUAN LEVETIRACETAM",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[4401850,"AMINOLEVULNIC ACID UR","CDM Code","IP/OP",300,"Lab",82135,"ASSAY AMINOLEVULINIC ACID",133,66.5,105.735,113.05,113.05,113.05,111.72,107.73,106.4,105.735,106.4]
[4401849,"HUMAN ANTIMOUSE ANTIBODY","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",401,200.5,318.79500000000002,340.84999999999997,340.84999999999997,340.84999999999997,336.84,324.81,320.8,318.79500000000002,320.8]
[4401843,"*RSV AB IGG","CDM Code","IP/OP",300,"Lab",86756,"RESPIRATORY VIRUS ANTIBODY",88,44,69.960000000000008,74.8,74.8,74.8,73.92,71.28,70.400000000000006,69.960000000000008,70.400000000000006]
[4401837,"LIPOPROTEIN A","CDM Code","IP/OP",300,"Lab",83695,"ASSAY OF LIPOPROTEIN(A)",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[4401831,"CYTOPATH SMEAR OTHER SOURCE","CDM Code","IP/OP",300,"Lab",88161,"CYTOPATH SMEAR OTHER SOURCE",190,95,151.05000000000001,161.5,161.5,161.5,159.6,153.9,152,151.05000000000001,152]
[4401829,"*WEST NILE VIRUS AB IGM","CDM Code","IP/OP",300,"Lab",86788,"WEST NILE VIRUS AB IGM",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[4401823,"PROINSULIN PLASMA","CDM Code","IP/OP",300,"Lab",84206,"ASSAY OF PROINSULIN",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[4401815,"HIV-1 GENOTYPIC DRUG RESISTANCE MUTATION","CDM Code","IP/OP",300,"Lab",87901,"NFCT AGT GNTYP ALYS HIV1 REV",611,305.5,485.745,519.35,519.35,519.35,513.24,494.91,488.8,485.745,488.8]
[4401804,"VITAMIN D1 25","CDM Code","IP/OP",300,"Lab",82652,"VIT D 1 25-DIHYDROXY",320,160,254.4,272,272,272,268.8,259.20000000000005,256,254.4,256]
[4401803,"ALUMINUM SERUM","CDM Code","IP/OP",300,"Lab",82108,"ASSAY OF ALUMINUM",189,94.5,150.255,160.65,160.65,160.65,158.76,153.09,151.20000000000002,150.255,151.20000000000002]
[4401796,"APOLIPOPROTEIN E GENOTYPE","CDM Code","IP/OP",300,"Lab",81401,"MOPATH PROCEDURE LEVEL 2",353,176.5,280.63499999999999,300.05,300.05,300.05,296.52,285.93,282.40000000000003,280.63499999999999,282.40000000000003]
[4401790,"MEN TYPE 2 SCREEN","CDM Code","IP/OP",300,"Lab",81405,"MOPATH PROCEDURE LEVEL 6",445,222.5,353.77500000000003,378.25,378.25,378.25,373.8,360.45000000000005,356,353.77500000000003,356]
[4401784,"MIB 1","CDM Code","IP/OP",310,"Pathology Lab",88360,"TUMOR IMMUNOHISTOCHEM/MANUAL",1160,580,922.2,986,986,986,974.4,939.6,928,922.2,928]
[4401783,"CYSTINURIA 24 HR","CDM Code","IP/OP",300,"Lab",82136,"AMINO ACIDS QUANT 2-5",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[4401778,"*WEST NILE VIRUS ANTIBODY","CDM Code","IP/OP",300,"Lab",86789,"WEST NILE VIRUS ANTIBODY",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[4401768,"*LDH ENZYMES","CDM Code","IP/OP",300,"Lab",83615,"LACTATE (LD) (LDH) ENZYME",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[4401762,"LAB *TEST*","CDM Code","IP/OP",300,"Lab",82948,"REAGENT STRIP/BLOOD GLUCOSE",118,59,93.81,100.3,100.3,100.3,99.11999999999999,95.580000000000013,94.4,93.81,94.4]
[4401760,"HEPATITIS C GENOTYPE","CDM Code","IP/OP",300,"Lab",87902,"NFCT AGT GNTYP ALYS HEP C",691,345.5,549.34500000000003,587.35,587.35,587.35,580.43999999999994,559.71,552.80000000000007,549.34500000000003,552.80000000000007]
[4401749,"*DESMOGLEIN 1","CDM Code","IP/OP",300,"Lab",83516,"IMMUNOASSAY NONANTIBODY",163,81.5,129.58500000000001,138.54999999999998,138.54999999999998,138.54999999999998,136.91999999999999,132.03,130.4,129.58500000000001,130.4]
[4401743,"*CRYPTOSPORIDIUM","CDM Code","IP/OP",300,"Lab",87272,"CRYPTOSPORIDIUM AG IF",139,69.5,110.50500000000001,118.14999999999999,118.14999999999999,118.14999999999999,116.75999999999999,112.59,111.2,110.50500000000001,111.2]
[4401738,"*TISSUE CULTURE","CDM Code","IP/OP",300,"Lab",88230,"TISSUE CULTURE LYMPHOCYTE",527,263.5,418.96500000000003,447.95,447.95,447.95,442.68,426.87,421.6,418.96500000000003,421.6]
[4401736,"BRUCELLA TOTAL AB CONFIRM","CDM Code","IP/OP",300,"Lab",86622,"BRUCELLA ANTIBODY",124,62,98.58,105.39999999999999,105.39999999999999,105.39999999999999,104.16,100.44000000000001,99.2,98.58,99.2]
[4401731,"*EASTERN EQUINE AB IGM","CDM Code","IP/OP",300,"Lab",86652,"ENCEPHALTIS EAST EQNE ANBDY",131,65.5,104.14500000000001,111.35,111.35,111.35,110.03999999999999,106.11000000000001,104.80000000000001,104.14500000000001,104.80000000000001]
[4401726,"*NON GYN CYTOLOGY URINE","CDM Code","IP/OP",300,"Lab",88108,"CYTOPATH CONCENTRATE TECH",195,97.5,155.02500000000001,165.75,165.75,165.75,163.79999999999998,157.95000000000002,156,155.02500000000001,156]
[4401720,"ENTAMOEBA HISTOLYTICA AG STOOL","CDM Code","IP/OP",300,"Lab",87337,"ENTAMOEB HIST GROUP AG IA",191,95.5,151.845,162.35,162.35,162.35,160.44,154.71,152.80000000000001,151.845,152.80000000000001]
[4401718,"*MONONUCLEAR CELL ANTIGEN QUANTITATIVE","CDM Code","IP/OP",300,"Lab",86356,"MONONUCLEAR CELL ANTIGEN",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[4401707,"UROVYSION DETECTION OF BLADDER CANCER","CDM Code","IP/OP",300,"Lab",88120,"CYTP URNE 3-5 PROBES EA SPEC",1477,738.5,1174.2150000000001,1255.45,1255.45,1255.45,1240.68,1196.3700000000001,1181.6000000000001,1174.2150000000001,1181.6000000000001]
[4401694,"*R HIV 2 AB","CDM Code","IP/OP",300,"Lab",86702,"HIV-2 ANTIBODY",137,68.5,108.91500000000001,116.45,116.45,116.45,115.08,110.97000000000001,109.60000000000001,108.91500000000001,109.60000000000001]
[4401688,"RSV PCR","CDM Code","IP/OP",300,"Lab",87503,"INFLUENZA DNA AMP PROB ADDL",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[4401687,"PARAINFLUENZAE 1 2 3 PCR","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",245,122.5,194.77500000000001,208.25,208.25,208.25,205.79999999999998,198.45000000000002,196,194.77500000000001,196]
[4401680,"*BRUCELLA AB IGM","CDM Code","IP/OP",300,"Lab",86622,"BRUCELLA ANTIBODY",129,64.5,102.55500000000001,109.64999999999999,109.64999999999999,109.64999999999999,108.36,104.49000000000001,103.2,102.55500000000001,103.2]
[4401671,"*COCCIDIOMYCOSIS CF IGG","CDM Code","IP/OP",300,"Lab",86635,"COCCIDIOIDES ANTIBODY",166,83,131.97,141.1,141.1,141.1,139.44,134.46,132.80000000000001,131.97,132.80000000000001]
[4401661,"HEPATITIS BE AB","CDM Code","IP/OP",300,"Lab",86707,"HEPATITIS BE ANTIBODY",167,83.5,132.76500000000001,141.94999999999999,141.94999999999999,141.94999999999999,140.28,135.27000000000001,133.6,132.76500000000001,133.6]
[4401660,"ANTI HU","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",159,79.5,126.405,135.15,135.15,135.15,133.56,128.79000000000002,127.2,126.405,127.2]
[4401648,"*PHOSPHATIDYLSERINE AB IGG","CDM Code","IP/OP",300,"Lab",86148,"ANTI-PHOSPHOLIPID ANTIBODY",231,115.5,183.64500000000001,196.35,196.35,196.35,194.04,187.11,184.8,183.64500000000001,184.8]
[4401643,"CARBOHYDRATE DEFICIENT TRANSFERRIN","CDM Code","IP/OP",300,"Lab",82373,"ASSAY C-D TRANSFER MEASURE",191,95.5,151.845,162.35,162.35,162.35,160.44,154.71,152.80000000000001,151.845,152.80000000000001]
[4401633,"*APOLIPOPROTEIN A1","CDM Code","IP/OP",300,"Lab",82172,"ASSAY OF APOLIPOPROTEIN",187,93.5,148.66500000000002,158.94999999999999,158.94999999999999,158.94999999999999,157.07999999999998,151.47,149.6,148.66500000000002,149.6]
[4401632,"HEPARIN INDUCED THROMBOCYTOPENIA PF4 AB","CDM Code","IP/OP",300,"Lab",86022,"PLATELET ANTIBODIES",265,132.5,210.67500000000001,225.25,225.25,225.25,222.6,214.65,212,210.67500000000001,212]
[4401626,"HHV 6 PCR PLASMA","CDM Code","IP/OP",300,"Lab",87532,"HHV-6 DNA AMP PROBE",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[4401617,"VARICELLA ZOSTER PCR","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",310,155,246.45000000000002,263.5,263.5,263.5,260.39999999999998,251.10000000000002,248,246.45000000000002,248]
[4401607,"EPSTEIN BARR PCR QUANT BLOOD","CDM Code","IP/OP",300,"Lab",87799,"DETECT AGENT NOS DNA QUANT",617,308.5,490.51500000000004,524.44999999999993,524.44999999999993,524.44999999999993,518.28,499.77000000000004,493.6,490.51500000000004,493.6]
[4401606,"TRYPTASE SERUM","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[4401595,"HISTAMINE 24 HOUR URINE","CDM Code","IP/OP",300,"Lab",83088,"ASSAY OF HISTAMINE",365,182.5,290.17500000000001,310.25,310.25,310.25,306.59999999999997,295.65000000000003,292,290.17500000000001,292]
[4401577,"PLATELET ANTIBODY SERUM","CDM Code","IP/OP",300,"Lab",86022,"PLATELET ANTIBODIES",265,132.5,210.67500000000001,225.25,225.25,225.25,222.6,214.65,212,210.67500000000001,212]
[4401568,"*ROCKY MOUNTAIN SPOTTED FEVER AB IGM","CDM Code","IP/OP",300,"Lab",86757,"RICKETTSIA ANTIBODY",388,194,308.46000000000004,329.8,329.8,329.8,325.92,314.28000000000003,310.40000000000003,308.46000000000004,310.40000000000003]
[4401566,"CSF ANGIOTENSIN CONVERTING ENZYME","CDM Code","IP/OP",300,"Lab",82164,"ANGIOTENSIN I ENZYME TEST",210,105,166.95000000000002,178.5,178.5,178.5,176.4,170.10000000000002,168,166.95000000000002,168]
[4401560,"CHROMAGRANIN A","CDM Code","IP/OP",300,"Lab",86316,"IMMUNOASSAY TUMOR OTHER",299,149.5,237.70500000000001,254.15,254.15,254.15,251.16,242.19000000000003,239.20000000000002,237.70500000000001,239.20000000000002]
[4401554,"*IMMUNOFIXATION","CDM Code","IP/OP",300,"Lab",86664,"EPSTEIN-BARR NUCLEAR ANTIGEN",221,110.5,175.69500000000002,187.85,187.85,187.85,185.64,179.01000000000002,176.8,175.69500000000002,176.8]
[4401542,"CYANIDE BLOOD","CDM Code","IP/OP",300,"Lab",82600,"ASSAY OF CYANIDE",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[4401539,"VASOPRESSIN","CDM Code","IP/OP",300,"Lab",84588,"ASSAY OF VASOPRESSIN",182,91,144.69,154.69999999999999,154.69999999999999,154.69999999999999,152.88,147.42000000000002,145.6,144.69,145.6]
[4401533,"INTERLEUKIN 1A","CDM Code","IP/OP",300,"Lab",83519,"RIA NONANTIBODY",197,98.5,156.61500000000001,167.45,167.45,167.45,165.48,159.57000000000002,157.60000000000002,156.61500000000001,157.60000000000002]
[4401528,"C TELOPEPTIDE BETA CROSSLAPS","CDM Code","IP/OP",300,"Lab",82523,"COLLAGEN CROSSLINKS",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[4401522,"*CYTOPATH CELL EHANCE TECH","CDM Code","IP/OP",300,"Lab",88112,"CYTOPATH CELL ENHANCE TECH",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[4401521,"*SPECIAL STAINS LIPID LADEN MACROPHAGES","CDM Code","IP/OP",300,"Lab",88313,"SPECIAL STAINS GROUP 2",247,123.5,196.36500000000001,209.95,209.95,209.95,207.48,200.07000000000002,197.60000000000002,196.36500000000001,197.60000000000002]
[4401510,"*UROTHELIAL CANCER FISH EACH","CDM Code","IP/OP",300,"Lab",88368,"INSITU HYBRIDIZATION MANUAL",161,80.5,127.995,136.85,136.85,136.85,135.24,130.41,128.80000000000001,127.995,128.80000000000001]
[4401505,"DIRECT LDL","CDM Code","IP/OP",300,"Lab",83721,"ASSAY OF BLOOD LIPOPROTEIN",113,56.5,89.835000000000008,96.05,96.05,96.05,94.92,91.53,90.4,89.835000000000008,90.4]
[4401499,"BETA 2 TRANSFERRIN BF","CDM Code","IP/OP",300,"Lab",86335,"IMMUNFIX E-PHORSIS/URINE/CSF",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[4401496,"*FLOW CYTOMETRY EACH ADD-ON","CDM Code","IP/OP",310,"Pathology Lab",88185,"FLOWCYTOMETRY/TC ADD-ON",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[4401489,"LIVER KIDNEY MICROSOM AB","CDM Code","IP/OP",300,"Lab",86376,"MICROSOMAL ANTIBODY EACH",213,106.5,169.33500000000001,181.04999999999998,181.04999999999998,181.04999999999998,178.92,172.53,170.4,169.33500000000001,170.4]
[4401478,"*DENGUE FEVER VIRUS AB IgG","CDM Code","IP/OP",300,"Lab",86790,"VIRUS ANTIBODY NOS",185,92.5,147.07500000000002,157.25,157.25,157.25,155.4,149.85000000000002,148,147.07500000000002,148]
[4401473,"NTX SERUM","CDM Code","IP/OP",300,"Lab",82523,"COLLAGEN CROSSLINKS",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[4401472,"*ALKALINE PHOSPHATE ISO","CDM Code","IP/OP",300,"Lab",84080,"ASSAY ALKALINE PHOSPHATASES",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[4401463,"AFP ONLY OBS","CDM Code","IP/OP",300,"Lab",82105,"ALPHA-FETOPROTEIN SERUM",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[4401454,"TUMOR ANALYSIS","CDM Code","IP/OP",310,"Pathology Lab",88358,"ANALYSIS TUMOR",1360,680,1081.2,1156,1156,1156,1142.3999999999999,1101.6000000000001,1088,1081.2,1088]
[4401446,"FELBAMATE SERUM","CDM Code","IP/OP",300,"Lab",80299,"QUANTITATIVE ASSAY DRUG",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[4401439,"CENTROMERE ANTIBODY SERUM","CDM Code","IP/OP",300,"Lab",83516,"IMMUNOASSAY NONANTIBODY",166,83,131.97,141.1,141.1,141.1,139.44,134.46,132.80000000000001,131.97,132.80000000000001]
[4401430,"FRUCTOSAMINE SERUM","CDM Code","IP/OP",300,"Lab",82985,"ASSAY OF GLYCATED PROTEIN",217,108.5,172.51500000000001,184.45,184.45,184.45,182.28,175.77,173.60000000000002,172.51500000000001,173.60000000000002]
[4401416,"FATTY ACID VERY LONG CHAIN SERUM","CDM Code","IP/OP",300,"Lab",82726,"LONG CHAIN FATTY ACIDS",264,132,209.88000000000002,224.4,224.4,224.4,221.76,213.84,211.20000000000002,209.88000000000002,211.20000000000002]
[4401410,"BILE ACID TOTAL","CDM Code","IP/OP",300,"Lab",82239,"BILE ACIDS TOTAL",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[4401408,"SODIUM URINE 24 HOUR","CDM Code","IP/OP",300,"Lab",84300,"ASSAY OF URINE SODIUM",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[4401400,"RAPID STREP TEST INFECTIOUS AGENT DETECT","CDM Code","IP/OP",300,"Lab",87880,"STREP A ASSAY W/OPTIC",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[4401393,"ARSENIC HAIR","CDM Code","IP/OP",300,"Lab",82175,"ASSAY OF ARSENIC",270,135,214.65,229.5,229.5,229.5,226.79999999999998,218.70000000000002,216,214.65,216]
[4401378,"HEPATITIS C QN RT PCR VIRAL LOAD","CDM Code","IP/OP",300,"Lab",87522,"HEPATITIS C REVRS TRNSCRPJ",617,308.5,490.51500000000004,524.44999999999993,524.44999999999993,524.44999999999993,518.28,499.77000000000004,493.6,490.51500000000004,493.6]
[4401377,"*HCV QN BDNA PROC","CDM Code","IP/OP",300,"Lab",87522,"HEPATITIS C REVRS TRNSCRPJ",451,225.5,358.54500000000002,383.34999999999997,383.34999999999997,383.34999999999997,378.84,365.31,360.8,358.54500000000002,360.8]
[4401366,"*TISSUE CULTURE CHROMO","CDM Code","IP/OP",310,"Pathology Lab",88230,"TISSUE CULTURE LYMPHOCYTE",529,264.5,420.55500000000001,449.65,449.65,449.65,444.35999999999996,428.49,423.20000000000005,420.55500000000001,423.20000000000005]
[4401362,"IGA","CDM Code","IP/OP",300,"Lab",82784,"ASSAY IGA/IGD/IGG/IGM EACH",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[4401353,"EBV PCR EPSTEIN BARR CSF","CDM Code","IP/OP",300,"Lab",87798,"DETECT AGENT NOS DNA AMP",504,252,400.68,428.4,428.4,428.4,423.35999999999996,408.24,403.20000000000005,400.68,403.20000000000005]
[4401351,"HEPARIN ASSAY LOW MOLECULAR WEIGHT","CDM Code","IP/OP",300,"Lab",85520,"HEPARIN ASSAY",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[4401338,"*LIPID PANEL","CDM Code","IP/OP",300,"Lab",80061,"LIPID PANEL",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[4401333,"*CHLAMYDIA PSITTACI IGG","CDM Code","IP/OP",300,"Lab",86631,"CHLAMYDIA ANTIBODY",198,99,157.41,168.29999999999998,168.29999999999998,168.29999999999998,166.32,160.38000000000002,158.4,157.41,158.4]
[4401326,"BABESIA AB IGG","CDM Code","IP/OP",300,"Lab",86753,"PROTOZOA ANTIBODY NOS",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[4401323,"*CKMB","CDM Code","IP/OP",300,"Lab",82553,"CREATINE MB FRACTION",167,83.5,132.76500000000001,141.94999999999999,141.94999999999999,141.94999999999999,140.28,135.27000000000001,133.6,132.76500000000001,133.6]
[4401315,"*COXSACKIE B-6","CDM Code","IP/OP",300,"Lab",86658,"ENTEROVIRUS ANTIBODY",151,75.5,120.045,128.35,128.35,128.35,126.83999999999999,122.31,120.80000000000001,120.045,120.80000000000001]
[4401310,"*COXSACKIE B-1","CDM Code","IP/OP",300,"Lab",86658,"ENTEROVIRUS ANTIBODY",151,75.5,120.045,128.35,128.35,128.35,126.83999999999999,122.31,120.80000000000001,120.045,120.80000000000001]
[4401305,"*COXSACKIE A-4","CDM Code","IP/OP",300,"Lab",86658,"ENTEROVIRUS ANTIBODY",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[4401304,"*COXSACKIE A-2","CDM Code","IP/OP",300,"Lab",86658,"ENTEROVIRUS ANTIBODY",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[4401294,"*ANALYZE 100 TO 300 CELLS","CDM Code","IP/OP",310,"Pathology Lab",88275,"CYTOGENETICS 100-300",597,298.5,474.61500000000001,507.45,507.45,507.45,501.47999999999996,483.57000000000005,477.6,474.61500000000001,477.6]
[4401286,"*MOLECULAR GENE 10-30 CELL","CDM Code","IP/OP",310,"Pathology Lab",88273,"CYTOGENETICS 10-30",468,234,372.06,397.8,397.8,397.8,393.12,379.08000000000004,374.40000000000003,372.06,374.40000000000003]
[4401276,"ARSENIC URINE 24 HR","CDM Code","IP/OP",300,"Lab",82175,"ASSAY OF ARSENIC",263,131.5,209.08500000000001,223.54999999999998,223.54999999999998,223.54999999999998,220.92,213.03,210.4,209.08500000000001,210.4]
[4401275,"POTASSIUM URINE 24 HOUR","CDM Code","IP/OP",300,"Lab",84133,"ASSAY OF URINE POTASSIUM",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[4401269,"PSA DIAGNOSTIC","CDM Code","IP/OP",300,"Lab",84153,"ASSAY OF PSA TOTAL",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[4401260,"*THYROPEROXIDASE ANTIBODY","CDM Code","IP/OP",300,"Lab",86376,"MICROSOMAL ANTIBODY EACH",210,105,166.95000000000002,178.5,178.5,178.5,176.4,170.10000000000002,168,166.95000000000002,168]
[4401247,"*HEMOGLOBIN","CDM Code","IP/OP",300,"Lab",85018,"HEMOGLOBIN",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[4401246,"*CARDIOLIPIN AB IgM","CDM Code","IP/OP",300,"Lab",86147,"CARDIOLIPIN ANTIBODY EA IG",240,120,190.8,204,204,204,201.6,194.4,192,190.8,192]
[4401241,"*PARVOVIRUS IgM","CDM Code","IP/OP",300,"Lab",86747,"PARVOVIRUS ANTIBODY",217,108.5,172.51500000000001,184.45,184.45,184.45,182.28,175.77,173.60000000000002,172.51500000000001,173.60000000000002]
[4401236,"*HERPES SIMPLEX TYPE 1 IgG","CDM Code","IP/OP",300,"Lab",86695,"HERPES SIMPLEX TYPE 1 TEST",126,63,100.17,107.1,107.1,107.1,105.83999999999999,102.06,100.80000000000001,100.17,100.80000000000001]
[4401231,"*EB VIRAL CAPSID ANTIGEN IgG","CDM Code","IP/OP",300,"Lab",86665,"EPSTEIN-BARR CAPSID VCA",261,130.5,207.495,221.85,221.85,221.85,219.23999999999998,211.41000000000003,208.8,207.495,208.8]
[4401230,"*LYME DISEASE IgM","CDM Code","IP/OP",300,"Lab",86617,"LYME DISEASE ANTIBODY",223,111.5,177.285,189.54999999999998,189.54999999999998,189.54999999999998,187.32,180.63000000000002,178.4,177.285,178.4]
[4401225,"*STREP PNEUMO IgG SEROTYPE 14","CDM Code","IP/OP",300,"Lab",86609,"BACTERIUM ANTIBODY",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[4401220,"*BARTONELLA HENSELAE IgM","CDM Code","IP/OP",300,"Lab",86611,"BARTONELLA ANTIBODY",147,73.5,116.86500000000001,124.95,124.95,124.95,123.47999999999999,119.07000000000001,117.60000000000001,116.86500000000001,117.60000000000001]
[4401201,"*ARSENIC URINE","CDM Code","IP/OP",300,"Lab",82175,"ASSAY OF ARSENIC",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[4401200,"*INHIBIN A","CDM Code","IP/OP",300,"Lab",86336,"INHIBIN A",225,112.5,178.875,191.25,191.25,191.25,189,182.25,180,178.875,180]
[4401187,"VENIPUNCTURE","CDM Code","IP/OP",300,"Lab",36415,"ROUTINE VENIPUNCTURE",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[4401151,"BODY FLUID CELL COUNT","CDM Code","IP/OP",300,"Lab",89050,"BODY FLUID CELL COUNT",68,34,54.06,57.8,57.8,57.8,57.12,55.080000000000005,54.400000000000006,54.06,54.400000000000006]
[4401121,"SPECIAL STAIN II","CDM Code","IP/OP",310,"Pathology Lab",88313,"SPECIAL STAINS GROUP 2",201,100.5,159.79500000000002,170.85,170.85,170.85,168.84,162.81,160.80000000000001,159.79500000000002,160.80000000000001]
[4401118,"GROSS EXAM+MICRO LEVEL VI","CDM Code","IP/OP",310,"Pathology Lab",88309,"TISSUE EXAM BY PATHOLOGIST",583,291.5,463.48500000000001,495.55,495.55,495.55,489.71999999999997,472.23,466.40000000000003,463.48500000000001,466.40000000000003]
[4401114,"GROSS EXAM+MICRO LEVEL IV","CDM Code","IP/OP",310,"Pathology Lab",88305,"TISSUE EXAM BY PATHOLOGIST",511,255.5,406.245,434.34999999999997,434.34999999999997,434.34999999999997,429.24,413.91,408.8,406.245,408.8]
[4401083,"*TISSUE CULTURE SKIN","CDM Code","IP/OP",310,"Pathology Lab",88233,"TISSUE CULTURE SKIN/BIOPSY",790,395,628.05000000000007,671.5,671.5,671.5,663.6,639.90000000000009,632,628.05000000000007,632]
[4401038,"GONORRHEA PROBE","CDM Code","IP/OP",300,"Lab",87591,"N.GONORRHOEAE DNA AMP PROB",198,99,157.41,168.29999999999998,168.29999999999998,168.29999999999998,166.32,160.38000000000002,158.4,157.41,158.4]
[4401026,"**HCV QL RNA RT-PCR","CDM Code","IP/OP",300,"Lab",87521,"HEPATITIS C PROBE&RVRS TRNSC",408,204,324.36,346.8,346.8,346.8,342.71999999999997,330.48,326.40000000000003,324.36,326.40000000000003]
[4401004,"HEPATITIS B SURF AG","CDM Code","IP/OP",300,"Lab",87340,"HEPATITIS B SURFACE AG IA",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[4400989,"*INFLUENZA A IFA","CDM Code","IP/OP",300,"Lab",87276,"INFLUENZA A AG IF",165,82.5,131.17500000000001,140.25,140.25,140.25,138.6,133.65,132,131.17500000000001,132]
[4400964,"*AFB OR FLUORSCENT SMEAR","CDM Code","IP/OP",300,"Lab",87206,"SMEAR FLUORESCENT/ACID STAI",79,39.5,62.805,67.149999999999991,67.149999999999991,67.149999999999991,66.36,63.99,63.2,62.805,63.2]
[4400961,"GRAM STAIN FOR BACTERIA","CDM Code","IP/OP",300,"Lab",87205,"SMEAR GRAM STAIN",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[4400946,"PIN WORM SCOTCH TAPE PREP","CDM Code","IP/OP",300,"Lab",87172,"PINWORM EXAM",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[4400922,"CULTURE URINE","CDM Code","IP/OP",300,"Lab",87086,"URINE CULTURE/COLONY COUNT",81,40.5,64.39500000000001,68.849999999999994,68.849999999999994,68.849999999999994,68.039999999999992,65.61,64.8,64.39500000000001,64.8]
[4400908,"CULTURE WOUND ABSCESS","CDM Code","IP/OP",300,"Lab",87070,"CULTURE OTHR SPECIMN AEROBIC",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[4400907,"CULTURE SKIN","CDM Code","IP/OP",300,"Lab",87070,"CULTURE OTHR SPECIMN AEROBIC",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[4400897,"CULTURE BODY FLUID","CDM Code","IP/OP",300,"Lab",87070,"CULTURE OTHR SPECIMN AEROBIC",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[4400885,"BB ABO TYPING","CDM Code","IP/OP",300,"Lab",86900,"BLOOD TYPING SEROLOGIC ABO",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[4400862,"TOXOPLASMA AB IGM","CDM Code","IP/OP",300,"Lab",86778,"TOXOPLASMA ANTIBODY IGM",208,104,165.36,176.79999999999998,176.79999999999998,176.79999999999998,174.72,168.48000000000002,166.4,165.36,166.4]
[4400861,"TOXOPLASMA  AB IGG","CDM Code","IP/OP",300,"Lab",86777,"TOXOPLASMA ANTIBODY",208,104,165.36,176.79999999999998,176.79999999999998,176.79999999999998,174.72,168.48000000000002,166.4,165.36,166.4]
[4400849,"*MYCOPLASMA AB IGG & IGM","CDM Code","IP/OP",300,"Lab",86738,"MYCOPLASMA ANTIBODY",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[4400838,"HEPATITIS B SURF AB","CDM Code","IP/OP",300,"Lab",86706,"HEP B SURFACE ANTIBODY",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[4400790,"LYME DISEASE SCREEN AB","CDM Code","IP/OP",300,"Lab",86618,"LYME DISEASE ANTIBODY",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[4400788,"**R LYME DISEASE AB CONFIRM WEST BLOT","CDM Code","IP/OP",300,"Lab",86617,"LYME DISEASE ANTIBODY",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[4400771,"CRYPTOCOCCAL ANTIGEN CSF","CDM Code","IP/OP",300,"Lab",86403,"PARTICLE AGGLUT ANTBDY SCRN",147,73.5,116.86500000000001,124.95,124.95,124.95,123.47999999999999,119.07000000000001,117.60000000000001,116.86500000000001,117.60000000000001]
[4400762,"INSULIN AB QUANT","CDM Code","IP/OP",300,"Lab",86337,"INSULIN ANTIBODIES",308,154,244.86,261.8,261.8,261.8,258.71999999999997,249.48000000000002,246.4,244.86,246.4]
[4400748,"CA 19-9","CDM Code","IP/OP",300,"Lab",86301,"IMMUNOASSAY TUMOR CA 19-9",300,150,238.5,255,255,255,252,243.00000000000003,240,238.5,240]
[4400747,"CA 27.29 BREAST CARCINOMA","CDM Code","IP/OP",300,"Lab",86300,"IMMUNOASSAY TUMOR CA 15-3",300,150,238.5,255,255,255,252,243.00000000000003,240,238.5,240]
[4400730,"*DNA ANTIBODY DS (NATIVE)","CDM Code","IP/OP",300,"Lab",86255,"FLUORESCENT ANTIBODY SCREEN",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[4400718,"*LA AB (SSB)","CDM Code","IP/OP",300,"Lab",86235,"NUCLEAR ANTIGEN ANTIBODY",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[4400708,"COMPLEMENT C3","CDM Code","IP/OP",300,"Lab",86160,"COMPLEMENT ANTIGEN",173,86.5,137.535,147.04999999999998,147.04999999999998,147.04999999999998,145.32,140.13,138.4,137.535,138.4]
[4400706,"*COLD AGGLUTININS SERUM 37%","CDM Code","IP/OP",300,"Lab",86156,"COLD AGGLUTININ SCREEN",98,49,77.910000000000011,83.3,83.3,83.3,82.32,79.38000000000001,78.400000000000006,77.910000000000011,78.400000000000006]
[4400699,"*ANTISTREPTOLYSIN O SCREEN","CDM Code","IP/OP",300,"Lab",86063,"ANTISTREPTOLYSIN O SCREEN",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[4400687,"LATEX ALLERGY","CDM Code","IP/OP",300,"Lab",86003,"ALLG SPEC IGE CRUDE XTRC EA",69,34.5,54.855000000000004,58.65,58.65,58.65,57.96,55.89,55.2,54.855000000000004,55.2]
[4400679,"ESR-SEDIMENTATION RATE","CDM Code","IP/OP",300,"Lab",85651,"RBC SED RATE NONAUTOMATED",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[4400677,"*DILUTE RUSSELL VIPER VENOM TIME","CDM Code","IP/OP",300,"Lab",85613,"RUSSELL VIPER VENOM DILUTED",138,69,109.71000000000001,117.3,117.3,117.3,115.92,111.78,110.4,109.71000000000001,110.4]
[4400653,"D DIMER QUANTITATIVE","CDM Code","IP/OP",300,"Lab",85379,"FIBRIN DEGRADATION QUANT",147,73.5,116.86500000000001,124.95,124.95,124.95,123.47999999999999,119.07000000000001,117.60000000000001,116.86500000000001,117.60000000000001]
[4400640,"ANTI-THROMBIN III","CDM Code","IP/OP",300,"Lab",85300,"ANTITHROMBIN III ACTIVITY",171,85.5,135.94499999999999,145.35,145.35,145.35,143.63999999999999,138.51000000000002,136.80000000000001,135.94499999999999,136.80000000000001]
[4400620,"RETICULOCYTE COUNT","CDM Code","IP/OP",300,"Lab",85044,"MANUAL RETICULOCYTE COUNT",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[4400619,"*HEMOGRAM","CDM Code","IP/OP",300,"Lab",85027,"COMPLETE CBC AUTOMATED",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[4400594,"PREGNANCY SCREEN SERUM","CDM Code","IP/OP",300,"Lab",84703,"CHORIONIC GONADOTROPIN ASSAY",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[4400584,"VITAMIN A","CDM Code","IP/OP",300,"Lab",84590,"ASSAY OF VITAMIN A",167,83.5,132.76500000000001,141.94999999999999,141.94999999999999,141.94999999999999,140.28,135.27000000000001,133.6,132.76500000000001,133.6]
[4400570,"T3 REVERSE","CDM Code","IP/OP",300,"Lab",84482,"T3 REVERSE",228,114,181.26000000000002,193.79999999999998,193.79999999999998,193.79999999999998,191.51999999999998,184.68,182.4,181.26000000000002,182.4]
[4400568,"T3 FREE","CDM Code","IP/OP",300,"Lab",84481,"FREE ASSAY (FT-3)",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[4400562,"AST","CDM Code","IP/OP",300,"Lab",84450,"TRANSFERASE (AST) (SGOT)",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[4400552,"T4 TOTAL","CDM Code","IP/OP",300,"Lab",84436,"ASSAY OF TOTAL THYROXINE",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[4400540,"*TAY SACHS","CDM Code","IP/OP",300,"Lab",84311,"SPECTROPHOTOMETRY",103,51.5,81.885000000000005,87.55,87.55,87.55,86.52,83.43,82.4,81.885000000000005,82.4]
[4400539,"PORPHYRINS TOTAL RBC","CDM Code","IP/OP",300,"Lab",84311,"SPECTROPHOTOMETRY",113,56.5,89.835000000000008,96.05,96.05,96.05,94.92,91.53,90.4,89.835000000000008,90.4]
[4400532,"SODIUM","CDM Code","IP/OP",300,"Lab",84295,"ASSAY OF SERUM SODIUM",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[4400506,"*PROTEIN ELECTROPHORESIS URINE RANDOM","CDM Code","IP/OP",300,"Lab",84165,"PROTEIN E-PHORESIS SERUM",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[4400498,"*PSA FREE","CDM Code","IP/OP",300,"Lab",84154,"ASSAY OF PSA FREE",265,132.5,210.67500000000001,225.25,225.25,225.25,222.6,214.65,212,210.67500000000001,212]
[4400497,"*FREE PSA","CDM Code","IP/OP",300,"Lab",84154,"ASSAY OF PSA FREE",160,80,127.2,136,136,136,134.4,129.60000000000002,128,127.2,128]
[4400490,"PREALBUMIN SERUM","CDM Code","IP/OP",300,"Lab",84134,"ASSAY OF PREALBUMIN",118,59,93.81,100.3,100.3,100.3,99.11999999999999,95.580000000000013,94.4,93.81,94.4]
[4400475,"PKU NEWBORN SCREENING","CDM Code","IP/OP",300,"Lab",84030,"ASSAY OF BLOOD PKU",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[4400461,"OSMOLALITY SERUM","CDM Code","IP/OP",300,"Lab",83930,"ASSAY OF BLOOD OSMOLALITY",96,48,76.320000000000007,81.599999999999994,81.599999999999994,81.599999999999994,80.64,77.760000000000005,76.800000000000011,76.320000000000007,76.800000000000011]
[4400456,"NUCLEOTIDASE 5","CDM Code","IP/OP",300,"Lab",83915,"ASSAY OF NUCLEOTIDASE",162,81,128.79000000000002,137.69999999999999,137.69999999999999,137.69999999999999,136.07999999999998,131.22,129.6,128.79000000000002,129.6]
[4400413,"MANGANESE","CDM Code","IP/OP",300,"Lab",83785,"ASSAY OF MANGANESE",242,121,192.39000000000001,205.7,205.7,205.7,203.28,196.02,193.60000000000002,192.39000000000001,193.60000000000002]
[4400400,"LDH (LACTATE DEHYDROGENASE)","CDM Code","IP/OP",300,"Lab",83615,"LACTATE (LD) (LDH) ENZYME",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[4400383,"*MAG DUAL AGNAUTO AB","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",202,101,160.59,171.7,171.7,171.7,169.68,163.62,161.60000000000002,160.59,161.60000000000002]
[4400380,"IGF BINDING PROTEIN-3","CDM Code","IP/OP",300,"Lab",83520,"IMMUNOASSAY QUANT NOS NONAB",202,101,160.59,171.7,171.7,171.7,169.68,163.62,161.60000000000002,160.59,161.60000000000002]
[4400359,"HIAA 5 SCREEN URINE","CDM Code","IP/OP",300,"Lab",83497,"ASSAY OF 5-HIAA",188,94,149.46,159.79999999999998,159.79999999999998,159.79999999999998,157.91999999999999,152.28,150.4,149.46,150.4]
[4400346,"*HEAVY METAL SCREEN URINE","CDM Code","IP/OP",300,"Lab",83018,"HEAVY METAL QUANT EACH NES",316,158,251.22,268.59999999999997,268.59999999999997,268.59999999999997,265.44,255.96,252.8,251.22,252.8]
[4400326,"*GLUCOSE TT EACH ADD SPEC","CDM Code","IP/OP",300,"Lab",82952,"GTT-ADDED SAMPLES",59,29.5,46.905000000000001,50.15,50.15,50.15,49.559999999999995,47.790000000000006,47.2,46.905000000000001,47.2]
[4400323,"LACTOSE TOLERANCE TEST","CDM Code","IP/OP",300,"Lab",82951,"GLUCOSE TOLERANCE TEST (GTT)",173,86.5,137.535,147.04999999999998,147.04999999999998,147.04999999999998,145.32,140.13,138.4,137.535,138.4]
[4400314,"GLUCOSE BODY FLUID","CDM Code","IP/OP",300,"Lab",82945,"GLUCOSE OTHER FLUID",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[4400303,"IGE","CDM Code","IP/OP",300,"Lab",82785,"ASSAY OF IGE",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[4400293,"FERRITIN","CDM Code","IP/OP",300,"Lab",82728,"ASSAY OF FERRITIN",145,72.5,115.27500000000001,123.25,123.25,123.25,121.8,117.45,116,115.27500000000001,116]
[4400289,"ESTRONE","CDM Code","IP/OP",300,"Lab",82679,"ASSAY OF ESTRONE",359,179.5,285.40500000000003,305.14999999999998,305.14999999999998,305.14999999999998,301.56,290.79000000000002,287.2,285.40500000000003,287.2]
[4400267,"DHEA-S","CDM Code","IP/OP",300,"Lab",82627,"DEHYDROEPIANDROSTERONE",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[4400258,"CREATININE CLEARANCE","CDM Code","IP/OP",300,"Lab",82575,"CREATININE CLEARANCE TEST",89,44.5,70.75500000000001,75.649999999999991,75.649999999999991,75.649999999999991,74.759999999999991,72.09,71.2,70.75500000000001,71.2]
[4400243,"COPPER SERUM","CDM Code","IP/OP",300,"Lab",82525,"ASSAY OF COPPER",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[4400239,"CITRATE URINE 24","CDM Code","IP/OP",300,"Lab",82507,"ASSAY OF CITRATE",400,200,318,340,340,340,336,324,320,318,320]
