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["GORDON MEMORIAL HOSPITAL - CHARGE MASTER 07/01/2022"]
["The listing below is the standard charge amount by procedure at Gordon Memorial Hospital as of 07/01/2022.  All patients are charged the same amount by the facility.   Insurance companies have specific agreements with the Hospital that ultimately determine the patient’s and the insurance companies financial obligation. The amounts due from patients who qualify for discounted care (charity care) are determined under the Hospital’s policy related to discounted care. "]
[]
[]
[]
[]
["CHARGE CODE","DESCRIPTION","DEPT","REVCODE","CPT CODE","MOD1","MOD2","AMOUNT"]
[" 2501255","NF-ICAPS AREDS ORAL TABLET","PHARMACY",250,null,null,null,0.36]
[" 2501025","NF-Trileptal Suspension 300MG/5ML","PHARMACY",250,null,null,null,1]
[" 2501026","NF-Trileptal Suspension 300MG/5ML","PHARMACY",250,null,null,null,1]
[" 2501412","NF-Methylphenidate Oral Tablet 5MG","PHARMACY",250,null,null,null,1]
[" 2500053","BACITRACIN OINT UD PACKET 0.9GM","PHARMACY",250,null,null,"GY",2]
[" 2500084","CARMEX LIP BALM TUBE 10 GRM","PHARMACY",250,null,null,"GY",2]
[" 2500388","NICOTINE GUM 2MG DEVICE","PHARMACY",250,"J3490",null,"GY",2]
[" 2500574","ZINC SULFATE 220MG CAPSULE","PHARMACY",250,null,null,"GY",2]
[" 2500884","NF-Allopurinol Oral Tablet 300MG","PHARMACY",250,null,null,null,2]
[" 2500900","LOPERAMIDE 2MG CAPSULE","PHARMACY",250,null,null,null,2]
[" 2500959","ACETAMINOPHEN/ASPIRIN/CAFFEINE TABLET","PHARMACY",250,null,null,null,2]
[" 2501199","CHOLECALCIFEROL (VIT D3) 5000IU TABLET","PHARMACY",250,null,null,null,2]
[" 2501200","MELATONIN 3MG TABLET","PHARMACY",250,null,null,null,2]
[" 2501359","SODIUM BICARBONATE 650MG TABLET","PHARMACY",250,null,null,null,2]
[" 2501387","NF-Isosorbide Dinitrate Oral Tablet 5MG","PHARMACY",250,null,null,null,2]
[" 2501491","NF-Hyoscyamine Sulfate SL Tablet 0.125MG","PHARMACY",250,null,null,null,2]
[" 2500825","NF-Calcitriol Liquid Cap 0.25MCG","PHARMACY",250,null,null,"GY",3]
[" 2501247","NF-Minoxidil Tablet 10MG","PHARMACY",250,null,null,null,3]
[" 2501347","NF-Sprintec Tablet","PHARMACY",250,null,null,null,3]
[" 2501378","NF-Imipramine HCl Tablet 50MG","PHARMACY",250,null,null,null,3]
[" 2501405","NF-Pyridostigmine Bromide Oral Tablet 60","PHARMACY",250,null,null,null,3]
[" 2500850","SALINE NASAL GEL WITH ALOE 14.1GM TUBE","PHARMACY",250,null,null,"GY",3.18]
[" 2500427","PHENYLEPHRINE 0.5% NASAL SPRAY","PHARMACY",250,null,null,"GY",3.8]
[" 2500282","LACTULOSE 20GRAM/30ML SYRUP","PHARMACY",250,null,null,"GY",4]
[" 2500362","MISOPROSTOL 100 MCG TABLET","PHARMACY",250,"J8499",null,"GY",4]
[" 2500526","SULFAMETH/TRIMETH ORAL SUS 473ML BOTTLE","PHARMACY",250,"J8499",null,"GY",4]
[" 2500880","BENZONATATE 100MG CAPSULE","PHARMACY",250,null,null,null,4]
[" 2500896","LEVOTHYROXINE 125 MCG TABLET","PHARMACY",250,null,null,null,4]
[" 2500997","NF-tiZANidine HCl Tablet 4mg","PHARMACY",250,null,null,null,4]
[" 2501129","LEVETIRACETAM 500MG TABLET","PHARMACY",250,null,null,null,4]
[" 2501154","TORSEMIDE 20MG TABLET","PHARMACY",250,null,null,null,4]
[" 2501191","NF-Olanzapine Oral Tablet 10mg","PHARMACY",250,null,null,null,4]
[" 2501352","MEDROXYPROGESTERONE ACETATE 10MG TABLET","PHARMACY",250,null,null,null,4]
[" 2501393","SODIUM CHLORIDE 7% INHALATION AMPULE 4ML","PHARMACY",250,null,null,null,4]
[" 2501394","SODIUM CHLORIDE 3% INHALATION AMPULE","PHARMACY",250,null,null,null,4]
[" 2501398","NF-Rosuvastatin Calcium Oral Tablet 20MG","PHARMACY",250,null,null,null,4]
[" 2501437","SODIUM CHLORIDE 0.9% 5ML NEB SOLUTION","PHARMACY",250,null,null,null,4]
[" 2500817","VITAMIN A&D OINTMENT 113GM","PHARMACY",250,null,null,"GY",4.24]
[" 2500101","CETACAINE SPRAY","PHARMACY",250,"J3490",null,null,5]
[" 2500210","FLUORESCEIN SODIUM 1 MG STRIP","PHARMACY",250,null,null,null,5]
[" 2500240","HEPARIN 500UNITS/5ML FLUSH","PHARMACY",250,"J1642",null,null,5]
[" 2500888","EYE IRRIGATING SOLUTION 4 OZ","PHARMACY",250,null,null,null,5]
[" 6000176","H2O STERILE 500 ML IRR","PHARMACY",250,null,null,null,5]
[" 2501243","MIDODRINE 10MG TABLET","PHARMACY",250,null,null,null,5.16]
[" 2500859","BACITRACIN OINTMENT 28.4GM TUBE","PHARMACY",250,null,null,null,5.25]
[" 2500809","NF-Flecainide Acetate Oral Tablet 50MG","PHARMACY",250,null,null,"GY",6]
[" 2501185","NF-azaTHIOprine Oral Tablet 50MG","PHARMACY",250,null,null,null,6]
[" 2501230","NF-Verapamil HCl Capsule 180MG","PHARMACY",250,null,null,null,6]
[" 2500177","DULOXETINE 30MG CAPSULE","PHARMACY",250,"J8499",null,"GY",6.88]
[" 2500753","NF-Norco Oral Tablet 325MG/10MG","PHARMACY",250,null,null,"GY",7]
[" 6000177","ENEMA OIL","PHARMACY",250,null,null,"GY",7]
[" 2500268","IPRATROPIUM BROMIDE 0.5MG/2.5ML NEB SOLN","PHARMACY",250,"J7644",null,"GY",7.4]
[" 2507006","CL-BUPIVACAINE 0.5% VIAL 30 ML","PHARMACY",250,"J3490",null,null,7.97]
[" 2500288","LEVALBUTEROL 0.63 MG/3 ML VIAL","PHARMACY",250,"J7614",null,null,8]
[" 2501557","MAGIC MOUTHWASH","PHARMACY",250,null,null,null,8]
[" 2507007","CL-cefTRIAXone 1 GM VIAL","PHARMACY",250,"J0696",null,null,8]
[" 2507009","CL-DEXAMETHASONE 10 MG/ML VIAL","PHARMACY",250,"J1100",null,null,8]
[" 2507012","CL-diphenhydrAMINE 50 MG/ML VIAL","PHARMACY",250,"J1200",null,null,8]
[" 2507019","CL-KETOROLAC 30 MG/ML VIAL 1 ML","PHARMACY",250,"J1885",null,null,8]
[" 2507021","CL-LIDOCAINE 1% W/EPINEPHRINE 20ML INJ","PHARMACY",250,"J3490",null,null,8]
[" 2507030","CL-cefTRIAXone 500 MG VIAL","PHARMACY",250,"J0696",null,null,8]
[" 2500481","NF-Rifampin Oral Capsule 300MG","PHARMACY",250,"J8499",null,"GY",8.0399999999999991]
[" 2501232","FLECAINIDE 50MG TABLET","PHARMACY",250,null,null,null,8.08]
[" 2500545","TOPAMAX 25MG TABLET","PHARMACY",250,"J8499",null,"GY",8.4]
[" 2500517","SODIUM CITRATE/CITRIC ACID 30ML SOLUTION","PHARMACY",250,"J8499",null,"GY",8.68]
[" 2501189","NF-Levofloxacin Oral Tablet 750mg","PHARMACY",250,null,null,null,8.68]
[" 2501183","NF-Prograf Capsule 1MG","PHARMACY",250,null,null,null,9]
[" 2501184","NF-Prograf Capsule 1MG","PHARMACY",250,null,null,null,9]
[" 2501272","NF-Vitamin B6 100mg Oral Tablet","PHARMACY",250,null,null,null,9]
[" 2501283","NF-acetaZOLAMIDE Tablet 250MG","PHARMACY",250,null,null,null,9]
[" 2507029","CL-PROMETHazine 25 MG/ML 1ML VIAL","PHARMACY",250,"J2550",null,null,9.11]
[" 2501245","ORPHENADRINE 100MG ER TABLET","PHARMACY",250,null,null,null,9.23]
[" 2500241","HEPARIN 10UNITS/ML 3ML FLUSH","PHARMACY",250,null,null,null,9.8000000000000007]
[" 2507020","CL-LIDOCAINE 1% 10MG/ML 20ML VIAL","PHARMACY",250,"J3490",null,null,9.99]
[" 2500681","CL-B12 CYANOCOBALAMIN 1000 MCG/ML INJ","PHARMACY",250,"J3420",null,null,10]
[" 2500856","NF- Ropinirole Oral Tablet 2MG","PHARMACY",250,null,null,null,10]
[" 2507008","CL-CYANOCOBALAMIN(VIT B-12) 1000MCG VIAL","PHARMACY",250,"J3420",null,null,10]
[" 6000234","20 mEq/L POTASSIUM CHLORIDE 5% DEX 0.45%","PHARMACY",250,null,null,null,10]
[" 6000309","20 mEq/L POTASSIUM CHLORIDE 0.9%","PHARMACY",250,null,null,null,10]
[" 6000334","20mEq KCL/0.45% NORMAL SALINE","PHARMACY",250,null,null,null,10]
[" 2500945","ROPINIROLE 0.5MG TABLET","PHARMACY",250,null,null,null,10.039999999999999]
[" 2500718","CL-Vitamin K1 Inj 1MG/0.5ML NEWBORN","PHARMACY",250,null,null,null,10.14]
[" 2500716","CL-HEPARIN 10,000 UNITS/1 ML VIAL","PHARMACY",250,"J1644",null,null,11.25]
[" 2501233","MICONAZOLE 2% VAGINAL CREAM","PHARMACY",250,null,null,null,11.79]
[" 6000158","MINI BAG 100 ML NORMAL SALINE","PHARMACY",250,null,null,null,12]
[" 2501098","CL-LIDOCAINE/PRILOCAINE 2.5%/2.5% CREAM","PHARMACY",250,null,null,null,12.06]
[" 2500925","DIVALPROEX SODIUM 500MG DR TABLET","PHARMACY",250,null,null,null,12.92]
[" 2500818","NF-Flecainide Acetate Oral Tablet 100MG","PHARMACY",250,null,null,"GY",14]
[" 2500520","STERILE WATER - IRRIGATION 1000ML","PHARMACY",250,"A4217",null,null,14.6]
[" 2500511","SODIUM CHLORIDE 0.9% 500ML IRRIGATION","PHARMACY",250,"A4217",null,null,15.16]
[" 2500796","CL-INFLUENZA VACCINE(FLULAVAL) 0.5ML SYR","PHARMACY",250,"90686",null,null,15.18]
[" 2500090","CEFDINIR 300MG CAPSULE","PHARMACY",250,"J8499",null,"GY",15.33]
[" 2500559","VASOPRESSIN 20UN/ML VIAL","PHARMACY",250,null,null,null,15.54]
[" 2500504","SODIUM CHLORIDE 0.9% 1000ML IRRIGATION","PHARMACY",250,null,null,null,15.8]
[" 2507025","CL-METHYLPREDNISOLONE SUCC 40MG/ML VIAL","PHARMACY",250,"J2920",null,null,16.32]
[" 2500523","STERILE WATER IRRIGATION 500 ML","PHARMACY",250,null,null,null,16.399999999999999]
[" 2501461","NF-Urea 15 Gram Packet","PHARMACY",250,null,null,null,16.8]
[" 2501250","NF-Naltrexone 50mg Oral Tablet","PHARMACY",250,null,null,null,17.25]
[" 2501047","ESCITALOPRAM 10MG TABLET","PHARMACY",250,null,null,null,17.52]
[" 2501024","NF-Topiramate Oral Tablet 100MG","PHARMACY",250,null,null,null,18]
[" 2501159","NF-Suboxone Sublingual Film 2MG-0.5MG","PHARMACY",250,null,null,null,18]
[" 2500828","ESCITALOPRAM 5MG TABLET","PHARMACY",250,null,null,"GY",18.04]
[" 2501099","CL-TETRACAINE 0.5% OPHTH SOLUTION 4ML","PHARMACY",250,null,null,null,18.420000000000002]
[" 2500493","SILVER NITRATE APPLICATOR","PHARMACY",250,null,null,null,18.48]
[" 2500047","ATROPINE SULFATE 0.1MG/1ML  10ML VIAL","PHARMACY",250,null,null,null,19.2]
[" 2501085","VFC ROTARIX","PHARMACY",250,"90681",null,null,19.82]
[" 2501226","NF-Ivermectin 3mg Oral Tablet","PHARMACY",250,null,null,null,19.88]
[" 2500587","XYLOCAINE-MPF 1% INJECTION SOLUTION 2ML","PHARMACY",250,null,null,null,20]
[" 2500225","GENTAMICIN 80 MG/2 ML VIAL","PHARMACY",250,"J1580",null,null,21.01]
[" 2500278","KETOROLAC 30 MG/ML VIAL 1 ML","PHARMACY",250,"J1885",null,null,21.04]
[" 2500198","FAMOTIDINE 10MG/ML 2ML VIAL","PHARMACY",250,"S0028",null,null,21.07]
[" 2500486","cefTRIAXone 500 MG VIAL: IM/IV USE","PHARMACY",250,"J0696",null,null,21.14]
[" 2500164","diphenhydrAMINE 50 MG/ML VIAL","PHARMACY",250,"J1200",null,null,21.28]
[" 2500355","METOPROLOL TARTRATE 1MG/ML 5ML VIAL","PHARMACY",250,"J3490",null,null,21.28]
[" 2500070","BUPIVACAINE 0.75% 30ML INJECTION","PHARMACY",250,null,null,null,21.31]
[" 2500728","CL-TUBERSOL INJ","PHARMACY",250,null,null,null,21.32]
[" 2500350","METOCLOPRAMIDE 5MG/ML 2ML VIAL","PHARMACY",250,"J2765",null,null,21.35]
[" 2500324","LORAZEPAM 2 MG/1ML VIAL","PHARMACY",250,"J2060",null,null,21.41]
[" 2500906","LIDOCAINE 2% 120MG/6ML SYRINGE PF","PHARMACY",250,null,null,null,21.42]
[" 2500199","fentaNYL 100MCG/2ML VIAL","PHARMACY",250,"J3010",null,null,21.53]
[" 2500088","ceFAZolin 1 GM VIAL","PHARMACY",250,"J0690",null,null,21.64]
[" 2500566","VERSED 5MG/5ML VIAL","PHARMACY",250,"J2250",null,null,21.68]
[" 2500135","DEXAMETHASONE 10 MG/ML VIAL","PHARMACY",250,"J1100",null,null,21.71]
[" 2500095","cefTRIAXone 1 GM VIAL: IM/IV USE","PHARMACY",250,"J0696",null,null,21.83]
[" 2500022","AMIODARONE 150MG/3ML VIAL","PHARMACY",250,"J0282",null,null,21.85]
[" 2500824","NF-Brilinta Oral Tablet 90MG","PHARMACY",250,null,null,"GY",22]
[" 2500442","POTASSIUM CHLORIDE 2MEQ/ML 10ML VIAL","PHARMACY",250,null,null,null,22.1]
[" 2500331","MAGNESIUM SULFATE 5GM/10ML VIAL","PHARMACY",250,"J3475",null,null,22.27]
[" 2500357","metroNIDAZOLE/NS 500MG/100ML PREMIX","PHARMACY",250,"J3490",null,null,22.3]
[" 2500430","PHENYTOIN 100 MG/2 ML VIAL","PHARMACY",250,null,null,null,22.39]
[" 2500239","HEPARIN 10,000 UNITS/ML VIAL","PHARMACY",250,"J1644",null,null,22.52]
[" 2500301","LIDOCAINE/EPINEPHRINE 1% 20ML VIAL","PHARMACY",250,"J3490",null,null,22.57]
[" 2500588","DOPAMINE 200MG/5ML VIAL","PHARMACY",250,null,null,null,22.59]
[" 2500315","LIDOCAINE-MPF 1% 5ML VIAL","PHARMACY",250,"J3490",null,null,22.75]
[" 2500034","NF-Ampicillin 500mg Vial","PHARMACY",250,"J0290",null,null,22.76]
[" 2507031","CL-TRIAMCINOLONE ACETONIDE 40MG/ML 1ML","PHARMACY",250,"J3301",null,null,22.95]
[" 2500913","NF-Mesalamine DR Oral Tablet 800MG","PHARMACY",250,null,null,null,23]
[" 2500607","DEXAMETHASONE 4MG/1ML VIAL","PHARMACY",250,"J1100",null,null,23.16]
[" 2500890","MEPERIDINE 50MG/ML 1ML VIAL","PHARMACY",250,"J2175",null,null,23.17]
[" 2500068","BUMETANIDE 1 MG/4 ML VIAL","PHARMACY",250,"J3490",null,null,23.3]
[" 2500284","LASIX 40MG/4ML VIAL","PHARMACY",250,"J1940",null,null,23.36]
[" 2500114","CLINDAMYCIN 600 MG/4 ML VIAL","PHARMACY",250,"J3490",null,null,23.53]
[" 2500069","BUPIVACAINE 0.5% 30ML VIAL","PHARMACY",250,null,null,null,23.54]
[" 2500419","OXYTOCIN 10 UNIT/ML VIAL 1 ML","PHARMACY",250,"J2590",null,null,23.6]
[" 2500437","PIPERACILLIN/TAZOBACTAM 3.375GM VIAL","PHARMACY",250,"J2543",null,null,23.6]
[" 2500307","LIDOCAINE 2% 20MG/ML 5ML VIAL - PF","PHARMACY",250,"J2001",null,null,23.74]
[" 2500543","NF-Tolterodine ER Oral Capsule 2MG","PHARMACY",250,null,null,"GY",24.12]
[" 2501227","BRIMONIDINE 0.2% OPHTH SOLUTION 5ML","PHARMACY",250,null,null,null,25]
[" 2500302","LIDOCAINE 2% 20ML INJECTION","PHARMACY",250,"J3490",null,null,25.04]
[" 2500862","NF-Pradaxa Oral Capsule 150MG","PHARMACY",250,null,null,null,25.96]
[" 2501246","NF-Rosuvastatin Oral Tablet 40MG","PHARMACY",250,null,null,null,26]
[" 2500851","POLYMYXIN B/TRIMETHOPRIM OPHTH DROPS","PHARMACY",250,null,null,"GY",26.14]
[" 2507024","CL-METHYLPREDNISOLONE SUCC 125MG/2ML VIA","PHARMACY",250,"J2930",null,null,26.28]
[" 2507015","CL-EPINEPHrine 1 MG/ML VIAL","PHARMACY",250,"J0171",null,null,26.93]
[" 2500057","BACTERIOSTATIC SODIUM CHLORIDE 30ML VIAL","PHARMACY",250,null,null,null,27.3]
[" 2500533","TETRACAINE 0.5% OPHTH SOLN BOT","PHARMACY",250,"J3490",null,"GY",27.96]
[" 2500428","PHENYLEPHRINE 10 MG/ML 1ML VIAL","PHARMACY",250,"J2370",null,null,29]
[" 6000175","SALINE NORMAL 1000 ML IRR","PHARMACY",250,null,null,null,29]
[" 2500459","PROMETHazine 25 MG/ML 1ML VIAL","PHARMACY",250,"J2550",null,null,29.05]
[" 2500110","CIPROFLOXACIN 400MG/200ML IV PREMIX","PHARMACY",250,"J0744",null,null,29.2]
[" 2500304","LIDOCAINE 2% 5ML SYRINGE","PHARMACY",250,"J2001",null,null,29.25]
[" 2500441","POTASSIUM CHLORIDE 10MEQ/100ML PREMIX IV","PHARMACY",250,"J3480",null,null,29.34]
[" 2500300","LIDOCAINE 1% 10MG/ML 20ML VIAL","PHARMACY",250,"J2001",null,null,29.44]
[" 2500522","STERILE WATER FOR INJECTION 20ML VIAL","PHARMACY",250,null,null,null,29.55]
[" 2500308","LIDOCAINE/EPINEPHRINE 2% 20ML VIAL","PHARMACY",250,"J3490",null,null,29.56]
[" 2500516","SODIUM CHLORIDE IRRIG SOLN 3000ML","PHARMACY",250,"A4217",null,null,29.61]
[" 2500159","DILTIAZEM 50MG/10ML VIAL","PHARMACY",250,"J3490",null,null,29.68]
[" 2500530","TERBUTALINE 1 MG/ML VIAL 1 ML","PHARMACY",250,"J3105",null,null,29.8]
[" 2500558","VANCOMYCIN 500 MG VIAL","PHARMACY",250,"J3370",null,null,29.93]
[" 2501517","NF-Doxylamine Succinate Powder","PHARMACY",250,null,null,null,30]
[" 2500303","LIDOCAINE 2% 20MG/ML 20ML VIAL","PHARMACY",250,null,null,null,30.04]
[" 2500501","SODIUM CHL CONCENTRATE 23.4% 30ML VIAL","PHARMACY",250,null,null,null,30.39]
[" 2500224","GENTAMICIN 20 MG/2 ML VIAL *PEDIATRIC*","PHARMACY",250,"J1580",null,null,30.64]
[" 2500233","GLYDO 2% SYRINGE 6 ML","PHARMACY",250,"J8499",null,null,30.95]
[" 2500290","LEVOFLOXACIN/D5W 500MG/100ML IV PREMIX","PHARMACY",250,"J1956",null,null,31]
[" 2500093","CEFTAZIDIME 1 GM VIAL","PHARMACY",250,"J0713",null,null,31.24]
[" 2500309","LIDOCAINE 4% AMPULE 5 ML","PHARMACY",250,null,null,null,31.56]
[" 2500156","DIGOXIN 500 MCG/2 ML AMPULE","PHARMACY",250,"J1160",null,null,31.6]
[" 2500560","VECURONIUM BROMIDE 10MG VIAL","PHARMACY",250,"J3490",null,null,31.6]
[" 2500037","APIXABAN 5MG TABLET","PHARMACY",250,"J8499",null,"GY",31.74]
[" 2500274","KETAMINE 1000 MG/10 ML VIAL","PHARMACY",250,null,null,null,31.99]
[" 2500415","OXYCODONE HCL 20MG ER TABLET","PHARMACY",250,"J8499",null,"GY",32.08]