[4400212,"CATECHOLAMINES FRAC UR","CDM Code","IP/OP",300,"Lab",82384,"ASSAY THREE CATECHOLAMINES",364,182,289.38,309.39999999999998,309.39999999999998,309.39999999999998,305.76,294.84000000000003,291.2,289.38,291.2]
[4400202,"CARBOXYHEMOGLOBIN","CDM Code","IP/OP",300,"Lab",82375,"ASSAY CARBOXYHB QUANT",178,89,141.51000000000002,151.29999999999998,151.29999999999998,151.29999999999998,149.51999999999998,144.18,142.4,141.51000000000002,142.4]
[4400194,"IONIZED CALCIUM","CDM Code","IP/OP",300,"Lab",82330,"ASSAY OF CALCIUM",197,98.5,156.61500000000001,167.45,167.45,167.45,165.48,159.57000000000002,157.60000000000002,156.61500000000001,157.60000000000002]
[4400191,"*CALCIUM/CREATININE RATIO","CDM Code","IP/OP",300,"Lab",82310,"ASSAY OF CALCIUM",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[4400180,"BILIRUBIN DIRECT","CDM Code","IP/OP",300,"Lab",82248,"BILIRUBIN DIRECT",76,38,60.42,64.599999999999994,64.599999999999994,64.599999999999994,63.839999999999996,61.56,60.800000000000004,60.42,60.800000000000004]
[4400164,"ANDROSTENEDIONE","CDM Code","IP/OP",300,"Lab",82157,"ASSAY OF ANDROSTENEDIONE",438,219,348.21000000000004,372.3,372.3,372.3,367.91999999999996,354.78000000000003,350.40000000000003,348.21000000000004,350.40000000000003]
[4400142,"AFP(TUMOR MARKER)","CDM Code","IP/OP",300,"Lab",82105,"ALPHA-FETOPROTEIN SERUM",242,121,192.39000000000001,205.7,205.7,205.7,203.28,196.02,193.60000000000002,192.39000000000001,193.60000000000002]
[4400138,"*ALPHA-1-ANTITRYPSIN PHENO","CDM Code","IP/OP",300,"Lab",82104,"ALPHA-1-ANTITRYPSIN PHENO",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[4400130,"*MICROALBUMIN URINE","CDM Code","IP/OP",300,"Lab",82043,"UR ALBUMIN QUANTITATIVE",88,44,69.960000000000008,74.8,74.8,74.8,73.92,71.28,70.400000000000006,69.960000000000008,70.400000000000006]
[4400120,"URINE MICROSCOPIC ONLY","CDM Code","IP/OP",300,"Lab",81015,"MICROSCOPIC EXAM OF URINE",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[4400083,"PAROXETINE","CDM Code","IP/OP",300,"Lab",80299,"QUANTITATIVE ASSAY DRUG",207,103.5,164.565,175.95,175.95,175.95,173.88,167.67000000000002,165.60000000000002,164.565,165.60000000000002]
[4400079,"FLECAINIDE","CDM Code","IP/OP",300,"Lab",80299,"QUANTITATIVE ASSAY DRUG",244,122,193.98000000000002,207.4,207.4,207.4,204.95999999999998,197.64000000000001,195.20000000000002,193.98000000000002,195.20000000000002]
[4400068,"THEOPHYLLINE","CDM Code","IP/OP",300,"Lab",80198,"ASSAY OF THEOPHYLLINE",201,100.5,159.79500000000002,170.85,170.85,170.85,168.84,162.81,160.80000000000001,159.79500000000002,160.80000000000001]
[4400061,"*PRIMIDONE","CDM Code","IP/OP",300,"Lab",80188,"ASSAY OF PRIMIDONE",249,124.5,197.95500000000001,211.65,211.65,211.65,209.16,201.69000000000003,199.20000000000002,197.95500000000001,199.20000000000002]
[4400053,"HALOPERIDOL","CDM Code","IP/OP",300,"Lab",80173,"ASSAY OF HALOPERIDOL",159,79.5,126.405,135.15,135.15,135.15,133.56,128.79000000000002,127.2,126.405,127.2]
[4400052,"GENTAMICIN RANDOM","CDM Code","IP/OP",300,"Lab",80170,"ASSAY OF GENTAMICIN",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[4400043,"CARBAMAZEPINE","CDM Code","IP/OP",300,"Lab",80156,"ASSAY CARBAMAZEPINE TOTAL",219,109.5,174.10500000000002,186.15,186.15,186.15,183.95999999999998,177.39000000000001,175.20000000000002,174.10500000000002,175.20000000000002]
[4400019,"RENAL PROFILE","CDM Code","IP/OP",300,"Lab",80069,"RENAL FUNCTION PANEL",125,62.5,99.375,106.25,106.25,106.25,105,101.25,100,99.375,100]
[4400011,"LIPID PROFILE","CDM Code","IP/OP",300,"Lab",80061,"LIPID PANEL",119,59.5,94.605000000000004,101.14999999999999,101.14999999999999,101.14999999999999,99.96,96.39,95.2,94.605000000000004,95.2]
[4400009,"*PRENATAL PANEL","CDM Code","IP/OP",300,"Lab",80055,"OBSTETRIC PANEL",528,264,419.76000000000005,448.8,448.8,448.8,443.52,427.68,422.40000000000003,419.76000000000005,422.40000000000003]
[4400001,"BONE MARROW ASPIRATION","CDM Code","IP/OP",300,"Lab",38220,"DX BONE MARROW ASPIRATIONS",3974,1987,3159.3300000000004,3377.9,3377.9,3377.9,3338.16,3218.94,3179.2000000000003,3159.3300000000004,3179.2000000000003]
[4300135,"NM WBC LTD AREA 78803","CDM Code","IP/OP",340,"Nuclear Medicine",78803,"RP LOCLZJ TUM SPECT 1 AREA",1552,776,1233.8400000000001,1319.2,1319.2,1319.2,1303.68,1257.1200000000001,1241.6000000000001,1233.8400000000001,1241.6000000000001]
[4300132,"*NM IODINE I-123 IOFLUPANE PER STUDY","CDM Code","IP/OP",343,"Nuc Med Dx Radiopharm","A9584","IODINE I-123 IOFLUPANE",5826,2913,4631.67,4952.0999999999995,4952.0999999999995,4952.0999999999995,4893.84,4719.0600000000004,4660.8,4631.67,4660.8]
[4300129,"NM BONE MARROW IMAGE BODY 78104","CDM Code","IP/OP",340,"Nuclear Medicine",78104,"BONE MARROW IMAGING BODY",1314,657,1044.6300000000001,1116.8999999999999,1116.8999999999999,1116.8999999999999,1103.76,1064.3400000000001,1051.2,1044.6300000000001,1051.2]
[4300123,"*NM HEPATOBILIARY SYSTEM IMAGING 78226","CDM Code","IP/OP",340,"Nuclear Medicine",78226,"HEPATOBILIARY SYSTEM IMAGING",1981,990.5,1574.895,1683.85,1683.85,1683.85,1664.04,1604.6100000000001,1584.8000000000002,1574.895,1584.8000000000002]
[4300118,"NM GALLIUM GA-67 CITRATE 6 MILLICURIE","CDM Code","IP/OP",636,"Drug/Detail Code","A9556","GA67 GALLIUM",680,340,540.6,578,578,578,571.19999999999993,550.80000000000007,544,540.6,544]
[4300111,"NM 99M PENTETATE PER DOSE DTPA","CDM Code","IP/OP",636,"Drug/Detail Code","A9539","TC99M PENTETATE",151,75.5,120.045,128.35,128.35,128.35,126.83999999999999,122.31,120.80000000000001,120.045,120.80000000000001]
[4300110,"NM 99M PYROPHOSPHATE PER DOSE","CDM Code","IP/OP",636,"Drug/Detail Code","A9538","TC99M PYROPHOSPHATE",86,43,68.37,73.099999999999994,73.099999999999994,73.099999999999994,72.239999999999995,69.660000000000011,68.8,68.37,68.8]
[4300102,"NM 99M MEBROFENIN PER VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","A4641","RADIOPHARM DX AGENT NOC",285,142.5,226.57500000000002,242.25,242.25,242.25,239.39999999999998,230.85000000000002,228,226.57500000000002,228]
[4300097,"NM RADIOPH ABLAT GLAND FOR T","CDM Code","IP/OP",340,"Nuclear Medicine",79005,"NUCLEAR RX ORAL ADMIN",1517,758.5,1206.0150000000001,1289.45,1289.45,1289.45,1274.28,1228.77,1213.6000000000001,1206.0150000000001,1213.6000000000001]
[4300078,"NM KID FUNC W/PHARMACOLOCIC INTV 78708","CDM Code","IP/OP",340,"Nuclear Medicine",78708,"K FLOW/FUNCT IMAGE W/DRUG",2697,1348.5,2144.1150000000002,2292.4499999999998,2292.4499999999998,2292.4499999999998,2265.48,2184.5700000000002,2157.6,2144.1150000000002,2157.6]
[4300077,"NM RENAL W VASCULAR FLOW 78707","CDM Code","IP/OP",340,"Nuclear Medicine",78707,"K FLOW/FUNCT IMAGE W/O DRUG",2546,1273,2024.0700000000002,2164.1,2164.1,2164.1,2138.64,2062.2600000000002,2036.8000000000002,2024.0700000000002,2036.8000000000002]
[4300030,"NM BONE &/OR JOINT LIM AREA 78300","CDM Code","IP/OP",340,"Nuclear Medicine",78300,"BONE IMAGING LIMITED AREA",2415,1207.5,1919.9250000000002,2052.75,2052.75,2052.75,2028.6,1956.15,1932,1919.9250000000002,1932]
[4100535,"*US DOPPLER","CDM Code","IP/OP",921,"Peri Vascul Lab",93975,"VASCULAR STUDY",624,312,496.08000000000004,530.4,530.4,530.4,524.16,505.44000000000005,499.20000000000005,496.08000000000004,499.20000000000005]
[4100529,"XR CHEST 3V INSP EXPT LAT 71047","CDM Code","IP/OP",320,"Dx x-Ray",71047,"X-RAY EXAM CHEST 3 VIEWS",222,111,176.49,188.7,188.7,188.7,186.48,179.82000000000002,177.60000000000002,176.49,177.60000000000002]
[4100528,"20ML DOTAREM GADOTERATE MEGLUMI","CDM Code","IP/OP",255,"Drugs/Incident Rad","A9575","INJ GADOTERATE MEGLUMI 0.1ML",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[4100517,"XR ABD 1V KUB 74018","CDM Code","IP/OP",320,"Dx x-Ray",74018,"X-RAY EXAM ABDOMEN 1 VIEW",231,115.5,183.64500000000001,196.35,196.35,196.35,194.04,187.11,184.8,183.64500000000001,184.8]
[4100512,"XR CHEST 2V 71046","CDM Code","IP/OP",320,"Dx x-Ray",71046,"X-RAY EXAM CHEST 2 VIEWS",439,219.5,349.005,373.15,373.15,373.15,368.76,355.59000000000003,351.20000000000005,349.005,351.20000000000005]
[4100504,"*MM 3D MAMMO DX BIL ADDON 77062","CDM Code","IP/OP",401,"Diag Mammography",77062,"BREAST TOMOSYNTHESIS BI",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[4100503,"*MM 3D MAMMO SCREEN BIL ADDON 77063","CDM Code","IP/OP",403,"Scrn mammography",77063,"BREAST TOMOSYNTHESIS BI",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[4100493,"XR FLUORO STENT PLACEMENT W C ARM 50387","CDM Code","IP/OP",761,"Treatment Rm",50387,"CHANGE NEPHROURETERAL CATH",1617,808.5,1285.5150000000001,1374.45,1374.45,1374.45,1358.28,1309.77,1293.6000000000001,1285.5150000000001,1293.6000000000001]
[4100486,"XR SCOLIOSIS 2V 72082","CDM Code","IP/OP",320,"Dx x-Ray",72082,"X-RAY EXAM ENTIRE SPI 2/3 VW",829,414.5,659.05500000000006,704.65,704.65,704.65,696.36,671.49,663.2,659.05500000000006,663.2]
[4100470,"*IR BX BREAST ADDITIONAL LESION US 19084","CDM Code","IP/OP",761,"Treatment Rm",19084,"BX BREAST ADD LESION US IMAG",1200,600,954,1020,1020,1020,1008,972.00000000000011,960,954,960]
[4100469,"MM NEEDLE PLACEMENT 1ST LESION 19281","CDM Code","IP/OP",761,"Treatment Rm",19281,"PERQ DEVICE BREAST 1ST IMAG",899,449.5,714.70500000000004,764.15,764.15,764.15,755.16,728.19,719.2,714.70500000000004,719.2]
[4100436,"US FETAL BIOPHYSIC PROFILE WO NST 76819","CDM Code","IP/OP",402,"Ultrasound",76819,"FETAL BIOPHYS PROFIL W/O NST",1270,635,1009.6500000000001,1079.5,1079.5,1079.5,1066.8,1028.7,1016,1009.6500000000001,1016]
[4100406,"US GUIDANCE VASCULAR ACCESS 76937","CDM Code","IP/OP",402,"Ultrasound",76937,"US GUIDE VASCULAR ACCESS",1554,777,1235.43,1320.8999999999999,1320.8999999999999,1320.8999999999999,1305.3599999999999,1258.74,1243.2,1235.43,1243.2]
[4100399,"US SOFT TISSUE EXTREMITY LIMITED 76882","CDM Code","IP/OP",402,"Ultrasound",76882,"US LMTD JT/FCL EVL NVASC XTR",827,413.5,657.46500000000003,702.94999999999993,702.94999999999993,702.94999999999993,694.68,669.87,661.6,657.46500000000003,661.6]
[4100398,"US SOFT TISSUE EXTERMITY COMPLETE 76881","CDM Code","IP/OP",402,"Ultrasound",76881,"US COMPL JOINT R-T W/IMG",1593,796.5,1266.4350000000002,1354.05,1354.05,1354.05,1338.12,1290.3300000000002,1274.4000000000001,1266.4350000000002,1274.4000000000001]
[4100393,"CONT GADOXETATE DISODIUM INJ","CDM Code","IP/OP",636,"Drug/Detail Code","A9581","GADOXETATE DISODIUM INJ",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[4100385,"CONTRAST PROHANCE PER 5 ML VIAL MRI","CDM Code","IP/OP",636,"Drug/Detail Code","A9576","INJ PROHANCE MULTIPACK",418,209,332.31,355.3,355.3,355.3,351.12,338.58000000000004,334.40000000000003,332.31,334.40000000000003]
[4100379,"XR THORACOLUMBAR 2 VIEW 72080","CDM Code","IP/OP",320,"Dx x-Ray",72080,"X-RAY EXAM THORACOLMB 2/> VW",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[4100378,"XR FLUORO SPINE INJ 77003","CDM Code","IP/OP",320,"Dx x-Ray",77003,"FLUOROGUIDE FOR SPINE INJECT",1021,510.5,811.69500000000005,867.85,867.85,867.85,857.64,827.0100000000001,816.80000000000007,811.69500000000005,816.80000000000007]
[4100368,"XR BONE SURVEY 77075","CDM Code","IP/OP",320,"Dx x-Ray",77075,"X-RAYS BONE SURVEY COMPLETE",969,484.5,770.35500000000002,823.65,823.65,823.65,813.95999999999992,784.8900000000001,775.2,770.35500000000002,775.2]
[4100354,"XR BONY SURVEY INFANT 77076","CDM Code","IP/OP",320,"Dx x-Ray",77076,"X-RAYS BONE SURVEY INFANT",397,198.5,315.61500000000001,337.45,337.45,337.45,333.47999999999996,321.57,317.60000000000002,315.61500000000001,317.60000000000002]
[4100349,"CONT SINOGRAFIN PER ML","CDM Code","IP/OP",636,"Drug/Detail Code","Q9963","HOCM 350-399MG/ML IODINE,1ML",436,218,346.62,370.59999999999997,370.59999999999997,370.59999999999997,366.24,353.16,348.8,346.62,348.8]
[4100347,"CT FACIAL WO CONTRAST 70486","CDM Code","IP/OP",350,"CT Scan",70486,"CT MAXILLOFACIAL W/O DYE",1848,924,1469.16,1570.8,1570.8,1570.8,1552.32,1496.88,1478.4,1469.16,1478.4]
[4100330,"CT 3D RECON 76376","CDM Code","IP/OP",350,"CT Scan",76376,"3D RENDER W/INTRP POSTPROCES",723,361.5,574.78500000000008,614.54999999999995,614.54999999999995,614.54999999999995,607.31999999999994,585.63,578.4,574.78500000000008,578.4]
[4100320,"CTA PELV WWO CONTRAST 72191","CDM Code","IP/OP",350,"CT Scan",72191,"CT ANGIOGRAPH PELV W/O&W/DYE",2513,1256.5,1997.835,2136.0499999999997,2136.0499999999997,2136.0499999999997,2110.92,2035.5300000000002,2010.4,1997.835,2010.4]
[4100297,"US PREG TRANS VAGINAL 76817","CDM Code","IP/OP",402,"Ultrasound",76817,"TRANSVAGINAL US OBSTETRIC",766,383,608.97,651.1,651.1,651.1,643.43999999999994,620.46,612.80000000000007,608.97,612.80000000000007]
[4100296,"US PREG LT 14 WKS ADDTL FET 76802","CDM Code","IP/OP",402,"Ultrasound",76802,"OB US < 14 WKS ADDL FETUS",650,325,516.75,552.5,552.5,552.5,546,526.5,520,516.75,520]
[4100286,"XR CSPINE 4V 72050","CDM Code","IP/OP",320,"Dx x-Ray",72050,"X-RAY EXAM NECK SPINE 4/5VWS",577,288.5,458.71500000000003,490.45,490.45,490.45,484.68,467.37,461.6,458.71500000000003,461.6]
[4100246,"US GUIDE NEEDLE PL 76942","CDM Code","IP/OP",402,"Ultrasound",76942,"ECHO GUIDE FOR BIOPSY",2016,1008,1602.72,1713.6,1713.6,1713.6,1693.4399999999998,1632.96,1612.8000000000002,1602.72,1612.8000000000002]
[4100239,"US PELV HYSTERO 76831","CDM Code","IP/OP",402,"Ultrasound",76831,"ECHO EXAM UTERUS",828,414,658.26,703.8,703.8,703.8,695.52,670.68000000000006,662.40000000000009,658.26,662.40000000000009]
[4100238,"US PELV TRANSVAG","CDM Code","IP/OP",402,"Ultrasound",76830,"TRANSVAGINAL US NON-OB",871,435.5,692.44500000000005,740.35,740.35,740.35,731.64,705.51,696.80000000000007,692.44500000000005,696.80000000000007]
[4100233,"US PREG GT 14 WKS 76805","CDM Code","IP/OP",402,"Ultrasound",76805,"OB US >= 14 WKS SNGL FETUS",788,394,626.46,669.8,669.8,669.8,661.92,638.28000000000009,630.40000000000009,626.46,630.40000000000009]
[4100227,"US CHEST 76604","CDM Code","IP/OP",402,"Ultrasound",76604,"US EXAM CHEST",913,456.5,725.83500000000004,776.05,776.05,776.05,766.92,739.53000000000009,730.40000000000009,725.83500000000004,730.40000000000009]
[4100188,"XR BARIUM ENEMA 74270","CDM Code","IP/OP",320,"Dx x-Ray",74270,"X-RAY XM COLON 1CNTRST STD",953,476.5,757.63499999999999,810.05,810.05,810.05,800.52,771.93000000000006,762.40000000000009,757.63499999999999,762.40000000000009]
[4100187,"XR SMALL BOWEL 74250","CDM Code","IP/OP",320,"Dx x-Ray",74250,"X-RAY XM SM INT 1CNTRST STD",642,321,510.39000000000004,545.69999999999993,545.69999999999993,545.69999999999993,539.28,520.02,513.6,510.39000000000004,513.6]
[4100181,"*MR ABDOMEN W CONTRAST 74182","CDM Code","IP/OP",610,"MRI",74182,"MRI ABDOMEN W/DYE",2956,1478,2350.02,2512.6,2512.6,2512.6,2483.04,2394.36,2364.8000000000002,2350.02,2364.8000000000002]
[4100176,"XR ACUTE ABD SER 74022","CDM Code","IP/OP",320,"Dx x-Ray",74022,"X-RAY EXAM COMPLETE ABDOMEN",601,300.5,477.79500000000002,510.84999999999997,510.84999999999997,510.84999999999997,504.84,486.81000000000006,480.8,477.79500000000002,480.8]
[4100168,"*MR LOW EXT W CONTRAST 73719","CDM Code","IP/OP",610,"MRI",73719,"MRI LOWER EXTREMITY W/DYE",2307,1153.5,1834.0650000000001,1960.95,1960.95,1960.95,1937.8799999999999,1868.67,1845.6000000000001,1834.0650000000001,1845.6000000000001]
[4100167,"MR LOW EXT WO CONTRAST 73718","CDM Code","IP/OP",610,"MRI",73718,"MRI LOWER EXTREMITY W/O DYE",2780,1390,2210.1,2363,2363,2363,2335.1999999999998,2251.8000000000002,2224,2210.1,2224]
[4100162,"*XR CALCANEOUS 73650","CDM Code","IP/OP",320,"Dx x-Ray",73650,"X-RAY EXAM OF HEEL",444,222,352.98,377.4,377.4,377.4,372.96,359.64000000000004,355.20000000000005,352.98,355.20000000000005]
[4100156,"XR TIB FIB 2V 73590","CDM Code","IP/OP",320,"Dx x-Ray",73590,"X-RAY EXAM OF LOWER LEG",412,206,327.54000000000002,350.2,350.2,350.2,346.08,333.72,329.6,327.54000000000002,329.6]
[4100149,"XR KNEE 2V 73560","CDM Code","IP/OP",320,"Dx x-Ray",73560,"X-RAY EXAM OF KNEE 1 OR 2",481,240.5,382.39500000000004,408.84999999999997,408.84999999999997,408.84999999999997,404.03999999999996,389.61,384.8,382.39500000000004,384.8]
[4100144,"*MRA UP EXT WWO CONTRAST 73225","CDM Code","IP/OP",618,"Magnetic Resonance Tech. (MRT): MRA - Other",73225,"MR ANGIO UPR EXTR W/O&W/DYE",1838,919,1461.21,1562.3,1562.3,1562.3,1543.9199999999998,1488.7800000000002,1470.4,1461.21,1470.4]
[4100139,"*MR UP EXT W CONTRAST 73219","CDM Code","IP/OP",610,"MRI",73219,"MRI UPPER EXTREMITY W/DYE",2559,1279.5,2034.4050000000002,2175.15,2175.15,2175.15,2149.56,2072.79,2047.2,2034.4050000000002,2047.2]
[4100134,"XR FINGER 73140","CDM Code","IP/OP",320,"Dx x-Ray",73140,"X-RAY EXAM OF FINGER(S)",444,222,352.98,377.4,377.4,377.4,372.96,359.64000000000004,355.20000000000005,352.98,355.20000000000005]
[4100129,"XR INF ARM 73092","CDM Code","IP/OP",320,"Dx x-Ray",73092,"X-RAY EXAM OF ARM INFANT",576,288,457.92,489.59999999999997,489.59999999999997,489.59999999999997,483.84,466.56000000000006,460.8,457.92,460.8]
[4100128,"XR RADIUS ULNA 73090","CDM Code","IP/OP",320,"Dx x-Ray",73090,"X-RAY EXAM OF FOREARM",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[4100123,"XR AC JOINTS BIL 73050","CDM Code","IP/OP",320,"Dx x-Ray",73050,"X-RAY EXAM OF SHOULDERS",576,288,457.92,489.59999999999997,489.59999999999997,489.59999999999997,483.84,466.56000000000006,460.8,457.92,460.8]
[4100118,"*XR CLAVICLE  73000","CDM Code","IP/OP",320,"Dx x-Ray",73000,"X-RAY EXAM OF COLLAR BONE",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[4100112,"*MR PELV W CONTRAST 72196","CDM Code","IP/OP",610,"MRI",72196,"MRI PELVIS W/DYE",2559,1279.5,2034.4050000000002,2175.15,2175.15,2175.15,2149.56,2072.79,2047.2,2034.4050000000002,2047.2]
[4100111,"MR PELV WO CONTRAST 72195","CDM Code","IP/OP",610,"MRI",72195,"MRI PELVIS W/O DYE",3105,1552.5,2468.4749999999999,2639.25,2639.25,2639.25,2608.1999999999998,2515.0500000000002,2484,2468.4749999999999,2484]
[4100106,"XR PELVIS 1 OR 2V 72170","CDM Code","IP/OP",320,"Dx x-Ray",72170,"X-RAY EXAM OF PELVIS",577,288.5,458.71500000000003,490.45,490.45,490.45,484.68,467.37,461.6,458.71500000000003,461.6]
[4100100,"MR LSPINE WO CONTRAST 72148","CDM Code","IP/OP",610,"MRI",72148,"MRI LUMBAR SPINE W/O DYE",3370,1685,2679.15,2864.5,2864.5,2864.5,2830.7999999999997,2729.7000000000003,2696,2679.15,2696]
[4100095,"*CT LSSPINE WWO CONTRAST 72133","CDM Code","IP/OP",350,"CT Scan",72133,"CT LUMBAR SPINE W/O & W/DYE",3309,1654.5,2630.6550000000002,2812.65,2812.65,2812.65,2779.56,2680.29,2647.2000000000003,2630.6550000000002,2647.2000000000003]
[4100094,"*CT LSSPINE W CONTRAST 72132","CDM Code","IP/OP",350,"CT Scan",72132,"CT LUMBAR SPINE W/DYE",2435,1217.5,1935.825,2069.75,2069.75,2069.75,2045.3999999999999,1972.3500000000001,1948,1935.825,1948]
[4100089,"*CT CSPINE WWO CONTRAST 72127","CDM Code","IP/OP",350,"CT Scan",72127,"CT NECK SPINE W/O & W/DYE",2667,1333.5,2120.2650000000003,2266.9499999999998,2266.9499999999998,2266.9499999999998,2240.2799999999997,2160.27,2133.6,2120.2650000000003,2133.6]
[4100084,"XR LSSPINE 2V 72100","CDM Code","IP/OP",320,"Dx x-Ray",72100,"X-RAY EXAM L-S SPINE 2/3 VWS",613,306.5,487.33500000000004,521.04999999999995,521.04999999999995,521.04999999999995,514.91999999999996,496.53000000000003,490.40000000000003,487.33500000000004,490.40000000000003]
[4100077,"*MR CHEST WWO CONTRAST 71552","CDM Code","IP/OP",610,"MRI",71552,"MRI CHEST W/O & W/DYE",4149,2074.5,3298.4550000000004,3526.65,3526.65,3526.65,3485.16,3360.69,3319.2000000000003,3298.4550000000004,3319.2000000000003]
[4100075,"MR CHEST WO CONTRAST 71550","CDM Code","IP/OP",610,"MRI",71550,"MRI CHEST W/O DYE",2769,1384.5,2201.355,2353.65,2353.65,2353.65,2325.96,2242.8900000000003,2215.2000000000003,2201.355,2215.2000000000003]
[4100070,"XR STERNUM 71120","CDM Code","IP/OP",320,"Dx x-Ray",71120,"X-RAY EXAM BREASTBONE 2/>VWS",423,211.5,336.28500000000003,359.55,359.55,359.55,355.32,342.63,338.40000000000003,336.28500000000003,338.40000000000003]
[4100061,"*MR BRAIN WWO CONTRAST 70553","CDM Code","IP/OP",610,"MRI",70553,"MRI BRAIN STEM W/O & W/DYE",4570,2285,3633.15,3884.5,3884.5,3884.5,3838.7999999999997,3701.7000000000003,3656,3633.15,3656]
[4100056,"MRA NECK WO CONTRAST 70547*","CDM Code","IP/OP",615,"MRA/Head & Neck",70547,"MR ANGIOGRAPHY NECK W/O DYE",2780,1390,2210.1,2363,2363,2363,2335.1999999999998,2251.8000000000002,2224,2210.1,2224]
[4100055,"*MRA HEAD WWO CONTRAST 70546","CDM Code","IP/OP",615,"MRA/Head & Neck",70546,"MR ANGIOGRAPH HEAD W/O&W/DYE",3204,1602,2547.1800000000003,2723.4,2723.4,2723.4,2691.36,2595.2400000000002,2563.2000000000003,2547.1800000000003,2563.2000000000003]
[4100050,"*CT NECK W CONTRAST 70491","CDM Code","IP/OP",350,"CT Scan",70491,"CT SOFT TISSUE NECK W/DYE",2317,1158.5,1842.0150000000001,1969.45,1969.45,1969.45,1946.28,1876.7700000000002,1853.6000000000001,1842.0150000000001,1853.6000000000001]
[4100045,"*CT EAR WWO CONTRAST 70482","CDM Code","IP/OP",350,"CT Scan",70482,"CT ORBIT/EAR/FOSSA W/O&W/DYE",2776,1388,2206.92,2359.6,2359.6,2359.6,2331.8399999999997,2248.56,2220.8000000000002,2206.92,2220.8000000000002]
[4100040,"CT HEAD WO CONTRAST 70450","CDM Code","IP/OP",350,"CT Scan",70450,"CT HEAD/BRAIN W/O DYE",1756,878,1396.02,1492.6,1492.6,1492.6,1475.04,1422.3600000000001,1404.8000000000002,1396.02,1404.8000000000002]
[4100037,"XR SOFT TISSUE NECK 70360","CDM Code","IP/OP",320,"Dx x-Ray",70360,"X-RAY EXAM OF NECK",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[4100031,"XR SINUS 3 OR MORE VIEWS 70220","CDM Code","IP/OP",320,"Dx x-Ray",70220,"X-RAY EXAM OF SINUSES",943,471.5,749.68500000000006,801.55,801.55,801.55,792.12,763.83,754.40000000000009,749.68500000000006,754.40000000000009]
[4100026,"XR FACIAL BONES LT 3VIEWS 70140","CDM Code","IP/OP",320,"Dx x-Ray",70140,"X-RAY EXAM OF FACIAL BONES",425,212.5,337.875,361.25,361.25,361.25,357,344.25,340,337.875,340]
[4000038,"ANESTHESIA SERVICES PER MINUTE","CDM Code","IP/OP",370,"Anesthesia","","",16,8,12.72,13.6,13.6,13.6,13.44,12.96,12.8,12.72,12.8]
[4000037,"ANESTESTIST LOCAL","CDM Code","IP/OP",370,"Anesthesia","","",554,277,440.43,470.9,470.9,470.9,465.35999999999996,448.74,443.20000000000005,440.43,443.20000000000005]
[3900046,"CHILD BIRTHING PRIVATE CLASS PER SESSION","CDM Code","IP/OP",942,"Educ/Training","","",162,81,128.79000000000002,137.69999999999999,137.69999999999999,137.69999999999999,136.07999999999998,131.22,129.6,128.79000000000002,129.6]
[3900041,"BLOOD TRANSFUSION 4- 6 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1229,614.5,977.05500000000006,1044.6499999999999,1044.6499999999999,1044.6499999999999,1032.3599999999999,995.49,983.2,977.05500000000006,983.2]
[3900036,"IV PUSH EA ADDITIONAL SEQ SUBSTANCE","CDM Code","IP/OP",260,"IV Therapy",96375,"TX/PRO/DX INJ NEW DRUG ADDON",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[3900035,"IV PUSH INITIAL","CDM Code","IP/OP",260,"IV Therapy",96374,"THER/PROPH/DIAG INJ IV PUSH",524,262,416.58000000000004,445.4,445.4,445.4,440.15999999999997,424.44000000000005,419.20000000000005,416.58000000000004,419.20000000000005]
[3900028,"INFUSION THERAPY OR PROPHYLAXIS 1ST HOUR","CDM Code","IP/OP",260,"IV Therapy",96365,"THER/PROPH/DIAG IV INF INIT",784,392,623.28000000000009,666.4,666.4,666.4,658.56,635.04000000000008,627.20000000000005,623.28000000000009,627.20000000000005]
[3900017,"VAGINAL DELIVERY IN THE OR","CDM Code","IP/OP",360,"OR Services","","",6698,3349,5324.91,5693.3,5693.3,5693.3,5626.32,5425.38,5358.4000000000005,5324.91,5358.4000000000005]
[3900012,"SURG PRO IN L&D 0-15 MIN","CDM Code","IP/OP",360,"OR Services","","",245,122.5,194.77500000000001,208.25,208.25,208.25,205.79999999999998,198.45000000000002,196,194.77500000000001,196]
[3900011,"VAGINAL BIRTH","CDM Code","IP/OP",720,"Delivery Room/Labor","","",4478,2239,3560.01,3806.2999999999997,3806.2999999999997,3806.2999999999997,3761.52,3627.1800000000003,3582.4,3560.01,3582.4]
[3900002,"NON STRESS TEST","CDM Code","IP/OP",920,"Other Dx Svcs",59025,"FETAL NON-STRESS TEST",559,279.5,444.40500000000003,475.15,475.15,475.15,469.56,452.79,447.20000000000005,444.40500000000003,447.20000000000005]
[3800013,"RECOVERY PACU PER MINUTE","CDM Code","IP/OP",710,"Recovery Room","","",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[3700044,"OPTHOMOLOGY PROCEDURE PER MINUTE","CDM Code","IP/OP",360,"OR Services","","",160,80,127.2,136,136,136,134.4,129.60000000000002,128,127.2,128]
[3700001,"IV PUSH INITIAL","CDM Code","Pro",510,"Clinic",96374,"THER/PROPH/DIAG INJ IV PUSH",523,261.5,415.78500000000003,444.55,444.55,444.55,439.32,423.63000000000005,418.40000000000003,415.78500000000003,418.40000000000003]
[3300006,"CAR SEAT BED TESTING EACH ADDTL 30 MIN","CDM Code","IP/OP",920,"Other Dx Svcs",94781,"CARS/BD TST INFT-12MO +30MIN",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[2500028,"IV PUSH INITIAL","CDM Code","IP/OP",260,"IV Therapy",96374,"THER/PROPH/DIAG INJ IV PUSH",524,262,416.58000000000004,445.4,445.4,445.4,440.15999999999997,424.44000000000005,419.20000000000005,416.58000000000004,419.20000000000005]
[2500022,"INFUSION THER HYDRATION EA ADDTL HOUR","CDM Code","IP/OP",260,"IV Therapy",96361,"HYDRATE IV INFUSION ADD-ON",294,147,233.73000000000002,249.9,249.9,249.9,246.95999999999998,238.14000000000001,235.20000000000002,233.73000000000002,235.20000000000002]
[2500021,"INFUSION THER HYDRATION 1ST HOUR","CDM Code","IP/OP",260,"IV Therapy",96360,"HYDRATION IV INFUSION INIT",536,268,426.12,455.59999999999997,455.59999999999997,455.59999999999997,450.24,434.16,428.8,426.12,428.8]
[2500015,"BLOOD TRSF OVER 6 HOURS","CDM Code","IP/OP",391,"Blood/Admin",36430,"BLOOD TRANSFUSION SERVICE",1545,772.5,1228.2750000000001,1313.25,1313.25,1313.25,1297.8,1251.45,1236,1228.2750000000001,1236]
[699238,"ER OBSERVATION CARE DISCHARGE","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",99217,"OBSERVATION CARE DISCHARGE",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[699221,"INITIAL OBSERVATION CARE 30 MINS","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",99221,"1ST HOSP IP/OBS SF/LOW 40",297,148.5,236.11500000000001,252.45,252.45,252.45,249.48,240.57000000000002,237.60000000000002,236.11500000000001,237.60000000000002]
[699215,"ESTABLISHED LEVEL 5 99215-ER","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",99215,"OFFICE O/P EST HI 40-54 MIN",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[632556,"PERQ DRAINAGE PLEURA INSERT CATH W/O PRO","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",32556,"INSERT CATH PLEURA W/O IMAGE",430,215,341.85,365.5,365.5,365.5,361.2,348.3,344,341.85,344]
[620552,"INJ TRIGGER POINT 1 2 MUSCLES","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",20552,"INJ TRIGGER POINT 1/2 MUSCL",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[599497,"ADVNCD CARE PLAN 30 MIN","CDM Code","Pro",510,"Clinic",99497,"ADVNCD CARE PLAN 30 MIN",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[599496,"TRANS CARE MGMT 7 DAY DISCH","CDM Code","Pro",510,"Clinic",99496,"TRANSJ CARE MGMT HIGH F2F 7D",466,233,370.47,396.09999999999997,396.09999999999997,396.09999999999997,391.44,377.46000000000004,372.8,370.47,372.8]
[599464,"ATTENDANCE AT DELIVERY","CDM Code","Pro",510,"Clinic",99464,"ATTENDANCE AT DELIVERY",256,128,203.52,217.6,217.6,217.6,215.04,207.36,204.8,203.52,204.8]
[599443,"PHONE EVAL MGMT 21 TO 30 MIN","CDM Code","Pro",510,"Clinic",99443,"PHONE E/M PHYS/QHP 21-30 MIN",81,40.5,64.39500000000001,68.849999999999994,68.849999999999994,68.849999999999994,68.039999999999992,65.61,64.8,64.39500000000001,64.8]
[599406,"BEHAV CHNG SMOKING 3 TO 10 MIN","CDM Code","Pro",510,"Clinic",99406,"BEHAV CHNG SMOKING 3-10 MIN",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[599397,"EST PT PREV MED 65 YR AND UP 99397","CDM Code","Pro",510,"Clinic",99397,"PER PM REEVAL EST PAT 65+ YR",383,191.5,304.48500000000001,325.55,325.55,325.55,321.71999999999997,310.23,306.40000000000003,304.48500000000001,306.40000000000003]
[599392,"EST PT PREV MED 1-4 YR 99392","CDM Code","Pro",510,"Clinic",99392,"PREV VISIT EST AGE 1-4",237,118.5,188.41500000000002,201.45,201.45,201.45,199.07999999999998,191.97,189.60000000000002,188.41500000000002,189.60000000000002]
[599384,"NEW PT PREV MED 12-17 YR 99384","CDM Code","Pro",510,"Clinic",99384,"PREV VISIT NEW AGE 12-17",361,180.5,286.995,306.84999999999997,306.84999999999997,306.84999999999997,303.24,292.41000000000003,288.8,286.995,288.8]
[599358,"PROLONG SERVICE W O CONTRACT","CDM Code","Pro",510,"Clinic",99358,"PROLONG SERVICE W/O CONTACT",204,102,162.18,173.4,173.4,173.4,171.35999999999999,165.24,163.20000000000002,162.18,163.20000000000002]
[599357,"PROLONGED SERVICE INPATIENT ADDL 30 MIN","CDM Code","Pro",510,"Clinic",99357,"PROLNG SVC I/P/OBS EA ADDL",305,152.5,242.47500000000002,259.25,259.25,259.25,256.2,247.05,244,242.47500000000002,244]
[599349,"HOME VISIT - ESTAB PATIENT LEVEL 3 99349","CDM Code","Pro",510,"Clinic",99349,"HOME/RES VST EST MOD MDM 40",266,133,211.47,226.1,226.1,226.1,223.44,215.46,212.8,211.47,212.8]
[599343,"HOME VISIT - NEW PATIENT LEVEL 3 99343","CDM Code","Pro",510,"Clinic",99343,"HOME VISIT NEW PATIENT",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[599335,"DOMICIL R-HOMEVISIT EST PATIENT 21 99335","CDM Code","Pro",510,"Clinic",99335,"DOMICIL/R-HOME VISIT EST PAT",211,105.5,167.745,179.35,179.35,179.35,177.23999999999998,170.91000000000003,168.8,167.745,168.8]
[599334,"DOMICIL R-HOMEVISIT EST PATIENT L1 99334","CDM Code","Pro",510,"Clinic",99334,"DOMICIL/R-HOME VISIT EST PAT",137,68.5,108.91500000000001,116.45,116.45,116.45,115.08,110.97000000000001,109.60000000000001,108.91500000000001,109.60000000000001]
[599324,"DOMICIL R-HOMEVISIT NEW PATIENT L1 99324","CDM Code","Pro",510,"Clinic",99324,"DOMICIL/R-HOME VISIT NEW PAT",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[599309,"SUBSEQ NURSING FAC CARE L3 99309","CDM Code","Pro",510,"Clinic",99309,"SBSQ NF CARE MODERATE MDM 30",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[599304,"INIT NURSING FAC CARE PER DAY L1 99304","CDM Code","Pro",510,"Clinic",99304,"1ST NF CARE SF/LOW MDM 25",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[599285,"EMERGENCY DEPT VISIT LEVEL 5","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",99285,"EMERGENCY DEPT VISIT HI MDM",753,376.5,598.63499999999999,640.04999999999995,640.04999999999995,640.04999999999995,632.52,609.93000000000006,602.4,598.63499999999999,602.4]
[599283,"EMERGENCY DEPT VISIT LEVEL 3","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",99283,"EMERGENCY DEPT VISIT LOW MDM",248,124,197.16,210.79999999999998,210.79999999999998,210.79999999999998,208.32,200.88000000000002,198.4,197.16,198.4]
[599253,"INPATIENT CONSULTATION LEVEL 3 99253","CDM Code","Pro",510,"Clinic",99253,"IP/OBS CNSLTJ NEW/EST LOW 45",281,140.5,223.39500000000001,238.85,238.85,238.85,236.04,227.61,224.8,223.39500000000001,224.8]
[599243,"CLINIC OUT PT CONSULT LEVEL 3 99243","CDM Code","Pro",510,"Clinic",99243,"OFF/OP CNSLTJ NEW/EST LOW 30",542,271,430.89000000000004,460.7,460.7,460.7,455.28,439.02000000000004,433.6,430.89000000000004,433.6]
[599242,"CLINIC OUT PT CONSULT LEVEL 2 99242","CDM Code","Pro",510,"Clinic",99242,"OFF/OP CONSLTJ NEW/EST SF 20",475,237.5,377.625,403.75,403.75,403.75,399,384.75,380,377.625,380]
[599235,"OBSERVATION HOSPITAL CARE LEVEL","CDM Code","Pro",510,"Clinic",99235,"HOSP IP/OBS SAME DATE MOD 70",964,482,766.38,819.4,819.4,819.4,809.76,780.84,771.2,766.38,771.2]
[599225,"SUBSEQUENT OBSERVATION CARE","CDM Code","Pro",510,"Clinic",99225,"SUBSEQUENT OBSERVATION CARE",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[599220,"INIT OBSERV CARE PER DAY FOR","CDM Code","Pro",510,"Clinic",99220,"INITIAL OBSERVATION CARE",581,290.5,461.89500000000004,493.84999999999997,493.84999999999997,493.84999999999997,488.03999999999996,470.61,464.8,461.89500000000004,464.8]
[599219,"INIT OBSERV CARE PER DAY FOR E","CDM Code","IP/OP",987,"Professional fee, house visit",99219,"INITIAL OBSERVATION CARE",426,213,338.67,362.09999999999997,362.09999999999997,362.09999999999997,357.84,345.06,340.8,338.67,340.8]
[599213,"ESTABLISHED PATIENT LEVEL 3 99213","CDM Code","Pro",510,"Clinic",99213,"OFFICE O/P EST LOW 20-29 MIN",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[599203,"NEW PATIENT LEVEL 3 99203","CDM Code","Pro",510,"Clinic",99203,"OFFICE O/P NEW LOW 30-44 MIN",334,167,265.53000000000003,283.89999999999998,283.89999999999998,283.89999999999998,280.56,270.54000000000002,267.2,265.53000000000003,267.2]
[599156,"MOD SED OTH PHYS QHP GREATER THAN 5 YEAR","CDM Code","Pro",510,"Clinic",99156,"MOD SED OTH PHYS/QHP 5/>YRS",145,72.5,115.27500000000001,123.25,123.25,123.25,121.8,117.45,116,115.27500000000001,116]
[599153,"MOD SED SAME PHYS QHP EA","CDM Code","Pro",510,"Clinic",99153,"MOD SED SAME PHYS/QHP EA",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[599076,"DESTROY VULVA LESIONS COMPL","CDM Code","Pro",510,"Clinic",56515,"DESTROY VULVA LESION/S COMPL",433,216.5,344.23500000000001,368.05,368.05,368.05,363.71999999999997,350.73,346.40000000000003,344.23500000000001,346.40000000000003]
[599071,"TREAT ULNAR FRACTURE","CDM Code","Pro",510,"Clinic",24675,"TREAT ULNAR FRACTURE",877,438.5,697.21500000000003,745.44999999999993,745.44999999999993,745.44999999999993,736.68,710.37,701.6,697.21500000000003,701.6]
[598927,"OSTEO MANIP 5-6 REGIONS 98927","CDM Code","Pro",510,"Clinic",98927,"OSTEOPATH MANJ 5-6 REGIONS",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[598926,"OSTEO MANIP 3-4 REGIONS 98926","CDM Code","Pro",510,"Clinic",98926,"OSTEOPATH MANJ 3-4 REGIONS",232,116,184.44,197.2,197.2,197.2,194.88,187.92000000000002,185.60000000000002,184.44,185.60000000000002]
[597607,"NEG PRES WND THRPY PER SESS LT 50CM","CDM Code","Pro",510,"Clinic",97607,"NEG PRESS WND TX <=50 SQ CM",434,217,345.03000000000003,368.9,368.9,368.9,364.56,351.54,347.20000000000005,345.03000000000003,347.20000000000005]
[596405,"CHEMO INTRALESIONAL UP TO 7","CDM Code","Pro",510,"Clinic",96405,"CHEMO INTRALESIONAL UP TO 7",141,70.5,112.095,119.85,119.85,119.85,118.44,114.21000000000001,112.80000000000001,112.095,112.80000000000001]
[596110,"DEVELOPMENTAL TEST LIMITED 96110","CDM Code","Pro",510,"Clinic",96110,"DEVELOPMENTAL SCREEN W/SCORE",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[596001,"COMPRE COMPUTER BASED MOTION ANALYSIS","CDM Code","Pro",510,"Clinic",96001,"MOTION TEST W/FT PRESS MEAS",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[595910,"NERVE CONDUCTION STUDIES 7 TO 8 STUDIES","CDM Code","Pro",510,"Clinic",95910,"NRV CNDJ TEST 7-8 STUDIES",482,241,383.19,409.7,409.7,409.7,404.88,390.42,385.6,383.19,385.6]
[595886,"MUSCLE TEST DONE W NERVE TEST COMPLETE","CDM Code","Pro",510,"Clinic",95886,"MUSC TEST DONE W/N TEST COMP",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[595863,"MUSCLE TEST THREE LIMBS","CDM Code","Pro",510,"Clinic",95863,"MUSCLE TEST 3 LIMBS",455,227.5,361.72500000000002,386.75,386.75,386.75,382.2,368.55,364,361.72500000000002,364]
[595861,"MUSCLE TEST TWO LIMBS","CDM Code","Pro",510,"Clinic",95861,"MUSCLE TEST 2 LIMBS",374,187,297.33000000000004,317.89999999999998,317.89999999999998,317.89999999999998,314.15999999999997,302.94,299.2,297.33000000000004,299.2]
[595812,"EEG 41 60 MINUTES","CDM Code","Pro",510,"Clinic",95812,"EEG 41-60 MINUTES",112,56,89.04,95.2,95.2,95.2,94.08,90.72,89.600000000000009,89.04,89.600000000000009]
[594727,"PFT PLETHYSMOGRAPH","CDM Code","Pro",510,"Clinic",94727,"PULM FUNCTION TEST BY GAS",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[594060,"BRONCHODILATION RESPONSIVENESS SPIROMETR","CDM Code","Pro",510,"Clinic",94060,"EVALUATION OF WHEEZING",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[594010,"SPIROMETRY INCL GRAPHIC RECORD TOTAL","CDM Code","Pro",510,"Clinic",94010,"BREATHING CAPACITY TEST",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[593926,"LOWER EXTREMITY STUDY","CDM Code","IP/OP",960,"Professional fees",93926,"LOWER EXTREMITY STUDY",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[593880,"VASCULAR LAB EXTRACRANIAL BILAT STUDY","CDM Code","IP/OP",960,"Professional fees",93880,"EXTRACRANIAL BILAT STUDY",99,49.5,78.704999999999998,84.149999999999991,84.149999999999991,84.149999999999991,83.16,80.190000000000012,79.2,78.704999999999998,79.2]
[593227,"ECG MONITORING FOR 24 HOURS PHY REVIEW","CDM Code","Pro",510,"Clinic",93227,"ECG MONIT/REPRT UP TO 48 HRS",126,63,100.17,107.1,107.1,107.1,105.83999999999999,102.06,100.80000000000001,100.17,100.80000000000001]
[593042,"RHYTHM ECG 3 LEADS INTERPRETATION ONLY","CDM Code","Pro",510,"Clinic",93042,"RHYTHM ECG REPORT",154,77,122.43,130.9,130.9,130.9,129.35999999999999,124.74000000000001,123.2,122.43,123.2]
[592950,"HEART LUNG RESUSCITATION CPR","CDM Code","Pro",510,"Clinic",92950,"HEART/LUNG RESUSCITATION CPR",636,318,505.62,540.6,540.6,540.6,534.24,515.16000000000008,508.8,505.62,508.8]
[592548,"POSTUROGRAPHY","CDM Code","Pro",510,"Clinic",92548,"CDP-SOT 6 COND W/I&R",232,116,184.44,197.2,197.2,197.2,194.88,187.92000000000002,185.60000000000002,184.44,185.60000000000002]
[590853,"GROUP PSYCHOTHERAPY NON FAMILY","CDM Code","Pro",510,"Clinic","","",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[590847,"FAMILY PSYCHOTHERAPY W PT","CDM Code","IP/OP",900,"Behavior Health Treatments/Services",90847,"FAMILY PSYTX W/PT 50 MIN",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[590837,"PSYCHOTHERAPY PT  FAM 60 MIN","CDM Code","IP/OP",900,"Behavior Health Treatments/Services",90837,"PSYTX W PT 60 MINUTES",239,119.5,190.005,203.15,203.15,203.15,200.76,193.59,191.20000000000002,190.005,191.20000000000002]
[590792,"PSYCHIATRIC DIAGNOSTIC EVAL W MED SRVCES","CDM Code","IP/OP",900,"Behavior Health Treatments/Services",90792,"PSYCH DIAG EVAL W/MED SRVCS",343,171.5,272.685,291.55,291.55,291.55,288.12,277.83000000000004,274.40000000000003,272.685,274.40000000000003]
[590738,"CL- INACTD JAPANESE ENCEPHALITIS VAX","CDM Code","IP/OP",636,"Drug/Detail Code",90738,"INACTIVATED JE VACC IM",531,265.5,422.14500000000004,451.34999999999997,451.34999999999997,451.34999999999997,446.03999999999996,430.11,424.8,422.14500000000004,424.8]
[590734,"CL- MENACTRA VACCINE","CDM Code","IP/OP",636,"Drug/Detail Code",90734,"MENACWYD/MENACWYCRM VACC IM",330,165,262.35000000000002,280.5,280.5,280.5,277.2,267.3,264,262.35000000000002,264]
[590702,"CL- DT ABSORBED FOR USE IN INDIVID LT 7Y","CDM Code","Pro",510,"Clinic",90702,"DT VACCINE UNDER 7 YRS IM",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[590674,"CL- FLU VAX QUAD FOR 64 YO AND UNDER","CDM Code","IP/OP",636,"Drug/Detail Code",90674,"CCIIV4 VAC NO PRSV 0.5 ML IM",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[590636,"CL- HEPATITIS A  B COMBO ADULT DOSAGE","CDM Code","IP/OP",636,"Drug/Detail Code",90636,"HEP A/HEP B VACC ADULT IM",511,255.5,406.245,434.34999999999997,434.34999999999997,434.34999999999997,429.24,413.91,408.8,406.245,408.8]
[590633,"CL- HEPATITIS A VACCINE PEDI-ADOLESCENT","CDM Code","IP/OP",636,"Drug/Detail Code",90633,"HEPA VACC PED/ADOL 2 DOSE IM",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[590375,"CL- RABIES IMMUNE GLOBULIN 2 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code",90375,"RABIES IG IM/SC",1195,597.5,950.02500000000009,1015.75,1015.75,1015.75,1003.8,967.95,956,950.02500000000009,956]
[585610,"POC INR","CDM Code","IP/OP",300,"Lab",85610,"PROTHROMBIN TIME",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[582270,"BLOOD OCCULT BY PEROXIDASE ACTIVITY","CDM Code","IP/OP",300,"Lab",82270,"OCCULT BLOOD FECES",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[582075,"POC BREATH ETHANOL","CDM Code","IP/OP",300,"Lab",82075,"ASSAY OF BREATH ETHANOL",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[580305,"CL- MAT DRUG URINE 10","CDM Code","IP/OP",300,"Lab",80305,"DRUG TEST PRSMV DIR OPT OBS",31,15.5,24.645,26.349999999999998,26.349999999999998,26.349999999999998,26.04,25.110000000000003,24.8,24.645,24.8]
[578707,"K FLOW FUNCT IMAGE W O DRUG","CDM Code","IP/OP",960,"Professional fees",78707,"K FLOW/FUNCT IMAGE W/O DRUG",99,49.5,78.704999999999998,84.149999999999991,84.149999999999991,84.149999999999991,83.16,80.190000000000012,79.2,78.704999999999998,79.2]
[578320,"NM BONE IMAGING 3 D","CDM Code","IP/OP",960,"Professional fees",78320,"BONE IMAGING (3D)",123,61.5,97.785000000000011,104.55,104.55,104.55,103.32,99.63000000000001,98.4,97.785000000000011,98.4]
[578315,"NM BONE IMAGING 3 PHASE","CDM Code","IP/OP",960,"Professional fees",78315,"BONE IMAGING 3 PHASE",134,67,106.53,113.89999999999999,113.89999999999999,113.89999999999999,112.56,108.54,107.2,106.53,107.2]
[578227,"NM HEPATOBILIARY SYSTEM IMAGING W DRUG","CDM Code","IP/OP",960,"Professional fees",78227,"HEPATOBIL SYST IMAGE W/DRUG",114,57,90.63000000000001,96.899999999999991,96.899999999999991,96.899999999999991,95.759999999999991,92.34,91.2,90.63000000000001,91.2]
[577080,"BD DXA AXIAL","CDM Code","IP/OP",960,"Professional fees",77080,"DXA BONE DENSITY AXIAL",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[577067,"SCR MAMMO BI INCL CAD","CDM Code","IP/OP",960,"Professional fees",77067,"SCR MAMMO BI INCL CAD",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[577066,"DX MAMMO INCL CAD BI","CDM Code","IP/OP",960,"Professional fees",77066,"DX MAMMO INCL CAD BI",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[577012,"CT SCAN NEEDLE BIOPSY","CDM Code","IP/OP",960,"Professional fees",77012,"CT SCAN FOR NEEDLE BIOPSY",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[576998,"US GUIDE INTRAOP","CDM Code","IP/OP",960,"Professional fees",76998,"US GUIDE INTRAOP",119,59.5,94.605000000000004,101.14999999999999,101.14999999999999,101.14999999999999,99.96,96.39,95.2,94.605000000000004,95.2]
[576881,"US EXTREMITY NON-VASCULAR COMPLETE","CDM Code","IP/OP",960,"Professional fees",76881,"US COMPL JOINT R-T W/IMG",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[576872,"US TRANSRECTAL","CDM Code","IP/OP",960,"Professional fees",76872,"US TRANSRECTAL",83,41.5,65.984999999999999,70.55,70.55,70.55,69.72,67.23,66.400000000000006,65.984999999999999,66.400000000000006]
[576830,"US NON-OB TRANSVAGINAL","CDM Code","IP/OP",960,"Professional fees",76830,"TRANSVAGINAL US NON-OB",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[576817,"US OB TRANSVAGINAL","CDM Code","IP/OP",960,"Professional fees",76817,"TRANSVAGINAL US OBSTETRIC",99,49.5,78.704999999999998,84.149999999999991,84.149999999999991,84.149999999999991,83.16,80.190000000000012,79.2,78.704999999999998,79.2]
[576805,"US OB  14 WKS SINGLE FETUS","CDM Code","IP/OP",960,"Professional fees",76805,"OB US >= 14 WKS SNGL FETUS",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[576802,"US OB  14 WKS ADDL FETUS","CDM Code","IP/OP",960,"Professional fees",76802,"OB US < 14 WKS ADDL FETUS",106,53,84.27000000000001,90.1,90.1,90.1,89.039999999999992,85.86,84.800000000000011,84.27000000000001,84.800000000000011]
[576700,"US EXAM ABDOMINAL COMPLETE","CDM Code","IP/OP",960,"Professional fees",76700,"US EXAM ABDOM COMPLETE",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[576498,"MR DIAGNOSTIC INTERVENTIONAL READ","CDM Code","IP/OP",960,"Professional fees",76498,"UNLISTED MR PROCEDURE",200,100,159,170,170,170,168,162,160,159,160]
[576000,"FLUORO EXAMINATION","CDM Code","IP/OP",960,"Professional fees",76000,"FLUOROSCOPY <1 HR PHYS/QHP",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[575989,"XR ABCESS DRAINAGE","CDM Code","IP/OP",960,"Professional fees",75989,"ABSCESS DRAINAGE UNDER X-RAY",144,72,114.48,122.39999999999999,122.39999999999999,122.39999999999999,120.96,116.64000000000001,115.2,114.48,115.2]
[574430,"XR CONTRAST BLADDER","CDM Code","IP/OP",960,"Professional fees",74430,"CONTRAST X-RAY BLADDER",40,20,31.8,34,34,34,33.6,32.400000000000006,32,31.8,32]
[574270,"XR CONTRAST EXAM COLON","CDM Code","IP/OP",960,"Professional fees",74270,"X-RAY XM COLON 1CNTRST STD",86,43,68.37,73.099999999999994,73.099999999999994,73.099999999999994,72.239999999999995,69.660000000000011,68.8,68.37,68.8]
[574230,"XR CIN VID THROAT ESOPHAGUS","CDM Code","IP/OP",960,"Professional fees",74230,"X-RAY XM SWLNG FUNCJ C+",65,32.5,51.675000000000004,55.25,55.25,55.25,54.6,52.650000000000006,52,51.675000000000004,52]
[574220,"XR CONTRAST ESOPHAGUS","CDM Code","IP/OP",960,"Professional fees",74220,"X-RAY XM ESOPHAGUS 1CNTRST",58,29,46.11,49.3,49.3,49.3,48.72,46.980000000000004,46.400000000000006,46.11,46.400000000000006]
[574177,"CT ABDOMEN AND PELVIS W DYE","CDM Code","IP/OP",960,"Professional fees",74177,"CT ABD & PELV W/CONTRAST",229,114.5,182.05500000000001,194.65,194.65,194.65,192.35999999999999,185.49,183.20000000000002,182.05500000000001,183.20000000000002]
[574160,"CT ABDOMEN W DYE","CDM Code","IP/OP",960,"Professional fees",74160,"CT ABDOMEN W/DYE",160,80,127.2,136,136,136,134.4,129.60000000000002,128,127.2,128]
[574018,"XRAY EXAM ABDOMEN 1 VIEW","CDM Code","IP/OP",960,"Professional fees",74018,"X-RAY EXAM ABDOMEN 1 VIEW",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[573723,"MR JOINT LOWER EXTREMITY WWO DYE","CDM Code","IP/OP",960,"Professional fees",73723,"MRI JOINT LWR EXTR W/O&W/DYE",274,137,217.83,232.9,232.9,232.9,230.16,221.94000000000003,219.20000000000002,217.83,219.20000000000002]
[573718,"MR LOWER EXTREMITY WO DYE","CDM Code","IP/OP",960,"Professional fees",73718,"MRI LOWER EXTREMITY W/O DYE",176,88,139.92000000000002,149.6,149.6,149.6,147.84,142.56,140.80000000000001,139.92000000000002,140.80000000000001]
[573660,"XR EXAM TOE S","CDM Code","IP/OP",960,"Professional fees",73660,"X-RAY EXAM OF TOE(S)",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[573610,"XR EXAM ANKLE 3V","CDM Code","IP/OP",960,"Professional fees",73610,"X-RAY EXAM OF ANKLE",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[573600,"XR EXAM ANKLE 2V","CDM Code","IP/OP",960,"Professional fees",73600,"X-RAY EXAM OF ANKLE",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[573562,"XR EXAM KNEE 3V","CDM Code","IP/OP",960,"Professional fees",73562,"X-RAY EXAM OF KNEE 3",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[573522,"X RAY EXAM HIPS BI 3 4 VIEWS","CDM Code","IP/OP",960,"Professional fees",73522,"X-RAY EXAM HIPS BI 3-4 VIEWS",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[573222,"MR JOINT UPPER EXTREMITY W DYE","CDM Code","IP/OP",960,"Professional fees",73222,"MRI JOINT UPR EXTREM W/DYE",216,108,171.72,183.6,183.6,183.6,181.44,174.96,172.8,171.72,172.8]
[573221,"MR JOINT UPPER EXTREMITY WO DYE","CDM Code","IP/OP",960,"Professional fees",73221,"MRI JOINT UPR EXTREM W/O DYE",172,86,136.74,146.19999999999999,146.19999999999999,146.19999999999999,144.47999999999999,139.32000000000002,137.6,136.74,137.6]
[573201,"CT UPPER EXTREMITY W DYE","CDM Code","IP/OP",960,"Professional fees",73201,"CT UPPER EXTREMITY W/DYE",136,68,108.12,115.6,115.6,115.6,114.24,110.16000000000001,108.80000000000001,108.12,108.80000000000001]
[573115,"XR CONTRAST WRIST","CDM Code","IP/OP",960,"Professional fees",73115,"CONTRAST X-RAY OF WRIST",70,35,55.650000000000006,59.5,59.5,59.5,58.8,56.7,56,55.650000000000006,56]
[573080,"XR EXAM ELBOW 3V","CDM Code","IP/OP",960,"Professional fees",73080,"X-RAY EXAM OF ELBOW",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[573070,"XR EXAM ELBOW 2V","CDM Code","IP/OP",960,"Professional fees",73070,"X-RAY EXAM OF ELBOW",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[573010,"XR EXAM SHOULDER BLADE","CDM Code","IP/OP",960,"Professional fees",73010,"X-RAY EXAM OF SHOULDER BLADE",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[572197,"MR PELVIS WWO DYE","CDM Code","IP/OP",960,"Professional fees",72197,"MRI PELVIS W/O & W/DYE",278,139,221.01000000000002,236.29999999999998,236.29999999999998,236.29999999999998,233.51999999999998,225.18,222.4,221.01000000000002,222.4]
[572193,"CT PELVIS W DYE","CDM Code","IP/OP",960,"Professional fees",72193,"CT PELVIS W/DYE",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[572190,"XR EXAM PELVIS 3V","CDM Code","IP/OP",960,"Professional fees",72190,"X-RAY EXAM OF PELVIS",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[572149,"MR LUMBAR SPINE W DYE","CDM Code","IP/OP",960,"Professional fees",72149,"MRI LUMBAR SPINE W/DYE",211,105.5,167.745,179.35,179.35,179.35,177.23999999999998,170.91000000000003,168.8,167.745,168.8]
[572132,"CT LUMBAR SPINE W DYE","CDM Code","IP/OP",960,"Professional fees",72132,"CT LUMBAR SPINE W/DYE",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[572127,"CT NECK SPINE WO AND WDYE","CDM Code","IP/OP",960,"Professional fees",72127,"CT NECK SPINE W/O & W/DYE",136,68,108.12,115.6,115.6,115.6,114.24,110.16000000000001,108.80000000000001,108.12,108.80000000000001]
[572126,"CT NECK SPINE W DYE","CDM Code","IP/OP",960,"Professional fees",72126,"CT NECK SPINE W/DYE",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[572082,"XR SCOLIOSIS 2 V","CDM Code","IP/OP",960,"Professional fees",72082,"X-RAY EXAM ENTIRE SPI 2/3 VW",35,17.5,27.825000000000003,29.75,29.75,29.75,29.4,28.35,28,27.825000000000003,28]
[572050,"XR EXAM NECK SPINE 4V OR 5V","CDM Code","IP/OP",960,"Professional fees",72050,"X-RAY EXAM NECK SPINE 4/5VWS",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[571550,"MR CHEST W O DYE","CDM Code","IP/OP",960,"Professional fees",71550,"MRI CHEST W/O DYE",169,84.5,134.35500000000002,143.65,143.65,143.65,141.96,136.89000000000001,135.20000000000002,134.35500000000002,135.20000000000002]
[571275,"CT ANGIOGRAPHY CHEST","CDM Code","IP/OP",960,"Professional fees",71275,"CT ANGIOGRAPHY CHEST",225,112.5,178.875,191.25,191.25,191.25,189,182.25,180,178.875,180]
[571130,"XR STRENOCLAVIC JOINT 3V","CDM Code","IP/OP",960,"Professional fees",71130,"X-RAY STRENOCLAVIC JT 3/>VWS",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[571100,"XR EXAM RIBS UNILATERAL 2V","CDM Code","IP/OP",960,"Professional fees",71100,"X-RAY EXAM RIBS UNI 2 VIEWS",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[570553,"MR BRAIN STEM WWO DYE","CDM Code","IP/OP",960,"Professional fees",70553,"MRI BRAIN STEM W/O & W/DYE",284,142,225.78,241.4,241.4,241.4,238.56,230.04000000000002,227.20000000000002,225.78,227.20000000000002]
[570552,"MR BRAIN STEM W DYE","CDM Code","IP/OP",960,"Professional fees",70552,"MRI BRAIN STEM W/DYE",251,125.5,199.54500000000002,213.35,213.35,213.35,210.84,203.31,200.8,199.54500000000002,200.8]
[570546,"MRA HEAD WWO DYE 70546","CDM Code","IP/OP",960,"Professional fees",70546,"MR ANGIOGRAPH HEAD W/O&W/DYE",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[570498,"CT ANGIOGRAPHY NECK*","CDM Code","IP/OP",960,"Professional fees",70498,"CT ANGIOGRAPHY NECK",226,113,179.67000000000002,192.1,192.1,192.1,189.84,183.06,180.8,179.67000000000002,180.8]
[570488,"CT MAXILLOFACIAL WWO DYE","CDM Code","IP/OP",960,"Professional fees",70488,"CT MAXILLOFACIAL W/O & W/DYE",158,79,125.61,134.29999999999998,134.29999999999998,134.29999999999998,132.72,127.98,126.4,125.61,126.4]
[570487,"CT MAXILLOFACIAL W DYE","CDM Code","IP/OP",960,"Professional fees",70487,"CT MAXILLOFACIAL W/DYE",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[570460,"CT HEAD BRAIN W DYE","CDM Code","IP/OP",960,"Professional fees",70460,"CT HEAD/BRAIN W/DYE",138,69,109.71000000000001,117.3,117.3,117.3,115.92,111.78,110.4,109.71000000000001,110.4]
[570250,"XR EXAM SKULL","CDM Code","IP/OP",960,"Professional fees",70250,"X-RAY EXAM OF SKULL",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[570160,"XR EXAM NASAL BONES","CDM Code","IP/OP",960,"Professional fees",70160,"X-RAY EXAM OF NASAL BONES",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[570150,"XR EXAM FACIAL BONES","CDM Code","IP/OP",960,"Professional fees",70150,"X-RAY EXAM OF FACIAL BONES",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[569210,"REMOVE IMPACTED CERUMEN","CDM Code","Pro",510,"Clinic",69210,"REMOVE IMPACTED EAR WAX UNI",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[567938,"REMOVE EYELID FOREIGN BODY","CDM Code","Pro",510,"Clinic",67938,"REMOVE EYELID FOREIGN BODY",568,284,451.56,482.8,482.8,482.8,477.12,460.08000000000004,454.40000000000003,451.56,454.40000000000003]
[565205,"REMOVE FOREIGN BODY FROM EYE","CDM Code","Pro",510,"Clinic",65205,"REMOVE FOREIGN BODY FROM EYE",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[564999,"NERVOUS SYSTEM SURGERY","CDM Code","Pro",510,"Clinic",64999,"UNLISTED PX NERVOUS SYSTEM",480,240,381.6,408,408,408,403.2,388.8,384,381.6,384]
[564726,"DECOMPRESSION PLANTAR DIGITAL NERVE","CDM Code","Pro",510,"Clinic",64726,"RELEASE FOOT/TOE NERVE",1156,578,919.0200000000001,982.6,982.6,982.6,971.04,936.36,924.80000000000007,919.0200000000001,924.80000000000007]
[564704,"REVISE HAND FOOT NERVE","CDM Code","Pro",510,"Clinic",64704,"REVISE HAND/FOOT NERVE",1729,864.5,1374.5550000000001,1469.6499999999999,1469.6499999999999,1469.6499999999999,1452.36,1400.49,1383.2,1374.5550000000001,1383.2]
[564488,"TAP BLOCK BI INJECTION","CDM Code","Pro",510,"Clinic",64488,"TAP BLOCK BI INJECTION",343,171.5,272.685,291.55,291.55,291.55,288.12,277.83000000000004,274.40000000000003,272.685,274.40000000000003]
[564486,"TAP BLOCK BY INJECTION","CDM Code","Pro",510,"Clinic",64486,"TAP BLOCK UNIL BY INJECTION",301,150.5,239.29500000000002,255.85,255.85,255.85,252.84,243.81,240.8,239.29500000000002,240.8]
[564450,"NERVE BLOCK PERIPHERAL NERVE","CDM Code","Pro",510,"Clinic",64450,"NJX AA&/STRD OTHER PN/BRANCH",214,107,170.13,181.9,181.9,181.9,179.76,173.34,171.20000000000002,170.13,171.20000000000002]
[564417,"N BLOCK INJ AXILLARY","CDM Code","Pro",510,"Clinic",64417,"NJX AA&/STRD AX NERVE IMG",271,135.5,215.44500000000002,230.35,230.35,230.35,227.64,219.51000000000002,216.8,215.44500000000002,216.8]
[564400,"NERVE BLOCK ANESTHETIC TRIGEMINAL NERVE","CDM Code","Pro",510,"Clinic",64400,"NJX AA&/STRD TRIGEMINAL NRV",266,133,211.47,226.1,226.1,226.1,223.44,215.46,212.8,211.47,212.8]
[563267,"EXCISE INTRSPINL LESION LMBR","CDM Code","Pro",510,"Clinic",63267,"EXCISE INTRSPINL LESION LMBR",2722,1361,2163.9900000000002,2313.6999999999998,2313.6999999999998,2313.6999999999998,2286.48,2204.8200000000002,2177.6,2163.9900000000002,2177.6]
[563042,"LAMINOTOMY SINGLE LUMBAR","CDM Code","Pro",510,"Clinic",63042,"LAMINOTOMY SINGLE LUMBAR",2339,1169.5,1859.5050000000001,1988.1499999999999,1988.1499999999999,1988.1499999999999,1964.76,1894.5900000000001,1871.2,1859.5050000000001,1871.2]
[562321,"NJX INTERLAMINAR CRV THRC","CDM Code","Pro",510,"Clinic",62321,"NJX INTERLAMINAR CRV/THRC",494,247,392.73,419.9,419.9,419.9,414.96,400.14000000000004,395.20000000000005,392.73,395.20000000000005]
[560220,"PARTIAL REMOVAL OF THYROID","CDM Code","Pro",510,"Clinic",60220,"PARTIAL REMOVAL OF THYROID",1416,708,1125.72,1203.5999999999999,1203.5999999999999,1203.5999999999999,1189.44,1146.96,1132.8,1125.72,1132.8]
[560100,"BIOPSY OF THYROID","CDM Code","IP/OP",960,"Professional fees",60100,"BIOPSY OF THYROID",279,139.5,221.80500000000001,237.15,237.15,237.15,234.35999999999999,225.99,223.20000000000002,221.80500000000001,223.20000000000002]
[559821,"TREATMENT OF MISCARRIAGE","CDM Code","Pro",510,"Clinic",59821,"TREATMENT OF MISCARRIAGE",838,419,666.21,712.3,712.3,712.3,703.92,678.78000000000009,670.40000000000009,666.21,670.40000000000009]
[559614,"VBAC CARE AFTER DELIVERY","CDM Code","Pro",510,"Clinic",59614,"VBAC CARE AFTER DELIVERY",2472,1236,1965.24,2101.1999999999998,2101.1999999999998,2101.1999999999998,2076.48,2002.3200000000002,1977.6000000000001,1965.24,1977.6000000000001]
[559514,"CAESAREAN DELIVERY ONLY","CDM Code","Pro",510,"Clinic",59514,"CESAREAN DELIVERY ONLY",4185,2092.5,3327.0750000000003,3557.25,3557.25,3557.25,3515.4,3389.8500000000004,3348,3327.0750000000003,3348]
[559510,"CESAREAN DELIVERY","CDM Code","Pro",510,"Clinic",59510,"CESAREAN DELIVERY",5182,2591,4119.6900000000005,4404.7,4404.7,4404.7,4352.88,4197.42,4145.6000000000004,4119.6900000000005,4145.6000000000004]
[559412,"EXT CEPHALIC VERSION W WO TOCOLYIS","CDM Code","Pro",510,"Clinic",59412,"ANTEPARTUM MANIPULATION",449,224.5,356.95500000000004,381.65,381.65,381.65,377.15999999999997,363.69,359.20000000000005,356.95500000000004,359.20000000000005]
[559200,"INSERT CERVICAL DILATOR","CDM Code","Pro",510,"Clinic",59200,"INSERT CERVICAL DILATOR",143,71.5,113.685,121.55,121.55,121.55,120.11999999999999,115.83000000000001,114.4,113.685,114.4]
[558999,"GENITAL SURGERY PROCEDURE","CDM Code","Pro",510,"Clinic",58999,"UNLISTED PX FML GENITAL SYS",4259,2129.5,3385.9050000000002,3620.15,3620.15,3620.15,3577.56,3449.7900000000004,3407.2000000000003,3385.9050000000002,3407.2000000000003]
[558940,"REMOVAL OF OVARY S","CDM Code","Pro",510,"Clinic",58940,"REMOVAL OF OVARY(S)",972,486,772.74,826.19999999999993,826.19999999999993,826.19999999999993,816.48,787.32,777.6,772.74,777.6]
[558671,"LAPAROSCOPY SURG W OCCLUSION OF","CDM Code","Pro",510,"Clinic",58671,"LAPAROSCOPY TUBAL BLOCK",2284,1142,1815.7800000000002,1941.3999999999999,1941.3999999999999,1941.3999999999999,1918.56,1850.0400000000002,1827.2,1815.7800000000002,1827.2]
[558611,"LIGATION TRANSECTION FALLOPIAN","CDM Code","Pro",510,"Clinic",58611,"LIGATE OVIDUCT(S) ADD-ON",357,178.5,283.815,303.45,303.45,303.45,299.88,289.17,285.60000000000002,283.815,285.60000000000002]
[558570,"TLH UTERUS 250 G OR LESS","CDM Code","Pro",510,"Clinic",58570,"TLH UTERUS 250 G OR LESS",1522,761,1209.99,1293.7,1293.7,1293.7,1278.48,1232.8200000000002,1217.6000000000001,1209.99,1217.6000000000001]
[558563,"HYSTEROSCOPY ABLATION","CDM Code","Pro",510,"Clinic",58563,"HYSTEROSCOPY ABLATION",1160,580,922.2,986,986,986,974.4,939.6,928,922.2,928]
[558552,"LAPARO SURGICAL VAG HYST 250 G OR LESS","CDM Code","Pro",510,"Clinic",58552,"LAPARO-VAG HYST INCL T/O",3009,1504.5,2392.1550000000002,2557.65,2557.65,2557.65,2527.56,2437.29,2407.2000000000003,2392.1550000000002,2407.2000000000003]
[558301,"REMOVAL IUD 58301","CDM Code","Pro",510,"Clinic",58301,"REMOVE INTRAUTERINE DEVICE",405,202.5,321.97500000000002,344.25,344.25,344.25,340.2,328.05,324,321.97500000000002,324]
[558263,"VAGINAL HYSTERECTOMY W TUBAL W REPAIR","CDM Code","Pro",510,"Clinic",58263,"VAG HYST W/T/O & VAG REPAIR",2310,1155,1836.45,1963.5,1963.5,1963.5,1940.3999999999999,1871.1000000000001,1848,1836.45,1848]
[558262,"VAGINAL HYSTERECTOMY INCL T O","CDM Code","Pro",510,"Clinic",58262,"VAG HYST INCLUDING T/O",3884,1942,3087.78,3301.4,3301.4,3301.4,3262.56,3146.0400000000004,3107.2000000000003,3087.78,3107.2000000000003]
[558145,"MYOMECTOMY VAG METHOD","CDM Code","Pro",510,"Clinic",58145,"MYOMECTOMY VAG METHOD",1097,548.5,872.11500000000001,932.44999999999993,932.44999999999993,932.44999999999993,921.48,888.57,877.6,872.11500000000001,877.6]
[557530,"EXCISION CERVIX UTERI","CDM Code","Pro",510,"Clinic",57530,"REMOVAL OF CERVIX",1500,750,1192.5,1275,1275,1275,1260,1215,1200,1192.5,1200]
[557505,"ENDOCERVICAL CURETTAGE","CDM Code","Pro",510,"Clinic",57505,"ENDOCERVICAL CURETTAGE",386,193,306.87,328.09999999999997,328.09999999999997,328.09999999999997,324.24,312.66000000000003,308.8,306.87,308.8]
[557500,"BIOPSY OF THE CERVIX","CDM Code","Pro",510,"Clinic",57500,"BIOPSY OF CERVIX",446,223,354.57,379.09999999999997,379.09999999999997,379.09999999999997,374.64,361.26000000000005,356.8,354.57,356.8]
[557452,"COLPOSCOPY SCREENING","CDM Code","Pro",510,"Clinic",57452,"EXAM OF CERVIX W/SCOPE",385,192.5,306.07499999999999,327.25,327.25,327.25,323.39999999999998,311.85000000000002,308,306.07499999999999,308]
[557287,"REVISE REMOVE SLING REPAIR","CDM Code","Pro",510,"Clinic",57287,"REVISE/REMOVE SLING REPAIR",1706,853,1356.27,1450.1,1450.1,1450.1,1433.04,1381.8600000000001,1364.8000000000002,1356.27,1364.8000000000002]
[557260,"REPAIR OF VAGINA","CDM Code","Pro",510,"Clinic",57260,"CMBN ANT PST COLPRHY",1745,872.5,1387.2750000000001,1483.25,1483.25,1483.25,1465.8,1413.45,1396,1387.2750000000001,1396]
[557250,"REPAIR RECTUM   VAGINA","CDM Code","Pro",510,"Clinic",57250,"REPAIR RECTUM & VAGINA",1648,824,1310.1600000000001,1400.8,1400.8,1400.8,1384.32,1334.88,1318.4,1310.1600000000001,1318.4]
[557160,"INSERT PESSARY","CDM Code","Pro",510,"Clinic",57160,"INSERT PESSARY/OTHER DEVICE",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[557100,"BIOPSY OF VAGINA SIMPLE","CDM Code","Pro",510,"Clinic",57100,"BIOPSY OF VAGINA",518,259,411.81,440.3,440.3,440.3,435.12,419.58000000000004,414.40000000000003,411.81,414.40000000000003]
[556606,"BIOPSY OF VULVA OR PERINEUM ADD ON","CDM Code","Pro",510,"Clinic",56606,"BIOPSY OF VULVA/PERINEUM",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[556605,"BIOPSY OF VULVA OR PERINEUM","CDM Code","Pro",510,"Clinic",56605,"BIOPSY OF VULVA/PERINEUM",281,140.5,223.39500000000001,238.85,238.85,238.85,236.04,227.61,224.8,223.39500000000001,224.8]
[556405,"I  D VULVA ABSCESS","CDM Code","Pro",510,"Clinic",56405,"I & D OF VULVA/PERINEUM",514,257,408.63,436.9,436.9,436.9,431.76,416.34000000000003,411.20000000000005,408.63,411.20000000000005]
[555700,"BIOPSY OF PROSTATE","CDM Code","Pro",510,"Clinic",55700,"BIOPSY OF PROSTATE",569,284.5,452.35500000000002,483.65,483.65,483.65,477.96,460.89000000000004,455.20000000000005,452.35500000000002,455.20000000000005]
[555250,"VASECTOMY BILATERAL","CDM Code","Pro",510,"Clinic",55250,"REMOVAL OF SPERM DUCT(S)",1092,546,868.1400000000001,928.19999999999993,928.19999999999993,928.19999999999993,917.28,884.5200000000001,873.6,868.1400000000001,873.6]
[555150,"REMOVAL OF SCROTUM","CDM Code","Pro",510,"Clinic",55150,"REMOVAL OF SCROTUM",10097,5048.5,8027.1150000000007,8582.4499999999989,8582.4499999999989,8582.4499999999989,8481.48,8178.5700000000006,8077.6,8027.1150000000007,8077.6]
[555000,"PUNC ASPIRATION HYDROCELE TUNICA VAGINAL","CDM Code","Pro",510,"Clinic",55000,"DRAINAGE OF HYDROCELE",335,167.5,266.32499999999999,284.75,284.75,284.75,281.39999999999998,271.35000000000002,268,266.32499999999999,268]
[554700,"DRAINAGE OF SCROTUM","CDM Code","Pro",510,"Clinic",54700,"DRAINAGE OF SCROTUM",478,239,380.01,406.3,406.3,406.3,401.52,387.18,382.40000000000003,380.01,382.40000000000003]
[554450,"PREPUTIAL STRETCHING","CDM Code","Pro",510,"Clinic",54450,"PREPUTIAL STRETCHING",128,64,101.76,108.8,108.8,108.8,107.52,103.68,102.4,101.76,102.4]
[554300,"REVISION OF PENIS","CDM Code","Pro",510,"Clinic",54300,"REVISION OF PENIS",1622,811,1289.49,1378.7,1378.7,1378.7,1362.48,1313.8200000000002,1297.6000000000001,1289.49,1297.6000000000001]
[554065,"DESTRUCTION PENIS LESION(S)","CDM Code","Pro",510,"Clinic",54065,"DESTRUCTION PENIS LESION(S)",2018,1009,1604.3100000000002,1715.3,1715.3,1715.3,1695.12,1634.5800000000002,1614.4,1604.3100000000002,1614.4]
[553620,"DILATE URETHRA STRICTURE","CDM Code","Pro",510,"Clinic",53620,"DILATE URETHRA STRICTURE",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[553450,"REVISION OF URETHRA","CDM Code","Pro",510,"Clinic",53450,"REVISION OF URETHRA",1354,677,1076.43,1150.8999999999999,1150.8999999999999,1150.8999999999999,1137.3599999999999,1096.74,1083.2,1076.43,1083.2]
[553275,"EXCISION OR FULGURATION URETHRAL PROLAPS","CDM Code","Pro",510,"Clinic",53275,"REPAIR OF URETHRA DEFECT",559,279.5,444.40500000000003,475.15,475.15,475.15,469.56,452.79,447.20000000000005,444.40500000000003,447.20000000000005]