[" 2500238","HALOPERIDOL LACTATE 5 MG/ML VIAL","PHARMACY",250,"J1630",null,null,32.19]
[" 2500051","AZITHROMYCIN 500 MG VIAL","PHARMACY",250,"J0456",null,null,32.200000000000003]
[" 2500578","ZOSYN 4.5GRAM VIAL","PHARMACY",250,"J2543",null,null,32.200000000000003]
[" 2500339","MEPERIDINE 25MG/1ML SYRINGE","PHARMACY",250,"J2175",null,null,32.25]
[" 2500347","METHYLPREDNISOLONE SUCC 40MG/ML 1ML VIAL","PHARMACY",250,"J2920",null,null,32.25]
[" 2500232","GLYCOPYRROLATE 0.2 MG/ML VIAL","PHARMACY",250,"J3490",null,null,32.31]
[" 2500014","ADENOSINE 6 MG/2 ML VIAL","PHARMACY",250,"J0153",null,null,32.44]
[" 2500242","HEPARIN/NS 0.45% 25000 UN/500ML","PHARMACY",250,"J1644",null,null,32.6]
[" 2500895","ATROPINE 0.1MG/ML 10ML SYRINGE","PHARMACY",250,"J0461",null,null,32.65]
[" 2500092","CEFOXITIN 1 GM VIAL","PHARMACY",250,"J0694",null,null,32.659999999999997]
[" 2500291","LEVOFLOXACIN/D5W 750MG/150ML IV PREMIX","PHARMACY",250,"J1956",null,null,32.799999999999997]
[" 2500306","LIDOCAINE 2% JELLY URO-JET","PHARMACY",250,"J3490",null,null,33.299999999999997]
[" 2500536","THIAMINE 200MG/2ML VIAL","PHARMACY",250,"J3411",null,null,33.299999999999997]
[" 2507059","CL-LASIX 40MG/4ML VIAL","PHARMACY",250,"J1940",null,null,33.33]
[" 2500608","NEOSTIGMINE 10MG/10ML INJ *ANESTHESIA*","PHARMACY",250,"J2710",null,null,33.4]
[" 2500209","FLUMAZENIL 0.5 MG/5 ML VIAL","PHARMACY",250,"J3490",null,null,33.5]
[" 2500033","AMPICILLIN 1GRAM VIAL","PHARMACY",250,"J0290",null,null,33.64]
[" 2500127","CYANOCOBALAMIN (VIT B-12) 1000MCG VIAL","PHARMACY",250,"J3420",null,null,33.74]
[" 2500275","KETAMINE 500 MG/10 ML VIAL","PHARMACY",250,null,null,null,33.78]
[" 2500194","ESMOLOL 100 MG/10 ML VIAL","PHARMACY",250,"J3490",null,null,33.799999999999997]
[" 2500035","AMPICILLIN/SULBACTAM 1.5 GM VIAL","PHARMACY",250,"J0295",null,null,34.25]
[" 2500094","NF-Ceftazidime 2GM Vial","PHARMACY",250,null,null,null,34.409999999999997]
[" 2500196","ETOMIDATE 20MG/10ML VIAL","PHARMACY",250,null,null,null,34.6]
[" 2500521","STERILE WATER 1000ML IV","PHARMACY",250,null,null,null,35]
[" 2507013","CL-EPINEPHRINE 0.1MG/1ML SYRINGE","PHARMACY",250,null,null,null,35.9]
[" 2501144","NF-SUCRALFATE 1GM/10ML ORAL SUSPENSION","PHARMACY",250,null,null,null,36.54]
[" 2500359","MICONAZOLE VAG SUPP KIT (3 SUPP)","PHARMACY",250,"J8498",null,null,36.57]
[" 2501186","NF-Incruse Ellipta Inh Pwd 62.5MCG/1ACT","PHARMACY",250,null,null,null,37]
[" 2500167","DIPTH/PERTUSSIS/ACELL (DTaP) 0.5ML VACC","PHARMACY",250,"90700",null,null,37.049999999999997]
[" 2501427","NF-Entresto 24-26mg Tablet","PHARMACY",250,null,null,null,37.42]
[" 2500348","NF-Methylprednisolone Succ 500MG Vial","PHARMACY",250,null,null,null,39.200000000000003]
[" 2501235","SHUGARCAINE 0.25/7.5 MG/ML 1ML VIAL","PHARMACY",250,null,null,null,39.6]
[" 2501480","NF-Anastrozole Oral Tablet 1MG","PHARMACY",250,null,null,null,40]
[" 2500106","NF-ChlorproMAZINE 25 MG/ML AMPULE","PHARMACY",250,null,null,null,40.75]
[" 2500340","MEPERIDINE 50MG/1ML SYRINGE","PHARMACY",250,"J2175",null,null,40.75]
[" 2500367","MORPHINE 4MG/ML VIAL","PHARMACY",250,null,null,null,40.75]
[" 2500549","TRIAMCINOLONE ACETONIDE 40MG/ML 1ML VIAL","PHARMACY",250,"J3301",null,null,40.799999999999997]
[" 2500848","OFLOXACIN 0.3% OPHTHALMIC DROPS 5ML","PHARMACY",250,"J3490",null,"GY",41.88]
[" 2500185","EPINEPHRINE 0.1MG/1ML SYRINGE","PHARMACY",250,"J0171",null,null,42]
[" 2500487","ROCURONIUM 50 MG/5 ML VIAL","PHARMACY",250,"J3490",null,null,42]
[" 2501265","ATROPINE 1% OPHTHALMIC OINTMENT 3.5GM","PHARMACY",250,null,null,null,42]
[" 2500410","OSELTAMIVIR PHOSPHATE 45MG CAP","PHARMACY",250,"J8499",null,"GY",42.54]
[" 2500313","LIDOCAINE/DEXTROSE 5% DRIP 4MG/ML 500ML","PHARMACY",250,null,null,null,42.62]
[" 2500640","CALCIUM CHLORIDE 10% 1000MG/10ML SYRINGE","PHARMACY",250,"J3490",null,null,43.2]
[" 2507023","CL-METHYLPREDNISOLONE ACET 80MG/ML 1ML","PHARMACY",250,"J1040",null,null,44.06]
[" 2500554","TUBERCULIN SKIN TEST 5TU/0.1ML INJ","PHARMACY",250,null,null,null,45.24]
[" 2500444","POTASSIUM CHLORIDE ORAL 20MEQ/15ML SOLN","PHARMACY",250,null,null,"GY",45.65]
[" 2501376","NF-VESIcare Oral Tablet 10MG","PHARMACY",250,null,null,null,46]
[" 6000159","H2O STERILE 1000 ML IRR","PHARMACY",250,null,null,null,46]
[" 2500346","METHYLPREDNISOLONE SUCC 125MG/2ML VIAL","PHARMACY",250,"J2930",null,null,46.72]
[" 2500376","NAFCILLIN 1 GM VIAL","PHARMACY",250,"J3490",null,null,47.95]
[" 2501087","CL-ETHYL CHLORIDE TOPICAL MIST SPRAY","PHARMACY",250,null,null,null,48]
[" 6000172","SALINE NORMAL 500 ML IRR","PHARMACY",250,"A4217",null,null,48]
[" 2500075","CALCIUM GLUCONATE 10% 10ML VIAL","PHARMACY",250,"J0610",null,null,48.08]
[" 2507057","CL-hydrOXYzine 25 MG/ML VIAL 1 ML","PHARMACY",250,"J3410",null,null,48.4]
[" 2500148","DEXTROSE 50% SYRINGE 50 ML","PHARMACY",250,"J7799",null,null,48.6]
[" 2500673","CL-HIB (HAEMOPHILUS B) VACCINE 0.5 INJ","PHARMACY",250,"90648",null,null,48.92]
[" 2501361","NF-Bicalutamide Oral Tablet 50MG","PHARMACY",250,null,null,null,49]
[" 2500440","POLIOVIRUS VACCINE, INACTIVE 0.5ML INJ","PHARMACY",250,null,null,null,49.22]
[" 2500524","SUCCINYLCHOLINE 200MG/10ML VIAL","PHARMACY",250,"J0330",null,null,49.92]
[" 2500994","NF-GoLYTELY Oral Solution 4000ML","PHARMACY",250,null,null,null,51]
[" 2501244","DICLOFENAC SODIUM 1% GEL 100GM","PHARMACY",250,null,null,null,51.92]
[" 2500465","PROSTIGMIN 1:1000 1MG/ML 10ML VIAL","PHARMACY",250,"J2710",null,null,52.4]
[" 2500665","BUPIVACAINE 0.5% 50ML VIAL","PHARMACY",250,"J3490",null,null,53.76]
[" 2500844","NF-Januvia Oral Tablet 50MG","PHARMACY",250,null,null,"GY",54.14]
[" 2500540","NF-Tobramycin 80MG/2 ML Vial","PHARMACY",250,null,null,null,54.45]
[" 2500017","ALBUTEROL SULF 0.9MG/ACT INHALER","PHARMACY",250,"J7613",null,"GY",54.52]
[" 2500280","LABETALOL 5 MG/ML MDV 20 ML","PHARMACY",250,"J3490",null,null,55]
[" 2500413","NF-Oxacillin 2GM Vial","PHARMACY",250,null,null,null,55.55]
[" 2500013","ADENOSINE 6MG/2ML SYRINGE","PHARMACY",250,"J0150",null,null,55.88]
[" 2501234","NF-Cyclopentolate 2% Ophth Solution 2ML","PHARMACY",250,null,null,null,59.02]
[" 2500366","MORPHINE 30 MG/30 ML PCA VIAL","PHARMACY",250,null,null,null,59.65]
[" 2500497","SODIUM BICARBONATE 4.2% 10ML SYRINGE","PHARMACY",250,null,null,null,59.92]
[" 2500257","IMIPENEM/CILASTATIN 500 MG VIAL","PHARMACY",250,"J0743",null,null,60]
[" 2500299","LIDOCAINE 0.5% 5MG/ML 50ML VIAL - MPF","PHARMACY",250,"J2001",null,null,60.44]
[" 2500433","PHILIPS RESPIRONICS OPTICHAMBER","PHARMACY",250,null,null,null,60.6]
[" 2500579","DOBUTamine 500MG/250ML IV PREMIX","PHARMACY",250,"J1250",null,null,61]
[" 2500995","NF-Spiriva Inh/Neb Cap 18MCG","PHARMACY",250,null,null,null,61]
[" 2500424","PENICILLIN G POTASSIUM 5 MIU VIAL","PHARMACY",250,"J2540",null,null,61.08]
[" 2500091","NF-Cefotaxime Sodium 1GM Vial","PHARMACY",250,null,null,null,61.45]
[" 2500059","BENTYL 20 MG/2 ML AMPULE","PHARMACY",250,null,null,null,61.55]
[" 2500172","DOPAMINE 400MG/D5W 250ML IV PREMIX","PHARMACY",250,"J1265",null,null,63.1]
[" 2501231","NF-Spiriva HandiHaler Inh/Neb Cap 18MCG","PHARMACY",250,null,null,null,64]
[" 2500466","PROTAMINE SULFATE 50MG/5ML VIAL","PHARMACY",250,"J2720",null,null,64.61]
[" 2500251","HYDROCORTISONE SOD SUCC 100MG/2ML VIAL","PHARMACY",250,"J1720",null,null,65.72]
[" 2500609","BSS STERILE IRRIGATING SOLUTION","PHARMACY",250,null,null,null,66]
[" 2500244","hydrALAZINE 20MG/ML 1ML VIAL","PHARMACY",250,"J0360",null,null,68.739999999999995]
[" 2500562","VERAPAMIL 10 MG/4 ML INJECTION","PHARMACY",250,null,null,null,69.86]
[" 2507055","CL-fentaNYL 100 MCG/2 ML VIAL","PHARMACY",250,"J3010",null,null,70.55]
[" 2500671","CL-HepB PEDS (ENGERIX-B) 10MCG/0.5ML INJ","PHARMACY",250,"90744",null,null,70.77]
[" 2500010","ACTIVATED CHARCOAL 50GM SOLUTION","PHARMACY",250,"J8499",null,"GY",70.95]