[552500,"TRANSURETHRAL RESECTION BLADDER NECK","CDM Code","Pro",510,"Clinic",52500,"REVISION OF BLADDER NECK",1473,736.5,1171.0350000000001,1252.05,1252.05,1252.05,1237.32,1193.1300000000001,1178.4000000000001,1171.0350000000001,1178.4000000000001]
[552353,"CYSTOURETERO WITH LITHOTRIPSY","CDM Code","Pro",510,"Clinic",52353,"CYSTOURETERO W/LITHOTRIPSY",1694,847,1346.73,1439.8999999999999,1439.8999999999999,1439.8999999999999,1422.96,1372.14,1355.2,1346.73,1355.2]
[552341,"CYSTO W URETER STRICTURE TX","CDM Code","Pro",510,"Clinic",52341,"CYSTO W/URETER STRICTURE TX",603,301.5,479.38500000000005,512.54999999999995,512.54999999999995,512.54999999999995,506.52,488.43,482.40000000000003,479.38500000000005,482.40000000000003]
[552332,"CYSTOSCOPY TX  INSERT INDWELLING STENT","CDM Code","Pro",510,"Clinic",52332,"CYSTOSCOPY AND TREATMENT",742,371,589.89,630.69999999999993,630.69999999999993,630.69999999999993,623.28,601.0200000000001,593.6,589.89,593.6]
[552315,"CYSTOURETHROSCOPY W REM FGN BODY COMPLIC","CDM Code","Pro",510,"Clinic",52315,"CYSTOSCOPY AND TREATMENT",1140,570,906.30000000000007,969,969,969,957.59999999999991,923.40000000000009,912,906.30000000000007,912]
[552276,"CYSTOSCOPY AND TREATMENT","CDM Code","Pro",510,"Clinic",52276,"CYSTOSCOPY AND TREATMENT",543,271.5,431.685,461.55,461.55,461.55,456.12,439.83000000000004,434.40000000000003,431.685,434.40000000000003]
[552250,"CYSTOSCOPY AND RADIOTRACER","CDM Code","Pro",510,"Clinic",52250,"CYSTOSCOPY AND RADIOTRACER",533,266.5,423.73500000000001,453.05,453.05,453.05,447.71999999999997,431.73,426.40000000000003,423.73500000000001,426.40000000000003]
[552240,"CYSTOURETHROSCOPY W FULGURATION OR RESEC","CDM Code","Pro",510,"Clinic",52240,"CYSTOSCOPY AND TREATMENT",1376,688,1093.92,1169.5999999999999,1169.5999999999999,1169.5999999999999,1155.8399999999999,1114.5600000000002,1100.8,1093.92,1100.8]
[552204,"CYSTOURETHROSCOPY WITH BIOPSY","CDM Code","Pro",510,"Clinic",52204,"CYSTOSCOPY W/BIOPSY(S)",673,336.5,535.03500000000008,572.04999999999995,572.04999999999995,572.04999999999995,565.31999999999994,545.13,538.4,535.03500000000008,538.4]
[551992,"LAPARO SLING OPERATION","CDM Code","Pro",510,"Clinic",51992,"LAPARO SLING OPERATION",3169,1584.5,2519.355,2693.65,2693.65,2693.65,2661.96,2566.8900000000003,2535.2000000000003,2519.355,2535.2000000000003]
[551710,"CHANGE OF BLADDER TUBE","CDM Code","Pro",510,"Clinic",51710,"CHANGE OF BLADDER TUBE",297,148.5,236.11500000000001,252.45,252.45,252.45,249.48,240.57000000000002,237.60000000000002,236.11500000000001,237.60000000000002]
[551705,"CHANGE OF BLADDER TUBE","CDM Code","Pro",510,"Clinic",51705,"CHANGE OF BLADDER TUBE",178,89,141.51000000000002,151.29999999999998,151.29999999999998,151.29999999999998,149.51999999999998,144.18,142.4,141.51000000000002,142.4]
[551525,"REMOVAL OF BLADDER LESION","CDM Code","Pro",510,"Clinic",51525,"REMOVAL OF BLADDER LESION",1735,867.5,1379.325,1474.75,1474.75,1474.75,1457.3999999999999,1405.3500000000001,1388,1379.325,1388]
[551050,"REMOVAL OF BLADDER STONE","CDM Code","Pro",510,"Clinic",51050,"REMOVAL OF BLADDER STONE",1092,546,868.1400000000001,928.19999999999993,928.19999999999993,928.19999999999993,917.28,884.5200000000001,873.6,868.1400000000001,873.6]
[550549,"LAPAROSCOPE PROC RENAL","CDM Code","Pro",510,"Clinic",50549,"UNLISTED LAPS PX RENAL",3104,1552,2467.6800000000003,2638.4,2638.4,2638.4,2607.36,2514.2400000000002,2483.2000000000003,2467.6800000000003,2483.2000000000003]
[550548,"LAPARO REMOVE W URETER","CDM Code","Pro",510,"Clinic",50548,"LAPARO REMOVE W/URETER",2460,1230,1955.7,2091,2091,2091,2066.4,1992.6000000000001,1968,1955.7,1968]
[550542,"LAPARO ABLATE RENAL MASS","CDM Code","Pro",510,"Clinic",50542,"LAPARO ABLATE RENAL MASS",2467,1233.5,1961.2650000000001,2096.9499999999998,2096.9499999999998,2096.9499999999998,2072.2799999999997,1998.2700000000002,1973.6000000000001,1961.2650000000001,1973.6000000000001]
[550384,"REMOVE INDWELLING URETER STENT PERCUTAN","CDM Code","Pro",510,"Clinic",50384,"REMOVE URETER STENT PERCUT",1363,681.5,1083.585,1158.55,1158.55,1158.55,1144.9199999999998,1104.03,1090.4000000000001,1083.585,1090.4000000000001]
[549999,"ABDOMEN SURGERY UNLISTED","CDM Code","Pro",510,"Clinic",49999,"UNLISTED PX ABD PERTM&OMN",1313,656.5,1043.835,1116.05,1116.05,1116.05,1102.92,1063.53,1050.4000000000001,1043.835,1050.4000000000001]
[549905,"OMENTAL FLAP INTRA ABDOM","CDM Code","Pro",510,"Clinic",49905,"OMENTAL FLAP INTRA-ABDOM",660,330,524.70000000000005,561,561,561,554.4,534.6,528,524.70000000000005,528]
[549654,"LAP INC HERNIA REPAIR","CDM Code","Pro",510,"Clinic",49654,"LAP INC HERNIA REPAIR",2009,1004.5,1597.155,1707.6499999999999,1707.6499999999999,1707.6499999999999,1687.56,1627.2900000000002,1607.2,1597.155,1607.2]
[549593,"RPR AA HERNIA 1ST 3-10 CM REDUCIBLE","CDM Code","IP/OP",960,"Professional fees",49593,"RPR AA HRN 1ST 3-10 RDC",1677,838.5,1333.2150000000001,1425.45,1425.45,1425.45,1408.6799999999998,1358.3700000000001,1341.6000000000001,1333.2150000000001,1341.6000000000001]
[549568,"IMPLANT OF MESH OR OTHER PROSTH","CDM Code","Pro",510,"Clinic",49568,"HERNIA REPAIR W/MESH",1238,619,984.21,1052.3,1052.3,1052.3,1039.92,1002.7800000000001,990.40000000000009,984.21,990.40000000000009]
[549566,"REREPAIR VENTRL HERN BLOCK","CDM Code","Pro",510,"Clinic",49566,"REREPAIR VENTRL HERN BLOCK",1753,876.5,1393.635,1490.05,1490.05,1490.05,1472.52,1419.93,1402.4,1393.635,1402.4]
[549550,"REPAIR FEM HERNIA INIT REDUCE","CDM Code","Pro",510,"Clinic",49550,"RPR REM HERNIA INIT REDUCE",1263,631.5,1004.085,1073.55,1073.55,1073.55,1060.92,1023.0300000000001,1010.4000000000001,1004.085,1010.4000000000001]
[549505,"REPAIR INIT INGUINAL HERNIA AGE","CDM Code","Pro",510,"Clinic",49505,"PRP I/HERN INIT REDUC >5 YR",2657,1328.5,2112.3150000000001,2258.4499999999998,2258.4499999999998,2258.4499999999998,2231.88,2152.17,2125.6,2112.3150000000001,2125.6]
[549322,"LAPAROSCOPY ASPIRATION","CDM Code","Pro",510,"Clinic",49322,"LAPAROSCOPY ASPIRATION",777,388.5,617.71500000000003,660.44999999999993,660.44999999999993,660.44999999999993,652.67999999999995,629.37,621.6,617.71500000000003,621.6]
[549321,"LAPAROSCOPY BIOPSY","CDM Code","Pro",510,"Clinic",49321,"LAPAROSCOPY BIOPSY",862,431,685.29000000000008,732.69999999999993,732.69999999999993,732.69999999999993,724.07999999999993,698.22,689.6,685.29000000000008,689.6]
[549082,"ABDOMINAL PARACENTESIS WO IMAGING GUID","CDM Code","Pro",510,"Clinic",49082,"ABD PARACENTESIS",350,175,278.25,297.5,297.5,297.5,294,283.5,280,278.25,280]
[547564,"LAP SURG CHOLECYST W EXPLOR DUCT","CDM Code","Pro",510,"Clinic",47564,"LAPARO CHOLECYSTECTOMY/EXPLR",2014,1007,1601.13,1711.8999999999999,1711.8999999999999,1711.8999999999999,1691.76,1631.3400000000001,1611.2,1601.13,1611.2]
[547001,"NEEDLE BIOPSY LIVER ADDON W MJR PROCEDUR","CDM Code","Pro",510,"Clinic",47001,"NEEDLE BIOPSY LIVER ADD-ON",226,113,179.67000000000002,192.1,192.1,192.1,189.84,183.06,180.8,179.67000000000002,180.8]
[547000,"NEEDLE BIOPSY OF LIVER","CDM Code","IP/OP",960,"Professional fees",47000,"NEEDLE BIOPSY OF LIVER",898,449,713.91000000000008,763.3,763.3,763.3,754.31999999999994,727.38,718.40000000000009,713.91000000000008,718.40000000000009]
[546910,"DESTRUCTION ANAL LESION S","CDM Code","Pro",510,"Clinic",46910,"DESTRUCTION ANAL LESION(S)",520,260,413.40000000000003,442,442,442,436.8,421.20000000000005,416,413.40000000000003,416]
[546320,"REMOVAL OF HEMORRHOID CLOT","CDM Code","Pro",510,"Clinic",46320,"REMOVAL OF HEMORRHOID CLOT",389,194.5,309.255,330.65,330.65,330.65,326.76,315.09000000000003,311.20000000000005,309.255,311.20000000000005]
[546255,"REMOVE INT EXT HEM 1 GROUP","CDM Code","Pro",510,"Clinic",46255,"REMOVE INT/EXT HEM 1 GROUP",1091,545.5,867.34500000000003,927.35,927.35,927.35,916.43999999999994,883.71,872.80000000000007,867.34500000000003,872.80000000000007]
[546250,"REMOVE EXT HEM GROUPS 2","CDM Code","Pro",510,"Clinic",46250,"REMOVE EXT HEM GROUPS 2+",982,491,780.69,834.69999999999993,834.69999999999993,834.69999999999993,824.88,795.42000000000007,785.6,780.69,785.6]
[546050,"I D PERIANAL ABSCESS","CDM Code","Pro",510,"Clinic",46050,"INCISION OF ANAL ABSCESS",347,173.5,275.86500000000001,294.95,294.95,294.95,291.47999999999996,281.07,277.60000000000002,275.86500000000001,277.60000000000002]
[545398,"COLONOSCOPY W BAND LIGATION","CDM Code","Pro",510,"Clinic",45398,"COLONOSCOPY W/BAND LIGATION",713,356.5,566.83500000000004,606.04999999999995,606.04999999999995,606.04999999999995,598.91999999999996,577.53000000000009,570.4,566.83500000000004,570.4]
[545384,"COLONOSCOPY FLEX PROX-SPLENIC","CDM Code","Pro",510,"Clinic",45384,"COLONOSCOPY W/LESION REMOVAL",1090,545,866.55000000000007,926.5,926.5,926.5,915.6,882.90000000000009,872,866.55000000000007,872]
[545382,"COLONOSCOPY W CONTROL BLEED","CDM Code","Pro",510,"Clinic",45382,"COLONOSCOPY W/CONTROL BLEED",1244,622,988.98,1057.3999999999999,1057.3999999999999,1057.3999999999999,1044.96,1007.6400000000001,995.2,988.98,995.2]
[545350,"SGMDSC W BAND LIGATION","CDM Code","Pro",510,"Clinic",45350,"SGMDSC W/BAND LIGATION",1024,512,814.08,870.4,870.4,870.4,860.16,829.44,819.2,814.08,819.2]
[545321,"PROCTOSIGMOIDOSCOPY VOLVUL","CDM Code","Pro",510,"Clinic",45321,"PROCTOSIGMOIDOSCOPY VOLVUL",194,97,154.23000000000002,164.9,164.9,164.9,162.96,157.14000000000001,155.20000000000002,154.23000000000002,155.20000000000002]
[544970,"LAPAROSCOPY SURG APPENDECTOMY","CDM Code","Pro",510,"Clinic",44970,"LAPAROSCOPY APPENDECTOMY",2802,1401,2227.59,2381.6999999999998,2381.6999999999998,2381.6999999999998,2353.6799999999998,2269.6200000000003,2241.6,2227.59,2241.6]
[544950,"APPENDECTOMY","CDM Code","Pro",510,"Clinic",44950,"APPENDECTOMY",2651,1325.5,2107.5450000000001,2253.35,2253.35,2253.35,2226.8399999999997,2147.31,2120.8000000000002,2107.5450000000001,2120.8000000000002]
[544680,"INTESTINAL PLICATION","CDM Code","Pro",510,"Clinic",44680,"SURGICAL REVISION INTESTINE",2937,1468.5,2334.915,2496.4499999999998,2496.4499999999998,2496.4499999999998,2467.08,2378.9700000000003,2349.6,2334.915,2349.6]
[544620,"REPAIR BOWEL OPENING","CDM Code","Pro",510,"Clinic",44620,"REPAIR BOWEL OPENING",1916,958,1523.22,1628.6,1628.6,1628.6,1609.4399999999998,1551.96,1532.8000000000002,1523.22,1532.8000000000002]
[544389,"COLONOSCOPY WITH BIOPSY","CDM Code","Pro",510,"Clinic",44389,"COLONOSCOPY WITH BIOPSY",877,438.5,697.21500000000003,745.44999999999993,745.44999999999993,745.44999999999993,736.68,710.37,701.6,697.21500000000003,701.6]
[544388,"COLONOSCOPY THRU STOMA SPX","CDM Code","Pro",510,"Clinic",44388,"COLONOSCOPY THRU STOMA SPX",714,357,567.63,606.9,606.9,606.9,599.76,578.34,571.20000000000005,567.63,571.20000000000005]
[544202,"LAP ENTERECTOMY","CDM Code","Pro",510,"Clinic",44202,"LAP ENTERECTOMY",8188,4094,6509.46,6959.8,6959.8,6959.8,6877.92,6632.2800000000007,6550.4000000000005,6509.46,6550.4000000000005]
[544145,"PARTIAL REMOVAL OF COLON","CDM Code","Pro",510,"Clinic",44145,"PARTIAL REMOVAL OF COLON",3004,1502,2388.1800000000003,2553.4,2553.4,2553.4,2523.36,2433.2400000000002,2403.2000000000003,2388.1800000000003,2403.2000000000003]
[544139,"MOBILIZATION OF COLON","CDM Code","Pro",510,"Clinic",44139,"MOBILIZATION OF COLON",444,222,352.98,377.4,377.4,377.4,372.96,359.64000000000004,355.20000000000005,352.98,355.20000000000005]
[544125,"REMOVAL OF SMALL INTESTINE","CDM Code","Pro",510,"Clinic",44125,"REMOVAL OF SMALL INTESTINE",2595,1297.5,2063.0250000000001,2205.75,2205.75,2205.75,2179.7999999999997,2101.9500000000003,2076,2063.0250000000001,2076]
[543753,"TX GASTRO INTUB W ASP","CDM Code","Pro",510,"Clinic",43753,"TX GASTRO INTUB W/ASP",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[543251,"UPPER GI ENDOSCOPY WITH REMOVAL OF TUMOR","CDM Code","Pro",510,"Clinic",43251,"EGD REMOVE LESION SNARE",710,355,564.45000000000005,603.5,603.5,603.5,596.4,575.1,568,564.45000000000005,568]
[543246,"EGD PLACE GASTROSTOMY TUBE","CDM Code","Pro",510,"Clinic",43246,"EGD PLACE GASTROSTOMY TUBE",497,248.5,395.11500000000001,422.45,422.45,422.45,417.47999999999996,402.57000000000005,397.6,395.11500000000001,397.6]
[543245,"EGD DILATE STRICTURE","CDM Code","Pro",510,"Clinic",43245,"EGD DILATE STRICTURE",1392,696,1106.6400000000001,1183.2,1183.2,1183.2,1169.28,1127.52,1113.6000000000001,1106.6400000000001,1113.6000000000001]
[543215,"ESOPHAGOSCOPY FLEX REMOVE FB","CDM Code","Pro",510,"Clinic",43215,"ESOPHAGOSCOPY FLEX REMOVE FB",675,337.5,536.625,573.75,573.75,573.75,567,546.75,540,536.625,540]
[541800,"DRAINAGE OF GUM LESION","CDM Code","Pro",510,"Clinic",41800,"DRAINAGE OF GUM LESION",423,211.5,336.28500000000003,359.55,359.55,359.55,355.32,342.63,338.40000000000003,336.28500000000003,338.40000000000003]
[538571,"LAPAROSCOPY LYMPHADENECTOMY","CDM Code","Pro",510,"Clinic",38571,"LAPAROSCOPY LYMPHADENECTOMY",3531,1765.5,2807.145,3001.35,3001.35,3001.35,2966.04,2860.11,2824.8,2807.145,2824.8]
[538570,"LAPAROSCOPY LYMPH NODE BIOP","CDM Code","Pro",510,"Clinic",38570,"LAPAROSCOPY LYMPH NODE BIOP",1017,508.5,808.51499999999999,864.44999999999993,864.44999999999993,864.44999999999993,854.28,823.7700000000001,813.6,808.51499999999999,813.6]
[538222,"DX BONE MARROW BX AND ASPIR","CDM Code","Pro",510,"Clinic",38222,"DX BONE MARROW BX & ASPIR",332,166,263.94,282.2,282.2,282.2,278.88,268.92,265.60000000000002,263.94,265.60000000000002]
[536680,"PLACE NEEDLE FOR INTRAOSSEOUS INFUSION","CDM Code","Pro",510,"Clinic",36680,"INSERT NEEDLE BONE CAVITY",152,76,120.84,129.19999999999999,129.19999999999999,129.19999999999999,127.67999999999999,123.12,121.60000000000001,120.84,121.60000000000001]
[536573,"INSJ PICC RS&I 5YR+","CDM Code","Pro",510,"Clinic",36573,"INSJ PICC RS&I 5 YR+",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[536569,"INSERT PICC CATH","CDM Code","Pro",510,"Clinic",36569,"INSJ PICC 5 YR+ W/O IMAGING",342,171,271.89,290.7,290.7,290.7,287.27999999999997,277.02000000000004,273.60000000000002,271.89,273.60000000000002]
[536556,"INSERT NONTUNNEL CV CATH GT 5 YEARS OLD","CDM Code","Pro",510,"Clinic",36556,"INSERT NON-TUNNEL CV CATH",402,201,319.59000000000003,341.7,341.7,341.7,337.68,325.62,321.60000000000002,319.59000000000003,321.60000000000002]
[536406,"VENIPUNCTURE YOUNGER THAN AGE 3YRS","CDM Code","Pro",510,"Clinic",36406,"BL DRAW <3 YRS OTHER VEIN",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[534248,"EGD GUIDE WIRE INSERTION","CDM Code","Pro",510,"Clinic",43248,"EGD GUIDE WIRE INSERTION",886,443,704.37,753.1,753.1,753.1,744.24,717.66000000000008,708.80000000000007,704.37,708.80000000000007]
[533016,"PERICARDIOCENTESIS","CDM Code","Pro",510,"Clinic",33016,"PERICARDIOCENTESIS W/IMAGING",1664,832,1322.88,1414.3999999999999,1414.3999999999999,1414.3999999999999,1397.76,1347.8400000000001,1331.2,1322.88,1331.2]
[532550,"INSERT PLEURAL CATHETER","CDM Code","Pro",510,"Clinic",32550,"INSERT PLEURAL CATH",977,488.5,776.71500000000003,830.44999999999993,830.44999999999993,830.44999999999993,820.68,791.37,781.6,776.71500000000003,781.6]
[531575,"DIAGNOSTIC LARYNGOSCOPY","CDM Code","Pro",510,"Clinic",31575,"DIAGNOSTIC LARYNGOSCOPY",231,115.5,183.64500000000001,196.35,196.35,196.35,194.04,187.11,184.8,183.64500000000001,184.8]
[530903,"CONTROL NASAL HEMORRHAGE ANTERIOR COMPLE","CDM Code","Pro",510,"Clinic",30903,"CONTROL OF NOSEBLEED",367,183.5,291.76499999999999,311.95,311.95,311.95,308.27999999999997,297.27000000000004,293.60000000000002,291.76499999999999,293.60000000000002]
[530901,"CONTROL NASAL HEMORRHAGE ANTER","CDM Code","Pro",510,"Clinic",30901,"CONTROL OF NOSEBLEED",265,132.5,210.67500000000001,225.25,225.25,225.25,222.6,214.65,212,210.67500000000001,212]
[529895,"ANKLE ARTHROSCOPY SURGERY","CDM Code","Pro",510,"Clinic",29895,"ANKLE ARTHROSCOPY/SURGERY",1034,517,822.03000000000009,878.9,878.9,878.9,868.56,837.54000000000008,827.2,822.03000000000009,827.2]
[529884,"ARTHROSCOPY KNEE SURGICAL W LYSIS OF ADH","CDM Code","Pro",510,"Clinic",29884,"KNEE ARTHROSCOPY/SURGERY",1855,927.5,1474.7250000000001,1576.75,1576.75,1576.75,1558.2,1502.5500000000002,1484,1474.7250000000001,1484]
[529879,"KNEE ARTHROSCOPY SURGERY","CDM Code","Pro",510,"Clinic",29879,"KNEE ARTHROSCOPY/SURGERY",1599,799.5,1271.2050000000002,1359.1499999999999,1359.1499999999999,1359.1499999999999,1343.1599999999999,1295.19,1279.2,1271.2050000000002,1279.2]
[529877,"ARTHOSCOPY KNEE SURGICAL DEBRIDEMENT SHA","CDM Code","Pro",510,"Clinic",29877,"KNEE ARTHROSCOPY/SURGERY",2273,1136.5,1807.0350000000001,1932.05,1932.05,1932.05,1909.32,1841.13,1818.4,1807.0350000000001,1818.4]
[529870,"KNEE ARTHROSCOPY DX","CDM Code","Pro",510,"Clinic",29870,"KNEE ARTHROSCOPY DX",1248,624,992.16000000000008,1060.8,1060.8,1060.8,1048.32,1010.8800000000001,998.40000000000009,992.16000000000008,998.40000000000009]
[529834,"ELBOW ARTHROSCOPY SURGERY","CDM Code","Pro",510,"Clinic",29834,"ELBOW ARTHROSCOPY/SURGERY",938,469,745.71,797.3,797.3,797.3,787.92,759.78000000000009,750.40000000000009,745.71,750.40000000000009]
[529824,"ARTHOSCOPY SHOULDER SURGICAL DISTAL CLAV","CDM Code","Pro",510,"Clinic",29824,"SHO ARTHRS SRG DSTL CLAVICLC",2981,1490.5,2369.895,2533.85,2533.85,2533.85,2504.04,2414.61,2384.8000000000002,2369.895,2384.8000000000002]
[529823,"ARTHOSCOPY SHOULDER SURGICAL DEBRIDEMENT","CDM Code","Pro",510,"Clinic",29823,"SHO ARTHRS SRG XTNSV DBRDMT",2356,1178,1873.02,2002.6,2002.6,2002.6,1979.04,1908.3600000000001,1884.8000000000002,1873.02,1884.8000000000002]
[529806,"SHOULDER ARTHROSCOPY SURGERY","CDM Code","Pro",510,"Clinic",29806,"SHO ARTHRS SRG CAPSULORRAPHY",2132,1066,1694.94,1812.2,1812.2,1812.2,1790.8799999999999,1726.92,1705.6000000000001,1694.94,1705.6000000000001]
[529530,"STRAPPING OF KNEE","CDM Code","Pro",510,"Clinic",29530,"STRAPPING OF KNEE",112,56,89.04,95.2,95.2,95.2,94.08,90.72,89.600000000000009,89.04,89.600000000000009]
[529445,"APPLY RIGID LEG CAST","CDM Code","Pro",510,"Clinic",29445,"APPLY RIGID LEG CAST",242,121,192.39000000000001,205.7,205.7,205.7,203.28,196.02,193.60000000000002,192.39000000000001,193.60000000000002]
[529435,"APPLY SHORT LEG CAST  PTB","CDM Code","Pro",510,"Clinic",29435,"APPLY SHORT LEG CAST",268,134,213.06,227.79999999999998,227.79999999999998,227.79999999999998,225.12,217.08,214.4,213.06,214.4]
[529240,"STRAPPING OF SHOULDER","CDM Code","Pro",510,"Clinic",29240,"STRAPPING OF SHOULDER",91,45.5,72.344999999999999,77.349999999999994,77.349999999999994,77.349999999999994,76.44,73.710000000000008,72.8,72.344999999999999,72.8]
[529105,"ARM SPLINT LONG","CDM Code","Pro",510,"Clinic",29105,"APPLY LONG ARM SPLINT",227,113.5,180.465,192.95,192.95,192.95,190.68,183.87,181.60000000000002,180.465,181.60000000000002]
[528825,"PARTIAL AMPUTATION OF TOE","CDM Code","Pro",510,"Clinic",28825,"PARTIAL AMPUTATION OF TOE",1123,561.5,892.78500000000008,954.55,954.55,954.55,943.31999999999994,909.63000000000011,898.40000000000009,892.78500000000008,898.40000000000009]
[528820,"AMPUTATION TOE METATARSO-PHALA","CDM Code","Pro",510,"Clinic",28820,"AMPUTATION OF TOE",1285,642.5,1021.575,1092.25,1092.25,1092.25,1079.3999999999999,1040.8500000000001,1028,1021.575,1028]
[528740,"ARTHRODESIS GREAT TOE METATARSOPHALANGEA","CDM Code","Pro",510,"Clinic",28740,"FUSION OF FOOT BONES",1729,864.5,1374.5550000000001,1469.6499999999999,1469.6499999999999,1469.6499999999999,1452.36,1400.49,1383.2,1374.5550000000001,1383.2]
[528715,"ARTHRODESIS TRIPLE","CDM Code","Pro",510,"Clinic",28715,"FUSION OF FOOT BONES",2113,1056.5,1679.835,1796.05,1796.05,1796.05,1774.9199999999998,1711.5300000000002,1690.4,1679.835,1690.4]
[528645,"REPAIR TOE DISLOCATION","CDM Code","Pro",510,"Clinic",28645,"REPAIR TOE DISLOCATION",1418,709,1127.31,1205.3,1205.3,1205.3,1191.1199999999999,1148.5800000000002,1134.4000000000001,1127.31,1134.4000000000001]
[528630,"TREAT TOE DISLOCATION","CDM Code","Pro",510,"Clinic",28630,"TREAT TOE DISLOCATION",351,175.5,279.04500000000002,298.34999999999997,298.34999999999997,298.34999999999997,294.83999999999997,284.31,280.8,279.04500000000002,280.8]
[528505,"OPEN TX GREAT TOE FX INC INTERNAL FIX","CDM Code","Pro",510,"Clinic",28505,"TREAT BIG TOE FRACTURE",1449,724.5,1151.9550000000002,1231.6499999999999,1231.6499999999999,1231.6499999999999,1217.1599999999999,1173.69,1159.2,1151.9550000000002,1159.2]
[528465,"OPEN TX TARSAL BONE FX INC INT FIX EACH","CDM Code","Pro",510,"Clinic",28465,"TREAT MIDFOOT FRACTURE EACH",1375,687.5,1093.125,1168.75,1168.75,1168.75,1155,1113.75,1100,1093.125,1100]
[528315,"REMOVAL OF SESAMOID BONE","CDM Code","Pro",510,"Clinic",28315,"REMOVAL OF SESAMOID BONE",1559,779.5,1239.405,1325.1499999999999,1325.1499999999999,1325.1499999999999,1309.56,1262.7900000000002,1247.2,1239.405,1247.2]
[528313,"REPAIR DEFORMITY OF TOE","CDM Code","Pro",510,"Clinic",28313,"REPAIR DEFORMITY OF TOE",1611,805.5,1280.7450000000001,1369.35,1369.35,1369.35,1353.24,1304.9100000000001,1288.8000000000002,1280.7450000000001,1288.8000000000002]
[528300,"OSTEOTOMY CALCANEUS W/WO INTERNAL FIXAT","CDM Code","Pro",510,"Clinic",28300,"INCISION OF HEEL BONE",2223,1111.5,1767.2850000000001,1889.55,1889.55,1889.55,1867.32,1800.63,1778.4,1767.2850000000001,1778.4]
[528295,"CORRECTION HALLUX VALGUS","CDM Code","Pro",510,"Clinic",28295,"CORRECTION HALLUX VALGUS",2111,1055.5,1678.2450000000001,1794.35,1794.35,1794.35,1773.24,1709.91,1688.8000000000002,1678.2450000000001,1688.8000000000002]
[528285,"CORRECTION HAMMERTOE","CDM Code","Pro",510,"Clinic",28285,"REPAIR OF HAMMERTOE",1817,908.5,1444.5150000000001,1544.45,1544.45,1544.45,1526.28,1471.7700000000002,1453.6000000000001,1444.5150000000001,1453.6000000000001]
[528270,"RELEASE OF FOOT CONTRACTURE","CDM Code","Pro",510,"Clinic",28270,"RELEASE OF FOOT CONTRACTURE",1605,802.5,1275.9750000000001,1364.25,1364.25,1364.25,1348.2,1300.0500000000002,1284,1275.9750000000001,1284]
[528225,"RELEASE OF FOOT TENDON","CDM Code","Pro",510,"Clinic",28225,"RELEASE OF FOOT TENDON",1031,515.5,819.6450000000001,876.35,876.35,876.35,866.04,835.11,824.80000000000007,819.6450000000001,824.80000000000007]
[528192,"REMOVAL OF FOOT FOREIGN BODY","CDM Code","Pro",510,"Clinic",28192,"REMOVAL OF FOOT FOREIGN BODY",974,487,774.33,827.9,827.9,827.9,818.16,788.94,779.2,774.33,779.2]
[528122,"PARTIAL EXC BONE TARSAL OR META","CDM Code","Pro",510,"Clinic",28122,"PARTIAL REMOVAL OF FOOT BONE",1828,914,1453.26,1553.8,1553.8,1553.8,1535.52,1480.68,1462.4,1453.26,1462.4]
[528120,"PART REMOVAL OF ANKLE HEEL","CDM Code","Pro",510,"Clinic",28120,"PART REMOVAL OF ANKLE/HEEL",2372,1186,1885.74,2016.2,2016.2,2016.2,1992.48,1921.3200000000002,1897.6000000000001,1885.74,1897.6000000000001]
[528113,"PART REMOVAL OF METATARSAL","CDM Code","Pro",510,"Clinic",28113,"PART REMOVAL OF METATARSAL",1452,726,1154.3400000000001,1234.2,1234.2,1234.2,1219.68,1176.1200000000001,1161.6000000000001,1154.3400000000001,1161.6000000000001]
[528108,"REMOVAL OF TOE LESIONS","CDM Code","Pro",510,"Clinic",28108,"REMOVAL OF TOE LESIONS",1045,522.5,830.77500000000009,888.25,888.25,888.25,877.8,846.45,836,830.77500000000009,836]
[528092,"REMOVAL OF TOE LESIONS","CDM Code","Pro",510,"Clinic",28092,"REMOVAL OF TOE LESIONS",1935,967.5,1538.325,1644.75,1644.75,1644.75,1625.3999999999999,1567.3500000000001,1548,1538.325,1548]
[528090,"EXC LESION TENDON SHEATH OR C","CDM Code","Pro",510,"Clinic",28090,"REMOVAL OF FOOT LESION",2252,1126,1790.3400000000001,1914.2,1914.2,1914.2,1891.6799999999998,1824.1200000000001,1801.6000000000001,1790.3400000000001,1801.6000000000001]
[528054,"BIOSPY OF TOE JOINT LINING","CDM Code","Pro",510,"Clinic",28054,"BIOPSY OF TOE JOINT LINING",772,386,613.74,656.19999999999993,656.19999999999993,656.19999999999993,648.48,625.32000000000005,617.6,613.74,617.6]
[528039,"EXC FOOT TOE TUM SC 1 5 CM","CDM Code","Pro",510,"Clinic",28039,"EXC FOOT/TOE TUM SC 1.5 CM/>",1094,547,869.73,929.9,929.9,929.9,918.95999999999992,886.1400000000001,875.2,869.73,875.2]
[528005,"TX FOOT BONE LESION","CDM Code","Pro",510,"Clinic",28005,"TREAT FOOT BONE LESION",1097,548.5,872.11500000000001,932.44999999999993,932.44999999999993,932.44999999999993,921.48,888.57,877.6,872.11500000000001,877.6]
[527899,"LEG ANKLE SURGERY PROCEDURE","CDM Code","Pro",510,"Clinic",27899,"UNLISTED PX LEG/ANKLE",1480,740,1176.6000000000001,1258,1258,1258,1243.2,1198.8000000000002,1184,1176.6000000000001,1184]
[527870,"ARTHRODESIS ANKLE OPEN","CDM Code","Pro",510,"Clinic",27870,"FUSION OF ANKLE JOINT OPEN",2963,1481.5,2355.585,2518.5499999999997,2518.5499999999997,2518.5499999999997,2488.92,2400.0300000000002,2370.4,2355.585,2370.4]
[527828,"TREAT LOWER LEG FRACTURE","CDM Code","Pro",510,"Clinic",27828,"TREAT LOWER LEG FRACTURE",3125,1562.5,2484.375,2656.25,2656.25,2656.25,2625,2531.25,2500,2484.375,2500]
[527814,"OPEN TX OF BIMALLEOLAR ANKLE FX","CDM Code","Pro",510,"Clinic",27814,"TREATMENT OF ANKLE FRACTURE",1952,976,1551.8400000000001,1659.2,1659.2,1659.2,1639.6799999999998,1581.1200000000001,1561.6000000000001,1551.8400000000001,1561.6000000000001]
[527810,"TREATMENT OF ANKLE FRACTURE","CDM Code","Pro",510,"Clinic",27810,"TREATMENT OF ANKLE FRACTURE",940,470,747.30000000000007,799,799,799,789.6,761.40000000000009,752,747.30000000000007,752]
[527766,"OPTX MEDIAL ANKLE FX","CDM Code","Pro",510,"Clinic",27766,"OPTX MEDIAL ANKLE FX",1358,679,1079.6100000000001,1154.3,1154.3,1154.3,1140.72,1099.98,1086.4000000000001,1079.6100000000001,1086.4000000000001]
[527698,"REPAIR OF ANKLE LIGAMENT","CDM Code","Pro",510,"Clinic",27698,"REPAIR OF ANKLE LIGAMENT",1616,808,1284.72,1373.6,1373.6,1373.6,1357.44,1308.96,1292.8000000000002,1284.72,1292.8000000000002]
[527690,"REVISE LOWER LEG TENDON","CDM Code","Pro",510,"Clinic",27690,"REVISE LOWER LEG TENDON",1401,700.5,1113.7950000000001,1190.8499999999999,1190.8499999999999,1190.8499999999999,1176.8399999999999,1134.8100000000002,1120.8,1113.7950000000001,1120.8]
[527687,"REV CALF TENDON GASTROCNEMIUS RECISION","CDM Code","Pro",510,"Clinic",27687,"REVISION OF CALF TENDON",1395,697.5,1109.0250000000001,1185.75,1185.75,1185.75,1171.8,1129.95,1116,1109.0250000000001,1116]
[527665,"REPAIR OF LEG TENDON EACH","CDM Code","Pro",510,"Clinic",27665,"REPAIR OF LEG TENDON EACH",869,434.5,690.85500000000002,738.65,738.65,738.65,729.95999999999992,703.8900000000001,695.2,690.85500000000002,695.2]
[527652,"REPAIR GRAFT ACHILLES TENDON","CDM Code","Pro",510,"Clinic",27652,"REPAIR/GRAFT ACHILLES TENDON",1528,764,1214.76,1298.8,1298.8,1298.8,1283.52,1237.68,1222.4000000000001,1214.76,1222.4000000000001]
[527635,"REMOVE LOWER LEG BONE LESION","CDM Code","Pro",510,"Clinic",27635,"REMOVE LOWER LEG BONE LESION",1234,617,981.03000000000009,1048.8999999999999,1048.8999999999999,1048.8999999999999,1036.56,999.54000000000008,987.2,981.03000000000009,987.2]
[527632,"EXC LEG ANKLE LES SC 3 CM","CDM Code","Pro",510,"Clinic",27632,"EXC LEG/ANKLE LES SC 3 CM/>",869,434.5,690.85500000000002,738.65,738.65,738.65,729.95999999999992,703.8900000000001,695.2,690.85500000000002,695.2]
[527606,"TENOTOMY PERCUTANEOUS ACHILLES TENDON","CDM Code","Pro",510,"Clinic",27606,"INCISION OF ACHILLES TENDON",792,396,629.64,673.19999999999993,673.19999999999993,673.19999999999993,665.28,641.5200000000001,633.6,629.64,633.6]
[527570,"FIXATION OF KNEE JOINT","CDM Code","Pro",510,"Clinic",27570,"FIXATION OF KNEE JOINT",531,265.5,422.14500000000004,451.34999999999997,451.34999999999997,451.34999999999997,446.03999999999996,430.11,424.8,422.14500000000004,424.8]
[527535,"TREAT KNEE FRACTURE","CDM Code","Pro",510,"Clinic",27535,"TREAT KNEE FRACTURE",1982,991,1575.69,1684.7,1684.7,1684.7,1664.8799999999999,1605.42,1585.6000000000001,1575.69,1585.6000000000001]
[527532,"TREAT KNEE FRACTURE","CDM Code","Pro",510,"Clinic",27532,"TREAT KNEE FRACTURE",1225,612.5,973.875,1041.25,1041.25,1041.25,1029,992.25000000000011,980,973.875,980]
[527487,"REVISE REPLACE KNEE JOINT","CDM Code","Pro",510,"Clinic",27487,"REVISE/REPLACE KNEE JOINT",3335,1667.5,2651.3250000000003,2834.75,2834.75,2834.75,2801.4,2701.3500000000004,2668,2651.3250000000003,2668]
[527405,"REPAIR OF KNEE LIGAMENT","CDM Code","Pro",510,"Clinic",27405,"REPAIR OF KNEE LIGAMENT",1425,712.5,1132.875,1211.25,1211.25,1211.25,1197,1154.25,1140,1132.875,1140]
[527347,"REMOVE KNEE CYST","CDM Code","Pro",510,"Clinic",27347,"REMOVE KNEE CYST",1105,552.5,878.47500000000002,939.25,939.25,939.25,928.19999999999993,895.05000000000007,884,878.47500000000002,884]
[527345,"REMOVAL OF KNEE CYST","CDM Code","Pro",510,"Clinic",27345,"REMOVAL OF KNEE CYST",1053,526.5,837.13499999999999,895.05,895.05,895.05,884.52,852.93000000000006,842.40000000000009,837.13499999999999,842.40000000000009]
[527310,"EXPLORATION OF KNEE JOINT","CDM Code","Pro",510,"Clinic",27310,"EXPLORATION OF KNEE JOINT",1599,799.5,1271.2050000000002,1359.1499999999999,1359.1499999999999,1359.1499999999999,1343.1599999999999,1295.19,1279.2,1271.2050000000002,1279.2]
[527250,"TRMT HIP DISLOCATI0N","CDM Code","Pro",510,"Clinic",27250,"TREAT HIP DISLOCATION",385,192.5,306.07499999999999,327.25,327.25,327.25,323.39999999999998,311.85000000000002,308,306.07499999999999,308]
[527236,"OPEN TREATMENT FEMORAL FX PROXIMAL END","CDM Code","Pro",510,"Clinic",27236,"TREAT THIGH FRACTURE",2796,1398,2222.8200000000002,2376.6,2376.6,2376.6,2348.64,2264.7600000000002,2236.8000000000002,2222.8200000000002,2236.8000000000002]
[527222,"TREAT HIP SOCKET FRACTURE","CDM Code","Pro",510,"Clinic",27222,"TREAT HIP SOCKET FRACTURE",2181,1090.5,1733.895,1853.85,1853.85,1853.85,1832.04,1766.6100000000001,1744.8000000000002,1733.895,1744.8000000000002]
[527096,"INJECT SACROILIAC JOINT","CDM Code","Pro",510,"Clinic",27096,"INJECT SACROILIAC JOINT",337,168.5,267.91500000000002,286.45,286.45,286.45,283.08,272.97000000000003,269.60000000000002,267.91500000000002,269.60000000000002]
[527033,"EXPLORATION OF HIP JOINT","CDM Code","Pro",510,"Clinic",27033,"EXPLORATION OF HIP JOINT",2218,1109,1763.3100000000002,1885.3,1885.3,1885.3,1863.12,1796.5800000000002,1774.4,1763.3100000000002,1774.4]
[526785,"TREAT FINGER DISLOCATION","CDM Code","Pro",510,"Clinic",26785,"TREAT FINGER DISLOCATION",1257,628.5,999.31500000000005,1068.45,1068.45,1068.45,1055.8799999999999,1018.1700000000001,1005.6,999.31500000000005,1005.6]
[526775,"TX FINGER DISLOCATION","CDM Code","Pro",510,"Clinic",26775,"TREAT FINGER DISLOCATION",868,434,690.06000000000006,737.8,737.8,737.8,729.12,703.08,694.40000000000009,690.06000000000006,694.40000000000009]
[526746,"TREAT FINGER FRACTURE EACH","CDM Code","Pro",510,"Clinic",26746,"TREAT FINGER FRACTURE EACH",1472,736,1170.24,1251.2,1251.2,1251.2,1236.48,1192.3200000000002,1177.6000000000001,1170.24,1177.6000000000001]
[526715,"TREAT KNUCKLE DISLOCATION","CDM Code","Pro",510,"Clinic",26715,"TREAT KNUCKLE DISLOCATION",1265,632.5,1005.6750000000001,1075.25,1075.25,1075.25,1062.5999999999999,1024.6500000000001,1012,1005.6750000000001,1012]
[526615,"OPEN TX METACARPAL FX SINGLE EACH BONE","CDM Code","Pro",510,"Clinic",26615,"TREAT METACARPAL FRACTURE",1323,661.5,1051.7850000000001,1124.55,1124.55,1124.55,1111.32,1071.6300000000001,1058.4000000000001,1051.7850000000001,1058.4000000000001]
[526608,"PERCUTANEOUS SKELETAL FIX OF METACARPAL","CDM Code","Pro",510,"Clinic",26608,"TREAT METACARPAL FRACTURE",1228,614,976.2600000000001,1043.8,1043.8,1043.8,1031.52,994.68000000000006,982.40000000000009,976.2600000000001,982.40000000000009]
[526541,"REPAIR HAND JOINT WITH GRAFT","CDM Code","Pro",510,"Clinic",26541,"REPAIR HAND JOINT WITH GRAFT",1757,878.5,1396.8150000000001,1493.45,1493.45,1493.45,1475.8799999999999,1423.17,1405.6000000000001,1396.8150000000001,1405.6000000000001]