[" 2500498","SODIUM BICARBONATE 8.4% 50ML SYRINGE","PHARMACY",250,"J3490",null,null,71.239999999999995]
[" 2500187","EPINEPHRINE 1 MG/ML VIAL","PHARMACY",250,"J0171",null,null,71.81]
[" 2500134","DEXAMETHASONE 0.1% OPHTH SOLN","PHARMACY",250,null,null,"GY",72.72]
[" 2500937","NF-Viberzi Oral Tablet 100MG","PHARMACY",250,null,null,null,75]
[" 2500372","ACETYLCYSTEINE INH/ORAL SOLUTION 20%","PHARMACY",250,"J7608",null,null,75.02]
[" 2500397","NOREPINEPHRINE 1MG/ML 4ML VIAL","PHARMACY",250,"J3490",null,null,75.67]
[" 2500557","VANCOMYCIN 1000MG VIAL","PHARMACY",250,"J3370",null,null,76.319999999999993]
[" 2500344","METHYLPRED ACE (DEPO-MEDROL)80MG/ML 1ML","PHARMACY",250,"J1040",null,null,78.319999999999993]
[" 2500395","NITROGLYCERIN/D5W 25MG/250ML BOTTLE","PHARMACY",250,null,null,null,78.94]
[" 2500012","ACYCLOVIR 500 MG/10 ML VIAL","PHARMACY",250,"J0133",null,null,78.959999999999994]
[" 2500377","NF-Nafcillin 2GM Vial","PHARMACY",250,null,null,null,79.2]
[" 2500472","PYRIDOXINE 100MG/ML 1ML VIAL","PHARMACY",250,"J3415",null,null,79.540000000000006]
[" 2501541","ACETIC ACID 2% OTIC SOLUTION","PHARMACY",250,null,null,null,80]
[" 2500254","NF-hydrOXYzine 25 MG/ML VIAL 1 ML","PHARMACY",250,"J3410",null,null,84.7]
[" 2501046","CALCIUM CHLORIDE 10% 1 GM/10ML VIAL","PHARMACY",250,null,null,null,84.91]
[" 2500637","DIAZEPAM 50MG/10ML VIAL","PHARMACY",250,null,null,null,88]
[" 2500179","ENOXAPARIN 100MG/1ML INJECTION","PHARMACY",250,"J1650",null,null,89.75]
[" 2501399","NF-Triamcinolone 0.1% 454 Gram Jar","PHARMACY",250,null,null,null,93.3]
[" 2500936","NF-Sensipar Oral Tablet 30MG","PHARMACY",250,null,null,null,96]
[" 2500586","NF-Esomeprazole IV 40MG Vial","PHARMACY",250,null,null,null,96.44]
[" 2500669","CL-HepA PED (HAVRIX) 720EL.U./0.5ML INJ","PHARMACY",250,"90633",null,null,96.5]
[" 2501523","ETHYL CHLORIDE TOPICAL MIST SPRAY","PHARMACY",250,null,null,null,96.57]
[" 2500142","DEXTROSE 5% WATER 500ML BAG","PHARMACY",250,null,null,null,100]
[" 2500680","CL-TENIVAC (TD) over 7yrs VACCINE  0.5ML","PHARMACY",250,"90714",null,null,101.71]
[" 2500150","DIAZEPAM 10 MG/2 ML SYRINGE","PHARMACY",250,"J3360",null,null,103.39]
[" 2500436","PHYTONADIONE 1MG/0.5ML *PEDIATRIC*","PHARMACY",250,"J3430",null,null,103.88]
[" 2500180","ENOXAPARIN 30MG/0.3ML INJECTION","PHARMACY",250,"J1650",null,null,104.2]
[" 2500675","CL-IPV POLIO VIRUS VACCINE 0.5ML INJ","PHARMACY",250,"90713",null,null,104.27]
[" 2500857","AZITHROMYCIN 200MG/5ML SUSPENSION 15ML","PHARMACY",250,"J8499",null,null,104.64]
[" 2500568","NF-VIBRAMYCIN IV 100MG VIAL","PHARMACY",250,"J3490",null,null,105.7]
[" 2500384","NICARDIPINE 25MG/10ML VIAL","PHARMACY",250,"J3490",null,null,107.17]
[" 2500252","NF-HYDROCORTISONE SOD SUC 250MG/2ML VIAL","PHARMACY",250,null,null,null,114.1]
[" 2500499","SODIUM CHLORIDE 0.45%/KCL 20MEQ/1000ML","PHARMACY",250,null,null,null,115]
[" 2500343","METHYLERGONOVINE MALEATE 0.2MG/ML INJ","PHARMACY",250,"J2210",null,null,118.44]
[" 2500682","CL-TDAP (BOOSTRIX) 0.5ML INJ","PHARMACY",250,"90715",null,null,119.95]
[" 2501411","NF-Tresiba FlexTouch Pen SubQ Soln 100U/","PHARMACY",250,null,null,null,122]
[" 2501187","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",250,null,null,null,128]
[" 2507022","CL-MEDROXYPROGESTERONE ACETATE 150MG/ML","PHARMACY",250,"J1050",null,null,131.88]
[" 2501545","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",250,null,null,null,133]
[" 2500378","NALOXONE 2 MG/2 ML PREFILLED SYRINGE","PHARMACY",250,"J2310",null,null,138.6]
[" 2500181","ENOXAPARIN 40MG/0.4ML INJECTION","PHARMACY",250,"J1650",null,null,138.91999999999999]
[" 2500216","FOSPHENYTOIN 100 MG PE/2 ML VIAL","PHARMACY",250,"Q2009",null,null,143.02000000000001]
[" 2501340","NF-Cyclopentolate 2% Ophth Solution 5mL","PHARMACY",250,null,null,null,143.12]
[" 2500404","OLANZAPINE IM 10 MG VIAL","PHARMACY",250,"J3490",null,null,145.25]
[" 2500724","CL-SODIUM CHLORIDE 0.9% 1000 ML","PHARMACY",250,null,null,null,147.15]
[" 2500215","FOLIC ACID 50MG/10ML VIAL","PHARMACY",250,"J3490",null,null,153.13]
[" 2500676","CL-DTAP-IPV(KINRIX) 0.5ML INJ","PHARMACY",250,"90696",null,null,153.13999999999999]
[" 2500345","NF-METHYLPREDNISOLONE SUCC 1000MG VIAL","PHARMACY",250,"J2930",null,null,163.38]
[" 2500435","PHYTONADIONE 10MG/ML AMPULE","PHARMACY",250,"J3430",null,null,166.79]
[" 2500403","OFLOXACIN 0.3% OTIC DROPS 5ML","PHARMACY",250,"J3490",null,"GY",171.51]
[" 2500672","CL-HepB ADULT (ENGERIX-B) 20MCG/ML INJ","PHARMACY",250,"90746",null,null,173.28]
[" 2500632","MMR","PHARMACY",250,"90707",null,null,179.2]
[" 2500184","EPHEDRINE 50MG/ML 1ML VIAL","PHARMACY",250,null,null,null,184.44]
[" 2500015","ALBUMIN HUMAN 25% 50ML VIAL","PHARMACY",250,"P9047",null,null,187.2]
[" 2501343","NF-Cyclopentolate 0.5% Ophth Drops 15mL","PHARMACY",250,null,null,null,189]
[" 2500182","ENOXAPARIN 60MG/0.6ML INJECTION","PHARMACY",250,"J1650",null,null,193.73]
[" 2500636","NF-Lantus Solostar 300UNITS/3ML Pen","PHARMACY",250,null,null,"GY",204.15]
[" 2500061","BETAMETHASONE 30MG/5ML VIAL","PHARMACY",250,"J0702",null,null,204.39]
[" 2500133","DEPO-TESTOSTERONE 200MG/1ML INJ","PHARMACY",250,"J1071",null,null,206.15]
[" 2507053","CL-DEPO-TESTOSTERONE 200MG/1ML INJ","PHARMACY",250,"J1071",null,null,206.15]
[" 2500670","CL-HepA ADULT (HAVRIX) 1ML INJ","PHARMACY",250,"90632",null,null,206.69]
[" 2500277","KETOROLAC 0.5% OPHTHALMIC DROPS 5ML","PHARMACY",250,null,null,"GY",213.74]
[" 2500334","MEDROXYPROGESTERONE ACETATE 150MG INJ","PHARMACY",250,"J1050",null,null,214.31]
[" 2500445","PRALIDOXIME CHLORIDE 1GM","PHARMACY",250,null,null,null,216.75]
[" 2501289","NF-Buprenorphine 10MCG/HR Patch","PHARMACY",250,null,null,null,222.63]
[" 2500060","BENZTROPINE MESYLATE 2MG/2ML AMPULE","PHARMACY",250,"J0515",null,null,225]
[" 2500270","IRON SUCROSE 100MG/5ML VIAL","PHARMACY",250,"J1756",null,null,225.23]
[" 2500679","CL-ROTAVIRUS (ROTATEQ) VACCINE 2ML","PHARMACY",250,"90680",null,null,227.9]
[" 2500243","HEPATITIS B VACCINE 20MCG/ML 0.5ML INJ","PHARMACY",250,"90740",null,null,231.06]
[" 2500633","VARICELLA VACCINE LIVE","PHARMACY",250,"90396",null,null,232.5]
[" 2500678","CL-MMR VACCINE 0.5ML","PHARMACY",250,"90707",null,null,234.74]
[" 2500183","ENOXAPARIN 80MG/0.8ML INJECTION","PHARMACY",250,"J1650",null,null,238.43]
[" 2500677","CL-DTAP-HepB-IPV (PEDIARIX) 0.5ML INJ","PHARMACY",250,"90723",null,null,241.43]
[" 2500480","RhoGAM 300 mcg SYRINGE","PHARMACY",250,null,null,null,251.1]
[" 2507066","CL-RhoGAM 300 mcg SYRINGE","PHARMACY",250,null,null,null,251.1]
[" 2500660","DANTRIUM 20MG INJECTION","PHARMACY",250,null,null,null,252]
[" 2500527","SUMATRIPTAN 6 MG/0.5 ML VIAL","PHARMACY",250,"J3030",null,null,255]
[" 2501475","AMOXICILLIN/CLAV 600MG/42.9MG/5ML SUSP","PHARMACY",250,"J8499",null,null,260.74]
[" 2500052","AZTREONAM 2 GM VIAL","PHARMACY",250,"J3490",null,null,263.92]
[" 2500190","EPTIFIBATIDE 20MG/10ML VIAL","PHARMACY",250,null,null,null,278.88]
[" 2500434","PHYSOSTIGMINE 1 MG/ML AMP 2 ML","PHARMACY",250,"J3490",null,null,281.82]
[" 2501013","NF-Lumigan Ophth Solution 0.01%","PHARMACY",250,null,null,null,283]
[" 2501164","NYSTATIN 60GM TOPICAL POWDER","PHARMACY",250,null,null,null,287.64]
[" 2500631","DTAP-HEPB-IPV VACCINE 0.5ML","PHARMACY",250,"90723",null,null,296.25]
[" 2501341","BARICITINIB 2MG TABLET","PHARMACY",250,null,null,null,299.66000000000003]
[" 2500120","COLLAGENASE TOPICAL OINT 30GM","PHARMACY",250,"J3490",null,"GY",307.2]
[" 2500089","CEFDINIR 250MG/5ML ORAL SUSPENSION","PHARMACY",250,"J8499",null,"GY",314.92]
[" 2500860","CORTROSYN 0.25MG VIAL","PHARMACY",250,"J0834",null,null,319.75]
[" 2500294","LEVOTHYROXINE IV 100 MCG VIAL","PHARMACY",250,null,null,null,332.58]
[" 2501084","CL-ROTARIX VACCINE 1ML","PHARMACY",250,"90681",null,null,352.87]
[" 2501511","LINEZOLID 600MG TABLET","PHARMACY",250,null,null,null,366]
[" 2501543","CL-MENVEO VACCINE","PHARMACY",250,"90734",null,null,388.96]
[" 2500396","NITROPRUSSIDE 25MG/ML 2ML VIAL","PHARMACY",250,"J3490",null,null,390]
[" 2501282","NF-Stiolto Respimat Inh 2.5-2.5MCG/1Act","PHARMACY",250,null,null,null,394]
[" 2501483","CL-MENQUADFI 0.5ML VIAL","PHARMACY",250,"90619",null,null,401.18]
[" 2501436","CL-PENICILLIN G 1.2MU SYRINGE","PHARMACY",250,"J0561",null,null,454.5]
[" 2500019","ALTEPLASE 2MG VIAL","PHARMACY",250,"J2997",null,null,459.18]
[" 2500229","GLUCAGEN 1 MG/ML VIAL","PHARMACY",250,"J1610",null,null,463.32]
[" 2500923","CL-BEXSERO 0.5ML SYRINGE","PHARMACY",250,"90620",null,null,482.8]
[" 2500008","ACETYLCYSTEINE INJ 200MG/ML VIAL","PHARMACY",250,"J0132",null,null,507.6]
[" 2501507","NF-Fidaxomicin 200mg Oral Tablet","PHARMACY",250,null,null,null,537.02]
[" 2500420","PAMIDRONATE 30 MG/10 ML VIAL","PHARMACY",250,null,null,null,580.5]
[" 2500373","MULTIVITAMIN (ADULT) SOLN 10ML","PHARMACY",250,null,null,null,595.35]
[" 2501443","CL-PREVNAR-20 VACCINE 0.5ML SYRINGE","PHARMACY",250,"90677",null,null,597.29999999999995]
[" 2500674","CL-HPV (GARDASIL) VACCINE 0.5ML INJ","PHARMACY",250,"90651",null,null,608.34]
[" 2500439","PREVNAR-13 VACCINE 0.5ML SYRINGE","PHARMACY",250,"90670",null,null,611.03]
[" 2500993","METHYLENE BLUE 0.5% INJECTION 10ML","PHARMACY",250,null,null,null,703.17]
[" 2501458","NF-Tolvaptan Oral Tablet 15mg","PHARMACY",250,null,null,null,1248.47]
[" 2501097","CL-SKYLA 14MCG/24HR IUD","PHARMACY",250,"J7301",null,null,1310.5]
[" 2501431","CL-PARAGARD COPPER IUD","PHARMACY",250,"J7300",null,null,1326.75]
[" 2500204","NF-FILGRASTIM 480MG/1.6ML VIAL","PHARMACY",250,"J1442",null,null,1353.6]
[" 2500287","LEUPROLIDE ACETATE 45MG INJ","PHARMACY",250,null,null,null,1522.48]
[" 2500722","CL-MIRENA 20MCG/24HR IUD","PHARMACY",250,"J7298",null,null,1573.86]
[" 2501542","CL-KYLEENA 17.5MCG/24HR IUD","PHARMACY",250,"J7296",null,null,1573.86]
[" 2500157","DIGOXIN IMMUNE FAB 40MG INJ","PHARMACY",250,null,null,null,1649.1]
[" 2500191","EPTIFIBATIDE 200MG/100ML VIAL","PHARMACY",250,null,null,null,1930.02]
[" 2500479","REMICADE 100MG VIAL","PHARMACY",250,"J1745",null,null,2382.35]
[" 2500064","BORTEZOMIB 3.5MG SDV","PHARMACY",250,null,null,null,3077.73]
[" 2500125","CROTALIDAE POLYVALENT IMMUNE FAB VIAL","PHARMACY",250,null,null,null,3658.5]
[" 2500383","NEULASTA 6 MG/0.6 ML INJ","PHARMACY",250,null,null,null,6313.44]
[" 2500483","RITUXIMAB 500MG/50ML VIAL","PHARMACY",250,"J9312",null,null,7328.26]
[" 2500538","TNKASE 50MG VIAL","PHARMACY",250,"J3101",null,null,10807.59]
[" 2500009","ACTIVASE 100MG VIAL","PHARMACY",250,"J2997",null,null,13200.54]
[" 2500267","CONTRAST/LOCM 370 - 100MG/ML","PHARMACY",255,"Q9967",null,null,300]
[" 2500688","NF-ALLERGY BUSTER NASAL SPRAY 3X","PHARMACY",258,null,null,null,0.01]
[" 2501018","NF-1-BUTANOL LIQUID","PHARMACY",258,null,null,null,0.04]
[" 2500686","NF-Permethrin Cream 5%","PHARMACY",258,null,null,null,0.06]
[" 2501254","NF-I-PRIN ORAL TABLET 200MG","PHARMACY",258,null,null,null,0.56999999999999995]
[" 2500694","NF-Symbicort Inh Aer Liq 80MCG-4.5MCG","PHARMACY",258,null,null,null,1]
[" 2500769","NF-First - metroNIDAZOLE 50 Oral Kit","PHARMACY",258,null,null,null,1]
[" 2500770","NF-First - metroNIDAZOLE 50 Oral Kit","PHARMACY",258,null,null,null,1]
[" 2500784","NF-Levothyroxine Oral Tablet 75MCG","PHARMACY",258,null,null,null,1]
[" 2500795","NF-Systane Ophth Solution","PHARMACY",258,null,null,null,1]
[" 2500853","NF-Synthroid Oral Tablet 125MCG","PHARMACY",258,null,null,null,1]
[" 2500876","NF-Methadone HCL Oral Tablet 10MG","PHARMACY",258,null,null,null,1]
[" 2501017","NF-Tetrahydrozoline HCl Opth Solution 0.","PHARMACY",258,null,null,null,1]
[" 2501022","NF-HYDROmorphone Hydrochloride Tablet 4M","PHARMACY",258,null,null,null,1]
[" 2501027","NF-Trileptal Suspension 300MG/5ML","PHARMACY",258,null,null,null,1]
[" 2501031","NF-Megestrol Acetate Suspension 40MG/ML","PHARMACY",258,null,null,null,1]
[" 2501033","NF-N-Acetyl-L-Cysteine Capsule","PHARMACY",258,null,null,null,1]
[" 2501034","NF-Diclofenac Sodium Topical Gel 1%","PHARMACY",258,null,null,null,1]
[" 2501070","NF-Megestrol Acetate Oral Susp 40MG/1ML","PHARMACY",258,null,null,null,1]
[" 2501101","NF-Effer-K Oral Tab Eff 20MEQ","PHARMACY",258,null,null,null,1]
[" 2501114","NF-sulfaSALAzine EC Tab 500MG","PHARMACY",258,null,null,null,1]
[" 2501125","NF-Diclofenac Sodium Topical Gel 1%","PHARMACY",258,null,null,null,1]
[" 2501176","NF-Diclofenac Sodium Topical Gel 1%","PHARMACY",258,null,null,null,1]
[" 2501223","NF-HydrOXYzine HCl Tablet 10MG","PHARMACY",258,null,null,null,1]
[" 2501374","NF-Levothyroxin Tab  75MCG","PHARMACY",258,null,null,null,1]
[" 2501413","NF-Ritalin Tablet 5MG","PHARMACY",258,null,null,null,1]
[" 2501447","NF-Carboxymethylcelull Sod Ophth Soln 0.","PHARMACY",258,null,null,null,1]
[" 2501521","NF-Estradiol Oral Tablet 1MG","PHARMACY",258,null,null,null,1]
[" 2501188","NF-GLIMEPIRIDE ORAL TABLET 1MG","PHARMACY",258,null,null,null,1.21]
[" 2500696","VITAMIN B12 1000MCG TABLET","PHARMACY",258,null,null,null,2]
[" 2500708","FISH OIL CONCENTRATE ORAL LIQ CAP 1000MG","PHARMACY",258,null,null,null,2]
[" 2500781","NF-Metoprolol Tartrate Tablet 100MG","PHARMACY",258,null,null,null,2]
[" 2500799","NF-Poly Hist Forte Oral Tablet 7.5MG-10M","PHARMACY",258,null,null,null,2]
[" 2500852","NF-hydrOXYzine HCl Oral Tablet 25MG","PHARMACY",258,null,null,null,2]
[" 2500875","NF-HYDROmorphone HCl Tablet 4MG","PHARMACY",258,null,null,null,2]
[" 2500983","NF-Doxepin Oral Capsule 50MG","PHARMACY",258,null,null,null,2]
[" 2500986","NF-hydrOXYzine HCl Oral Tablet 10MG","PHARMACY",258,null,null,null,2]
[" 2501020","FAMOTIDINE 20MG ORAL TABLET","PHARMACY",258,"S0028",null,null,2]
[" 2501048","NF-metFORMIN HCl Tab ER 500MG","PHARMACY",258,null,null,null,2]
[" 2501061","NF-Estradiol Tablet 1MG","PHARMACY",258,null,null,null,2]
[" 2501469","NF-PHENobarbital Oral Tablet 32.4MG","PHARMACY",258,null,null,null,2]
[" 2501501","NF-Hyoscyamine Sulfate SL Tablet 0.125MG","PHARMACY",258,null,null,null,2]
[" 2501506","NF-Fludrocortisone Acetate Tablet 0.1MG","PHARMACY",258,null,null,null,2]
[" 2501510","NF-Fludrocortisone Acetate Tablet 0.1MG","PHARMACY",258,null,null,null,2]
[" 2501513","NF-Urea Topical Lotion 40%","PHARMACY",258,null,null,null,2]
[" 2501528","NF-Acetaminophen ER Oral Tab 650MG","PHARMACY",258,null,null,null,2]
[" 2501533","NF-rOPINIRole Hydrochloride Oral Tablet","PHARMACY",258,null,null,null,2]
[" 2501538","NF-Nystatin Topical Powder 100000U/1GM","PHARMACY",258,null,null,null,2]
[" 2501556","NF-Anastrozole 1MG Oral Tablet","PHARMACY",258,null,null,null,2]
[" 2501559","NF-Urea Topical Lotion 40%","PHARMACY",258,null,null,null,2]
[" 2501049","NF-METFORMIN ER ORAL TAB ER 500MG","PHARMACY",258,null,null,null,2.13]
[" 2501407","NF-BUTALBITAL COMPOUND ORAL TAB 50-325-4","PHARMACY",258,null,null,null,2.78]
[" 2500750","NF-Vitamin D3 Oral Capsule 50000IU","PHARMACY",258,null,null,null,3]
[" 2500761","NF-Vitamin D3 Oral Capsule 50000IU","PHARMACY",258,null,null,null,3]
[" 2500886","NF-Glimepiride Oral Tablet 4MG","PHARMACY",258,null,null,null,3]
[" 2500955","NF-Lisinopril/HCTZ Oral Tablet 20/12.5MG","PHARMACY",258,null,null,null,3]
[" 2501030","NF-Fosinopril Sodium Tablet 20MG","PHARMACY",258,null,null,null,3]
[" 2501035","NF-Nasacort Allergy 24HR Nasal Spray 55M","PHARMACY",258,null,null,null,3]
[" 2501063","NF-Hydrea Capsule 500MG","PHARMACY",258,null,null,null,3]
[" 2501115","NF-aMILoride/HCTZ Tablet","PHARMACY",258,null,null,null,3]
[" 2501161","NF-Nortriptyline Oral Capsule 25MG","PHARMACY",258,null,null,null,3]
[" 2501198","NF-Norethindrone Oral Tablet 0.35MG","PHARMACY",258,null,null,null,3]
[" 2501249","NF-Minoxidil Tablet 10MG","PHARMACY",258,null,null,null,3]
[" 2501267","NF-Mometason Furoate Cream 0.1%","PHARMACY",258,null,null,null,3]