[526460,"INCISE HAND FINGER TENDON","CDM Code","Pro",510,"Clinic",26460,"INCISE HAND/FINGER TENDON",898,449,713.91000000000008,763.3,763.3,763.3,754.31999999999994,727.38,718.40000000000009,713.91000000000008,718.40000000000009]
[526340,"MANIPULATE FINGER W ANESTHESIA","CDM Code","Pro",510,"Clinic",26340,"MANIPULATE FINGER W/ANESTH",779,389.5,619.30500000000006,662.15,662.15,662.15,654.36,630.99,623.20000000000005,619.30500000000006,623.20000000000005]
[526210,"REMOVAL OF FINGER LESION","CDM Code","Pro",510,"Clinic",26210,"REMOVAL OF FINGER LESION",882,441,701.19,749.69999999999993,749.69999999999993,749.69999999999993,740.88,714.42000000000007,705.6,701.19,705.6]
[526115,"EXC HAND LES SC < 1 5 CM","CDM Code","Pro",510,"Clinic",26115,"EXC HAND LES SC < 1.5 CM",1124,562,893.58,955.4,955.4,955.4,944.16,910.44,899.2,893.58,899.2]
[526070,"EXPLORE/TREAT HAND JOINT","CDM Code","Pro",510,"Clinic",26070,"EXPLORE/TREAT HAND JOINT",689,344.5,547.755,585.65,585.65,585.65,578.76,558.09,551.20000000000005,547.755,551.20000000000005]
[525651,"PIN ULNAR STYLOID FRACTURE","CDM Code","Pro",510,"Clinic",25651,"PIN ULNAR STYLOID FRACTURE",1071,535.5,851.44500000000005,910.35,910.35,910.35,899.64,867.5100000000001,856.80000000000007,851.44500000000005,856.80000000000007]
[525645,"TREAT WRIST BONE FRACTURE","CDM Code","Pro",510,"Clinic",25645,"TREAT WRIST BONE FRACTURE",1305,652.5,1037.4750000000001,1109.25,1109.25,1109.25,1096.2,1057.0500000000002,1044,1037.4750000000001,1044]
[525605,"TREAT FX DISTAL RADIAL W MANIPULATION","CDM Code","Pro",510,"Clinic",25605,"TREAT FRACTURE RADIUS/ULNA",1713,856.5,1361.835,1456.05,1456.05,1456.05,1438.9199999999998,1387.5300000000002,1370.4,1361.835,1370.4]
[525515,"OPEN TX OF RAD SHAFT FRAC INTERNAL FX","CDM Code","Pro",510,"Clinic",25515,"TREAT FRACTURE OF RADIUS",1875,937.5,1490.625,1593.75,1593.75,1593.75,1575,1518.75,1500,1490.625,1500]
[525248,"REMOVE FOREARM FOREIGN BODY","CDM Code","Pro",510,"Clinic",25248,"REMOVE FOREARM FOREIGN BODY",816,408,648.72,693.6,693.6,693.6,685.43999999999994,660.96,652.80000000000007,648.72,652.80000000000007]
[525246,"INJECTION FOR WRIST X-RAY","CDM Code","IP/OP",960,"Professional fees",25246,"INJECTION FOR WRIST X-RAY",415,207.5,329.92500000000001,352.75,352.75,352.75,348.59999999999997,336.15000000000003,332,329.92500000000001,332]
[525071,"EXC FOREARM LESION SC 3 CM","CDM Code","Pro",510,"Clinic",25071,"EXC FOREARM LES SC 3 CM/>",971,485.5,771.94500000000005,825.35,825.35,825.35,815.64,786.5100000000001,776.80000000000007,771.94500000000005,776.80000000000007]
[524666,"TREAT RADIUS FRACTURE","CDM Code","Pro",510,"Clinic",24666,"TREAT RADIUS FRACTURE",1532,766,1217.94,1302.2,1302.2,1302.2,1286.8799999999999,1240.92,1225.6000000000001,1217.94,1225.6000000000001]
[524600,"CLOSED TREATMENT ELBOW DISLOCATION","CDM Code","Pro",510,"Clinic",24600,"TREAT ELBOW DISLOCATION",1355,677.5,1077.2250000000001,1151.75,1151.75,1151.75,1138.2,1097.5500000000002,1084,1077.2250000000001,1084]
[524579,"TX HUMERUS FX","CDM Code","Pro",510,"Clinic",24579,"TREAT HUMERUS FRACTURE",1829,914.5,1454.0550000000001,1554.6499999999999,1554.6499999999999,1554.6499999999999,1536.36,1481.49,1463.2,1454.0550000000001,1463.2]
[524430,"REPAIR OF HUMERUS","CDM Code","Pro",510,"Clinic",24430,"REPAIR OF HUMERUS",2104,1052,1672.68,1788.3999999999999,1788.3999999999999,1788.3999999999999,1767.36,1704.24,1683.2,1672.68,1683.2]
[524341,"REPAIR ARM TENDON MUSCLE","CDM Code","Pro",510,"Clinic",24341,"RPR TDN/MUSC UPR A/E EACH",1573,786.5,1250.5350000000001,1337.05,1337.05,1337.05,1321.32,1274.1300000000001,1258.4000000000001,1250.5350000000001,1258.4000000000001]
[524073,"EXCIS TUMOR SFT TISSUE UPPER ARM 5 CM >","CDM Code","Pro",510,"Clinic",24073,"EX ARM/ELBOW TUM DEEP 5 CM/>",2265,1132.5,1800.6750000000002,1925.25,1925.25,1925.25,1902.6,1834.65,1812,1800.6750000000002,1812]
[524071,"EXC ARM ELBOW LES SC 3 CM","CDM Code","Pro",510,"Clinic",24071,"EXC ARM/ELBOW LES SC 3 CM/>",849,424.5,674.95500000000004,721.65,721.65,721.65,713.16,687.69,679.2,674.95500000000004,679.2]
[523700,"MANIPULATION W ANES SHOULDER JOINT W FIX","CDM Code","Pro",510,"Clinic",23700,"MNPJ ANES SHO JT FIXJ APRATS",604,302,480.18,513.4,513.4,513.4,507.35999999999996,489.24,483.20000000000005,480.18,483.20000000000005]
[523655,"CLOSED TX SHLDR DISLOC W MANIP REQ ANES","CDM Code","Pro",510,"Clinic",23655,"CLTX SHO DSLC W/MNPJ W/ANES",924,462,734.58,785.4,785.4,785.4,776.16,748.44,739.2,734.58,739.2]
[523575,"TREAT SHOULDER BLADE FX","CDM Code","Pro",510,"Clinic",23575,"CLTX SCAP FX W/MNPJ +-TRACTJ",912,456,725.04000000000008,775.19999999999993,775.19999999999993,775.19999999999993,766.07999999999993,738.72,729.6,725.04000000000008,729.6]
[523552,"TREAT CLAVICLE DISCLOCATION","CDM Code","Pro",510,"Clinic",23552,"OPTX ACRCLV DSLC AQ/CHRN GRF",1241,620.5,986.59500000000003,1054.8499999999999,1054.8499999999999,1054.8499999999999,1042.44,1005.21,992.80000000000007,986.59500000000003,992.80000000000007]
[523430,"TENODESIS LONG TENDON BICEPS","CDM Code","Pro",510,"Clinic",23430,"REPAIR BICEPS TENDON",2801,1400.5,2226.7950000000001,2380.85,2380.85,2380.85,2352.8399999999997,2268.81,2240.8000000000002,2226.7950000000001,2240.8000000000002]
[523350,"INJECTION FOR SHOULDER X-RAY","CDM Code","IP/OP",960,"Professional fees",23350,"INJECTION FOR SHOULDER X-RAY",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[523071,"EXC TUMOR SOFT TISSUE SHLDR AREA SUBCUT","CDM Code","Pro",510,"Clinic",23071,"EXC SHOULDER LES SC 3 CM/>",763,381.5,606.58500000000004,648.54999999999995,648.54999999999995,648.54999999999995,640.91999999999996,618.03000000000009,610.4,606.58500000000004,610.4]
[523000,"REMOVAL OF CALCUIM DEPOSITS","CDM Code","Pro",510,"Clinic",23000,"REMOVAL OF CALCIUM DEPOSITS",1124,562,893.58,955.4,955.4,955.4,944.16,910.44,899.2,893.58,899.2]
[522853,"INSJ BIOMECHANICAL DEVICE","CDM Code","Pro",510,"Clinic",22853,"INSJ BIOMECHANICAL DEVICE",555,277.5,441.22500000000002,471.75,471.75,471.75,466.2,449.55,444,441.22500000000002,444]
[521931,"EXC BACK LES SC 3 CM","CDM Code","Pro",510,"Clinic",21931,"EXC BACK LES SC 3 CM/>",895,447.5,711.52500000000009,760.75,760.75,760.75,751.8,724.95,716,711.52500000000009,716]
[521012,"EXC FACE LES SBQ 2 CM","CDM Code","Pro",510,"Clinic",21012,"EXC FACE LES SBQ 2 CM/>",718,359,570.81000000000006,610.29999999999995,610.29999999999995,610.29999999999995,603.12,581.58000000000004,574.4,570.81000000000006,574.4]
[520983,"ABLATE BONE TUMOR PERQ CRYO W GUIDANCE","CDM Code","Pro",510,"Clinic",20983,"ABLATE BONE TUMOR(S) PERQ",1679,839.5,1334.8050000000001,1427.1499999999999,1427.1499999999999,1427.1499999999999,1410.36,1359.99,1343.2,1334.8050000000001,1343.2]
[520703,"RMVL IMED RX DELIVERY DEVICE","CDM Code","Pro",510,"Clinic",20703,"RMVL IMED RX DELIVERY DEVICE",1854,927,1473.93,1575.8999999999999,1575.8999999999999,1575.8999999999999,1557.36,1501.74,1483.2,1473.93,1483.2]
[520680,"REMOVAL OF SUPPORT IMPLANT","CDM Code","Pro",510,"Clinic",20680,"REMOVAL OF SUPPORT IMPLANT",1195,597.5,950.02500000000009,1015.75,1015.75,1015.75,1003.8,967.95,956,950.02500000000009,956]
[520606,"US DRAIN INJ INTMED JOINT BURSA","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",20606,"DRAIN/INJ JOINT/BURSA W/US",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[520605,"XR ASP INJ INTERMEDIATE JOINT","CDM Code","Pro",510,"Clinic",20605,"DRAIN/INJ JOINT/BURSA W/O US",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[520551,"INJ SINGLE TENDON ORIGIN/INSERTION","CDM Code","Pro",510,"Clinic",20551,"INJ TENDON ORIGIN/INSERTION",118,59,93.81,100.3,100.3,100.3,99.11999999999999,95.580000000000013,94.4,93.81,94.4]
[520501,"INJECT SINUS TRACT FOR X RAY","CDM Code","Pro",510,"Clinic",20501,"INJECT SINUS TRACT FOR X-RAY",231,115.5,183.64500000000001,196.35,196.35,196.35,194.04,187.11,184.8,183.64500000000001,184.8]
[520205,"DEEP MUSCLE BIOPSY","CDM Code","IP/OP",960,"Professional fees",20205,"DEEP MUSCLE BIOPSY",701,350.5,557.29500000000007,595.85,595.85,595.85,588.84,567.81000000000006,560.80000000000007,557.29500000000007,560.80000000000007]
[520103,"EXPLORE WOUND EXTREMITY","CDM Code","Pro",510,"Clinic",20103,"EXPLORE WOUND EXTREMITY",1331,665.5,1058.145,1131.3499999999999,1131.3499999999999,1131.3499999999999,1118.04,1078.1100000000001,1064.8,1058.145,1064.8]
[519303,"MASTECTOMY SIMPLE COMPLETE","CDM Code","Pro",510,"Clinic",19303,"MAST SIMPLE COMPLETE",2312,1156,1838.0400000000002,1965.2,1965.2,1965.2,1942.08,1872.72,1849.6000000000001,1838.0400000000002,1849.6000000000001]
[519281,"PERQ DEVICE BREAST 1ST IMAGE","CDM Code","IP/OP",960,"Professional fees",19281,"PERQ DEVICE BREAST 1ST IMAG",481,240.5,382.39500000000004,408.84999999999997,408.84999999999997,408.84999999999997,404.03999999999996,389.61,384.8,382.39500000000004,384.8]
[519084,"PR BX BREAST W DEVICE ADDL LESION ULTRAS","CDM Code","Pro",510,"Clinic",19084,"BX BREAST ADD LESION US IMAG",169,84.5,134.35500000000002,143.65,143.65,143.65,141.96,136.89000000000001,135.20000000000002,134.35500000000002,135.20000000000002]
[519083,"BX BREAST 1ST LESION US IMAGING","CDM Code","Pro",510,"Clinic",19083,"BX BREAST 1ST LESION US IMAG",751,375.5,597.04500000000007,638.35,638.35,638.35,630.84,608.31000000000006,600.80000000000007,597.04500000000007,600.80000000000007]
[517999,"SKIN TISSUE PROCEDURE","CDM Code","Pro",510,"Clinic",17999,"UNLISTD PX SKN MUC MEMB SUBQ",503,251.5,399.88500000000005,427.55,427.55,427.55,422.52,407.43,402.40000000000003,399.88500000000005,402.40000000000003]
[517110,"DESTRUCTION OF WARTS CRYO","CDM Code","Pro",510,"Clinic",17110,"DESTRUCT B9 LESION 1-14",271,135.5,215.44500000000002,230.35,230.35,230.35,227.64,219.51000000000002,216.8,215.44500000000002,216.8]
[516025,"DRESS DEBRID P THICK BURN M","CDM Code","Pro",510,"Clinic",16025,"DRESS/DEBRID P-THICK BURN M",283,141.5,224.98500000000001,240.54999999999998,240.54999999999998,240.54999999999998,237.72,229.23000000000002,226.4,224.98500000000001,226.4]
[516020,"DRESS AND OR DEBRIDE PARTIAL THICK BURNS","CDM Code","Pro",510,"Clinic",16020,"DRESS/DEBRID P-THICK BURN S",226,113,179.67000000000002,192.1,192.1,192.1,189.84,183.06,180.8,179.67000000000002,180.8]
[515783,"DERMABRASION SUPERFICIAL ANY SITE","CDM Code","Pro",510,"Clinic",15783,"DERMABRASION SUPRFL ANY SITE",1073,536.5,853.03500000000008,912.05,912.05,912.05,901.31999999999994,869.13000000000011,858.40000000000009,853.03500000000008,858.40000000000009]
[515240,"SKIN FULL GRFT FACE GENIT HF","CDM Code","Pro",510,"Clinic",15240,"SKIN FULL GRFT FACE/GENIT/HF",2058,1029,1636.1100000000001,1749.3,1749.3,1749.3,1728.72,1666.98,1646.4,1636.1100000000001,1646.4]
[515003,"WOUND PREP ADDL 100 CM","CDM Code","Pro",510,"Clinic",15003,"WOUND PREP ADDL 100 CM",136,68,108.12,115.6,115.6,115.6,114.24,110.16000000000001,108.80000000000001,108.12,108.80000000000001]
[515002,"SURG WOUND PREP TRK ARM LEG 1ST 100 SQCM","CDM Code","Pro",510,"Clinic",15002,"WOUND PREP TRK/ARM/LEG",681,340.5,541.39499999999998,578.85,578.85,578.85,572.04,551.61,544.80000000000007,541.39499999999998,544.80000000000007]
[514000,"TIS TRNFR TRUNK 10 SQ CM","CDM Code","Pro",510,"Clinic",14000,"TIS TRNFR TRUNK 10 SQ CM/<",1134,567,901.53000000000009,963.9,963.9,963.9,952.56,918.54000000000008,907.2,901.53000000000009,907.2]
[513122,"CMPLX RPR S A L ADD 5 CM OR LESS","CDM Code","Pro",510,"Clinic",13122,"CMPLX RPR S/A/L ADDL 5 CM/>",282,141,224.19,239.7,239.7,239.7,236.88,228.42000000000002,225.60000000000002,224.19,225.60000000000002]
[512054,"INTMD RPR FACE MM 7 6 12 5 CM","CDM Code","Pro",510,"Clinic",12054,"INTMD RPR FACE/MM 7.6-12.5CM",693,346.5,550.93500000000006,589.04999999999995,589.04999999999995,589.04999999999995,582.12,561.33000000000004,554.4,550.93500000000006,554.4]
[512053,"INTERMED REPAIR FACE MM","CDM Code","Pro",510,"Clinic",12053,"INTMD RPR FACE/MM 5.1-7.5 CM",790,395,628.05000000000007,671.5,671.5,671.5,663.6,639.90000000000009,632,628.05000000000007,632]
[512042,"LAYER CLOSURE WOUND NECK ETC","CDM Code","Pro",510,"Clinic",12042,"INTMD RPR N-HF/GENIT2.6-7.5",876,438,696.42000000000007,744.6,744.6,744.6,735.83999999999992,709.56000000000006,700.80000000000007,696.42000000000007,700.80000000000007]
[512032,"INTERMEDIATE REPAIR WND SCALP E","CDM Code","Pro",510,"Clinic",12032,"INTMD RPR S/A/T/EXT 2.6-7.5",980,490,779.1,833,833,833,823.19999999999993,793.80000000000007,784,779.1,784]
[512015,"REPAIR WOUNDS FE E EN L M 7 6-12 5 CM","CDM Code","Pro",510,"Clinic",12015,"RPR F/E/E/N/L/M 7.6-12.5 CM",361,180.5,286.995,306.84999999999997,306.84999999999997,306.84999999999997,303.24,292.41000000000003,288.8,286.995,288.8]
[512014,"SUTURE SIMPLE LACERATION","CDM Code","Pro",510,"Clinic",12014,"RPR F/E/E/N/L/M 5.1-7.5 CM",454,227,360.93,385.9,385.9,385.9,381.36,367.74,363.20000000000005,360.93,363.20000000000005]
[512004,"SUTURE SIMPLE LACERATION","CDM Code","Pro",510,"Clinic",12004,"RPR S/N/AX/GEN/TRK7.6-12.5CM",342,171,271.89,290.7,290.7,290.7,287.27999999999997,277.02000000000004,273.60000000000002,271.89,273.60000000000002]
[511976,"REMOVE CONTRACEPTIVE CAPSULE","CDM Code","Pro",510,"Clinic",11976,"REMOVE CONTRACEPTIVE CAPSULE",330,165,262.35000000000002,280.5,280.5,280.5,277.2,267.3,264,262.35000000000002,264]
[511765,"WEDGE EXCISION SKIN NAIL FOLD","CDM Code","Pro",510,"Clinic",11765,"EXCISION OF NAIL FOLD TOE",336,168,267.12,285.59999999999997,285.59999999999997,285.59999999999997,282.24,272.16000000000003,268.8,267.12,268.8]
[511760,"REPAIR OF NAIL BED","CDM Code","Pro",510,"Clinic",11760,"REPAIR OF NAIL BED",337,168.5,267.91500000000002,286.45,286.45,286.45,283.08,272.97000000000003,269.60000000000002,267.91500000000002,269.60000000000002]
[511730,"EXCISION NAIL PLATE SINGLE","CDM Code","Pro",510,"Clinic",11730,"REMOVAL OF NAIL PLATE",203,101.5,161.38500000000002,172.54999999999998,172.54999999999998,172.54999999999998,170.51999999999998,164.43,162.4,161.38500000000002,162.4]
[511644,"EXC MALIGNANT LESION 3 1 TO 4 0 CM","CDM Code","Pro",510,"Clinic",11644,"EXC F/E/E/N/L MAL+MRG 3.1-4",862,431,685.29000000000008,732.69999999999993,732.69999999999993,732.69999999999993,724.07999999999993,698.22,689.6,685.29000000000008,689.6]
[511624,"EXC MALIGNANT LESION 3 1 TO 4 0 CM","CDM Code","Pro",510,"Clinic",11624,"EXC S/N/H/F/G MAL+MRG 3.1-4",1173,586.5,932.53500000000008,997.05,997.05,997.05,985.31999999999994,950.13000000000011,938.40000000000009,932.53500000000008,938.40000000000009]
[511623,"EXC S N H F G MAL MRG 2 1   3","CDM Code","Pro",510,"Clinic",11623,"EXC S/N/H/F/G MAL+MRG 2.1-3",605,302.5,480.97500000000002,514.25,514.25,514.25,508.2,490.05,484,480.97500000000002,484]
[511604,"EXC TR EXT MLG MARG 3 TO 4 CM","CDM Code","Pro",510,"Clinic",11604,"EXC TR-EXT MAL+MARG 3.1-4 CM",548,274,435.66,465.8,465.8,465.8,460.32,443.88000000000005,438.40000000000003,435.66,438.40000000000003]
[511462,"EXC SKIN SUBC TISSUE FOR HIDRADENITIS","CDM Code","Pro",510,"Clinic",11462,"REMOVAL SWEAT GLAND LESION",874,437,694.83,742.9,742.9,742.9,734.16,707.94,699.2,694.83,699.2]
[511426,"EXC BENIGN LESION GREATER THAN 4 0 CM","CDM Code","Pro",510,"Clinic",11426,"EXC H-F-NK-SP B9+MARG >4 CM",724,362,575.58000000000004,615.4,615.4,615.4,608.16,586.44000000000005,579.20000000000005,575.58000000000004,579.20000000000005]
[511424,"EXC BENIGN LESION 3 1 TO 4 0 CM","CDM Code","Pro",510,"Clinic",11424,"EXC H-F-NK-SP B9+MARG 3.1-4",530,265,421.35,450.5,450.5,450.5,445.2,429.3,424,421.35,424]
[511406,"EXC BENIGN LESION GREATER THAN 4 CM","CDM Code","Pro",510,"Clinic",11406,"EXC TR-EXT B9+MARG >4.0 CM",1215,607.5,965.92500000000007,1032.75,1032.75,1032.75,1020.5999999999999,984.15000000000009,972,965.92500000000007,972]
[511400,"LESION DIAM UP TO 0 5 CM EXC","CDM Code","Pro",510,"Clinic",11400,"EXC TR-EXT B9+MARG 0.5 CM<",272,136,216.24,231.2,231.2,231.2,228.48,220.32000000000002,217.60000000000002,216.24,217.60000000000002]
[511305,"SHAVE SKIN LESION UP TO 0 5 CM S N H F G","CDM Code","Pro",510,"Clinic",11305,"SHAVE SKIN LESION 0.5 CM/<",223,111.5,177.285,189.54999999999998,189.54999999999998,189.54999999999998,187.32,180.63000000000002,178.4,177.285,178.4]
[511303,"SHAVE SKIN LESION GREATER 2 0 CM T A L","CDM Code","Pro",510,"Clinic",11303,"SHAVE SKIN LESION >2.0 CM",222,111,176.49,188.7,188.7,188.7,186.48,179.82000000000002,177.60000000000002,176.49,177.60000000000002]
[511200,"REMOVAL OF SKIN TAGS UP TO 15","CDM Code","Pro",510,"Clinic",11200,"REMOVAL OF SKIN TAGS <W/15",300,150,238.5,255,255,255,252,243.00000000000003,240,238.5,240]
[511056,"PARING OR CUTTING BENIGN LESION 2-4","CDM Code","Pro",510,"Clinic",11056,"TRIM SKIN LESIONS 2 TO 4",87,43.5,69.165000000000006,73.95,73.95,73.95,73.08,70.47,69.600000000000009,69.165000000000006,69.600000000000009]
[511043,"DEBRIDE TISSUE MUSCLE 20 SQ CM OR LESS","CDM Code","Pro",510,"Clinic",11043,"DEB MUSC/FASCIA 20 SQ CM/<",594,297,472.23,504.9,504.9,504.9,498.96,481.14000000000004,475.20000000000005,472.23,475.20000000000005]
[511042,"DEBRIDE SKIN SUBCUTANEOUS UP TO 20 SQCM","CDM Code","Pro",510,"Clinic",11042,"DEB SUBQ TISSUE 20 SQ CM/<",256,128,203.52,217.6,217.6,217.6,215.04,207.36,204.8,203.52,204.8]
[511000,"DEBRIDE INFECTED SKIN","CDM Code","Pro",510,"Clinic",11000,"DEBRIDE INFECTED SKIN",125,62.5,99.375,106.25,106.25,106.25,105,101.25,100,99.375,100]
[510140,"I  D OF HEMATOMA","CDM Code","Pro",510,"Clinic",10140,"DRAINAGE OF HEMATOMA/FLUID",528,264,419.76000000000005,448.8,448.8,448.8,443.52,427.68,422.40000000000003,419.76000000000005,422.40000000000003]
[510060,"INCISION DRAINAGE OF ABSCESS","CDM Code","Pro",510,"Clinic",10060,"DRAINAGE OF SKIN ABSCESS",381,190.5,302.89500000000004,323.84999999999997,323.84999999999997,323.84999999999997,320.03999999999996,308.61,304.8,302.89500000000004,304.8]
[510040,"ACNE SURGERY","CDM Code","Pro",510,"Clinic",10040,"ACNE SURGERY",237,118.5,188.41500000000002,201.45,201.45,201.45,199.07999999999998,191.97,189.60000000000002,188.41500000000002,189.60000000000002]
[508043,"PT EVAL HIGH COMPLEXITY","CDM Code","IP/OP",420,"Physical Therp",97163,"PT EVAL HIGH COMPLEX 45 MIN",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[508024,"PT THERAPEUTIC ACTIVITIES EA 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97530,"THERAPEUTIC ACTIVITIES",179,89.5,142.30500000000001,152.15,152.15,152.15,150.35999999999999,144.99,143.20000000000002,142.30500000000001,143.20000000000002]
[508017,"PT THERAPEUTIC EXERCISES 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97110,"THERAPEUTIC EXERCISES",140,70,111.30000000000001,119,119,119,117.6,113.4,112,111.30000000000001,112]
[508016,"PT ULTRASOUND EA 15 MIN","CDM Code","IP/OP",420,"Physical Therp",97035,"ULTRASOUND THERAPY",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[508007,"PT REEVALUATION","CDM Code","IP/OP",420,"Physical Therp",97002,"PT RE-EVALUATION",274,137,217.83,232.9,232.9,232.9,230.16,221.94000000000003,219.20000000000002,217.83,219.20000000000002]
[506101,"CHIRO CERVICAL PILLOW","CDM Code","Pro",510,"Clinic","E0190","POSITIONING CUSHION",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[506060,"CHIRO CMT SPINAL 1 OR 2 REGIONS","CDM Code","Pro",510,"Clinic",98940,"CHIROPRACT MANJ 1-2 REGIONS",108,54,85.86,91.8,91.8,91.8,90.72,87.48,86.4,85.86,86.4]
[506059,"CHIRO SELF CARE HOME TRAINING EA 15 MIN","CDM Code","Pro",510,"Clinic",97535,"SELF CARE MNGMENT TRAINING",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[506054,"CHIRO ULTRASOUND EA 15 MIN","CDM Code","Pro",510,"Clinic",97035,"ULTRASOUND THERAPY",46,23,36.57,39.1,39.1,39.1,38.64,37.260000000000005,36.800000000000004,36.57,36.800000000000004]
[506014,"CHIRO OFFICE CONSULT L4 99244","CDM Code","Pro",510,"Clinic",99244,"OFF/OP CNSLTJ NEW/EST MOD 40",151,75.5,120.045,128.35,128.35,128.35,126.83999999999999,122.31,120.80000000000001,120.045,120.80000000000001]
[506009,"CHIRO EST PATIENT OFFICE VISIT L4 99214","CDM Code","Pro",510,"Clinic",99214,"OFFICE O/P EST MOD 30-39 MIN",243,121.5,193.185,206.54999999999998,206.54999999999998,206.54999999999998,204.12,196.83,194.4,193.185,194.4]
[506008,"CHIRO EST PATIENT OFFICE VISIT L3 99213","CDM Code","Pro",510,"Clinic",99213,"OFFICE O/P EST LOW 20-29 MIN",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[506003,"CHIRO NEW PATIENT OFFICE VISIT L3 99203","CDM Code","Pro",510,"Clinic",99203,"OFFICE O/P NEW LOW 30-44 MIN",265,132.5,210.67500000000001,225.25,225.25,225.25,222.6,214.65,212,210.67500000000001,212]
[503995,"SUBSEQUENT OBSERVATION CARE 25 MIN","CDM Code","Pro",510,"Clinic",99232,"SBSQ HOSP IP/OBS MODERATE 35",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[503990,"OBSERVATION CARE DIS","CDM Code","Pro",510,"Clinic",99238,"HOSP IP/OBS DSCHRG MGMT 30/<",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[503874,"IEP","CDM Code","Pro",510,"Clinic","T1018","SCHOOL-BASED IEP SERV BUNDLE",758,379,602.61,644.29999999999995,644.29999999999995,644.29999999999995,636.72,613.98,606.4,602.61,606.4]
[503839,"NTRPROF PH1/INTRNET/EHR 5-10","CDM Code","Pro",510,"Clinic",99446,"NTRPROF PH1/NTRNET/EHR 5-10",62,31,49.29,52.699999999999996,52.699999999999996,52.699999999999996,52.08,50.220000000000006,49.6,49.29,49.6]
[503834,"INSERT  DRUG DEVICE INTRAMEDULLARY","CDM Code","Pro",510,"Clinic",20702,"MNL PREP&INSJ IMED RX DEV",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[503829,"FNL RPT W/DOCU 1-MORE DOSE REDUCTION","CDM Code","IP/OP",960,"Professional fees","G9637","DOC >1 DOSE REDUC TECH",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[503828,"FINAL RPT CT CTA MRA MRA CST/NCK NOT REC","CDM Code","IP/OP",960,"Professional fees","G9556","CT/CTA/MRI/A NO FOLLUP IMAG",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[503823,"DOC MED RSN FOR FOLLOW IMAG","CDM Code","IP/OP",960,"Professional fees","G9549","DOC MED RSN FOR F/U IMAG",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[503811,"SUBSEQUENT OBSERVATION CARE 35>","CDM Code","Pro",510,"Clinic",99226,"SUBSEQUENT OBSERVATION CARE",192,96,152.64000000000001,163.19999999999999,163.19999999999999,163.19999999999999,161.28,155.52000000000001,153.60000000000002,152.64000000000001,153.60000000000002]
[503804,"REMOVAL DIGIT NERVE LESION","CDM Code","Pro",510,"Clinic",64774,"REMOVE SKIN NERVE LESION",1309,654.5,1040.655,1112.6499999999999,1112.6499999999999,1112.6499999999999,1099.56,1060.29,1047.2,1040.655,1047.2]
[503803,"REMOVAL DIGIT NERVE LESION","CDM Code","Pro",510,"Clinic",64776,"REMOVE DIGIT NERVE LESION",1254,627,996.93000000000006,1065.8999999999999,1065.8999999999999,1065.8999999999999,1053.3599999999999,1015.7400000000001,1003.2,996.93000000000006,1003.2]
[503798,"TELEHEALTH MEDICARE","CDM Code","Pro",510,"Clinic","G2025","DIS SITE TELE SVCS RHC/FQHC",96,48,76.320000000000007,81.599999999999994,81.599999999999994,81.599999999999994,80.64,77.760000000000005,76.800000000000011,76.320000000000007,76.800000000000011]
[503793,"ONLINE DIG EM 5 TO 10 MIN","CDM Code","Pro",510,"Clinic",99421,"OL DIG E/M SVC 5-10 MIN",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[503787,"BRIEF CHECK IN BY MD QHP","CDM Code","Pro",510,"Clinic","G2012","BRIEF CHECK IN BY MD/QHP",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[503786,"ONLINE E&M 5-10 MIN","CDM Code","Pro",510,"Clinic","G2010","REMOT IMAGE SUBMIT BY PT",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[503780,"GROUP PSYCHOTHERAPY","CDM Code","IP/OP",900,"Behavior Health Treatments/Services",90853,"GROUP PSYCHOTHERAPY",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[503779,"OB US GTOEQT 14 WKS SNGL FETUS","CDM Code","Pro",510,"Clinic",76805,"OB US >= 14 WKS SNGL FETUS",262,131,208.29000000000002,222.7,222.7,222.7,220.07999999999998,212.22000000000003,209.60000000000002,208.29000000000002,209.60000000000002]
[503778,"REMOVAL OF NAIL PLATE","CDM Code","Pro",510,"Clinic",11730,"REMOVAL OF NAIL PLATE",270,135,214.65,229.5,229.5,229.5,226.79999999999998,218.70000000000002,216,214.65,216]
[503777,"CL- DIAZEPAM 5 MG PER ML SYRINGE","CDM Code","IP/OP",636,"Drug/Detail Code","","",167,83.5,132.76500000000001,141.94999999999999,141.94999999999999,141.94999999999999,140.28,135.27000000000001,133.6,132.76500000000001,133.6]
[503776,"VISUAL ACUITY SCREENING","CDM Code","Pro",510,"Clinic",99173,"VISUAL ACUITY SCREEN",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[503775,"CL- LUPRON 11 25 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1950","LEUPROLIDE ACETATE /3.75 MG",4807,2403.5,3821.5650000000001,4085.95,4085.95,4085.95,4037.8799999999997,3893.67,3845.6000000000004,3821.5650000000001,3845.6000000000004]
[503774,"VITAMIN K PHYTONADIONE INJ","CDM Code","IP/OP",636,"Drug/Detail Code","J3430","VITAMIN K PHYTONADIONE INJ",196,98,155.82000000000002,166.6,166.6,166.6,164.64,158.76000000000002,156.80000000000001,155.82000000000002,156.80000000000001]
[503773,"CL- FLU RIV4 QUAD 18 AND OVER","CDM Code","IP/OP",636,"Drug/Detail Code",90682,"RIV4 VACC RECOMBINANT DNA IM",79,39.5,62.805,67.149999999999991,67.149999999999991,67.149999999999991,66.36,63.99,63.2,62.805,63.2]
[503772,"UNLISTED PROCEDURE MUSCULOSKELETAL SYST","CDM Code","Pro",510,"Clinic","","",266,133,211.47,226.1,226.1,226.1,223.44,215.46,212.8,211.47,212.8]
[503771,"US BREAST LIMITED","CDM Code","Pro",510,"Clinic",76642,"ULTRASOUND BREAST LIMITED",162,81,128.79000000000002,137.69999999999999,137.69999999999999,137.69999999999999,136.07999999999998,131.22,129.6,128.79000000000002,129.6]
[503770,"DIAPHRAGM","CDM Code","Pro",510,"Clinic","A4266","DIAPHRAGM",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[503769,"REMOVE IMPACTED EAR WAX UNI","CDM Code","Pro",510,"Clinic",69209,"REMOVE IMPACTED EAR WAX UNI",28,14,22.26,23.8,23.8,23.8,23.52,22.68,22.400000000000002,22.26,22.400000000000002]
[503768,"DRAIN BLOOD FROM UNDER NAIL","CDM Code","Pro",510,"Clinic",11740,"DRAIN BLOOD FROM UNDER NAIL",96,48,76.320000000000007,81.599999999999994,81.599999999999994,81.599999999999994,80.64,77.760000000000005,76.800000000000011,76.320000000000007,76.800000000000011]
[503767,"CL- DIHYDROERGOTAMINE INJ (DHE)","CDM Code","IP/OP",636,"Drug/Detail Code","J1110","INJ DIHYDROERGOTAMINE MESYLT",214,107,170.13,181.9,181.9,181.9,179.76,173.34,171.20000000000002,170.13,171.20000000000002]
[503766,"CL- EPOETIN ALFA 100 UNITS ESRD","CDM Code","IP/OP",636,"Drug/Detail Code","Q4081","EPOETIN ALFA, 100 UNITS ESRD",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[503765,"CL- DEPO MEDROL 20 MG 1 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1020","METHYLPREDNISOLONE 20 MG INJ",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[503764,"INJ SCLRSNT SPIDER VEIN","CDM Code","Pro",510,"Clinic",36468,"NJX SCLRSNT SPIDER VEINS",2891,1445.5,2298.3450000000003,2457.35,2457.35,2457.35,2428.44,2341.71,2312.8000000000002,2298.3450000000003,2312.8000000000002]
[503763,"METHYLPREDNISOLONE INJ 40MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2920","METHYLPREDNISOLONE INJECTION",50,25,39.75,42.5,42.5,42.5,42,40.5,40,39.75,40]
[503762,"PROGRAM INTAKE ASSESSMENT IEP","CDM Code","Pro",510,"Clinic","T1023","PROGRAM INTAKE ASSESS",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[503761,"CL- IUD MIRENA 52 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J7298","MIRENA, 52 MG",1180,590,938.1,1003,1003,1003,991.19999999999993,955.80000000000007,944,938.1,944]
[503760,"EXC OF LOCAL LESION OF EPIDIDYMIS","CDM Code","Pro",510,"Clinic",54830,"REMOVE EPIDIDYMIS LESION",828,414,658.26,703.8,703.8,703.8,695.52,670.68000000000006,662.40000000000009,658.26,662.40000000000009]
[503759,"STRAPPING ELBOW OR WRIST","CDM Code","Pro",510,"Clinic",29260,"STRAPPING OF ELBOW OR WRIST",66,33,52.470000000000006,56.1,56.1,56.1,55.44,53.46,52.800000000000004,52.470000000000006,52.800000000000004]
[503758,"CL- PREDNISOLONE 15MG 5ML ORAL SOLN","CDM Code","IP/OP",636,"Drug/Detail Code","","",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[503756,"COMPLEX REPAIR F C C M N AX G H F","CDM Code","Pro",510,"Clinic",13132,"CMPLX RPR F/C/C/M/N/AX/G/H/F",922,461,732.99,783.69999999999993,783.69999999999993,783.69999999999993,774.48,746.82,737.6,732.99,737.6]
[503755,"CL- OB US LESS 14 WKS SNGL FETUS","CDM Code","Pro",510,"Clinic",76801,"OB US < 14 WKS SINGLE FETUS",250,125,198.75,212.5,212.5,212.5,210,202.5,200,198.75,200]
[503754,"SOTRADECOL 1% 2 ML VL SODIUM TETRADECYL","CDM Code","IP/OP",250,"Pharmacy","","",318,159,252.81,270.3,270.3,270.3,267.12,257.58000000000004,254.4,252.81,254.4]
[503753,"HANDLING CONVEYANCE SPECIMEN","CDM Code","Pro",510,"Clinic",99000,"SPECIMEN HANDLING OFFICE-LAB",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[503752,"CL- RABIES IMMUNE GLOBULIN 1 ML","CDM Code","IP/OP",636,"Drug/Detail Code",90375,"RABIES IG IM/SC",1586,793,1260.8700000000001,1348.1,1348.1,1348.1,1332.24,1284.6600000000001,1268.8000000000002,1260.8700000000001,1268.8000000000002]
[503751,"US EXAM PELVIC LIMITED","CDM Code","Pro",510,"Clinic",76857,"US EXAM PELVIC LIMITED",95,47.5,75.525000000000006,80.75,80.75,80.75,79.8,76.95,76,75.525000000000006,76]
[503750,"VASCULAR LAB BILATERAL EXTREMITY STUDY","CDM Code","Pro",510,"Clinic",93970,"EXTREMITY STUDY",454,227,360.93,385.9,385.9,385.9,381.36,367.74,363.20000000000005,360.93,363.20000000000005]
[503749,"US EXAM CHEST","CDM Code","Pro",510,"Clinic",76604,"US EXAM CHEST",206,103,163.77000000000001,175.1,175.1,175.1,173.04,166.86,164.8,163.77000000000001,164.8]
[503748,"INS PICC LINE WO IMAGING","CDM Code","Pro",510,"Clinic",36569,"INSJ PICC 5 YR+ W/O IMAGING",182,91,144.69,154.69999999999999,154.69999999999999,154.69999999999999,152.88,147.42000000000002,145.6,144.69,145.6]
[503747,"INJ FORAMEN EPIDURAL L S","CDM Code","Pro",510,"Clinic",64483,"NJX AA&/STRD TFRM EPI L/S 1",440,220,349.8,374,374,374,369.59999999999997,356.40000000000003,352,349.8,352]
[503746,"CL- BCG LIVE INTRAVESICAL 1 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9030","BCG LIVE INTRAVESICAL 1MG",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[503744,"US URINE CAPACITY MEASURE","CDM Code","Pro",510,"Clinic",51798,"US URINE CAPACITY MEASURE",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[503743,"US URINE CAPACITY MEASURE","CDM Code","Pro",510,"Clinic","","",25,12.5,19.875,21.25,21.25,21.25,21,20.25,20,19.875,20]
[503742,"N BLOCK INJ FEM SINGLE","CDM Code","Pro",510,"Clinic",64447,"NJX AA&/STRD FEMORAL NRV IMG",236,118,187.62,200.6,200.6,200.6,198.23999999999998,191.16000000000003,188.8,187.62,188.8]
[503741,"PESSARY NON RUBBER ANY TYPE","CDM Code","IP/OP",270,"Med-Sur Supplies","A4562","PESSARY, NON RUBBER,ANY TYPE",120,60,95.4,102,102,102,100.8,97.2,96,95.4,96]
[503740,"US OB FOLLOW UP PER FETUS","CDM Code","Pro",510,"Clinic",76816,"OB US FOLLOW-UP PER FETUS",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[503739,"US LIMITED","CDM Code","Pro",510,"Clinic",76882,"US LMTD JT/FCL EVL NVASC XTR",112,56,89.04,95.2,95.2,95.2,94.08,90.72,89.600000000000009,89.04,89.600000000000009]
[503738,"TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDO","CDM Code","Pro",510,"Clinic",28011,"INCISION OF TOE TENDONS",624,312,496.08000000000004,530.4,530.4,530.4,524.16,505.44000000000005,499.20000000000005,496.08000000000004,499.20000000000005]
[503737,"CL-REPAIR SIMPLE 2.5 CM OR LESS","CDM Code","Pro",510,"Clinic",12001,"RPR S/N/AX/GEN/TRNK 2.5CM/<",184,92,146.28,156.4,156.4,156.4,154.56,149.04000000000002,147.20000000000002,146.28,147.20000000000002]
[503736,"DEBRIDE SUBQ TISSUE 20 SQ CM OR LESS","CDM Code","Pro",510,"Clinic",11042,"DEB SUBQ TISSUE 20 SQ CM/<",238,119,189.21,202.29999999999998,202.29999999999998,202.29999999999998,199.92,192.78,190.4,189.21,190.4]
[503734,"DRAINAGE OF PILONIDAL CYST","CDM Code","Pro",510,"Clinic",10080,"DRAINAGE OF PILONIDAL CYST",343,171.5,272.685,291.55,291.55,291.55,288.12,277.83000000000004,274.40000000000003,272.685,274.40000000000003]
[503733,"US EXAM ABDO BACK WALL COMP","CDM Code","Pro",510,"Clinic",76770,"US EXAM ABDO BACK WALL COMP",220,110,174.9,187,187,187,184.79999999999998,178.20000000000002,176,174.9,176]
[503732,"US EXTREMITY STUDY","CDM Code","Pro",510,"Clinic",93971,"EXTREMITY STUDY",236,118,187.62,200.6,200.6,200.6,198.23999999999998,191.16000000000003,188.8,187.62,188.8]
[503731,"INCISION OF ANAL ABSCESS","CDM Code","Pro",510,"Clinic",46050,"INCISION OF ANAL ABSCESS",408,204,324.36,346.8,346.8,346.8,342.71999999999997,330.48,326.40000000000003,324.36,326.40000000000003]
[503730,"EPIFIX PER SQ CM","CDM Code","IP/OP",636,"Drug/Detail Code","Q4186","EPIFIX 1 SQ CM",286,143,227.37,243.1,243.1,243.1,240.23999999999998,231.66000000000003,228.8,227.37,228.8]
[503729,"CL- CEFAZOLIN INJECTION 500MG","CDM Code","IP/OP",636,"Drug/Detail Code","J0690","CEFAZOLIN SODIUM INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[503728,"CL- EPINEPHRINE 1-1000 INJ 1MG/1ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0171","ADRENALIN EPINEPHRINE INJECT",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[503727,"CL- METOCLOPRAMIDE 10 MG TABLET","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[503726,"RPR SUPERFICIAL WOUNDS","CDM Code","Pro",510,"Clinic",12011,"RPR F/E/E/N/L/M 2.5 CM/<",221,110.5,175.69500000000002,187.85,187.85,187.85,185.64,179.01000000000002,176.8,175.69500000000002,176.8]
[503725,"CL- DIPHENHYDRAMINE CAPSULE 25MG","CDM Code","IP/OP",250,"Pharmacy","","",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[503724,"LDCT LUNG CANCER SCR READ","CDM Code","IP/OP",960,"Professional fees","G0297","LDCT FOR LUNG CA SCREEN",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[503723,"ENDOCERVICAL CURETTAGE W SCOPE","CDM Code","Pro",510,"Clinic",57456,"ENDOCERV CURETTAGE W/SCOPE",305,152.5,242.47500000000002,259.25,259.25,259.25,256.2,247.05,244,242.47500000000002,244]
[503722,"DIPHENHYDRAMINE HCL INJ","CDM Code","IP/OP",636,"Drug/Detail Code","J1200","DIPHENHYDRAMINE HCL INJECTIO",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[503721,"OB US LESS THAN 14 WKS SNGL FETUS - ER","CDM Code","Pro",510,"Clinic",76801,"OB US < 14 WKS SINGLE FETUS",284,142,225.78,241.4,241.4,241.4,238.56,230.04000000000002,227.20000000000002,225.78,227.20000000000002]
[503720,"PALIPERIDIONE PALMITATE INJ 117MG PER 75","CDM Code","IP/OP",636,"Drug/Detail Code","J2426","INJ, INVEGA SUSTENNA, 1 MG",3101,1550.5,2465.2950000000001,2635.85,2635.85,2635.85,2604.8399999999997,2511.81,2480.8000000000002,2465.2950000000001,2480.8000000000002]
[503718,"TX FIBULA FX","CDM Code","Pro",510,"Clinic",27780,"TREATMENT OF FIBULA FRACTURE",564,282,448.38,479.4,479.4,479.4,473.76,456.84000000000003,451.20000000000005,448.38,451.20000000000005]
[503717,"BX DONE W COLPOSCOPY ADDON","CDM Code","Pro",510,"Clinic",58110,"BX DONE W/COLPOSCOPY ADD-ON",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[503716,"INS PICC 5YR+ WO IMAGE","CDM Code","Pro",510,"Clinic",36569,"INSJ PICC 5 YR+ W/O IMAGING",219,109.5,174.10500000000002,186.15,186.15,186.15,183.95999999999998,177.39000000000001,175.20000000000002,174.10500000000002,175.20000000000002]
[503715,"GASTROSTOMY TUBE PLCMT","CDM Code","Pro",510,"Clinic",43762,"RPLC GTUBE NO REVJ TRC",416,208,330.72,353.59999999999997,353.59999999999997,353.59999999999997,349.44,336.96000000000004,332.8,330.72,332.8]
[503713,"EXC BENIGN LESION UP TO 0 5 CM","CDM Code","Pro",510,"Clinic",11420,"EXC H-F-NK-SP B9+MARG 0.5/<",241,120.5,191.595,204.85,204.85,204.85,202.44,195.21,192.8,191.595,192.8]
[503712,"CHANGE OF WINDPIPE AIRWAY","CDM Code","Pro",510,"Clinic",31502,"CHANGE OF WINDPIPE AIRWAY",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[503711,"DEVELOPMENTAL TEST ADMIN ADDTL 30 MIN","CDM Code","Pro",510,"Clinic",96113,"DEVEL TST PHYS/QHP EA ADDL",117,58.5,93.015000000000001,99.45,99.45,99.45,98.28,94.77000000000001,93.600000000000009,93.015000000000001,93.600000000000009]
[503710,"DEVELOPMENTAL TEST ADMIN 1ST HR","CDM Code","Pro",510,"Clinic",96112,"DEVEL TST PHYS/QHP 1ST HR",262,131,208.29000000000002,222.7,222.7,222.7,220.07999999999998,212.22000000000003,209.60000000000002,208.29000000000002,209.60000000000002]
[503709,"RPLC GTUBE WO IMAGING W REVISION","CDM Code","Pro",510,"Clinic",43763,"RPLC GTUBE REVJ GSTRST TRC",648,324,515.16000000000008,550.79999999999995,550.79999999999995,550.79999999999995,544.31999999999994,524.88,518.4,515.16000000000008,518.4]
[503708,"INCISIONAL BX SKIN LESION EACH ADDITIONA","CDM Code","Pro",510,"Clinic",11107,"INCAL BX SKN EA SEP/ADDL",142,71,112.89,120.7,120.7,120.7,119.28,115.02000000000001,113.60000000000001,112.89,113.60000000000001]
[503707,"INCISIONAL BX SKIN LESION SINGLE","CDM Code","Pro",510,"Clinic",11106,"INCAL BX SKN SINGLE LES",304,152,241.68,258.39999999999998,258.39999999999998,258.39999999999998,255.35999999999999,246.24,243.20000000000002,241.68,243.20000000000002]
[503706,"PUNCH BX SKIN LESION EACH ADDITIONAL","CDM Code","Pro",510,"Clinic",11105,"PUNCH BX SKIN EA SEP/ADDL",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[503705,"PUNCH BX SKIN LESION SINGLE","CDM Code","Pro",510,"Clinic",11104,"PUNCH BX SKIN SINGLE LESION",256,128,203.52,217.6,217.6,217.6,215.04,207.36,204.8,203.52,204.8]
[503704,"TANGENTIAL BX SKIN LESION EA ADDITIONAL","CDM Code","Pro",510,"Clinic",11103,"TANGNTL BX SKIN EA SEP/ADDL",109,54.5,86.655000000000001,92.649999999999991,92.649999999999991,92.649999999999991,91.56,88.29,87.2,86.655000000000001,87.2]
[503703,"TANGENTIAL BX SKIN SINGLE LESION","CDM Code","Pro",510,"Clinic",11102,"TANGNTL BX SKIN SINGLE LES",197,98.5,156.61500000000001,167.45,167.45,167.45,165.48,159.57000000000002,157.60000000000002,156.61500000000001,157.60000000000002]
[503702,"BIOPSY OF THYROID","CDM Code","Pro",510,"Clinic",60100,"BIOPSY OF THYROID",257,128.5,204.315,218.45,218.45,218.45,215.88,208.17000000000002,205.60000000000002,204.315,205.60000000000002]
[503700,"BIOPSY OF UTERUS LINING","CDM Code","Pro",510,"Clinic",58100,"BIOPSY OF UTERUS LINING",204,102,162.18,173.4,173.4,173.4,171.35999999999999,165.24,163.20000000000002,162.18,163.20000000000002]
[503698,"US EXAM ABDOM COMPLETE","CDM Code","Pro",510,"Clinic",76700,"US EXAM ABDOM COMPLETE",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[503697,"ENDOCERVICAL CURETTAGE","CDM Code","Pro",510,"Clinic",57505,"ENDOCERVICAL CURETTAGE",204,102,162.18,173.4,173.4,173.4,171.35999999999999,165.24,163.20000000000002,162.18,163.20000000000002]
[503696,"BIOPSY OF VULVA PERINEUM","CDM Code","Pro",510,"Clinic",56605,"BIOPSY OF VULVA/PERINEUM",170,85,135.15,144.5,144.5,144.5,142.79999999999998,137.70000000000002,136,135.15,136]
[503695,"INJ FILGRASTIM 300 MCG","CDM Code","IP/OP",636,"Drug/Detail Code","J1442","INJ FILGRASTIM EXCL BIOSIMIL",688,344,546.96,584.79999999999995,584.79999999999995,584.79999999999995,577.91999999999996,557.28000000000009,550.4,546.96,550.4]
[503694,"FETAL BIOPHYS PROFIL W O NST","CDM Code","Pro",510,"Clinic",76819,"FETAL BIOPHYS PROFIL W/O NST",191,95.5,151.845,162.35,162.35,162.35,160.44,154.71,152.80000000000001,151.845,152.80000000000001]
[503693,"DRAINAGE OF GLAND ABSCESS","CDM Code","Pro",510,"Clinic",56420,"DRAINAGE OF GLAND ABSCESS",267,133.5,212.26500000000001,226.95,226.95,226.95,224.28,216.27,213.60000000000002,212.26500000000001,213.60000000000002]
[503692,"BX OF CERVIX W SCOPE LEEP","CDM Code","Pro",510,"Clinic",57460,"BX OF CERVIX W/SCOPE LEEP",587,293.5,466.66500000000002,498.95,498.95,498.95,493.08,475.47,469.6,466.66500000000002,469.6]
[503690,"DRAINAGE OF SKIN ABSCESS","CDM Code","Pro",510,"Clinic",10061,"DRAINAGE OF SKIN ABSCESS",396,198,314.82,336.59999999999997,336.59999999999997,336.59999999999997,332.64,320.76000000000005,316.8,314.82,316.8]
[503689,"DRAINAGE OF BREAST LESION","CDM Code","Pro",510,"Clinic",19000,"DRAINAGE OF BREAST LESION",219,109.5,174.10500000000002,186.15,186.15,186.15,183.95999999999998,177.39000000000001,175.20000000000002,174.10500000000002,175.20000000000002]
[503688,"FRENULOTOMY OF PENIS","CDM Code","Pro",510,"Clinic",54164,"FRENULOTOMY OF PENIS",376,188,298.92,319.59999999999997,319.59999999999997,319.59999999999997,315.83999999999997,304.56,300.8,298.92,300.8]
[503687,"CL- FLU VAX PRES FREE 6 MO AND UP QUAD","CDM Code","IP/OP",636,"Drug/Detail Code",90686,"IIV4 VACC NO PRSV 0.5 ML IM",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[503686,"SKIN TISSUE PROCEDURE","CDM Code","Pro",510,"Clinic",17999,"UNLISTD PX SKN MUC MEMB SUBQ",503,251.5,399.88500000000005,427.55,427.55,427.55,422.52,407.43,402.40000000000003,399.88500000000005,402.40000000000003]
[503685,"CL- HYDROXYPROGESTERONE CAPROATE","CDM Code","IP/OP",636,"Drug/Detail Code","J1726","MAKENA, 10 MG",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[503684,"TREAT HUMERUS FRACTURE","CDM Code","Pro",510,"Clinic",24500,"TREAT HUMERUS FRACTURE",719,359.5,571.60500000000002,611.15,611.15,611.15,603.95999999999992,582.39,575.20000000000005,571.60500000000002,575.20000000000005]
[503683,"ADJUST BONE FIXATION DEVICE","CDM Code","Pro",510,"Clinic",20693,"ADJUST BONE FIXATION DEVICE",848,424,674.16000000000008,720.8,720.8,720.8,712.31999999999994,686.88,678.40000000000009,674.16000000000008,678.40000000000009]
[503682,"FETAL BIOPHYS PROFILE W NST INTERP","CDM Code","Pro",510,"Clinic",76816,"OB US FOLLOW-UP PER FETUS",108,54,85.86,91.8,91.8,91.8,90.72,87.48,86.4,85.86,86.4]
[503681,"SKIN SUB GRAFT F N HF G ADDL","CDM Code","Pro",510,"Clinic",15276,"SKIN SUB GRAFT F/N/HF/G ADDL",67,33.5,53.265000000000001,56.949999999999996,56.949999999999996,56.949999999999996,56.28,54.27,53.6,53.265000000000001,53.6]
[503680,"CLTX THIGH FX","CDM Code","Pro",510,"Clinic",27267,"CLTX THIGH FX",857,428.5,681.31500000000005,728.44999999999993,728.44999999999993,728.44999999999993,719.88,694.17000000000007,685.6,681.31500000000005,685.6]
[503679,"TREAT HIP SOCKET FRACTURE","CDM Code","Pro",510,"Clinic",27222,"TREAT HIP SOCKET FRACTURE",1843,921.5,1465.1850000000002,1566.55,1566.55,1566.55,1548.12,1492.8300000000002,1474.4,1465.1850000000002,1474.4]
[503678,"CL- MAKENA 250MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1726","MAKENA, 10 MG",55,27.5,43.725000000000001,46.75,46.75,46.75,46.199999999999996,44.550000000000004,44,43.725000000000001,44]
[503677,"NEW PT OFFICE OUTPATIENT LEVEL 5","CDM Code","Pro",510,"Clinic",99205,"OFFICE O/P NEW HI 60-74 MIN",562,281,446.79,477.7,477.7,477.7,472.08,455.22,449.6,446.79,449.6]
[503676,"IR BIOPSY OF NECK CHEST","CDM Code","IP/OP",960,"Professional fees",21550,"BIOPSY OF NECK/CHEST",529,264.5,420.55500000000001,449.65,449.65,449.65,444.35999999999996,428.49,423.20000000000005,420.55500000000001,423.20000000000005]
[503675,"CLTX POST ANKLE FX","CDM Code","Pro",510,"Clinic",27767,"CLTX POST ANKLE FX",564,282,448.38,479.4,479.4,479.4,473.76,456.84000000000003,451.20000000000005,448.38,451.20000000000005]
[503674,"CLTX MEDICAL ANKLE FX","CDM Code","Pro",510,"Clinic",27760,"CLTX MEDIAL ANKLE FX",671,335.5,533.44500000000005,570.35,570.35,570.35,563.64,543.51,536.80000000000007,533.44500000000005,536.80000000000007]
[503673,"CL- EXPAREL 20 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","C9290","INJ, BUPIVACAINE LIPOSOME",604,302,480.18,513.4,513.4,513.4,507.35999999999996,489.24,483.20000000000005,480.18,483.20000000000005]
[503672,"CL- HZV VACC RECOMBINANT IM NJX SHINGRIX","CDM Code","IP/OP",636,"Drug/Detail Code",90750,"HZV VACC RECOMBINANT IM",265,132.5,210.67500000000001,225.25,225.25,225.25,222.6,214.65,212,210.67500000000001,212]
[503671,"COMPREHENSIVE HEARING TEST","CDM Code","Pro",510,"Clinic",92557,"COMPREHENSIVE HEARING TEST",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[503670,"STAB PHLEB VEINS XTR 10 20","CDM Code","Pro",510,"Clinic",37765,"STAB PHLEB VEINS XTR 10-20",1236,618,982.62,1050.5999999999999,1050.5999999999999,1050.5999999999999,1038.24,1001.1600000000001,988.80000000000007,982.62,988.80000000000007]
[503669,"COMPREHENSIVE HEARING TEST","CDM Code","Pro",510,"Clinic",92557,"COMPREHENSIVE HEARING TEST",75,37.5,59.625,63.75,63.75,63.75,63,60.750000000000007,60,59.625,60]
[503667,"CL- TRIAMCINOLONE ACETONIDE 10MG INJ","CDM Code","IP/OP",636,"Drug/Detail Code","J3301","TRIAMCINOLONE ACET INJ NOS",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[503666,"TREATMENT OF ANKLE FRACTURE","CDM Code","Pro",510,"Clinic",27808,"TREATMENT OF ANKLE FRACTURE",676,338,537.42000000000007,574.6,574.6,574.6,567.84,547.56000000000006,540.80000000000007,537.42000000000007,540.80000000000007]
[503665,"OB US LIMITED FETUS","CDM Code","Pro",510,"Clinic",76815,"OB US LIMITED FETUS(S)",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[503664,"ECHO EXAM OF ABDOMEN","CDM Code","Pro",510,"Clinic",76705,"ECHO EXAM OF ABDOMEN",61,30.5,48.495000000000005,51.85,51.85,51.85,51.239999999999995,49.410000000000004,48.800000000000004,48.495000000000005,48.800000000000004]
[503663,"US EXAM PELVIC LIMITED","CDM Code","Pro",510,"Clinic",76857,"US EXAM PELVIC LIMITED",100,50,79.5,85,85,85,84,81,80,79.5,80]
[503662,"VASCULAR SURGERY PROCEDURE","CDM Code","Pro",510,"Clinic",37799,"UNLISTED PX VASCULAR SURGERY",870,435,691.65000000000009,739.5,739.5,739.5,730.8,704.7,696,691.65000000000009,696]
[503661,"CHIROPRACTIC MANJ 5 REGIONS 98942","CDM Code","Pro",510,"Clinic",98942,"CHIROPRACTIC MANJ 5 REGIONS",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[503660,"FNA WO IMAGING","CDM Code","Pro",510,"Clinic",10021,"FNA BX W/O IMG GDN 1ST LES",224,112,178.08,190.4,190.4,190.4,188.16,181.44,179.20000000000002,178.08,179.20000000000002]
[503659,"TREAT HUMERUS FRACTURE","CDM Code","Pro",510,"Clinic",23600,"CLTX PROX HUMRL FX W/O MNPJ",631,315.5,501.64500000000004,536.35,536.35,536.35,530.04,511.11,504.8,501.64500000000004,504.8]
[503658,"TREATMENT OF TOE FRACTURE","CDM Code","Pro",510,"Clinic",28510,"TREATMENT OF TOE FRACTURE",237,118.5,188.41500000000002,201.45,201.45,201.45,199.07999999999998,191.97,189.60000000000002,188.41500000000002,189.60000000000002]
[503657,"CL- NUCALA 100MG NC","CDM Code","IP/OP",636,"Drug/Detail Code","J2182","INJECTION, MEPOLIZUMAB, 1MG",82,41,65.19,69.7,69.7,69.7,68.88,66.42,65.600000000000009,65.19,65.600000000000009]
[503656,"TTE LIMITED PRO FEE","CDM Code","IP/OP",981,"Professional fees (096x) Emergency room",93308,"TTE F-UP OR LMTD",51,25.5,40.545000000000002,43.35,43.35,43.35,42.839999999999996,41.31,40.800000000000004,40.545000000000002,40.800000000000004]
[503655,"ECHO EXAM ABDOMEN","CDM Code","Pro",510,"Clinic",76705,"ECHO EXAM OF ABDOMEN",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[503654,"TREAT FINGER FRACTURE EACH","CDM Code","Pro",510,"Clinic",26740,"TREAT FINGER FRACTURE EACH",446,223,354.57,379.09999999999997,379.09999999999997,379.09999999999997,374.64,361.26000000000005,356.8,354.57,356.8]
[503653,"CL- ROPIVACAINE 0.5% 30ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2795","ROPIVACAINE HCL INJECTION",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[503651,"CYSTOSCOPY REMOVAL OF CLOTS","CDM Code","Pro",510,"Clinic",52001,"CYSTOSCOPY REMOVAL OF CLOTS",749,374.5,595.45500000000004,636.65,636.65,636.65,629.16,606.69000000000005,599.20000000000005,595.45500000000004,599.20000000000005]
[503650,"TRIM SKIN LESION","CDM Code","Pro",510,"Clinic",11055,"TRIM SKIN LESION",97,48.5,77.115000000000009,82.45,82.45,82.45,81.48,78.570000000000007,77.600000000000009,77.115000000000009,77.600000000000009]
[503649,"CYSTOURETHROSCOPY REM URETERAL CALCULUS","CDM Code","Pro",510,"Clinic",52320,"CYSTOSCOPY AND TREATMENT",479,239.5,380.80500000000001,407.15,407.15,407.15,402.35999999999996,387.99,383.20000000000005,380.80500000000001,383.20000000000005]
[503647,"TRIM SKIN LESIONS 2 TO 4","CDM Code","Pro",510,"Clinic",11056,"TRIM SKIN LESIONS 2 TO 4",119,59.5,94.605000000000004,101.14999999999999,101.14999999999999,101.14999999999999,99.96,96.39,95.2,94.605000000000004,95.2]
[503646,"REPAIR SIMPLE 2 6 TO 7 5 CM","CDM Code","Pro",510,"Clinic",12002,"RPR S/N/AX/GEN/TRNK2.6-7.5CM",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[503645,"REMOVAL OF FINGER LESION","CDM Code","Pro",510,"Clinic",26210,"REMOVAL OF FINGER LESION",848,424,674.16000000000008,720.8,720.8,720.8,712.31999999999994,686.88,678.40000000000009,674.16000000000008,678.40000000000009]
[503644,"SIMPLE REPAIR 7.6 CM TO 12.5 CM","CDM Code","Pro",510,"Clinic",12004,"RPR S/N/AX/GEN/TRK7.6-12.5CM",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[503643,"CL- PREDNISONE 20MG TAB","CDM Code","IP/OP",250,"Pharmacy","","",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[503642,"REMOVAL TUNNELED CV CATH","CDM Code","Pro",510,"Clinic",36589,"REMOVAL TUNNELED CV CATH",316,158,251.22,268.59999999999997,268.59999999999997,268.59999999999997,265.44,255.96,252.8,251.22,252.8]
[503640,"CL- AZITHROMYCIN TAB 250MG","CDM Code","IP/OP",250,"Pharmacy","","",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[503639,"GENITAL SURGERY PROCEDURE","CDM Code","Pro",510,"Clinic",55899,"UNLISTED PX MALE GENITAL SYS",730,365,580.35,620.5,620.5,620.5,613.19999999999993,591.30000000000007,584,580.35,584]
[503638,"DESTRUCT PREMALG LES 2 14","CDM Code","Pro",510,"Clinic",17003,"DESTRUCT PREMALG LES 2-14",14,7,11.13,11.9,11.9,11.9,11.76,11.34,11.200000000000001,11.13,11.200000000000001]
[503637,"DESTRUCT PREMALG LESION","CDM Code","Pro",510,"Clinic",17000,"DESTRUCT PREMALG LESION",141,70.5,112.095,119.85,119.85,119.85,118.44,114.21000000000001,112.80000000000001,112.095,112.80000000000001]
[503635,"CL- INSULIN NOVOLOG 100unit/ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1815","INSULIN INJECTION",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[503634,"ASP INJ INTERMEDIATE JNT 20605","CDM Code","Pro",510,"Clinic",20605,"DRAIN/INJ JOINT/BURSA W/O US",177,88.5,140.715,150.44999999999999,150.44999999999999,150.44999999999999,148.68,143.37,141.6,140.715,141.6]
[503633,"DRESS DEBRID P THICK BURN S","CDM Code","Pro",510,"Clinic",16020,"DRESS/DEBRID P-THICK BURN S",167,83.5,132.76500000000001,141.94999999999999,141.94999999999999,141.94999999999999,140.28,135.27000000000001,133.6,132.76500000000001,133.6]
[503632,"CONSULT BEFORE SCREENING COLONOSCOPY","CDM Code","Pro",510,"Clinic","S0285","CNSLT BEFORE SCREEN COLONOSCOP",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[503631,"LOWER EXTREMITY STUDY","CDM Code","Pro",510,"Clinic",93926,"LOWER EXTREMITY STUDY",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[503630,"ALCOHOL SUBS INTERV GREATER THAN 30 MIN","CDM Code","Pro",510,"Clinic",99409,"AUDIT/DAST OVER 30 MIN",143,71.5,113.685,121.55,121.55,121.55,120.11999999999999,115.83000000000001,114.4,113.685,114.4]
[503629,"ALCOHOL SUBS INTERV 15 TO 30 MN","CDM Code","Pro",510,"Clinic",99408,"AUDIT/DAST 15-30 MIN",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[503628,"BRIEF EMOTIONAL BEHAV ASSMT","CDM Code","Pro",510,"Clinic",96127,"BRIEF EMOTIONAL/BEHAV ASSMT",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[503627,"ORAL HEALTH RISK  ASSESSMENT LESS 3 YRS","CDM Code","Pro",510,"Clinic","D0145","ORAL EVALUATION, PT < 3YRS",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[503626,"REVISION OF PENIS","CDM Code","Pro",510,"Clinic",54300,"REVISION OF PENIS",1309,654.5,1040.655,1112.6499999999999,1112.6499999999999,1112.6499999999999,1099.56,1060.29,1047.2,1040.655,1047.2]
[503625,"I AND D OF VULVA PERINEUM","CDM Code","Pro",510,"Clinic",56405,"I & D OF VULVA/PERINEUM",251,125.5,199.54500000000002,213.35,213.35,213.35,210.84,203.31,200.8,199.54500000000002,200.8]
[503624,"DIAGNOSTIC LARYNGOSCOPY","CDM Code","Pro",510,"Clinic",31575,"DIAGNOSTIC LARYNGOSCOPY",231,115.5,183.64500000000001,196.35,196.35,196.35,194.04,187.11,184.8,183.64500000000001,184.8]
[503623,"EXC F E E N L MAL PLUS MRG 1 1 2","CDM Code","Pro",510,"Clinic",11642,"EXC F/E/E/N/L MAL+MRG 1.1-2",550,275,437.25,467.5,467.5,467.5,462,445.50000000000006,440,437.25,440]
[503620,"AFO RIGID PLASTIC ANKLE CUSTOM FABRICATE","CDM Code","Pro",510,"Clinic","L1970","AFO PLASTIC MOLDED W/ANKLE J",977,488.5,776.71500000000003,830.44999999999993,830.44999999999993,830.44999999999993,820.68,791.37,781.6,776.71500000000003,781.6]
[503619,"INCISION OF FOOT TENDON","CDM Code","Pro",510,"Clinic",28234,"INCISION OF FOOT TENDON",848,424,674.16000000000008,720.8,720.8,720.8,712.31999999999994,686.88,678.40000000000009,674.16000000000008,678.40000000000009]
[503618,"CL- AMNIO OR BIODMATRIC INJ PER CC","CDM Code","IP/OP",636,"Drug/Detail Code","Q4139","AMNIO OR BIODMATRIX, INJ 1CC",3452,1726,2744.34,2934.2,2934.2,2934.2,2899.68,2796.1200000000003,2761.6000000000004,2744.34,2761.6000000000004]
[503616,"EXC FACE MM B9 PLUS MARG 0 6 1 CM","CDM Code","Pro",510,"Clinic",11441,"EXC FACE-MM B9+MARG 0.6-1 CM",353,176.5,280.63499999999999,300.05,300.05,300.05,296.52,285.93,282.40000000000003,280.63499999999999,282.40000000000003]
[503615,"BIOPSY REMOVAL LYMPH NODES","CDM Code","Pro",510,"Clinic",38500,"BIOPSY/REMOVAL LYMPH NODES",695,347.5,552.52499999999998,590.75,590.75,590.75,583.79999999999995,562.95000000000005,556,552.52499999999998,556]
[503614,"EXC H F NK SP B9 MARG 1  1 2","CDM Code","Pro",510,"Clinic",11422,"EXC H-F-NK-SP B9+MARG 1.1-2",352,176,279.84000000000003,299.2,299.2,299.2,295.68,285.12,281.60000000000002,279.84000000000003,281.60000000000002]
[503613,"INCISION OF ANAL ABSCESS","CDM Code","Pro",510,"Clinic",46050,"INCISION OF ANAL ABSCESS",484,242,384.78000000000003,411.4,411.4,411.4,406.56,392.04,387.20000000000005,384.78000000000003,387.20000000000005]
[503612,"DEBRIDE INFECTED SKIN","CDM Code","Pro",510,"Clinic",11000,"DEBRIDE INFECTED SKIN",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[503611,"EXC TR EXT B9 PLUS MARG 2 1 TO 3 CM","CDM Code","Pro",510,"Clinic",11403,"EXC TR-EXT B9+MARG 2.1-3CM",436,218,346.62,370.59999999999997,370.59999999999997,370.59999999999997,366.24,353.16,348.8,346.62,348.8]
[503610,"EXC TR EXT B9 PLUS MARG GREATER 4 CM","CDM Code","Pro",510,"Clinic",11406,"EXC TR-EXT B9+MARG >4.0 CM",627,313.5,498.46500000000003,532.94999999999993,532.94999999999993,532.94999999999993,526.67999999999995,507.87000000000006,501.6,498.46500000000003,501.6]
[503609,"REMOVAL OF SKIN TAGS W 15","CDM Code","Pro",510,"Clinic",11200,"REMOVAL OF SKIN TAGS <W/15",186,93,147.87,158.1,158.1,158.1,156.23999999999998,150.66,148.80000000000001,147.87,148.80000000000001]
[503608,"CL- METOCLOPRAMIDE HCL INJECT UP TO 10MG","CDM Code","IP/OP",636,"Drug/Detail Code","J2765","METOCLOPRAMIDE HCL INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[503607,"DESTRUCT B9 LESION 1 14","CDM Code","Pro",510,"Clinic",17110,"DESTRUCT B9 LESION 1-14",234,117,186.03,198.9,198.9,198.9,196.56,189.54000000000002,187.20000000000002,186.03,187.20000000000002]
[503606,"DEEP MUSCLE BIOPSY","CDM Code","Pro",510,"Clinic",20205,"DEEP MUSCLE BIOPSY",605,302.5,480.97500000000002,514.25,514.25,514.25,508.2,490.05,484,480.97500000000002,484]
[503603,"INJECT SACROILIAC JOINT","CDM Code","Pro",510,"Clinic",27096,"INJECT SACROILIAC JOINT",371,185.5,294.94499999999999,315.34999999999997,315.34999999999997,315.34999999999997,311.64,300.51000000000005,296.8,294.94499999999999,296.8]
[503602,"TX CLAVICLE FX","CDM Code","Pro",510,"Clinic",23500,"CLTX CLAVICULAR FX W/O MNPJ",465,232.5,369.67500000000001,395.25,395.25,395.25,390.59999999999997,376.65000000000003,372,369.67500000000001,372]
[503601,"TREAT FINGER FRACTURE EACH","CDM Code","Pro",510,"Clinic",26750,"TREAT FINGER FRACTURE EACH",393,196.5,312.435,334.05,334.05,334.05,330.12,318.33000000000004,314.40000000000003,312.435,314.40000000000003]
[503600,"TREAT METACARPAL FRACTURE","CDM Code","Pro",510,"Clinic",26600,"TREAT METACARPAL FRACTURE",625,312.5,496.875,531.25,531.25,531.25,525,506.25000000000006,500,496.875,500]
[503599,"BONE BIOPSY TROCAR NEEDLE","CDM Code","Pro",510,"Clinic",20220,"BONE BIOPSY TROCAR/NEEDLE",359,179.5,285.40500000000003,305.14999999999998,305.14999999999998,305.14999999999998,301.56,290.79000000000002,287.2,285.40500000000003,287.2]
[503598,"EXC TR EXT B9 MARG 3 1  4 CM","CDM Code","Pro",510,"Clinic",11404,"EXC TR-EXT B9+MARG 3.1-4 CM",520,260,413.40000000000003,442,442,442,436.8,421.20000000000005,416,413.40000000000003,416]
[503597,"LDCT FOR LUNG CA SCREEN","CDM Code","IP/OP",960,"Professional fees","G0297","LDCT FOR LUNG CA SCREEN",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[503595,"CARPAL TUNNEL SURGERY","CDM Code","Pro",510,"Clinic",64721,"CARPAL TUNNEL SURGERY",916,458,728.22,778.6,778.6,778.6,769.43999999999994,741.96,732.80000000000007,728.22,732.80000000000007]
[503594,"EXCISION OF NAIL FOLD TOE","CDM Code","Pro",510,"Clinic",11765,"EXCISION OF NAIL FOLD TOE",357,178.5,283.815,303.45,303.45,303.45,299.88,289.17,285.60000000000002,283.815,285.60000000000002]
[503590,"APPLY HAND WRIST CAST","CDM Code","Pro",510,"Clinic",29085,"APPLY HAND/WRIST CAST",204,102,162.18,173.4,173.4,173.4,171.35999999999999,165.24,163.20000000000002,162.18,163.20000000000002]
[503589,"TREAT FRACTURE OF ULNA","CDM Code","Pro",510,"Clinic",25530,"TREAT FRACTURE OF ULNA",554,277,440.43,470.9,470.9,470.9,465.35999999999996,448.74,443.20000000000005,440.43,443.20000000000005]
[503588,"TREAT WRIST BONE FRACTURE","CDM Code","Pro",510,"Clinic",25650,"TREAT WRIST BONE FRACTURE",673,336.5,535.03500000000008,572.04999999999995,572.04999999999995,572.04999999999995,565.31999999999994,545.13,538.4,535.03500000000008,538.4]
[503587,"CHANGE OF BLADDER TUBE","CDM Code","Pro",510,"Clinic",51705,"CHANGE OF BLADDER TUBE",184,92,146.28,156.4,156.4,156.4,154.56,149.04000000000002,147.20000000000002,146.28,147.20000000000002]
[503586,"CMPLX RPR F C C M N AX G H F","CDM Code","Pro",510,"Clinic",13131,"CMPLX RPR F/C/C/M/N/AX/G/H/F",809,404.5,643.15500000000009,687.65,687.65,687.65,679.56,655.29000000000008,647.20000000000005,643.15500000000009,647.20000000000005]
[503585,"SLITTING OF PREPUCE","CDM Code","Pro",510,"Clinic",54001,"SLITTING OF PREPUCE",390,195,310.05,331.5,331.5,331.5,327.59999999999997,315.90000000000003,312,310.05,312]
[503584,"CIRCUMCISION SURGICAL EXC OTH GTR 28DAYS","CDM Code","Pro",510,"Clinic",54161,"CIRCUM 28 DAYS OR OLDER",437,218.5,347.41500000000002,371.45,371.45,371.45,367.08,353.97,349.6,347.41500000000002,349.6]
[503583,"PARTIAL HYMENECTOMY REV OF HYMENAL RING","CDM Code","Pro",510,"Clinic",56700,"PARTIAL REMOVAL OF HYMEN",412,206,327.54000000000002,350.2,350.2,350.2,346.08,333.72,329.6,327.54000000000002,329.6]
[503582,"VULVECTOMY SIMPLE PARTIAL","CDM Code","Pro",510,"Clinic",56620,"PARTIAL REMOVAL OF VULVA",1142,571,907.8900000000001,970.69999999999993,970.69999999999993,970.69999999999993,959.28,925.0200000000001,913.6,907.8900000000001,913.6]
[503580,"MARSUPIALIZATION BARTHOLINS GLAND CYST","CDM Code","Pro",510,"Clinic",56440,"SURGERY FOR VULVA LESION",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[503578,"CYSTOSCOPY AND TREATMENT","CDM Code","Pro",510,"Clinic",52214,"CYSTOSCOPY AND TREATMENT",1397,698.5,1110.615,1187.45,1187.45,1187.45,1173.48,1131.5700000000002,1117.6000000000001,1110.615,1117.6000000000001]
[503577,"CL- PENICILLIN G BENZATHINE 600000 UNIT","CDM Code","IP/OP",636,"Drug/Detail Code","J0561","PENICILLIN G BENZATHINE INJ",116,58,92.22,98.6,98.6,98.6,97.44,93.960000000000008,92.800000000000011,92.22,92.800000000000011]
[503576,"RAD DRAIN INJ JOINT BURSA W O US","CDM Code","Pro",510,"Clinic",20610,"DRAIN/INJ JOINT/BURSA W/O US",146,73,116.07000000000001,124.1,124.1,124.1,122.64,118.26,116.80000000000001,116.07000000000001,116.80000000000001]
[503575,"CL- ALBUTEROL 25MG 3 ML NEB","CDM Code","IP/OP",250,"Pharmacy","J7613","ALBUTEROL NON-COMP UNIT",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[503574,"EPAT TREATMENTS 4 AND 5","CDM Code","Pro",510,"Clinic","","",110,55,87.45,93.5,93.5,93.5,92.399999999999991,89.100000000000009,88,87.45,88]
[503573,"EPAT TREATMENTS 1 TO 3","CDM Code","Pro",510,"Clinic","","",137,68.5,108.91500000000001,116.45,116.45,116.45,115.08,110.97000000000001,109.60000000000001,108.91500000000001,109.60000000000001]
[503569,"DRAIN INJ MAJOR JOINT BURSA W US CLINIC","CDM Code","Pro",510,"Clinic",20611,"DRAIN/INJ JOINT/BURSA W/US",207,103.5,164.565,175.95,175.95,175.95,173.88,167.67000000000002,165.60000000000002,164.565,165.60000000000002]
[503568,"DRAIN INJ INTMED JOINT BURSA W US CLINIC","CDM Code","Pro",510,"Clinic",20606,"DRAIN/INJ JOINT/BURSA W/US",185,92.5,147.07500000000002,157.25,157.25,157.25,155.4,149.85000000000002,148,147.07500000000002,148]
[503567,"DRAIN INJ SMALL JOINT BURSA W US CLINIC","CDM Code","Pro",510,"Clinic",20604,"DRAIN/INJ JOINT/BURSA W/US",164,82,130.38,139.4,139.4,139.4,137.76,132.84,131.20000000000002,130.38,131.20000000000002]
[503563,"CL- DEPO TESTOSTERONE PER MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1071","INJ TESTOSTERONE CYPIONATE",1,0.5,0.79500000000000004,0.85,0.85,0.85,0.84,0.81,0.8,0.79500000000000004,0.8]
[503562,"CYSTOSCOPY AND TREATMENT","CDM Code","Pro",510,"Clinic",52234,"CYSTOSCOPY AND TREATMENT",541,270.5,430.09500000000003,459.84999999999997,459.84999999999997,459.84999999999997,454.44,438.21000000000004,432.8,430.09500000000003,432.8]
[503561,"CL- DEXAMETHASONE 0 25 MG ORAL","CDM Code","IP/OP",636,"Drug/Detail Code","J8540","ORAL DEXAMETHASONE",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[503560,"NEEDLE BIOPSY LYMPH NODES SUPERFICIAL","CDM Code","Pro",510,"Clinic",38505,"NEEDLE BIOPSY LYMPH NODES",284,142,225.78,241.4,241.4,241.4,238.56,230.04000000000002,227.20000000000002,225.78,227.20000000000002]
[503558,"CL- MITOMYCIN INJECTION 5MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9280","MITOMYCIN INJECTION",147,73.5,116.86500000000001,124.95,124.95,124.95,123.47999999999999,119.07000000000001,117.60000000000001,116.86500000000001,117.60000000000001]
[503557,"DISP WND SUCTION DRSG AND ACCESS","CDM Code","Pro",510,"Clinic","A9272","DISP WOUND SUCT, DRSG/ACCESS",95,47.5,75.525000000000006,80.75,80.75,80.75,79.8,76.95,76,75.525000000000006,76]
[503554,"CL- TRAUMEEL 1 AMPULE 2 2ML","CDM Code","IP/OP",250,"Pharmacy","J3490","DRUGS UNCLASSIFIED INJECTION",17,8.5,13.515000000000001,14.45,14.45,14.45,14.28,13.770000000000001,13.600000000000001,13.515000000000001,13.600000000000001]
[503553,"CL- FIRMAGON 1MG INJ","CDM Code","IP/OP",636,"Drug/Detail Code","J9155","DEGARELIX INJECTION",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[503552,"NEURAL PROLOTHERAPY","CDM Code","Pro",510,"Clinic","","",254,127,201.93,215.9,215.9,215.9,213.35999999999999,205.74,203.20000000000002,201.93,203.20000000000002]
[503551,"CL- MEPIVACAINE 1.5%","CDM Code","IP/OP",636,"Drug/Detail Code","J0670","INJ MEPIVACAINE HCL/10 ML",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[503550,"CL- MONOVISC","CDM Code","IP/OP",636,"Drug/Detail Code","J7327","MONOVISC INJ PER DOSE",2051,1025.5,1630.5450000000001,1743.35,1743.35,1743.35,1722.84,1661.3100000000002,1640.8000000000002,1630.5450000000001,1640.8000000000002]
[503549,"CL- DOXYCYCLINE 100 MG VIAL","CDM Code","IP/OP",250,"Pharmacy","","",41,20.5,32.594999999999999,34.85,34.85,34.85,34.44,33.21,32.800000000000004,32.594999999999999,32.800000000000004]
[503548,"SUTURE REMOVAL OTHER PROVIDER 99211","CDM Code","Pro",510,"Clinic",99211,"OFF/OP EST MAY X REQ PHY/QHP",57,28.5,45.315000000000005,48.449999999999996,48.449999999999996,48.449999999999996,47.879999999999995,46.17,45.6,45.315000000000005,45.6]