[" 2501388","NF-Sprintec Tablet","PHARMACY",258,null,null,null,3]
[" 2501417","NF-Pyridostigmine Bromide Oral Tablet 60","PHARMACY",258,null,null,null,3]
[" 2501425","NF-Pyridostigmine Bromide Oral Tablet 60","PHARMACY",258,null,null,null,3]
[" 2501485","NF-Minoxidil Tablet 10MG","PHARMACY",258,null,null,null,3]
[" 2501487","NF-Norethindrone Oral Tablet 0.35MG","PHARMACY",258,null,null,null,3]
[" 2501252","NF-ALTAVERA ORAL TABLET 0.15MG-30MCG","PHARMACY",258,null,null,null,3.31]
[" 2501019","NF-CARTIA XT ORAL 24 HR CAP ER 120MG","PHARMACY",258,null,null,null,3.59]
[" 2500834","NF-Vitamin D Oral Capsule 50000IU","PHARMACY",258,null,null,null,4]
[" 2500873","NF-Ipratropium Bromide Nasal Spray 0.03%","PHARMACY",258,null,null,null,4]
[" 2500971","NF-Rosuvastatin Calcium Oral Tablet 10MG","PHARMACY",258,null,null,null,4]
[" 2501104","NF-Prochlorperazine Oral Tablet 10MG","PHARMACY",258,null,null,null,4]
[" 2501137","NF-Flonase Nasal Spray 0.05MG/1ACTUATION","PHARMACY",258,null,null,null,4]
[" 2501392","NF-Flonase Nasal Spray 0.05MG/1ACTUATION","PHARMACY",258,null,null,null,4]
[" 2501410","NF-Systane Complete Ophth Soln 0.6%","PHARMACY",258,null,null,null,4]
[" 2501549","NF-PROCHLORPERAZINE MALEATE ORAL TAB 5MG","PHARMACY",258,null,null,null,4.25]
[" 2500731","NF-Cilostazol Oral Tablet 100MG","PHARMACY",258,null,null,null,5]
[" 2500732","NF-Betamethasone Valerate Cream 0.1%","PHARMACY",258,null,null,null,5]
[" 2500756","NF-Vitamin D Oral Tablet 5000IU","PHARMACY",258,null,null,null,5]
[" 2500985","NF-Vitamin D2 Liquid-Filled Cap 50,000IU","PHARMACY",258,null,null,null,5]
[" 2501266","NF-Mometasone Furoate Topical Cream 0.1%","PHARMACY",258,null,null,null,5]
[" 2501418","NF-Vitamin D2 Liquid-Filled Cap 50,000IU","PHARMACY",258,null,null,null,5]
[" 2501498","NF-buPROPion SR 12 HR Tab ER 150MG","PHARMACY",258,null,null,null,5]
[" 2501531","NF-Synthroid Oral Tablet 200MCG","PHARMACY",258,null,null,null,5]
[" 2501238","NF-Midodrine Oral Tablet 10MG","PHARMACY",258,null,null,null,5.15]
[" 2501314","NF-Methenamine Hippurate 1GM Tablet","PHARMACY",258,null,null,null,6]
[" 2501319","NF-azaTHIOprine Oral Tablet 50MG","PHARMACY",258,null,null,null,6]
[" 2501331","NF-Methenamine Hippurate 1GM Tablet","PHARMACY",258,null,null,null,6]
[" 2501478","NF-Amitriptyline HCl Oral Tablet 150MG","PHARMACY",258,null,null,null,6]
[" 2501554","NF-Methenamine Hippurate 1GM Tablet","PHARMACY",258,null,null,null,6]
[" 2500703","NF-Hydroxychloroquine Sulfate Tab 200MG","PHARMACY",258,null,null,null,6.1]
[" 2500751","NF-Tessalon Perles Liquid Capsule 100MG","PHARMACY",258,null,null,null,7]
[" 2500765","NF-Tessalon Perles Liquid Capsule 100MG","PHARMACY",258,null,null,null,7]
[" 2500831","NF-Norethindrone Acetate Tablet 5MG","PHARMACY",258,null,null,null,7]
[" 2500969","NF-Ezetimibe Oral Tablet 10MG","PHARMACY",258,null,null,null,7]
[" 2501005","NF-Topiramate Oral Capsule 15MG","PHARMACY",258,null,null,null,7]
[" 2501012","NF-Fenofibrate Oral Tablet 160MG","PHARMACY",258,null,null,null,7]
[" 2501052","NF-TIZANIDINE ORAL TABLET 2MG","PHARMACY",258,null,null,null,7]
[" 2501069","NF-Midodrine HCl Oral Tablet 5MG","PHARMACY",258,null,null,null,7]
[" 2501091","NF-Midodrine HCl Tablet 5MG","PHARMACY",258,null,null,null,7]
[" 2501222","NF-Fexofenadine Hydrochloride Tablet 180","PHARMACY",258,null,null,null,7]
[" 2501373","NF-TraZODone HCl Oral Tablet 150MG","PHARMACY",258,null,null,null,7]
[" 2501525","NF-potassium citrate Oral Tablet, ER 15M","PHARMACY",258,null,null,null,7]
[" 2501534","NF-Allegra Oral Tablet 60MG","PHARMACY",258,null,null,null,7]
[" 2501536","NF-Gabapentin Oral Tablet 600MG","PHARMACY",258,null,null,null,7]
[" 2500783","NF-Augmented BetamethasoneDipropionate O","PHARMACY",258,null,null,null,8]
[" 2500789","NF-Clotrimazole Troche MM Lozenge 10MG","PHARMACY",258,null,null,null,8]
[" 2501479","NF-Pramipexole Dihydrochloride Tab 0.25M","PHARMACY",258,null,null,null,8]
[" 2501409","NF-BUTALBITAL-ASPIRIN-CAFFEINE-CODEINE C","PHARMACY",258,null,null,null,8.2200000000000006]
[" 2500979","NF-Unisom Oral Tablet 25MG","PHARMACY",258,null,null,null,9]
[" 2501317","NF-Prograf Capsule 1MG","PHARMACY",258,null,null,null,9]
[" 2501318","NF-Prograf Capsule 1MG","PHARMACY",258,null,null,null,9]
[" 2501441","NF-Methylphenidate HCl Chew Tab 2.5mg","PHARMACY",258,null,null,null,9]
[" 2501131","NF-Chlorthalidone Tablet 25MG","PHARMACY",258,null,null,null,9.19]
[" 2501408","NF-BUTALBITAL COMPOUND W/CODEINE CAPSULE","PHARMACY",258,null,null,null,9.2799999999999994]
[" 2500786","NF-levETIRAcetam Oral Tablet 500MG","PHARMACY",258,null,null,null,10]
[" 2500792","NF-Flecainide Acetate Tablet 100MG","PHARMACY",258,null,null,null,10]
[" 2500822","NF-Flecainide Acetate Tablet 100MG","PHARMACY",258,null,null,null,10]
[" 2500872","NF-Flecainide Acetate Tablet 100MG","PHARMACY",258,null,null,null,10]
[" 2500897","NF-Flecainide Acetate Tablet 100MG","PHARMACY",258,null,null,null,10]
[" 2500926","NF-Azelastine HCl Nasal Spray 137MCG/1IN","PHARMACY",258,null,null,null,10]
[" 2501175","NF-Brimonidine Tartrate Ophth Soln 0.2%","PHARMACY",258,null,null,null,10]
[" 2501257","NF-Cetirizine HCl Oral Syrup 1MG/ML","PHARMACY",258,null,null,null,10]
[" 2500879","NF-Keppra Oral Tablet 750MG","PHARMACY",258,null,null,null,11]
[" 2500883","NF-Nortriptyline HCL Oral Capsule 75MG","PHARMACY",258,null,null,null,12]
[" 2500910","NF-Cefadroxil Oral Capsule 500MG","PHARMACY",258,null,null,null,12]
[" 2501075","NF-Vitamin D3 Liquid","PHARMACY",258,null,null,null,12]
[" 2501169","NF-Eplerenone Oral Tablet 25MG","PHARMACY",258,null,null,null,12]
[" 2501303","NF-Simplist Dilaudid Inj Soln 4MG/1ML","PHARMACY",258,null,null,null,12]
[" 2501313","NF-Simplist Dilaudid Inj Soln 4MG/1ML","PHARMACY",258,null,null,null,12]
[" 2501537","NF-Nortriptyline Hydrochloride Cap 75MG","PHARMACY",258,null,null,null,12]
[" 2500790","NF-lamoTRIgine Oral Tablet 100MG","PHARMACY",258,null,null,null,13]
[" 2500902","NF-Dexilant Delayed-Release Capsule 60MG","PHARMACY",258,null,null,null,13]
[" 2501037","NF-Dilaudid Oral Tablet 4MG","PHARMACY",258,null,null,null,13]
[" 2501113","NF-Midodrine HCl Oral Tablet 5MG","PHARMACY",258,null,null,null,13]
[" 2500758","NF-MS Contin Oral Tablet ER 15MG","PHARMACY",258,null,null,null,14]
[" 2500836","NF-lamoTRIgine Oral Tablet 100MG","PHARMACY",258,null,null,null,14]
[" 2500956","NF-Meloxicam Oral Tablet 15MG","PHARMACY",258,null,null,null,14]
[" 2501028","NF-Metaxalone Oral Tablet 800MG","PHARMACY",258,null,null,null,14]
[" 2501261","NF-ivermectin Oral Tablet 3MG","PHARMACY",258,null,null,null,14]
[" 2501381","NF-ivermectin Oral Tablet 3MG","PHARMACY",258,null,null,null,14]
[" 2501385","NF-ivermectin Oral Tablet 3MG","PHARMACY",258,null,null,null,14]
[" 2501396","NF-ivermectin Oral Tablet 3MG","PHARMACY",258,null,null,null,14]
[" 2500747","NF-Bystolic Oral Tablet 10MG","PHARMACY",258,null,null,null,15]
[" 2500763","NF-Bystolic Oral Tablet 10MG","PHARMACY",258,null,null,null,15]
[" 2500854","NF-Bystolic Oral Tablet 10MG","PHARMACY",258,null,null,null,15]
[" 2500953","NF-MS Contin Oral Tablet ER 15MG","PHARMACY",258,null,null,null,15]
[" 2500954","NF-MS Contin Oral Tablet ER 15MG","PHARMACY",258,null,null,null,15]
[" 2501058","NF-Sotalol Oral Tablet 80MG","PHARMACY",258,null,null,null,15]
[" 2501065","NF-Sotalol Oral Tablet 80MG","PHARMACY",258,null,null,null,15]
[" 2501079","NF-Sotalol Oral Tablet 80MG","PHARMACY",258,null,null,null,15]
[" 2501043","NF-Telmisartan Oral Tablet 80MG","PHARMACY",258,null,null,null,16]
[" 2501108","NF-Ipratropium Brom Nasal Spray 0.03%","PHARMACY",258,null,null,null,16]
[" 2501494","NF-SEROquel Oral Tablet 100MG","PHARMACY",258,null,null,null,16]
[" 2500748","NF-Lansoprazole Oral Cap DR 15MG","PHARMACY",258,null,null,null,17]