[503547,"TREAT FINGER DISCLOCATION","CDM Code","Pro",510,"Clinic",26770,"TREAT FINGER DISLOCATION",636,318,505.62,540.6,540.6,540.6,534.24,515.16000000000008,508.8,505.62,508.8]
[503546,"EXAM/BIOPSY OF VAGINA W/SCOPE","CDM Code","Pro",510,"Clinic",57421,"EXAM/BIOPSY OF VAG W/SCOPE",363,181.5,288.58500000000004,308.55,308.55,308.55,304.92,294.03000000000003,290.40000000000003,288.58500000000004,290.40000000000003]
[503545,"EXAM OF VAGINA W SCOPE","CDM Code","Pro",510,"Clinic",57420,"EXAM OF VAGINA W/SCOPE",271,135.5,215.44500000000002,230.35,230.35,230.35,227.64,219.51000000000002,216.8,215.44500000000002,216.8]
[503544,"CL- SKYLA 13.5 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J7301","SKYLA, 13.5 MG",2147,1073.5,1706.865,1824.95,1824.95,1824.95,1803.48,1739.0700000000002,1717.6000000000001,1706.865,1717.6000000000001]
[503543,"THERAPEUTIC PROPHYLACTIC OR DX INJ","CDM Code","Pro",510,"Clinic",96372,"THER/PROPH/DIAG INJ SC/IM",61,30.5,48.495000000000005,51.85,51.85,51.85,51.239999999999995,49.410000000000004,48.800000000000004,48.495000000000005,48.800000000000004]
[503542,"HYDRATION IV INFUSION ADD-ON 96361","CDM Code","Pro",510,"Clinic",96361,"HYDRATE IV INFUSION ADD-ON",34,17,27.03,28.9,28.9,28.9,28.56,27.540000000000003,27.200000000000003,27.03,27.200000000000003]
[503541,"HYDRATION IV INFUSION INITIAL 96360","CDM Code","Pro",510,"Clinic",96360,"HYDRATION IV INFUSION INIT",132,66,104.94000000000001,112.2,112.2,112.2,110.88,106.92,105.60000000000001,104.94000000000001,105.60000000000001]
[503540,"REMOVE FOREIGN BODY NOSE 30300","CDM Code","Pro",510,"Clinic",30300,"REMOVE NASAL FOREIGN BODY",549,274.5,436.45500000000004,466.65,466.65,466.65,461.15999999999997,444.69000000000005,439.20000000000005,436.45500000000004,439.20000000000005]
[503539,"REMOVE FOREIGN BODY EYE 65205","CDM Code","Pro",510,"Clinic",65205,"REMOVE FOREIGN BODY FROM EYE",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[503538,"MEASURE BLOOD OXYGEN LEVEL 94760","CDM Code","Pro",510,"Clinic",94760,"MEASURE BLOOD OXYGEN LEVEL",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[503537,"EXC MALIGNANT LESION 2 1 TO 3 0 CM","CDM Code","Pro",510,"Clinic",11603,"EXC TR-EXT MAL+MARG 2.1-3 CM",615,307.5,488.92500000000001,522.75,522.75,522.75,516.6,498.15000000000003,492,488.92500000000001,492]
[503535,"EXC BACK LES SC 3 CM","CDM Code","Pro",510,"Clinic",21930,"EXC BACK LES SC < 3 CM",1084,542,861.78000000000009,921.4,921.4,921.4,910.56,878.04000000000008,867.2,861.78000000000009,867.2]
[503534,"EXC OF ANAL LESIONS","CDM Code","Pro",510,"Clinic",46922,"EXCISION OF ANAL LESION(S)",620,310,492.90000000000003,527,527,527,520.79999999999995,502.20000000000005,496,492.90000000000003,496]
[503533,"CYSTOMETROGRAM W VP  UP","CDM Code","Pro",510,"Clinic",51729,"CYSTOMETROGRAM W/VP&UP",793,396.5,630.43500000000006,674.05,674.05,674.05,666.12,642.33000000000004,634.40000000000009,630.43500000000006,634.40000000000009]
[503526,"CL- RACEPINEPHRINE HYDRCHL 11.25 MG .5ML","CDM Code","IP/OP",250,"Pharmacy","J3490","DRUGS UNCLASSIFIED INJECTION",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[503525,"CL- DUONEB","CDM Code","IP/OP",250,"Pharmacy","J7620","ALBUTEROL IPRATROP NON-COMP",3,1.5,2.3850000000000002,2.5499999999999998,2.5499999999999998,2.5499999999999998,2.52,2.4300000000000002,2.4000000000000004,2.3850000000000002,2.4000000000000004]
[503523,"CL- TRIPTORELIN TRELSTAR 3 75MG","CDM Code","IP/OP",636,"Drug/Detail Code","J3315","TRIPTORELIN PAMOATE",462,231,367.29,392.7,392.7,392.7,388.08,374.22,369.6,367.29,369.6]
[503520,"CL- DENOSUMAB PER MG","CDM Code","IP/OP",636,"Drug/Detail Code","J0897","DENOSUMAB INJECTION",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[503519,"EXC BREAST LESION ONE OR MORE","CDM Code","Pro",510,"Clinic",19120,"REMOVAL OF BREAST LESION",1311,655.5,1042.2450000000001,1114.3499999999999,1114.3499999999999,1114.3499999999999,1101.24,1061.9100000000001,1048.8,1042.2450000000001,1048.8]
[503518,"CL- ADRENALIN EPINEPHRINE 0 1MG","CDM Code","IP/OP",636,"Drug/Detail Code","J0171","ADRENALIN EPINEPHRINE INJECT",56,28,44.52,47.6,47.6,47.6,47.04,45.36,44.800000000000004,44.52,44.800000000000004]
[503516,"REM CENTRAL VENOUS ACCESS DEVICE","CDM Code","Pro",510,"Clinic",36590,"REMOVAL TUNNELED CV CATH",840,420,667.80000000000007,714,714,714,705.6,680.40000000000009,672,667.80000000000007,672]
[503515,"REMOVE INSERT DRUG IMPLANT","CDM Code","Pro",510,"Clinic",11983,"REMOVE/INSERT DRUG IMPLANT",468,234,372.06,397.8,397.8,397.8,393.12,379.08000000000004,374.40000000000003,372.06,374.40000000000003]
[503513,"DILATION URETHRAL STRICTURE MALE INITIAL","CDM Code","Pro",510,"Clinic",53620,"DILATE URETHRA STRICTURE",262,131,208.29000000000002,222.7,222.7,222.7,220.07999999999998,212.22000000000003,209.60000000000002,208.29000000000002,209.60000000000002]
[503512,"LYSIS OR EXC PENILE POSTCIRC ADHESI","CDM Code","Pro",510,"Clinic",54162,"LYSIS PENIL CIRCUMIC LESION",570,285,453.15000000000003,484.5,484.5,484.5,478.79999999999995,461.70000000000005,456,453.15000000000003,456]
[503511,"ANOSCOPY WITH BIOPSY SINGLE OR MULTIPLE","CDM Code","Pro",510,"Clinic",46606,"ANOSCOPY AND BIOPSY",471,235.5,374.44499999999999,400.34999999999997,400.34999999999997,400.34999999999997,395.64,381.51000000000005,376.8,374.44499999999999,376.8]
[503510,"IMPLANT NEUROSTIM SACRAL NERVE ADDTL","CDM Code","Pro",510,"Clinic",64561,"IMPLANT NEUROELECTRODES",1875,937.5,1490.625,1593.75,1593.75,1593.75,1575,1518.75,1500,1490.625,1500]
[503508,"RELEASE OF FOOT TENDON","CDM Code","Pro",510,"Clinic",28225,"RELEASE OF FOOT TENDON",856,428,680.52,727.6,727.6,727.6,719.04,693.36,684.80000000000007,680.52,684.80000000000007]
[503507,"IMPLANT NEUROSTIMULATOR SACRAL NERVE","CDM Code","Pro",510,"Clinic",64561,"IMPLANT NEUROELECTRODES",1875,937.5,1490.625,1593.75,1593.75,1593.75,1575,1518.75,1500,1490.625,1500]
[503506,"CL- MEDROXYPROGESTERONE ACETATE 1MG INJ","CDM Code","IP/OP",636,"Drug/Detail Code","J1050","MEDROXYPROGESTERONE ACETATE",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[503505,"CLOSED TX GRT HUMERAL TUBER FX WO MANIP","CDM Code","Pro",510,"Clinic",23620,"CLTX GR HMRL TBRS FX WO MNPJ",706,353,561.27,600.1,600.1,600.1,593.04,571.86,564.80000000000007,561.27,564.80000000000007]
[503504,"SKIN SUB GRAFT FACE NK HF G","CDM Code","Pro",510,"Clinic",15275,"SKIN SUB GRAFT FACE/NK/HF/G",318,159,252.81,270.3,270.3,270.3,267.12,257.58000000000004,254.4,252.81,254.4]
[503503,"WOUND PREP F N HF G","CDM Code","Pro",510,"Clinic",15004,"WOUND PREP F/N/HF/G",813,406.5,646.33500000000004,691.05,691.05,691.05,682.92,658.53000000000009,650.40000000000009,646.33500000000004,650.40000000000009]
[503501,"EXC HIP PELVIS LES SC 3C","CDM Code","Pro",510,"Clinic",27047,"EXC HIP/PELVIS LES SC < 3 CM",1071,535.5,851.44500000000005,910.35,910.35,910.35,899.64,867.5100000000001,856.80000000000007,851.44500000000005,856.80000000000007]
[503497,"CL- NEXPLANON 68MG","CDM Code","IP/OP",636,"Drug/Detail Code","J7307","ETONOGESTREL IMPLANT SYSTEM",2300,1150,1828.5,1955,1955,1955,1932,1863.0000000000002,1840,1828.5,1840]
[503490,"CL- LIDOCAINE 2  20 ML MDV","CDM Code","IP/OP",250,"Pharmacy","","",10,5,7.95,8.5,8.5,8.5,8.4,8.1000000000000014,8,7.95,8]
[503489,"CL- SODIUM BICARBONATE 8 4 SYRD 50 ML","CDM Code","IP/OP",250,"Pharmacy","","",18,9,14.31,15.299999999999999,15.299999999999999,15.299999999999999,15.12,14.580000000000002,14.4,14.31,14.4]
[503488,"CL- HEPARIN SODIUM PER 1000U PER ML 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1644","INJ HEPARIN SODIUM PER 1000U",2,1,1.59,1.7,1.7,1.7,1.68,1.62,1.6,1.59,1.6]
[503487,"INFLUENZA ASSAY W OPTIC EACH","CDM Code","Pro",510,"Clinic",87804,"INFLUENZA ASSAY W/OPTIC",45,22.5,35.774999999999999,38.25,38.25,38.25,37.799999999999997,36.450000000000003,36,35.774999999999999,36]
[503486,"EXC BACK LES SC 3 CM","CDM Code","Pro",510,"Clinic",21931,"EXC BACK LES SC 3 CM/>",886,443,704.37,753.1,753.1,753.1,744.24,717.66000000000008,708.80000000000007,704.37,708.80000000000007]
[503485,"TREATMENT OF ANKLE FRACTURE","CDM Code","Pro",510,"Clinic",27788,"TREATMENT OF ANKLE FRACTURE",853,426.5,678.13499999999999,725.05,725.05,725.05,716.52,690.93000000000006,682.40000000000009,678.13499999999999,682.40000000000009]
[503483,"CLOSED TX PHALANGEAL SHAFT FX EACH","CDM Code","Pro",510,"Clinic",26725,"TREAT FINGER FRACTURE EACH",810,405,643.95000000000005,688.5,688.5,688.5,680.4,656.1,648,643.95000000000005,648]
[503482,"DIMETHYL SULFOXIDE 50 50ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1212","DIMETHYL SULFOXIDE 50% 50 ML",210,105,166.95000000000002,178.5,178.5,178.5,176.4,170.10000000000002,168,166.95000000000002,168]
[503481,"THER INJECTION CARP TUNNEL 20526","CDM Code","Pro",510,"Clinic",20526,"THER INJECTION CARP TUNNEL",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[503480,"TREAT METATARSAL FRACTURE","CDM Code","Pro",510,"Clinic",28475,"TREAT METATARSAL FRACTURE",575,287.5,457.125,488.75,488.75,488.75,483,465.75000000000006,460,457.125,460]
[503479,"INCISION OF TOE TENDON","CDM Code","IP/OP",636,"Drug/Detail Code",28232,"INCISION OF TOE TENDON",503,251.5,399.88500000000005,427.55,427.55,427.55,422.52,407.43,402.40000000000003,399.88500000000005,402.40000000000003]
[503476,"I  D PILONIDAL CYST COMPLICATED","CDM Code","Pro",510,"Clinic",10081,"DRAINAGE OF PILONIDAL CYST",648,324,515.16000000000008,550.79999999999995,550.79999999999995,550.79999999999995,544.31999999999994,524.88,518.4,515.16000000000008,518.4]
[503467,"IMMUNIZATION ADMIN NASAL OR ORAL","CDM Code","Pro",510,"Clinic",90473,"IMMUNE ADMIN ORAL/NASAL",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[503466,"TX OF TOE FX","CDM Code","Pro",510,"Clinic",28515,"TREATMENT OF TOE FRACTURE",359,179.5,285.40500000000003,305.14999999999998,305.14999999999998,305.14999999999998,301.56,290.79000000000002,287.2,285.40500000000003,287.2]
[503462,"SPECIAL REPORTS OR FORMS","CDM Code","Pro",510,"Clinic",99080,"SPECIAL REPORTS OR FORMS",166,83,131.97,141.1,141.1,141.1,139.44,134.46,132.80000000000001,131.97,132.80000000000001]
[503460,"EXAM BIOPSY OF VULVA W SCOPE","CDM Code","Pro",510,"Clinic",56821,"EXAM/BIOPSY OF VULVA W/SCOPE",308,154,244.86,261.8,261.8,261.8,258.71999999999997,249.48000000000002,246.4,244.86,246.4]
[503459,"EXAM OF VULVA W SCOPE","CDM Code","Pro",510,"Clinic",56820,"EXAM OF VULVA W/SCOPE",246,123,195.57000000000002,209.1,209.1,209.1,206.64,199.26000000000002,196.8,195.57000000000002,196.8]
[503455,"N BLOCK INJ SUPRASCAPULAR","CDM Code","Pro",510,"Clinic",64418,"NJX AA&/STRD SPRSCAP NRV",334,167,265.53000000000003,283.89999999999998,283.89999999999998,283.89999999999998,280.56,270.54000000000002,267.2,265.53000000000003,267.2]
[503453,"GMC-ORTHOTICS FUNCTIONAL MET DEPOSIT","CDM Code","Pro",510,"Clinic","L3020","FOOT LONGITUD/METATARSAL SUP",110,55,87.45,93.5,93.5,93.5,92.399999999999991,89.100000000000009,88,87.45,88]
[503452,"APPLY MULTILAYER VENOUS WOUND COMPRESS","CDM Code","Pro",510,"Clinic",29581,"APPLY MULTLAY COMPRS LWR LEG",102,51,81.09,86.7,86.7,86.7,85.679999999999993,82.62,81.600000000000009,81.09,81.600000000000009]
[503450,"MEDICARE ANNUAL WELLNESS SUBSEQ PPPS","CDM Code","Pro",510,"Clinic","G0439","PPPS, SUBSEQ VISIT",247,123.5,196.36500000000001,209.95,209.95,209.95,207.48,200.07000000000002,197.60000000000002,196.36500000000001,197.60000000000002]
[503449,"MEDICARE ANNUAL WELLNESS INITIAL PPPS","CDM Code","Pro",510,"Clinic","G0438","PPPS, INITIAL VISIT",370,185,294.15000000000003,314.5,314.5,314.5,310.8,299.70000000000005,296,294.15000000000003,296]
[503448,"REMOVE DEVITAL TISSUE PER SESSION ADDL20","CDM Code","Pro",510,"Clinic",97598,"RMVL DEVITAL TIS ADDL 20CM/<",64,32,50.88,54.4,54.4,54.4,53.76,51.84,51.2,50.88,51.2]
[503447,"REMOVE DEVITAL TISSUE PER SESSION 20SQCM","CDM Code","Pro",510,"Clinic",97597,"RMVL DEVITAL TIS 20 CM/<",135,67.5,107.325,114.75,114.75,114.75,113.39999999999999,109.35000000000001,108,107.325,108]
[503443,"CLOSED TX OF DISTAL FIBULAR FX WO MANIP","CDM Code","Pro",510,"Clinic",27786,"TREATMENT OF ANKLE FRACTURE",944,472,750.48,802.4,802.4,802.4,792.95999999999992,764.6400000000001,755.2,750.48,755.2]
[503439,"SHAVE SKIN LESION GREATER 2 CM S N H F G","CDM Code","Pro",510,"Clinic",11308,"SHAVE SKIN LESION >2.0 CM",330,165,262.35000000000002,280.5,280.5,280.5,277.2,267.3,264,262.35000000000002,264]
[503437,"ANKLE FOOT ORTHOSIS RIGID PREFABRICATED","CDM Code","Pro",510,"Clinic","L2116","AFO TIBIAL FRACTURE RIGID",461,230.5,366.495,391.84999999999997,391.84999999999997,391.84999999999997,387.24,373.41,368.8,366.495,368.8]
[503435,"CL- ORTHOVISC PER DOSE","CDM Code","IP/OP",636,"Drug/Detail Code","J7324","ORTHOVISC INJ PER DOSE",597,298.5,474.61500000000001,507.45,507.45,507.45,501.47999999999996,483.57000000000005,477.6,474.61500000000001,477.6]
[503434,"APPLY LONG LEG CAST CYLINDER","CDM Code","Pro",510,"Clinic",29365,"APPLICATION OF LONG LEG CAST",285,142.5,226.57500000000002,242.25,242.25,242.25,239.39999999999998,230.85000000000002,228,226.57500000000002,228]
[503433,"APPLY LONG LEG CAST WALKER","CDM Code","Pro",510,"Clinic",29355,"APPLICATION OF LONG LEG CAST",312,156,248.04000000000002,265.2,265.2,265.2,262.08,252.72000000000003,249.60000000000002,248.04000000000002,249.60000000000002]
[503431,"TX BIG TOE FX","CDM Code","Pro",510,"Clinic",28490,"TREAT BIG TOE FRACTURE",348,174,276.66000000000003,295.8,295.8,295.8,292.32,281.88,278.40000000000003,276.66000000000003,278.40000000000003]
[503428,"CYSTOSCOPY AND TREATMENT","CDM Code","Pro",510,"Clinic",52224,"CYSTOSCOPY AND TREATMENT",1284,642,1020.7800000000001,1091.3999999999999,1091.3999999999999,1091.3999999999999,1078.56,1040.04,1027.2,1020.7800000000001,1027.2]
[503427,"CLOSED TX OF PHALANGEAL SHAFT FX","CDM Code","Pro",510,"Clinic",26720,"TREAT FINGER FRACTURE EACH",498,249,395.91,423.3,423.3,423.3,418.32,403.38000000000005,398.40000000000003,395.91,398.40000000000003]
[503426,"CL- INTERFERON ALFA-2B RECOMBINANT 1 MIL","CDM Code","IP/OP",636,"Drug/Detail Code","J9214","INTERFERON ALFA-2B INJ",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[503425,"CL- PROCHLORPERAZINE COMPAZINE 10MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0780","PROCHLORPERAZINE INJECTION",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[503422,"EXC BENIGN LESION UP TO 0 5 CM","CDM Code","Pro",510,"Clinic",11400,"EXC TR-EXT B9+MARG 0.5 CM<",350,175,278.25,297.5,297.5,297.5,294,283.5,280,278.25,280]
[503421,"CONTROL OF NOSEBLEED","CDM Code","Pro",510,"Clinic",30901,"CONTROL OF NOSEBLEED",218,109,173.31,185.29999999999998,185.29999999999998,185.29999999999998,183.12,176.58,174.4,173.31,174.4]
[503420,"CL- IMPLANON 68 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J7307","ETONOGESTREL IMPLANT SYSTEM",2250,1125,1788.75,1912.5,1912.5,1912.5,1890,1822.5000000000002,1800,1788.75,1800]
[503419,"APPLY SHORT LEG SPLINT","CDM Code","Pro",510,"Clinic",29515,"APPLICATION LOWER LEG SPLINT",208,104,165.36,176.79999999999998,176.79999999999998,176.79999999999998,174.72,168.48000000000002,166.4,165.36,166.4]
[503418,"APPLY LONG ARM SPLINT","CDM Code","Pro",510,"Clinic",29105,"APPLY LONG ARM SPLINT",224,112,178.08,190.4,190.4,190.4,188.16,181.44,179.20000000000002,178.08,179.20000000000002]
[503417,"APPLY LONG LEG CAST","CDM Code","Pro",510,"Clinic",29345,"APPLICATION OF LONG LEG CAST",321,160.5,255.19500000000002,272.84999999999997,272.84999999999997,272.84999999999997,269.64,260.01,256.8,255.19500000000002,256.8]
[503416,"APPLY SHORT LEG CAST WALKER","CDM Code","Pro",510,"Clinic",29425,"APPLY SHORT LEG CAST",243,121.5,193.185,206.54999999999998,206.54999999999998,206.54999999999998,204.12,196.83,194.4,193.185,194.4]
[503414,"APPLY SHORT ARM SPLINT","CDM Code","Pro",510,"Clinic",29125,"APPLY FOREARM SPLINT",191,95.5,151.845,162.35,162.35,162.35,160.44,154.71,152.80000000000001,151.845,152.80000000000001]
[503412,"APPLY SHORT ARM CAST","CDM Code","Pro",510,"Clinic",29075,"APPLICATION OF FOREARM CAST",250,125,198.75,212.5,212.5,212.5,210,202.5,200,198.75,200]
[503411,"APPLY LONG ARM CAST","CDM Code","Pro",510,"Clinic",29065,"APPLICATION OF LONG ARM CAST",262,131,208.29000000000002,222.7,222.7,222.7,220.07999999999998,212.22000000000003,209.60000000000002,208.29000000000002,209.60000000000002]
[503410,"REMOVAL NONBIODEGRADABLE DRUG DEVICE","CDM Code","Pro",510,"Clinic",11982,"REMOVE DRUG IMPLANT DEVICE",445,222.5,353.77500000000003,378.25,378.25,378.25,373.8,360.45000000000005,356,353.77500000000003,356]
[503409,"REMOVAL OF IMPLANT SUPERFICIAL","CDM Code","Pro",510,"Clinic",20670,"REMOVAL OF SUPPORT IMPLANT",838,419,666.21,712.3,712.3,712.3,703.92,678.78000000000009,670.40000000000009,666.21,670.40000000000009]
[503405,"CL- COSYNTROPIN 0 25MG ACTH","CDM Code","IP/OP",636,"Drug/Detail Code","J0834","INJ., COSYNTROPIN, 0.25 MG",239,119.5,190.005,203.15,203.15,203.15,200.76,193.59,191.20000000000002,190.005,191.20000000000002]
[503402,"CYSTOMETROGRAM W URINE VOIDING PRESSURE","CDM Code","Pro",510,"Clinic",51728,"CYSTOMETROGRAM W/VP",575,287.5,457.125,488.75,488.75,488.75,483,465.75000000000006,460,457.125,460]
[503400,"INCISION TENDON SHEATH","CDM Code","Pro",510,"Clinic",25000,"INCISION OF TENDON SHEATH",536,268,426.12,455.59999999999997,455.59999999999997,455.59999999999997,450.24,434.16,428.8,426.12,428.8]
[503399,"REMOVE TENDON SHEATH LESION","CDM Code","Pro",510,"Clinic",26160,"REMOVE TENDON SHEATH LESION",1324,662,1052.5800000000002,1125.3999999999999,1125.3999999999999,1125.3999999999999,1112.1599999999999,1072.44,1059.2,1052.5800000000002,1059.2]
[503398,"TENOTOMY PERCUTANEOUS TOE SINGLE TENDON","CDM Code","Pro",510,"Clinic",28010,"INCISION OF TOE TENDON",459,229.5,364.90500000000003,390.15,390.15,390.15,385.56,371.79,367.20000000000005,364.90500000000003,367.20000000000005]
[503394,"TX WRIST BONE FX","CDM Code","Pro",510,"Clinic",25622,"TREAT WRIST BONE FRACTURE",617,308.5,490.51500000000004,524.44999999999993,524.44999999999993,524.44999999999993,518.28,499.77000000000004,493.6,490.51500000000004,493.6]
[503391,"I D PERIRECTAL/ISCHIORECTAL ABSCESS","CDM Code","Pro",510,"Clinic",46040,"INCISION OF RECTAL ABSCESS",1213,606.5,964.33500000000004,1031.05,1031.05,1031.05,1018.92,982.53000000000009,970.40000000000009,964.33500000000004,970.40000000000009]
[503388,"PUNCTURE ASPIRATION OF HYDROCLE WWO INJ","CDM Code","Pro",510,"Clinic",55000,"DRAINAGE OF HYDROCELE",459,229.5,364.90500000000003,390.15,390.15,390.15,385.56,371.79,367.20000000000005,364.90500000000003,367.20000000000005]
[503386,"REMOVAL OF FOREIGN BODY SIMPLE","CDM Code","Pro",510,"Clinic",20520,"REMOVAL OF FOREIGN BODY",432,216,343.44,367.2,367.2,367.2,362.88,349.92,345.6,343.44,345.6]
[503381,"STATE SUP PED VACC ADMIN EA ADDL 90472","CDM Code","Pro",510,"Clinic",90472,"IMMUNIZATION ADMIN EACH ADD",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[503380,"STATE SUP PED VACC ADMIN 90471","CDM Code","Pro",510,"Clinic",90471,"IMMUNIZATION ADMIN",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[503379,"BLOOD COUNT HEMOGLOBIN FINGERSTICK","CDM Code","IP/OP",300,"Lab",85018,"HEMOGLOBIN",8,4,6.36,6.8,6.8,6.8,6.72,6.48,6.4,6.36,6.4]
[503378,"NERVE BLOCK INJ OCCIPITAL","CDM Code","Pro",510,"Clinic",64405,"NJX AA&/STRD GR OCPL NRV",255,127.5,202.72500000000002,216.75,216.75,216.75,214.2,206.55,204,202.72500000000002,204]
[503377,"CRYOSURGERY PENIS LESION S","CDM Code","Pro",510,"Clinic",54056,"CRYOSURGERY PENIS LESION(S)",263,131.5,209.08500000000001,223.54999999999998,223.54999999999998,223.54999999999998,220.92,213.03,210.4,209.08500000000001,210.4]
[503376,"EXCISION OF PENIS LESION","CDM Code","Pro",510,"Clinic",54060,"EXCISION OF PENIS LESION(S)",367,183.5,291.76499999999999,311.95,311.95,311.95,308.27999999999997,297.27000000000004,293.60000000000002,291.76499999999999,293.60000000000002]
[503371,"HEMORRHOIDECTOMY BY SIMPLE LIGATURE","CDM Code","Pro",510,"Clinic",46221,"LIGATION OF HEMORRHOID(S)",679,339.5,539.80500000000006,577.15,577.15,577.15,570.36,549.99,543.20000000000005,539.80500000000006,543.20000000000005]
[503367,"TREAT METATARSAL FRACTURE","CDM Code","Pro",510,"Clinic",28470,"TREAT METATARSAL FRACTURE",479,239.5,380.80500000000001,407.15,407.15,407.15,402.35999999999996,387.99,383.20000000000005,380.80500000000001,383.20000000000005]
[503366,"INJ INTRALESIONAL UP TO AND INCL 7 LESIO","CDM Code","Pro",510,"Clinic",11900,"INJECT SKIN LESIONS </W 7",121,60.5,96.195000000000007,102.85,102.85,102.85,101.64,98.01,96.800000000000011,96.195000000000007,96.800000000000011]
[503365,"DESTROY CONDOLYMATA MALE 54050","CDM Code","Pro",510,"Clinic",54050,"DESTRUCTION PENIS LESION(S)",420,210,333.90000000000003,357,357,357,352.8,340.20000000000005,336,333.90000000000003,336]
[503363,"GMC ORTHOTICS REPAIR","CDM Code","Pro",510,"Clinic","","",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503362,"US GUIDANCE NDL PLACEMENT SPRV  INTR NC","CDM Code","Pro",510,"Clinic",76942,"ECHO GUIDE FOR BIOPSY",111,55.5,88.245000000000005,94.35,94.35,94.35,93.24,89.910000000000011,88.800000000000011,88.245000000000005,88.800000000000011]
[503361,"INJECT SINGLE TENDON SHEATH OR LIGAMENT","CDM Code","Pro",510,"Clinic",20550,"INJ TENDON SHEATH/LIGAMENT",191,95.5,151.845,162.35,162.35,162.35,160.44,154.71,152.80000000000001,151.845,152.80000000000001]
[503360,"ARTHROCENTESIS ASPIR OR INJ SMJNT","CDM Code","Pro",510,"Clinic",20600,"DRAIN/INJ JOINT/BURSA W/O US",93,46.5,73.935000000000002,79.05,79.05,79.05,78.11999999999999,75.33,74.400000000000006,73.935000000000002,74.400000000000006]
[503359,"US GUIDANCE NDL PLACEMENT SPRV  INTRP","CDM Code","Pro",510,"Clinic",76942,"ECHO GUIDE FOR BIOPSY",198,99,157.41,168.29999999999998,168.29999999999998,168.29999999999998,166.32,160.38000000000002,158.4,157.41,158.4]
[503358,"IRRIGATION OF BLADDER","CDM Code","Pro",510,"Clinic",51700,"IRRIGATION OF BLADDER",148,74,117.66000000000001,125.8,125.8,125.8,124.32,119.88000000000001,118.4,117.66000000000001,118.4]
[503351,"REMOVAL SWEAT GLAND LESION","CDM Code","Pro",510,"Clinic",11450,"REMOVAL SWEAT GLAND LESION",803,401.5,638.38499999999999,682.55,682.55,682.55,674.52,650.43000000000006,642.40000000000009,638.38499999999999,642.40000000000009]
[503347,"TENDON SHEATH INCISION","CDM Code","Pro",510,"Clinic",26055,"INCISE FINGER TENDON SHEATH",1482,741,1178.19,1259.7,1259.7,1259.7,1244.8799999999999,1200.42,1185.6000000000001,1178.19,1185.6000000000001]
[503345,"INJ 3 OR MORE TRIGGER","CDM Code","Pro",510,"Clinic",20553,"INJECT TRIGGER POINTS 3/>",237,118.5,188.41500000000002,201.45,201.45,201.45,199.07999999999998,191.97,189.60000000000002,188.41500000000002,189.60000000000002]
[503344,"PLATELET RICH PLASMA INJECTION EA  ADDL","CDM Code","Pro",510,"Clinic","","",813,406.5,646.33500000000004,691.05,691.05,691.05,682.92,658.53000000000009,650.40000000000009,646.33500000000004,650.40000000000009]
[503343,"PLATELET RICH PLASMA INJECTION FIRST","CDM Code","Pro",510,"Clinic","","",1205,602.5,957.97500000000002,1024.25,1024.25,1024.25,1012.1999999999999,976.05000000000007,964,957.97500000000002,964]
[503339,"CHEMO ADMIN SQ IM HORMONAL ANTI NEOPLAST","CDM Code","IP/OP",331,"Rad-Chemo-Inject",96402,"CHEMO HORMON ANTINEOPL SQ/IM",95,47.5,75.525000000000006,80.75,80.75,80.75,79.8,76.95,76,75.525000000000006,76]
[503338,"BLADDER INSTILLATION OF ANTICARCINOGENIC","CDM Code","Pro",510,"Clinic",51720,"TREATMENT OF BLADDER LESION",403,201.5,320.38499999999999,342.55,342.55,342.55,338.52,326.43,322.40000000000003,320.38499999999999,322.40000000000003]
[503337,"INJECTION TREATMENT OF NERVE PLANTAR DIG","CDM Code","Pro",510,"Clinic",64455,"NJX AA&/STRD PLTR COM DG NRV",169,84.5,134.35500000000002,143.65,143.65,143.65,141.96,136.89000000000001,135.20000000000002,134.35500000000002,135.20000000000002]
[503335,"CLOSED TX METACARPAL FX SINGLE W MANIP","CDM Code","Pro",510,"Clinic",26605,"TREAT METACARPAL FRACTURE",793,396.5,630.43500000000006,674.05,674.05,674.05,666.12,642.33000000000004,634.40000000000009,630.43500000000006,634.40000000000009]
[503333,"CLOSED TX RADIUS ULNA FX W MANIPULATION","CDM Code","Pro",510,"Clinic",25605,"TREAT FRACTURE RADIUS/ULNA",1247,623.5,991.36500000000001,1059.95,1059.95,1059.95,1047.48,1010.07,997.6,991.36500000000001,997.6]
[503332,"APPLICATION RIGID TOTAL CONTACT LEG CAST","CDM Code","Pro",510,"Clinic",29445,"APPLY RIGID LEG CAST",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[503325,"TRANSVAGINAL US OBSTETRIC","CDM Code","Pro",510,"Clinic",76817,"TRANSVAGINAL US OBSTETRIC",239,119.5,190.005,203.15,203.15,203.15,200.76,193.59,191.20000000000002,190.005,191.20000000000002]
[503324,"ULTRASOUND PREGNANT UTERUS LIMITED","CDM Code","Pro",510,"Clinic",76815,"OB US LIMITED FETUS(S)",275,137.5,218.625,233.75,233.75,233.75,231,222.75000000000003,220,218.625,220]
[503317,"INSERTION NONBIODEGRADABLE DRUG DEVICE","CDM Code","Pro",510,"Clinic",11981,"INSERTION DRUG DLVR IMPLANT",358,179,284.61,304.3,304.3,304.3,300.71999999999997,289.98,286.40000000000003,284.61,286.40000000000003]
[503316,"CL- GENTAMICIN UP TO 80 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1580","GARAMYCIN GENTAMICIN INJ",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[503315,"INJECTION SINGLE ORIGIN INSERTION 20551","CDM Code","Pro",510,"Clinic",20551,"INJ TENDON ORIGIN/INSERTION",188,94,149.46,159.79999999999998,159.79999999999998,159.79999999999998,157.91999999999999,152.28,150.4,149.46,150.4]
[503314,"CL- ONDANSETRON(ZOFRAN)VIAL 4MG/2ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2405","ONDANSETRON HCL INJECTION",6,3,4.7700000000000005,5.0999999999999996,5.0999999999999996,5.0999999999999996,5.04,4.8600000000000003,4.8000000000000007,4.7700000000000005,4.8000000000000007]
[503311,"N BLOCK INJ PUDENDAL","CDM Code","Pro",510,"Clinic",64430,"NJX AA&/STRD PUDENDAL NERVE",279,139.5,221.80500000000001,237.15,237.15,237.15,234.35999999999999,225.99,223.20000000000002,221.80500000000001,223.20000000000002]
[503310,"NERVE BLOCK INJ PARACERVICAL","CDM Code","Pro",510,"Clinic",64435,"NJX AA&/STRD PARACRV NRV",328,164,260.76,278.8,278.8,278.8,275.52,265.68,262.40000000000003,260.76,262.40000000000003]
[503309,"DESTRUCTION PENIS LESION S","CDM Code","Pro",510,"Clinic",54055,"DESTRUCTION PENIS LESION(S)",243,121.5,193.185,206.54999999999998,206.54999999999998,206.54999999999998,204.12,196.83,194.4,193.185,194.4]
[503308,"SHAVE SKIN LESION 1 1 TO 2 CM S N H F G","CDM Code","Pro",510,"Clinic",11307,"SHAVE SKIN LESION 1.1-2.0 CM",306,153,243.27,260.09999999999997,260.09999999999997,260.09999999999997,257.03999999999996,247.86,244.8,243.27,244.8]
[503306,"CYSTOSCOPY W BIOPSY","CDM Code","Pro",510,"Clinic",52204,"CYSTOSCOPY W/BIOPSY(S)",782,391,621.69000000000005,664.69999999999993,664.69999999999993,664.69999999999993,656.88,633.42000000000007,625.6,621.69000000000005,625.6]
[503299,"TREATMENT OF HEEL FRACTURE","CDM Code","Pro",510,"Clinic",28400,"TREATMENT OF HEEL FRACTURE",532,266,422.94,452.2,452.2,452.2,446.88,430.92,425.6,422.94,425.6]
[503291,"ELECTROUROFLOWMETRY FIRST","CDM Code","Pro",510,"Clinic",51741,"ELECTRO-UROFLOWMETRY FIRST",49,24.5,38.955000000000005,41.65,41.65,41.65,41.16,39.690000000000005,39.200000000000003,38.955000000000005,39.200000000000003]
[503289,"DESTRUCTION OF HEMORRHOIDS","CDM Code","Pro",510,"Clinic",46083,"INCISE EXTERNAL HEMORRHOID",656,328,521.52,557.6,557.6,557.6,551.04,531.36,524.80000000000007,521.52,524.80000000000007]
[503287,"DIABETIC MANAGEMENT TRAINING PER INDIVID","CDM Code","Pro",510,"Clinic","G0108","DIAB MANAGE TRN  PER INDIV",98,49,77.910000000000011,83.3,83.3,83.3,82.32,79.38000000000001,78.400000000000006,77.910000000000011,78.400000000000006]
[503282,"ANOSCOPY DIAG W/WO COLLECTION HOSPITAL","CDM Code","Pro",510,"Clinic",46600,"DIAGNOSTIC ANOSCOPY SPX",232,116,184.44,197.2,197.2,197.2,194.88,187.92000000000002,185.60000000000002,184.44,185.60000000000002]
[503276,"INSERT TEMP INDWELLING CATHETER COMPLEX","CDM Code","Pro",510,"Clinic",51703,"INSERT BLADDER CATH COMPLEX",389,194.5,309.255,330.65,330.65,330.65,326.76,315.09000000000003,311.20000000000005,309.255,311.20000000000005]
[503275,"DILATION OF CERVICAL CANAL","CDM Code","Pro",510,"Clinic",57800,"DILATION OF CERVICAL CANAL",153,76.5,121.63500000000001,130.04999999999998,130.04999999999998,130.04999999999998,128.51999999999998,123.93,122.4,121.63500000000001,122.4]
[503274,"INCISION AND REMOVAL FOREIGN BODY SIMPLE","CDM Code","Pro",510,"Clinic",10120,"REMOVE FOREIGN BODY",437,218.5,347.41500000000002,371.45,371.45,371.45,367.08,353.97,349.6,347.41500000000002,349.6]
[503271,"APPLY SHORT LEG CAST","CDM Code","Pro",510,"Clinic",29405,"APPLY SHORT LEG CAST",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[503270,"INSERT PESSARY DEVICE","CDM Code","Pro",510,"Clinic",57160,"INSERT PESSARY/OTHER DEVICE",227,113.5,180.465,192.95,192.95,192.95,190.68,183.87,181.60000000000002,180.465,181.60000000000002]
[503268,"CL- BETAMETHASONE CELESTONE","CDM Code","IP/OP",636,"Drug/Detail Code","J0702","BETAMETHASONE ACET&SOD PHOSP",258,129,205.11,219.29999999999998,219.29999999999998,219.29999999999998,216.72,208.98000000000002,206.4,205.11,206.4]
[503267,"CYSTOSCOPY AND TREATMENT","CDM Code","Pro",510,"Clinic",52281,"CYSTOSCOPY AND TREATMENT",523,261.5,415.78500000000003,444.55,444.55,444.55,439.32,423.63000000000005,418.40000000000003,415.78500000000003,418.40000000000003]
[503266,"EUFLEXXA INJ PER DOSE","CDM Code","IP/OP",636,"Drug/Detail Code","J7323","EUFLEXXA INJ PER DOSE",357,178.5,283.815,303.45,303.45,303.45,299.88,289.17,285.60000000000002,283.815,285.60000000000002]
[503264,"DARBOPOETIN 1MCG INJ NON-ESRD","CDM Code","IP/OP",636,"Drug/Detail Code","J0881","DARBEPOETIN ALFA, NON-ESRD",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[503262,"CLOSED TX DISTAL RADIAL FX EPIPHYSEAL","CDM Code","Pro",510,"Clinic",25600,"TREAT FRACTURE RADIUS/ULNA",827,413.5,657.46500000000003,702.94999999999993,702.94999999999993,702.94999999999993,694.68,669.87,661.6,657.46500000000003,661.6]
[503261,"ARTHROCENTESIS ASPIR OR INJ MJRJNT","CDM Code","Pro",510,"Clinic",20610,"DRAIN/INJ JOINT/BURSA W/O US",238,119,189.21,202.29999999999998,202.29999999999998,202.29999999999998,199.92,192.78,190.4,189.21,190.4]
[503260,"ARTHROCENTESIS ASPIR OR INJ INTJNT","CDM Code","Pro",510,"Clinic",20605,"DRAIN/INJ JOINT/BURSA W/O US",199,99.5,158.20500000000001,169.15,169.15,169.15,167.16,161.19,159.20000000000002,158.20500000000001,159.20000000000002]
[503258,"OBSERVATION EST PATIENT LEVEL 2","CDM Code","Pro",510,"Clinic",99212,"OFFICE O/P EST SF 10-19 MIN",106,53,84.27000000000001,90.1,90.1,90.1,89.039999999999992,85.86,84.800000000000011,84.27000000000001,84.800000000000011]
[503257,"OBSERVATION EST PATIENT LEVEL 5 99215","CDM Code","Pro",510,"Clinic",99215,"OFFICE O/P EST HI 40-54 MIN",362,181,287.79000000000002,307.7,307.7,307.7,304.08,293.22000000000003,289.60000000000002,287.79000000000002,289.60000000000002]
[503256,"OBSERVATION EST PATIENT LEVEL 4 99214","CDM Code","Pro",510,"Clinic",99214,"OFFICE O/P EST MOD 30-39 MIN",214,107,170.13,181.9,181.9,181.9,179.76,173.34,171.20000000000002,170.13,171.20000000000002]
[503254,"CL- BEXSERO (MENIGOCOCCAL B 3STRAIN VAX)","CDM Code","IP/OP",636,"Drug/Detail Code",90620,"MENB-4C VACC 2 DOSE IM",507,253.5,403.065,430.95,430.95,430.95,425.88,410.67,405.6,403.065,405.6]
[503253,"CL- ZOSTER VACCINE ZOSTAVAX","CDM Code","IP/OP",636,"Drug/Detail Code",90736,"HZV VACCINE LIVE SUBQ",448,224,356.16,380.8,380.8,380.8,376.32,362.88,358.40000000000003,356.16,358.40000000000003]
[503250,"EXC BENIGN LESION 1 1 TO 2 0 CM","CDM Code","Pro",510,"Clinic",11442,"EXC FACE-MM B9+MARG 1.1-2 CM",532,266,422.94,452.2,452.2,452.2,446.88,430.92,425.6,422.94,425.6]