[" 2500764","NF-Lansoprazole Oral Cap DR 15MG","PHARMACY",258,null,null,null,17]
[" 2500787","NF-Aeroeclipse Nebulizer","PHARMACY",258,null,null,null,17]
[" 2500874","NF-Morphine Sulfate Oral Capsule ER 30MG","PHARMACY",258,null,null,null,17]
[" 2501021","NF-Morphine Sulfate Oral Capsule ER 30MG","PHARMACY",258,null,null,null,17]
[" 2501029","NF-Fioricet Oral Capsule 300MG-50MG-40MG","PHARMACY",258,null,null,null,18]
[" 2501429","NF-Dutasteride Liq Cap 0.5MG","PHARMACY",258,null,null,null,18]
[" 2500749","NF-Advair Diskus 100/50 Disk","PHARMACY",258,null,null,null,19]
[" 2500762","NF-Advair Diskus 100/50 Inhaler","PHARMACY",258,null,null,null,19]
[" 2500810","NF-Disulfiram Oral Tablet 500MG","PHARMACY",258,null,null,null,19]
[" 2500899","NF-Esgic Oral Tablet 50MG-325MG-40MG","PHARMACY",258,null,null,null,19]
[" 2501391","NF-Ortho Tri-Cyclen Lo Oral Kit","PHARMACY",258,null,null,null,19]
[" 2501446","NF-Brimonidine Tartrate Ophth Soln 0.2%","PHARMACY",258,null,null,null,19]
[" 2500687","NF-Methotrexate Inj Sol 50MG/2ML Vial","PHARMACY",258,null,null,null,19.32]
[" 2500595","NF-Escitalopram Oral Tablet 20MG","PHARMACY",258,null,null,null,20]
[" 2500788","NF-Breo Ellipta Inh Pwd 100MCG/1Actuatio","PHARMACY",258,null,null,null,20]
[" 2500791","NF-Renvela Oral Tablet 800MG","PHARMACY",258,null,null,null,20]
[" 2500918","NF-Dorzolamide Hydrochloride Ophth Soln","PHARMACY",258,null,null,null,20]
[" 2501067","NF-Colchicine Oral Tablet 0.6MG","PHARMACY",258,null,null,null,20]
[" 2501121","NF-Dorzolamide Hydrochloride Ophth Soln","PHARMACY",258,null,null,null,20]
[" 2501132","NF-Colchicine Oral Tablet 0.6MG","PHARMACY",258,null,null,null,20]
[" 2501146","NF-Dorzolamide Hydrochloride Ophth Soln","PHARMACY",258,null,null,null,20]
[" 2501532","NF-Topiramate Oral Tablet 100MG","PHARMACY",258,null,null,null,20]
[" 2501561","NF-Dorzolamide Hydrochloride Ophth Soln","PHARMACY",258,null,null,null,20]
[" 2500832","NF-Breo Ellipta Inh Pwd 100MCG/Actuation","PHARMACY",258,null,null,null,21]
[" 2501118","NF-Premarin Oral Tablet 0.45MG","PHARMACY",258,null,null,null,21]
[" 2501339","NF-Fluorouracil Topical Cream 5%","PHARMACY",258,null,null,null,21]
[" 2500972","NF-Mesalamine Oral Tablet, Delayed Relea","PHARMACY",258,null,null,null,23]
[" 2501124","NF-Avodart Capsule, Liquid-Filled 0.5MG","PHARMACY",258,null,null,null,23]
[" 2501518","NF-Alogliptin Benzoate Oral Tablet 12.5M","PHARMACY",258,null,null,null,23]
[" 2500782","NF-Latanoprost Ophthalmic Solution 0.005","PHARMACY",258,null,null,null,25]
[" 2501054","NF-Rosuvastatin Calcium Oral Tablet 20MG","PHARMACY",258,null,null,null,25]
[" 2500811","NF-Rosuvastatin Calcium Oral Tablet 40MG","PHARMACY",258,null,null,null,26]
[" 2501056","NF-Ziprasidone HCl Capsule 40MG","PHARMACY",258,null,null,null,26]
[" 2501248","NF-Rosuvastatin Oral Tablet 40MG","PHARMACY",258,null,null,null,26]
[" 2501256","NF-Rosuvastatin Calcium Oral Tablet 10MG","PHARMACY",258,null,null,null,26]
[" 2501338","NF-Spiriva Inh/Neb Cap 18MCG","PHARMACY",258,null,null,null,26]
[" 2501402","NF-Spiriva Inh/Neb Cap 18MCG","PHARMACY",258,null,null,null,26]
[" 2501383","NF-AMBIEN CR EXTENDED-RELEASE TABLET 12.","PHARMACY",258,null,null,null,26.76]
[" 2501253","NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG","PHARMACY",258,null,null,null,26.86]
[" 2500757","NF-MS Contin Oral Tablet ER 30MG","PHARMACY",258,null,null,null,27]
[" 2500826","NF-Dexmethylphenidate HCl Cap ER 10MG","PHARMACY",258,null,null,null,27]
[" 2500951","NF-Lyrica Oral Capsule 75MG","PHARMACY",258,null,null,null,28]
[" 2501372","NF-Adderall Oral Tablet 20MG","PHARMACY",258,null,null,null,29]
[" 2501492","NF-SEROquel XR Oral Tab ER 50MG","PHARMACY",258,null,null,null,29]
[" 2500982","NF-Danazol Capsule 200MG","PHARMACY",258,null,null,null,30]
[" 2501142","NF-Danazol Capsule 200MG","PHARMACY",258,null,null,null,30]
[" 2500978","NF-Advair Diskus 500/50 Disk","PHARMACY",258,null,null,null,31]
[" 2501228","NF-Clotrimazole 3 Vaginal Cream 2%","PHARMACY",258,null,null,null,32.97]
[" 2500952","NF-Restasis Ophthalmic Emulsion 0.05%","PHARMACY",258,null,null,null,33]
[" 2501040","NF-Restasis Ophthalmic Emulsion 0.05%","PHARMACY",258,null,null,null,33]
[" 2501403","NF-Crestor Oral Tablet 5MG","PHARMACY",258,null,null,null,33]
[" 2501450","NF-Crestor Tablet 40MG","PHARMACY",258,null,null,null,33]
[" 2501497","NF-Crestor Tablet 40MG","PHARMACY",258,null,null,null,33]
[" 2500594","TIMOLOL 0.5% OPHTH SOLUTION 5ML","PHARMACY",258,null,null,null,34]
[" 2500798","NF-Budesonide Inhalation Suspension 1MG/","PHARMACY",258,null,null,null,34]
[" 2501038","NF-Soma Tablet 350MG","PHARMACY",258,null,null,null,34]
[" 2501306","NF-Baclofen Intrathecal Solution 0.5MG/1","PHARMACY",258,null,null,null,34]
[" 2501269","NF-Restasis Ophthalmic Emulsion 0.05%","PHARMACY",258,null,null,null,36]
[" 2501440","NF-Viibryd Oral Tablet 40MG","PHARMACY",258,null,null,null,36]
[" 2501449","NF-Trelegy Ellipta 100/62.5/25MCG/INH","PHARMACY",258,null,null,null,37]
[" 2501320","NF-Incruse Ellipta Inh Pwd 62.5MCG/1ACT","PHARMACY",258,null,null,null,38]
[" 2501428","NF-terbinafine Oral Tablet 250MG","PHARMACY",258,null,null,null,38]
[" 2501547","NF-Restasis Ophthalmic Emulsion 0.05%","PHARMACY",258,null,null,null,38]
[" 2500697","NF-ACETYLCYSTEINE INH/ORAL SOLUTION 10%","PHARMACY",258,"J7608",null,null,39.26]
[" 2501011","NF-Systane Ultra Ophthalmic Soln 0.4%-0.","PHARMACY",258,null,null,null,40]
[" 2501481","NF-Anastrozole Oral Tablet 1MG","PHARMACY",258,null,null,null,40]
[" 2501529","NF-Diclofenac Epolamine 1.3% ER Patch","PHARMACY",258,null,null,null,40.28]
[" 2501167","NF-Detrol LA Oral Capsule ER 4MG","PHARMACY",258,null,null,null,43]
[" 6000162","SALINE NORMAL 50 ML MINI BAG","PHARMACY",258,"J7050",null,null,43]
[" 6000167","SALINE NORMAL 50 ML","PHARMACY",258,"J7050",null,null,43]
[" 2500730","SENSORCAINE/EPI 0.5% 1:200000 - MPF","PHARMACY",258,"J3490",null,null,43.4]
[" 2501473","NF-VESIcare Oral Tablet 5MG","PHARMACY",258,null,null,null,46]
[" 2501439","NF-Gelnique Transdermal Gel 100MG/1GM","PHARMACY",258,null,null,null,47]
[" 2501160","NF-Myrbetriq Oral Tablet ER 25MG","PHARMACY",258,null,null,null,48]
[" 2500970","NF-Leflunomide Oral Tablet 10MG","PHARMACY",258,null,null,null,49]
[" 2501463","NF-Prasugrel Oral Tablet 10MG","PHARMACY",258,null,null,null,49]
[" 2501509","NF-Bicalutamide Oral Tablet 50MG","PHARMACY",258,null,null,null,49]
[" 2500771","NF-Tradjenta Oral Tablet 5MG","PHARMACY",258,null,null,null,49.38]
[" 2500739","NF-Xarelto Oral Tablet 20MG","PHARMACY",258,null,null,null,50]
[" 2501051","NF-Linzess Oral Capsule 290MCG","PHARMACY",258,null,null,null,50]
[" 2501304","NF-Imipramine Pamoate Oral Capsule 100MG","PHARMACY",258,null,null,null,50]
[" 2501311","NF-Myrbetriq Oral Tablet ER 25MG","PHARMACY",258,null,null,null,50]
[" 2501332","NF-Myrbetriq Oral Tablet ER 25MG","PHARMACY",258,null,null,null,50]
[" 2501197","NF-Asmanex HFA Inh Aer Powder 100MCG/1AC","PHARMACY",258,null,null,null,52]
[" 2501504","NF-SEROquel XR Oral Tab ER 150MG","PHARMACY",258,null,null,null,53]
[" 2501053","NF-SEROQUEL XR ORAL TAB ER 150MG","PHARMACY",258,null,null,null,53.09]
[" 2500878","NF-Vimpat Oral Tablet 200MG","PHARMACY",258,null,null,null,54]
[" 2500924","NF-Vimpat Oral Tablet 200MG","PHARMACY",258,null,null,null,54]
[" 2500941","NF-Vimpat Oral Tablet 200MG","PHARMACY",258,null,null,null,54]
[" 2501126","NF-cloBAZam Oral Tablet 10MG","PHARMACY",258,null,null,null,54]
[" 2501166","NF-Spiriva Inh/Neb Cap 18MCG","PHARMACY",258,null,null,null,54]
[" 2500835","NF-Lunesta Oral Tablet 1MG","PHARMACY",258,null,null,null,56]
[" 2500877","NF-Zonegran Oral Capsule 100MG","PHARMACY",258,null,null,null,57]
[" 2501419","NF-Alendronate Sod Oral Tablet 35MG","PHARMACY",258,null,null,null,57]
[" 2501520","NF-Spiriva HandiHaler Inh/Neb Cap 18MCG","PHARMACY",258,null,null,null,57]