[503246,"TREATMENT OF ANKLE FRACTURE","CDM Code","Pro",510,"Clinic",29405,"APPLY SHORT LEG CAST",289,144.5,229.75500000000002,245.65,245.65,245.65,242.76,234.09,231.20000000000002,229.75500000000002,231.20000000000002]
[503244,"TREATMENT OF TOE FRACTURE","CDM Code","Pro",510,"Clinic",28510,"TREATMENT OF TOE FRACTURE",243,121.5,193.185,206.54999999999998,206.54999999999998,206.54999999999998,204.12,196.83,194.4,193.185,194.4]
[503241,"CL-ADMIN MODERNA BIVALENT BOOSTER 18YR>","CDM Code","Pro",510,"Clinic","0134A","ADM SARSCV2 BVL 50MCG/.5ML B",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503240,"CL-ADMIN PFIZER BIONTECH BIVALENT BO 12+","CDM Code","Pro",510,"Clinic","0124A","ADM SARSCV2 BVL 30MCG/.3ML B",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[503239,"REMOVE FOREIGN BODY EAR 69200","CDM Code","Pro",510,"Clinic",69200,"CLEAR OUTER EAR CANAL",286,143,227.37,243.1,243.1,243.1,240.23999999999998,231.66000000000003,228.8,227.37,228.8]
[503237,"CONIZATION OF CERVIX","CDM Code","Pro",510,"Clinic",57522,"CONIZATION OF CERVIX",1099,549.5,873.70500000000004,934.15,934.15,934.15,923.16,890.19,879.2,873.70500000000004,879.2]
[503234,"ROUTINE FOOTCARE PATIENT W LOPS","CDM Code","Pro",510,"Clinic","G0247","ROUTINE FOOTCARE PT W LOPS",113,56.5,89.835000000000008,96.05,96.05,96.05,94.92,91.53,90.4,89.835000000000008,90.4]
[503233,"FOLLOW UP EVAL OF FOOT LOPS","CDM Code","Pro",510,"Clinic","G0246","FOLLOWUP EVAL OF FOOT PT LOP",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[503232,"INITIAL FOOT EXAM PT LOPS","CDM Code","Pro",510,"Clinic","G0245","INITIAL FOOT EXAM PT LOPS",151,75.5,120.045,128.35,128.35,128.35,126.83999999999999,122.31,120.80000000000001,120.045,120.80000000000001]
[503230,"EXC MALIGNANT LESION UP TO 0 5 CM","CDM Code","Pro",510,"Clinic",11600,"EXC TR-EXT MAL+MARG 0.5 CM/<",524,262,416.58000000000004,445.4,445.4,445.4,440.15999999999997,424.44000000000005,419.20000000000005,416.58000000000004,419.20000000000005]
[503229,"CL-  PEGFILGRASTIM (NEULASTA) 6 MG INJ S","CDM Code","IP/OP",636,"Drug/Detail Code","J2506","INJ PEGFILGRAST EX BIO 0.5MG",7784,3892,6188.2800000000007,6616.4,6616.4,6616.4,6538.5599999999995,6305.04,6227.2000000000007,6188.2800000000007,6227.2000000000007]
[503226,"INITIAL PREVENTATIVE EXAM MEDICARE","CDM Code","Pro",510,"Clinic","G0402","INITIAL PREVENTIVE EXAM",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[503225,"REM IMPACTED CERUMEN/IRRIGATE EAR 69210","CDM Code","Pro",510,"Clinic",69210,"REMOVE IMPACTED EAR WAX UNI",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[503224,"CYSTOSCOPY AND TREATMENT","CDM Code","Pro",510,"Clinic",52310,"CYSTOSCOPY AND TREATMENT",934,467,742.53000000000009,793.9,793.9,793.9,784.56,756.54000000000008,747.2,742.53000000000009,747.2]
[503223,"EXC BENIGN LESION 0 6 TO 1 0 CM","CDM Code","Pro",510,"Clinic",11401,"EXC TR-EXT B9+MARG 0.6-1 CM",668,334,531.06000000000006,567.79999999999995,567.79999999999995,567.79999999999995,561.12,541.08000000000004,534.4,531.06000000000006,534.4]
[503222,"INTERABDOMINAL PRESSURE STUDY","CDM Code","Pro",510,"Clinic",51797,"INTRAABDOMINAL PRESSURE TEST",232,116,184.44,197.2,197.2,197.2,194.88,187.92000000000002,185.60000000000002,184.44,185.60000000000002]
[503220,"ANAL URINARY MUSCLE STUDY","CDM Code","Pro",510,"Clinic",51784,"ANAL/URINARY MUSCLE STUDY",440,220,349.8,374,374,374,369.59999999999997,356.40000000000003,352,349.8,352]
[503219,"COMPLEX CYSTOMETROGRAM","CDM Code","Pro",510,"Clinic",51726,"COMPLEX CYSTOMETROGRAM",488,244,387.96000000000004,414.8,414.8,414.8,409.91999999999996,395.28000000000003,390.40000000000003,387.96000000000004,390.40000000000003]
[503217,"SPIROMETRY PRE PST BRONCHODILATION 94060","CDM Code","Pro",510,"Clinic",94060,"EVALUATION OF WHEEZING",143,71.5,113.685,121.55,121.55,121.55,120.11999999999999,115.83000000000001,114.4,113.685,114.4]
[503216,"SPIROMETRY W GRAPH WO BRONCHODILAT 94010","CDM Code","Pro",510,"Clinic",94010,"BREATHING CAPACITY TEST",84,42,66.78,71.399999999999991,71.399999999999991,71.399999999999991,70.56,68.040000000000006,67.2,66.78,67.2]
[503215,"I  D ABSCESS SIMPLE","CDM Code","Pro",510,"Clinic",10060,"DRAINAGE OF SKIN ABSCESS",456,228,362.52000000000004,387.59999999999997,387.59999999999997,387.59999999999997,383.03999999999996,369.36,364.8,362.52000000000004,364.8]
[503213,"REMOVAL OF NAIL BED","CDM Code","Pro",510,"Clinic",11750,"REMOVAL OF NAIL BED",520,260,413.40000000000003,442,442,442,436.8,421.20000000000005,416,413.40000000000003,416]
[503211,"VASECTOMY UNILATERAL OR BILATERAL","CDM Code","Pro",510,"Clinic",55250,"REMOVAL OF SPERM DUCT(S)",1458,729,1159.1100000000001,1239.3,1239.3,1239.3,1224.72,1180.98,1166.4000000000001,1159.1100000000001,1166.4000000000001]
[503206,"CYSTOURETHROSCOPY","CDM Code","Pro",510,"Clinic",52000,"CYSTOSCOPY",737,368.5,585.91500000000008,626.44999999999993,626.44999999999993,626.44999999999993,619.07999999999993,596.97,589.6,585.91500000000008,589.6]
[503205,"SHAVE SKIN LESION 1 1 TO 2 CM F E EL N L","CDM Code","Pro",510,"Clinic",11312,"SHAVE SKIN LESION 1.1-2.0 CM",350,175,278.25,297.5,297.5,297.5,294,283.5,280,278.25,280]
[503204,"NERVE BLOCK PERIPHERAL NERVE","CDM Code","Pro",510,"Clinic",64450,"NJX AA&/STRD OTHER PN/BRANCH",260,130,206.70000000000002,221,221,221,218.4,210.60000000000002,208,206.70000000000002,208]
[503203,"OBSERVATION EST PATIENT LEVEL 3","CDM Code","Pro",510,"Clinic",99213,"OFFICE O/P EST LOW 20-29 MIN",115,57.5,91.425000000000011,97.75,97.75,97.75,96.6,93.15,92,91.425000000000011,92]
[503202,"OBTAINING SCREEN PAP SMEAR","CDM Code","Pro",510,"Clinic","Q0091","OBTAINING SCREEN PAP SMEAR",80,40,63.6,68,68,68,67.2,64.800000000000011,64,63.6,64]
[503201,"INJ 1 OR 2 TRIGGER","CDM Code","Pro",510,"Clinic",20552,"INJ TRIGGER POINT 1/2 MUSCL",236,118,187.62,200.6,200.6,200.6,198.23999999999998,191.16000000000003,188.8,187.62,188.8]
[503200,"SHAVE SKIN LESION GREATER 2CM F E EL N L","CDM Code","Pro",510,"Clinic",11313,"SHAVE SKIN LESION >2.0 CM",406,203,322.77000000000004,345.09999999999997,345.09999999999997,345.09999999999997,341.03999999999996,328.86,324.8,322.77000000000004,324.8]
[503199,"EXC BENIGN LESION UP TO 0 5 CM","CDM Code","Pro",510,"Clinic",11440,"EXC FACE-MM B9+MARG 0.5 CM/<",588,294,467.46000000000004,499.8,499.8,499.8,493.91999999999996,476.28000000000003,470.40000000000003,467.46000000000004,470.40000000000003]
[503198,"EXC BENIGN LESION 1 1 TO 2 0 CM","CDM Code","Pro",510,"Clinic",11402,"EXC TR-EXT B9+MARG 1.1-2 CM",684,342,543.78,581.4,581.4,581.4,574.55999999999995,554.04000000000008,547.20000000000005,543.78,547.20000000000005]
[503196,"EXC BENIGN LESION 2 1 TO 3 0 CM","CDM Code","Pro",510,"Clinic",11423,"EXC H-F-NK-SP B9+MARG 2.1-3",869,434.5,690.85500000000002,738.65,738.65,738.65,729.95999999999992,703.8900000000001,695.2,690.85500000000002,695.2]
[503195,"DESTROY CONDYLOMATA  FEMALE 56501","CDM Code","Pro",510,"Clinic",56501,"DESTROY VULVA LESIONS SIM",412,206,327.54000000000002,350.2,350.2,350.2,346.08,333.72,329.6,327.54000000000002,329.6]
[503194,"EXC MALIGNANT LESION GREATER THAN 4 0 CM","CDM Code","Pro",510,"Clinic",11626,"EXC S/N/H/F/G MAL+MRG >4 CM",890,445,707.55000000000007,756.5,756.5,756.5,747.6,720.90000000000009,712,707.55000000000007,712]
[503191,"INSERT TEMP INDWELLING CATHETER SIMPLE","CDM Code","Pro",510,"Clinic",51702,"INSERT TEMP BLADDER CATH",168,84,133.56,142.79999999999998,142.79999999999998,142.79999999999998,141.12,136.08000000000001,134.4,133.56,134.4]
[503189,"EXC MALIGNANT LESION 0 6 TO 1 0 CM","CDM Code","Pro",510,"Clinic",11641,"EXC F/E/E/N/L MAL+MRG 0.6-1",603,301.5,479.38500000000005,512.54999999999995,512.54999999999995,512.54999999999995,506.52,488.43,482.40000000000003,479.38500000000005,482.40000000000003]
[503186,"OBSERVATION > THAN 30 MINUTES","CDM Code","Pro",510,"Clinic",99239,"HOSP IP/OBS DSCHRG MGMT >30",264,132,209.88000000000002,224.4,224.4,224.4,221.76,213.84,211.20000000000002,209.88000000000002,211.20000000000002]
[503185,"EXC MALIGNANT LESION 2 1 TO 3 0 CM","CDM Code","Pro",510,"Clinic",11623,"EXC S/N/H/F/G MAL+MRG 2.1-3",655,327.5,520.72500000000002,556.75,556.75,556.75,550.19999999999993,530.55000000000007,524,520.72500000000002,524]
[503184,"BIOPSY OF CERVIX WITH SCOPE","CDM Code","Pro",510,"Clinic",57455,"BIOPSY OF CERVIX W/SCOPE",585,292.5,465.07500000000005,497.25,497.25,497.25,491.4,473.85,468,465.07500000000005,468]
[503179,"INCISION AND REMOVAL FOREIGN BODY COMP","CDM Code","Pro",510,"Clinic",10121,"REMOVE FOREIGN BODY",603,301.5,479.38500000000005,512.54999999999995,512.54999999999995,512.54999999999995,506.52,488.43,482.40000000000003,479.38500000000005,482.40000000000003]
[503176,"DILATION OF URETHRA","CDM Code","Pro",510,"Clinic",53660,"DILATION OF URETHRA",238,119,189.21,202.29999999999998,202.29999999999998,202.29999999999998,199.92,192.78,190.4,189.21,190.4]
[503175,"DILATE URETHRA STRICTURE","CDM Code","Pro",510,"Clinic",53600,"DILATE URETHRA STRICTURE",304,152,241.68,258.39999999999998,258.39999999999998,258.39999999999998,255.35999999999999,246.24,243.20000000000002,241.68,243.20000000000002]
[503174,"INSERT NON INDWELLING BLADDER CATHETER","CDM Code","Pro",510,"Clinic",51701,"INSERT BLADDER CATHETER",155,77.5,123.22500000000001,131.75,131.75,131.75,130.19999999999999,125.55000000000001,124,123.22500000000001,124]
[503172,"PROSTATIC MICROWAVE THERMOTHERAPY","CDM Code","Pro",510,"Clinic",53850,"PROSTATIC MICROWAVE THERMOTX",3502,1751,2784.09,2976.7,2976.7,2976.7,2941.68,2836.6200000000003,2801.6000000000004,2784.09,2801.6000000000004]
[503171,"CL- ZOLADEX 3 6 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9202","GOSERELIN ACETATE IMPLANT",2476,1238,1968.42,2104.6,2104.6,2104.6,2079.84,2005.5600000000002,1980.8000000000002,1968.42,1980.8000000000002]
[503170,"CL- LEUPROLIDE 7 5 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9217","LEUPROLIDE ACETATE SUSPNSION",2879,1439.5,2288.8050000000003,2447.15,2447.15,2447.15,2418.36,2331.9900000000002,2303.2000000000003,2288.8050000000003,2303.2000000000003]
[503169,"CL- BOTULINUM TOXIN A PER UNIT","CDM Code","IP/OP",636,"Drug/Detail Code","J0585","INJECTION,ONABOTULINUMTOXINA",60,30,47.7,51,51,51,50.4,48.6,48,47.7,48]
[503160,"WOUND CLOSURE UTILIZING TISSUE ADHESIVE","CDM Code","Pro",510,"Clinic","G0168","WOUND CLOSURE BY ADHESIVE",90,45,71.55,76.5,76.5,76.5,75.599999999999994,72.900000000000006,72,71.55,72]
[503157,"DESTRUCTION OF SKIN LESIONS","CDM Code","Pro",510,"Clinic",17280,"DESTRUCTION OF SKIN LESIONS",322,161,255.99,273.7,273.7,273.7,270.48,260.82,257.60000000000002,255.99,257.60000000000002]
[503153,"CL- DEXAMETHASONE SOD PHOS 1MG INJ","CDM Code","IP/OP",636,"Drug/Detail Code","J1100","DEXAMETHASONE SODIUM PHOS",7,3.5,5.5650000000000004,5.95,5.95,5.95,5.88,5.67,5.6000000000000005,5.5650000000000004,5.6000000000000005]
[503142,"NEW PT PREV GYN 18-39YR 99385","CDM Code","Pro",510,"Clinic",99385,"PREV VISIT NEW AGE 18-39",249,124.5,197.95500000000001,211.65,211.65,211.65,209.16,201.69000000000003,199.20000000000002,197.95500000000001,199.20000000000002]
[503140,"EXC MALIGNANT LESION 3 1 TO 4 0 CM","CDM Code","Pro",510,"Clinic",11604,"EXC TR-EXT MAL+MARG 3.1-4 CM",1001,500.5,795.79500000000007,850.85,850.85,850.85,840.83999999999992,810.81000000000006,800.80000000000007,795.79500000000007,800.80000000000007]
[503139,"REMOVAL OF HEMORRHOID CLOT","CDM Code","Pro",510,"Clinic",46320,"REMOVAL OF HEMORRHOID CLOT",433,216.5,344.23500000000001,368.05,368.05,368.05,363.71999999999997,350.73,346.40000000000003,344.23500000000001,346.40000000000003]
[503137,"INTERMEDIATE REPAIR TO S A T OR EXTREMIT","CDM Code","IP/OP",450,"Emerg Room",12034,"INTMD RPR S/TR/EXT 7.6-12.5",984,492,782.28000000000009,836.4,836.4,836.4,826.56,797.04000000000008,787.2,782.28000000000009,787.2]
[503136,"ADVANCE CARE PLANNING HOME VISIT","CDM Code","Pro",510,"Clinic",99497,"ADVNCD CARE PLAN 30 MIN",107,53.5,85.064999999999998,90.95,90.95,90.95,89.88,86.67,85.600000000000009,85.064999999999998,85.600000000000009]
[503135,"WRIST HAND FINGER SPLINT L3807","CDM Code","Pro",510,"Clinic","L3807","WHFO W/O JOINTS PRE CST",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[503133,"ADMIN IV INFUSION SOTROVIMAB INCLUDES IN","CDM Code","IP/OP",771,"Preventive Care Services: Admin. of vaccine","M0247","SOTROVIMAB INFUSION",530,265,421.35,450.5,450.5,450.5,445.2,429.3,424,421.35,424]
[503131,"IEP EVALUATION","CDM Code","Pro",510,"Clinic","H2000","COMP MULTIDISCIPLINE EVALUAT",78,39,62.010000000000005,66.3,66.3,66.3,65.52,63.180000000000007,62.400000000000006,62.010000000000005,62.400000000000006]
[503129,"IMMUNIZATION ADMIN PFIZER PEDI 2ND DOSE","CDM Code","Pro",510,"Clinic","0072A","ADM SARSCV2 10MCG TRS-SUCR 2",21,10.5,16.695,17.849999999999998,17.849999999999998,17.849999999999998,17.64,17.010000000000002,16.8,16.695,16.8]
[503127,"MODERNA BOOSTER ADMIN","CDM Code","Pro",510,"Clinic","0064A","ADM SARSCOV2 50MCG/0.25MLBST",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503121,"ADMIN PFIZER BOOSTER","CDM Code","Pro",510,"Clinic","0004A","ADM SARSCOV2 30MCG/0.3ML BST",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503119,"ARIZONA AFO","CDM Code","Pro",510,"Clinic","L1940","AFO MOLDED TO PATIENT PLASTI",850,425,675.75,722.5,722.5,722.5,714,688.5,680,675.75,680]
[503118,"ADMIN SARSCOV2 VAC JANSSEN","CDM Code","Pro",510,"Clinic","0031A","ADM SARSCOV2 VAC AD26 .5ML",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503117,"ADMIN SARSCOV2 MODERNA 2ND","CDM Code","Pro",510,"Clinic","0012A","ADM SARSCOV2 100MCG/0.5ML2ND",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503116,"ADMIN SARSCOV2 MODERNA 1ST","CDM Code","Pro",510,"Clinic","0011A","ADM SARSCOV2 100MCG/0.5ML1ST",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503115,"ADMIN SCRSCOV PFIZER 2ND","CDM Code","Pro",510,"Clinic","0002A","ADM SARSCOV2 30MCG/0.3ML 2ND",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503114,"IMMUN ADMIN HEP B MEDICARE 90471","CDM Code","Pro",510,"Clinic",90471,"IMMUNIZATION ADMIN",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[503113,"IMMUN ADMIN PNEUMOCOCCAL MEDICARE 90471","CDM Code","Pro",510,"Clinic",90471,"IMMUNIZATION ADMIN",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[503112,"IMMUN ADMIN INFLUENZA 90471","CDM Code","IP/OP",770,"Preventive care services, general",90471,"IMMUNIZATION ADMIN",22,11,17.490000000000002,18.7,18.7,18.7,18.48,17.82,17.600000000000001,17.490000000000002,17.600000000000001]
[503111,"ADMIN SARSCOV2 PFIZER 1ST","CDM Code","Pro",510,"Clinic","0001A","ADM SARSCOV2 30MCG/0.3ML 1ST",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[503110,"TREAT SESAMOID BONE FRACTURE","CDM Code","Pro",510,"Clinic",28530,"TREAT SESAMOID BONE FRACTURE",279,139.5,221.80500000000001,237.15,237.15,237.15,234.35999999999999,225.99,223.20000000000002,221.80500000000001,223.20000000000002]
[503109,"EST PT PREV GYN ONLY 65 YR AND UP 99397","CDM Code","Pro",510,"Clinic",99397,"PER PM REEVAL EST PAT 65+ YR",184,92,146.28,156.4,156.4,156.4,154.56,149.04000000000002,147.20000000000002,146.28,147.20000000000002]
[503108,"EST PT PREV GYN ONLY 40-64 YR 99396","CDM Code","Pro",510,"Clinic",99396,"PREV VISIT EST AGE 40-64",373,186.5,296.53500000000003,317.05,317.05,317.05,313.32,302.13,298.40000000000003,296.53500000000003,298.40000000000003]
[503107,"EST PT PREV GYN ONLY 18-39 YR 99395","CDM Code","Pro",510,"Clinic",99395,"PREV VISIT EST AGE 18-39",308,154,244.86,261.8,261.8,261.8,258.71999999999997,249.48000000000002,246.4,244.86,246.4]
[503106,"NEW PT PREV GYN ONLY 65 AND UP 99387","CDM Code","Pro",510,"Clinic",99387,"INIT PM E/M NEW PAT 65+ YRS",271,135.5,215.44500000000002,230.35,230.35,230.35,227.64,219.51000000000002,216.8,215.44500000000002,216.8]
[503105,"NEW PT PREV GYN ONLY 40-64 YR 99386","CDM Code","Pro",510,"Clinic",99386,"PREV VISIT NEW AGE 40-64",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[503104,"NEW PT PREV GYN ONLY 18-39 YR 99385","CDM Code","Pro",510,"Clinic",99385,"PREV VISIT NEW AGE 18-39",331,165.5,263.14500000000004,281.34999999999997,281.34999999999997,281.34999999999997,278.03999999999996,268.11,264.8,263.14500000000004,264.8]
[503103,"CL-TETNAS IMMUNE GLOBULIN HUMAN 250 UNIT","CDM Code","Pro",510,"Clinic","J1670","TETANUS IMMUNE GLOBULIN INJ",1348,674,1071.6600000000001,1145.8,1145.8,1145.8,1132.32,1091.8800000000001,1078.4000000000001,1071.6600000000001,1078.4000000000001]
[503102,"REMOVAL OF FOOT FOREIGN BODY","CDM Code","Pro",510,"Clinic",28192,"REMOVAL OF FOOT FOREIGN BODY",974,487,774.33,827.9,827.9,827.9,818.16,788.94,779.2,774.33,779.2]
[503101,"URINE PREGNANCY TEST BY VISUAL","CDM Code","IP/OP",300,"Lab",81025,"URINE PREGNANCY TEST",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[503099,"CAST SHOE-ZIMMER","CDM Code","Pro",510,"Clinic","L3260","AMBULATORY SURGICAL BOOT EAC",130,65,103.35000000000001,110.5,110.5,110.5,109.2,105.30000000000001,104,103.35000000000001,104]
[503096,"CERVICAL COLLAR-LOW CONTOUR","CDM Code","Pro",510,"Clinic","L0120","CERV FLEX N/ADJ FOAM PRE OTS",51,25.5,40.545000000000002,43.35,43.35,43.35,42.839999999999996,41.31,40.800000000000004,40.545000000000002,40.800000000000004]
[503095,"CL-HAEMOPHILUS B (ACTHIB)","CDM Code","IP/OP",636,"Drug/Detail Code",90648,"HIB PRP-T VACCINE 4 DOSE IM",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[503094,"AEROCHAMBER","CDM Code","Pro",510,"Clinic","A4627","SPACER BAG/RESERVOIR",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[503093,"NURSE VISIT ONLY W DOCUMENTATION 99211","CDM Code","Pro",510,"Clinic",99211,"OFF/OP EST MAY X REQ PHY/QHP",44,22,34.980000000000004,37.4,37.4,37.4,36.96,35.64,35.200000000000003,34.980000000000004,35.200000000000003]
[503090,"PATIENT CARE PLAN G9001","CDM Code","Pro",510,"Clinic","G9001","MCCD, INITIAL RATE",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[503089,"CL-XIAFLEX 0.9 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J0775","COLLAGENASE, CLOST HIST INJ",10620,5310,8442.9,9027,9027,9027,8920.7999999999993,8602.2000000000007,8496,8442.9,8496]
[503088,"MANIPULAT PALM CORD POST INJ","CDM Code","Pro",510,"Clinic",26341,"MANIPULAT PALM CORD POST INJ",180,90,143.1,153,153,153,151.19999999999999,145.80000000000001,144,143.1,144]
[503087,"INJ DUPUYTREN CORD W/ENZYME","CDM Code","Pro",510,"Clinic",20527,"INJ DUPUYTREN CORD W/ENZYME",319,159.5,253.60500000000002,271.14999999999998,271.14999999999998,271.14999999999998,267.95999999999998,258.39000000000004,255.20000000000002,253.60500000000002,255.20000000000002]
[503086,"CL- EPOETIN ALFA PROCRIT NON-ESRD 1000U","CDM Code","IP/OP",636,"Drug/Detail Code","J0885","EPOETIN ALFA, NON-ESRD",26,13,20.67,22.099999999999998,22.099999999999998,22.099999999999998,21.84,21.060000000000002,20.8,20.67,20.8]
[503085,"TISSUE EXAM KOH SLIDE FOR FUNGI","CDM Code","IP/OP",300,"Lab","Q0112","POTASSIUM HYDROXIDE PREPS",39,19.5,31.005000000000003,33.15,33.15,33.15,32.76,31.590000000000003,31.200000000000003,31.005000000000003,31.200000000000003]
[503084,"PVB SINGLE INJECTION SITE","CDM Code","Pro",510,"Clinic",64461,"PVB THORACIC SINGLE INJ SITE",777,388.5,617.71500000000003,660.44999999999993,660.44999999999993,660.44999999999993,652.67999999999995,629.37,621.6,617.71500000000003,621.6]
[503083,"PLACEMENT SETON","CDM Code","Pro",510,"Clinic",46020,"PLACEMENT OF SETON",2574,1287,2046.3300000000002,2187.9,2187.9,2187.9,2162.16,2084.94,2059.2000000000003,2046.3300000000002,2059.2000000000003]
[503082,"CL-EPOETIN ALFA 20,000","CDM Code","IP/OP",636,"Drug/Detail Code","J0885","EPOETIN ALFA, NON-ESRD",520,260,413.40000000000003,442,442,442,436.8,421.20000000000005,416,413.40000000000003,416]
[503081,"REMOVE INT EXT HEM 1 GRP","CDM Code","Pro",510,"Clinic",46255,"REMOVE INT/EXT HEM 1 GROUP",1091,545.5,867.34500000000003,927.35,927.35,927.35,916.43999999999994,883.71,872.80000000000007,867.34500000000003,872.80000000000007]
[503079,"PROLONGED OFFICE OR OTHER OUTPT E&M","CDM Code","Pro",510,"Clinic",99417,"PROLNG OP E/M EACH 15 MIN",33,16.5,26.235000000000003,28.05,28.05,28.05,27.72,26.73,26.400000000000002,26.235000000000003,26.400000000000002]
[503078,"GMC - ARCH BINDERS W MET PA EACH","CDM Code","Pro",510,"Clinic","L3050","FOOT ARCH SUPP PREMOLD METAT",54,27,42.93,45.9,45.9,45.9,45.36,43.74,43.2,42.93,43.2]
[503077,"GMC-ARCH BINDERS W O MET PAD EACH","CDM Code","IP/OP",274,"Prosth/Orth Dev","L3040","FT ARCH SUPRT PREMOLD LONGIT",36,18,28.62,30.599999999999998,30.599999999999998,30.599999999999998,30.24,29.160000000000004,28.8,28.62,28.8]
[503076,"GMC-ORTHOTICS FUNCTIONAL MET EACH","CDM Code","Pro",510,"Clinic","L3020","FOOT LONGITUD/METATARSAL SUP",175,87.5,139.125,148.75,148.75,148.75,147,141.75,140,139.125,140]
[503075,"GMC-ORTHOTICS FUNCTIONAL LONG EACH","CDM Code","IP/OP",274,"Prosth/Orth Dev","L3010","FOOT LONGITUDINAL ARCH SUPPO",150,75,119.25,127.5,127.5,127.5,126,121.50000000000001,120,119.25,120]
[503072,"EXCISION OF EXTERNAL HEMORRHOID","CDM Code","Pro",510,"Clinic",46220,"EXCISE ANAL EXT TAG/PAPILLA",438,219,348.21000000000004,372.3,372.3,372.3,367.91999999999996,354.78000000000003,350.40000000000003,348.21000000000004,350.40000000000003]
[503069,"CL- IUD PARAGARD","CDM Code","IP/OP",636,"Drug/Detail Code","J7300","INTRAUT COPPER CONTRACEPTIVE",1258,629,1000.11,1069.3,1069.3,1069.3,1056.72,1018.98,1006.4000000000001,1000.11,1006.4000000000001]
[503068,"RINGERS LACTATE INFUSION 1000 CC","CDM Code","IP/OP",250,"Pharmacy","J7120","RINGERS LACTATE INFUSION",4,2,3.18,3.4,3.4,3.4,3.36,3.24,3.2,3.18,3.2]
[503066,"CL- VITAMIN B-12 1000 MCG","CDM Code","IP/OP",636,"Drug/Detail Code","J3420","VITAMIN B12 INJECTION",20,10,15.9,17,17,17,16.8,16.200000000000003,16,15.9,16]
[503065,"AMBULATORY CGM MIN 72 HRS REPORT","CDM Code","Pro",510,"Clinic",95251,"CONT GLUC MNTR ANALYSIS I&R",63,31.5,50.085000000000001,53.55,53.55,53.55,52.919999999999995,51.03,50.400000000000006,50.085000000000001,50.400000000000006]
[503064,"CL- HYDROXYZINE INJECTION 50MG","CDM Code","IP/OP",636,"Drug/Detail Code","J3410","HYDROXYZINE HCL INJECTION",23,11.5,18.285,19.55,19.55,19.55,19.32,18.630000000000003,18.400000000000002,18.285,18.400000000000002]
[503063,"CL- TRIAMCINOLONE A INJ PRS-FREE 10 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J3300","TRIAMCINOLONE A INJ PRS-FREE",32,16,25.44,27.2,27.2,27.2,26.88,25.92,25.6,25.44,25.6]
[503062,"CL- SUMATRIPTAN SUCCINATE 6 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J3030","SUMATRIPTAN SUCCINATE / 6 MG",438,219,348.21000000000004,372.3,372.3,372.3,367.91999999999996,354.78000000000003,350.40000000000003,348.21000000000004,350.40000000000003]
[503061,"CL- RHOGAM ONE DOSE PACKAGE","CDM Code","IP/OP",636,"Drug/Detail Code",90384,"RH IG FULL-DOSE IM",366,183,290.97000000000003,311.09999999999997,311.09999999999997,311.09999999999997,307.44,296.46000000000004,292.8,290.97000000000003,292.8]
[503058,"CL- PHENERGAN UP TO 50 MG INJECTION","CDM Code","IP/OP",636,"Drug/Detail Code","J2550","PROMETHAZINE HCL INJECTION",42,21,33.39,35.699999999999996,35.699999999999996,35.699999999999996,35.28,34.020000000000003,33.6,33.39,33.6]
[503057,"CL- PHENERGAN 50 MG INJECTION","CDM Code","IP/OP",636,"Drug/Detail Code","J2550","PROMETHAZINE HCL INJECTION",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[503056,"CL- MORPHINE 10MG ML 1ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J2270","MORPHINE SULFATE INJECTION",5,2.5,3.9750000000000001,4.25,4.25,4.25,4.2,4.0500000000000007,4,3.9750000000000001,4]
[503055,"CL- MEPERIDINE DEMEROL 50MG 1ML","CDM Code","IP/OP",636,"Drug/Detail Code","J2175","MEPERIDINE HYDROCHL /100 MG",24,12,19.080000000000002,20.399999999999999,20.399999999999999,20.399999999999999,20.16,19.440000000000001,19.200000000000003,19.080000000000002,19.200000000000003]
[503054,"CL- LUPRON DEPOT 3 75 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J1950","LEUPROLIDE ACETATE /3.75 MG",2201,1100.5,1749.7950000000001,1870.85,1870.85,1870.85,1848.84,1782.8100000000002,1760.8000000000002,1749.7950000000001,1760.8000000000002]
[503053,"CL- KETOROLAC 15 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1885","KETOROLAC TROMETHAMINE INJ",77,38.5,61.215000000000003,65.45,65.45,65.45,64.679999999999993,62.370000000000005,61.6,61.215000000000003,61.6]
[503051,"AMBULATORY CGM MIN 72 HRS","CDM Code","IP/OP",920,"Other Dx Svcs",95250,"CONT GLUC MNTR PHYS/QHP EQP",239,119.5,190.005,203.15,203.15,203.15,200.76,193.59,191.20000000000002,190.005,191.20000000000002]
[503047,"CL- DEPO MEDROL 80 MG 1 ML","CDM Code","IP/OP",636,"Drug/Detail Code","J1040","METHYLPREDNISOLONE 80 MG INJ",100,50,79.5,85,85,85,84,81,80,79.5,80]
[503046,"CL- DEPO MEDROL 40 MG 1 ML VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J1030","METHYLPREDNISOLONE 40 MG INJ",48,24,38.160000000000004,40.799999999999997,40.799999999999997,40.799999999999997,40.32,38.880000000000003,38.400000000000006,38.160000000000004,38.400000000000006]
[503045,"CL-ELIGARD 45.0 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9217","LEUPROLIDE ACETATE SUSPNSION",702,351,558.09,596.69999999999993,596.69999999999993,596.69999999999993,589.67999999999995,568.62,561.6,558.09,561.6]
[503044,"CL-ELIGARD 22.5 MG","CDM Code","IP/OP",636,"Drug/Detail Code","J9217","LEUPROLIDE ACETATE SUSPNSION",351,175.5,279.04500000000002,298.34999999999997,298.34999999999997,298.34999999999997,294.83999999999997,284.31,280.8,279.04500000000002,280.8]
[503043,"CL- CEFTRIAXONE 250 MG VIAL","CDM Code","IP/OP",636,"Drug/Detail Code","J0696","CEFTRIAXONE SODIUM INJECTION",71,35.5,56.445,60.35,60.35,60.35,59.64,57.510000000000005,56.800000000000004,56.445,56.800000000000004]
[503042,"TRIMMING DYSTROPHIC NAILS","CDM Code","Pro",510,"Clinic","G0127","TRIM NAIL(S)",29,14.5,23.055,24.65,24.65,24.65,24.36,23.490000000000002,23.200000000000003,23.055,23.200000000000003]
[503041,"COLONOSCOPY SCREENING LOW/NO RI","CDM Code","IP/OP",960,"Professional fees",45378,"DIAGNOSTIC COLONOSCOPY",361,180.5,286.995,306.84999999999997,306.84999999999997,306.84999999999997,303.24,292.41000000000003,288.8,286.995,288.8]
[503039,"COLONOSCOPY SCREENING HIGH RISK","CDM Code","Pro",510,"Clinic","G0105","COLORECTAL SCRN; HI RISK IND",364,182,289.38,309.39999999999998,309.39999999999998,309.39999999999998,305.76,294.84000000000003,291.2,289.38,291.2]
[503038,"FLEXIBLE SIGMOIDOSCOPY SCREENING","CDM Code","Pro",510,"Clinic","G0104","CA SCREEN;FLEXI SIGMOIDSCOPE",296,148,235.32000000000002,251.6,251.6,251.6,248.64,239.76000000000002,236.8,235.32000000000002,236.8]
[503032,"SHAVE SKIN LESION GREATER 20 CM T AL","CDM Code","Pro",510,"Clinic",11303,"SHAVE SKIN LESION >2.0 CM",222,111,176.49,188.7,188.7,188.7,186.48,179.82000000000002,177.60000000000002,176.49,177.60000000000002]
[503031,"SURGICAL EQUIPMENT  SUPPLIES","CDM Code","Pro",510,"Clinic","A4550","SURGICAL TRAYS",47,23.5,37.365000000000002,39.949999999999996,39.949999999999996,39.949999999999996,39.479999999999997,38.07,37.6,37.365000000000002,37.6]
[503025,"DRUG SCREEN COLLECTION ONLY","CDM Code","Pro",510,"Clinic",99199,"UNLISTED SPECIAL SVC PX/RPRT",43,21.5,34.185000000000002,36.549999999999997,36.549999999999997,36.549999999999997,36.119999999999997,34.830000000000005,34.4,34.185000000000002,34.4]
[503024,"COMPREHENSIVE EYE EXAM","CDM Code","Pro",510,"Clinic",99177,"OCULAR INSTRUMNT SCREEN BIL",12,6,9.5400000000000009,10.199999999999999,10.199999999999999,10.199999999999999,10.08,9.7200000000000006,9.6000000000000014,9.5400000000000009,9.6000000000000014]
[503023,"DESTRUCTION CONDYLOMATA FEMALE","CDM Code","Pro",510,"Clinic",56515,"DESTROY VULVA LESION/S COMPL",416,208,330.72,353.59999999999997,353.59999999999997,353.59999999999997,349.44,336.96000000000004,332.8,330.72,332.8]
[503022,"US EXAM PELVIC COMPLETE","CDM Code","Pro",510,"Clinic",76856,"US EXAM PELVIC COMPLETE",196,98,155.82000000000002,166.6,166.6,166.6,164.64,158.76000000000002,156.80000000000001,155.82000000000002,156.80000000000001]
[503019,"ULTRASOUND NON-OB TRANSVAGINAL","CDM Code","Pro",510,"Clinic",76830,"TRANSVAGINAL US NON-OB",137,68.5,108.91500000000001,116.45,116.45,116.45,115.08,110.97000000000001,109.60000000000001,108.91500000000001,109.60000000000001]
[503018,"CL- YELLOW FEVER IMMUNIZATION TRAVEL","CDM Code","IP/OP",636,"Drug/Detail Code",90717,"YELLOW FEVER VACCINE SUBQ",249,124.5,197.95500000000001,211.65,211.65,211.65,209.16,201.69000000000003,199.20000000000002,197.95500000000001,199.20000000000002]
[503017,"CYSTOURETHROSCOPY FEMALE URETHRAL SYNDRO","CDM Code","Pro",510,"Clinic",52285,"CYSTOSCOPY AND TREATMENT",975,487.5,775.125,828.75,828.75,828.75,819,789.75,780,775.125,780]
[503016,"CL- VARICELLA VIRUS VACCINE LIVE","CDM Code","IP/OP",636,"Drug/Detail Code",90716,"VAR VACCINE LIVE SUBQ",344,172,273.48,292.39999999999998,292.39999999999998,292.39999999999998,288.95999999999998,278.64000000000004,275.2,273.48,275.2]
[503015,"CL- POLIOVIRUS VACCINE INACTIVATED","CDM Code","IP/OP",636,"Drug/Detail Code",90713,"POLIOVIRUS IPV SC/IM",122,61,96.990000000000009,103.7,103.7,103.7,102.47999999999999,98.820000000000007,97.600000000000009,96.990000000000009,97.600000000000009]
[503011,"CL- MMR LIVE","CDM Code","IP/OP",636,"Drug/Detail Code",90707,"MMR VACCINE SC",194,97,154.23000000000002,164.9,164.9,164.9,162.96,157.14000000000001,155.20000000000002,154.23000000000002,155.20000000000002]
[503010,"TYPHOID VACCINE VI CAPSULAR","CDM Code","IP/OP",636,"Drug/Detail Code",90691,"TYPHOID VACCINE IM",129,64.5,102.55500000000001,109.64999999999999,109.64999999999999,109.64999999999999,108.36,104.49000000000001,103.2,102.55500000000001,103.2]
[503007,"HEP A VACCINE ADULT IM","CDM Code","IP/OP",636,"Drug/Detail Code",90632,"HEPA VACCINE ADULT IM",346,173,275.07,294.09999999999997,294.09999999999997,294.09999999999997,290.64,280.26,276.8,275.07,276.8]
[503006,"OCCUPATIONAL PHYSICAL EXAM DOT CRASH CDL","CDM Code","Pro",510,"Clinic",99499,"UNLISTED E&M SERVICE",104,52,82.68,88.399999999999991,88.399999999999991,88.399999999999991,87.36,84.240000000000009,83.2,82.68,83.2]
[503004,"ANTEPARTUM CARE ONLY 7 OR MO","CDM Code","Pro",510,"Clinic",59426,"ANTEPARTUM CARE ONLY",3677,1838.5,2923.2150000000001,3125.45,3125.45,3125.45,3088.68,2978.3700000000003,2941.6000000000004,2923.2150000000001,2941.6000000000004]
[503003,"ANTEPARTUM CARE ONLY 4-6 VIS","CDM Code","Pro",510,"Clinic",59425,"ANTEPARTUM CARE ONLY",1831,915.5,1455.645,1556.35,1556.35,1556.35,1538.04,1483.1100000000001,1464.8000000000002,1455.645,1464.8000000000002]
[503002,"PENILE INJECTION","CDM Code","Pro",510,"Clinic",54235,"PENILE INJECTION",402,201,319.59000000000003,341.7,341.7,341.7,337.68,325.62,321.60000000000002,319.59000000000003,321.60000000000002]
[503001,"DESTRUCTION OF LESION VULVA","CDM Code","Pro",510,"Clinic",56515,"DESTROY VULVA LESION/S COMPL",216,108,171.72,183.6,183.6,183.6,181.44,174.96,172.8,171.72,172.8]
[503000,"BIOPSY OF PENIS","CDM Code","Pro",510,"Clinic",54100,"BIOPSY OF PENIS",222,111,176.49,188.7,188.7,188.7,186.48,179.82000000000002,177.60000000000002,176.49,177.60000000000002]
[500100,"ANESTHESIA","CDM Code","Pro",510,"Clinic","","",156,78,124.02000000000001,132.6,132.6,132.6,131.04,126.36000000000001,124.80000000000001,124.02000000000001,124.80000000000001]
[440395,"*GM 1 DIASIALO IGM","CDM Code","IP/OP",300,"Lab",83516,"IMMUNOASSAY NONANTIBODY",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]
[440394,"*GM 1 DIASIALO IGG","CDM Code","IP/OP",300,"Lab",83516,"IMMUNOASSAY NONANTIBODY",52,26,41.34,44.199999999999996,44.199999999999996,44.199999999999996,43.68,42.120000000000005,41.6,41.34,41.6]