[" 2500922","NF-Avelox Tablet 400MG","PHARMACY",258,null,null,null,58]
[" 2501453","NF-cloBAZam Oral Tablet 10MG","PHARMACY",258,null,null,null,59]
[" 2501460","NF-cloBAZam Oral Tablet 10MG","PHARMACY",258,null,null,null,59]
[" 2500702","NF-INVEGA SUSTENNA IM SUSP ER 156MG","PHARMACY",258,null,null,null,60.04]
[" 2501177","NF-Alendronate Sodium Oral Tablet 70MG","PHARMACY",258,null,null,null,61]
[" 2501368","NF-Jardiance Oral Tablet 25MG","PHARMACY",258,null,null,null,65]
[" 2501120","NF-Combigan Ophth Soln 0.2%-0.5%","PHARMACY",258,null,null,null,66]
[" 2501145","NF-Combigan Ophth Soln 0.2%-0.5%","PHARMACY",258,null,null,null,66]
[" 2500505","SODIUM CHLORIDE 0.9% 100ML BAG","PHARMACY",258,"J7040",null,null,70]
[" 2500507","SODIUM CHLORIDE 0.9% 100ML MINI-BAG PLUS","PHARMACY",258,null,null,null,70]
[" 2500512","SODIUM CHLORIDE 0.9% 50ML BAG","PHARMACY",258,"J7050",null,null,70]
[" 2500513","SODIUM CHLORIDE 0.9% 50ML MINI-BAG PLUS","PHARMACY",258,"J7050",null,null,70]
[" 2501009","NF-Flovent Inhaler 0.11MG/Act","PHARMACY",258,null,null,null,72]
[" 2501305","NF-Flovent HFA Inh Oral/Neb 0.11MG/1Act","PHARMACY",258,null,null,null,79]
[" 2500332","MANNITOL 20% 500ML IV SOLN","PHARMACY",258,null,null,null,80.010000000000005]
[" 2501055","NF-SUMATRIPTAN SUCCINATE ORAL TABLET 100","PHARMACY",258,null,null,null,80.55]
[" 2501060","NF-MEROPENEM IV POWDER FOR SOLUTION 1GM","PHARMACY",258,null,null,null,80.790000000000006]
[" 2500137","DEXTROSE 5 % IN WATER 250 ML BAG","PHARMACY",258,"J7060",null,null,85]
[" 2500508","SODIUM CHLORIDE 0.9% 250ML BAG","PHARMACY",258,"J7050",null,null,85]
[" 2501050","NF-topiramate Capsule ER 200MG","PHARMACY",258,null,null,null,93]
[" 2500903","NF-Calcitonin-Salmon Nasal Spray 200IU/1","PHARMACY",258,null,null,null,96]
[" 2501312","NF-Rizatriptan Benzoate Oral Tablet 10MG","PHARMACY",258,null,null,null,99]
[" 2501493","NF-Topiramate Oral Capsule ER 200MG","PHARMACY",258,null,null,null,99]
[" 2500510","SODIUM CHLORIDE 0.9% 500ML BAG","PHARMACY",258,"J7040",null,null,100]
[" 2500514","SODIUM CHLORIDE 3 % 500ML IV HYPERTONIC","PHARMACY",258,"J7131",null,null,100]
[" 6000168","SALINE NORMAL 100 ML","PHARMACY",258,"J7040",null,null,101]
[" 6000169","SALINE NORMAL 250 ML","PHARMACY",258,"J7050",null,null,101]
[" 2501071","NF-Miconazole Powder","PHARMACY",258,null,null,null,102]
[" 2501323","NF-NovoLOG Injection 100U/ML","PHARMACY",258,null,null,null,104]
[" 2501503","NF-topiramate Capsule ER 200MG","PHARMACY",258,null,null,null,105]
[" 2500957","NF-Symbicort Inh Aer Liq 80MCG-4.5MCG","PHARMACY",258,null,null,null,107]
[" 2501062","NF-Symbicort Inh Aer Liq 80MCG-4.5MCG","PHARMACY",258,null,null,null,107]
[" 2501322","NF-Levemir FlexTouch SubQ Soln 100U/1ML","PHARMACY",258,null,null,null,110]
[" 2501064","NF-Azopt Ophth Suspension 1%","PHARMACY",258,null,null,null,111]
[" 2500950","NF-Latanoprost Ophth Solution 0.005%","PHARMACY",258,null,null,null,114]
[" 2500139","DEXTROSE 5% WATER 1000ML IV","PHARMACY",258,null,null,null,115]
[" 2500143","DEXTROSE 5% / 0.45% NORMAL SALINE 1000ML","PHARMACY",258,"S50110","0",null,115]
[" 2500144","DEXTROSE 5% / LACTATED RINGERS 1000ML","PHARMACY",258,null,null,null,115]
[" 2500145","DEXTROSE 5%/NS 0.45%/KCL 20MEQ 1000ML","PHARMACY",258,null,null,null,115]
[" 2500147","DEXTROSE 5% /SODIUM CHLORIDE 0.9% 1000ML","PHARMACY",258,null,null,null,115]
[" 2500281","LACTATED RINGERS 1000 ML IV BAG","PHARMACY",258,"J7120",null,null,115]
[" 2500500","SODIUM CHLORIDE 0.9%/KCL 20MEQ/1000ML","PHARMACY",258,"J7030",null,null,115]
[" 2500502","SODIUM CHLORIDE 0.45% 1000ML BAG","PHARMACY",258,null,null,null,115]
[" 2500503","SODIUM CHLORIDE 0.9% 1000ML BAG","PHARMACY",258,"J7030",null,null,115]
[" 2501103","NF-Capecitabine Oral Tablet 500MG","PHARMACY",258,null,null,null,117]
[" 2501165","NF-Azopt Ophth Suspension 1%","PHARMACY",258,null,null,null,117]
[" 2501000","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",258,null,null,null,122]
[" 2501010","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",258,null,null,null,122]
[" 2501530","NF-Lidocanna Topical Patch ER 4%","PHARMACY",258,null,null,null,123]
[" 2500917","NF-Combigan Ophth Soln 0.2%-0.5%","PHARMACY",258,null,null,null,126]
[" 2500737","NF-Xifaxan Oral Tablet 550MG","PHARMACY",258,null,null,null,131]
[" 2500745","NF-Xifaxan Oral Tablet 550MG","PHARMACY",258,null,null,null,131]
[" 2501321","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",258,null,null,null,131]
[" 2501337","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",258,null,null,null,131]
[" 2500785","NF-Zofran Oral Tablet 8MG","PHARMACY",258,null,null,null,139]
[" 2501462","NF-Combigan Ophth Soln 0.2%-0.5%","PHARMACY",258,null,null,null,146]
[" 2501505","NF-Combigan Ophth Soln 0.2%-0.5%","PHARMACY",258,null,null,null,146]
[" 2500138","DEXTROSE 5 % IN WATER 500 ML BAG","PHARMACY",258,"J7060",null,null,147.15]
[" 2501416","NF-Symbicort Inh Aer Liq 160MCG-4.5MCG","PHARMACY",258,null,null,null,151]
[" 6000163","DEXTROSE 5% WATER 1000 ML","PHARMACY",258,null,null,null,151]
[" 6000164","DEXTROSE 5% 1/2 NS 1000 ML","PHARMACY",258,"S50110","0",null,151]
[" 6000165","DEXTROSE 5% NS 1000 ML","PHARMACY",258,null,null,null,151]
[" 6000166","DEXTROSE-LR 1000 ML","PHARMACY",258,null,null,null,151]
[" 6000170","SALINE NORMAL 500 ML","PHARMACY",258,"J7040",null,null,151]
[" 6000171","SALINE NORMAL --DO NOT USE","PHARMACY",258,"J7030",null,null,151]
[" 6000173","1/2 NORMAL SALINE 1000 ML","PHARMACY",258,null,null,null,151]
[" 6000174","LACTATED RINGERS 1000 ML","PHARMACY",258,"J7120",null,null,151]
[" 2501445","NF-Bimatoprost Ophthalmic Solution 0.03%","PHARMACY",258,null,null,null,161]
[" 2500146","DEXTROSE 5%/LAC RINGER/KCL 20MEQ 1000ML","PHARMACY",258,null,null,null,164.05]
[" 2500920","LATANOPROST 0.005% OPHTH SOLUTION 2.5ML","PHARMACY",258,null,null,null,190]
[" 2501344","NF-Lotemax Ophth Suspension 0.5%","PHARMACY",258,null,null,null,192]
[" 2501110","NF-Striverdi Respimat Inh Spray 2.5MCG/1","PHARMACY",258,null,null,null,202]
[" 2500827","NF-Latuda Oral Tablet 120MG","PHARMACY",258,null,null,null,219]
[" 2500709","NF-Calcitonin Salmon Nasal Spray 200IU","PHARMACY",258,null,null,null,237.08]
[" 2500766","NF-Travatan Z Ophthalmic Solution 0.004%","PHARMACY",258,null,null,null,245]
[" 2500813","NF-Domperidone Powder","PHARMACY",258,null,null,null,256]
[" 2500707","cefTRIAXone 2 GM VIAL: IM/IV USE","PHARMACY",258,"J0696",null,null,274.23]
[" 2500991","NF-Lumigan Ophth Solution 0.01%","PHARMACY",258,null,null,null,283]
[" 2501041","NF-Lumigan Ophth Solution 0.01%","PHARMACY",258,null,null,null,283]
[" 2500919","NF-Xalatan Ophthalmic Solution 0.005%","PHARMACY",258,null,null,null,293]
[" 2501133","NF-Lumigan Ophth Solution 0.01%","PHARMACY",258,null,null,null,297]
[" 2501268","NF-Lumigan Ophth Solution 0.01%","PHARMACY",258,null,null,null,312]
[" 2501448","NF-BIMATOPROST OPHTH SOLN 0.01%","PHARMACY",258,null,null,null,312.58]
[" 2501495","NF-Ubrelvy Oral Tablet 100MG","PHARMACY",258,null,null,null,337]
[" 2501502","NF-Ubrelvy Oral Tablet 100MG","PHARMACY",258,null,null,null,337]
[" 2500733","NF-Genvoya Oral Tablet","PHARMACY",258,null,null,null,353]
[" 2500741","NF-Genvoya Oral Tablet","PHARMACY",258,null,null,null,353]
[" 2501293","NF-Xtandi Oral Liquid Filled Capsule 40M","PHARMACY",258,null,null,null,368]
[" 2501297","NF-Xtandi Oral Tablet 40MG","PHARMACY",258,null,null,null,368]
[" 2501327","NF-Xtandi Oral Liquid Filled Capsule 40M","PHARMACY",258,null,null,null,368]
[" 2500912","NF-Spiriva Respimat Inh Spray 2.5MCG/Act","PHARMACY",258,null,null,null,386]
[" 2501508","NF-Xtandi Oral Tablet 40MG","PHARMACY",258,null,null,null,390]
[" 2501181","NF-Spiriva Respimat Inh Spray 2.5MCG/1Ac","PHARMACY",258,null,null,null,409]
[" 2501192","NF-Spiriva Respimat Inh Spray 2.5MCG/1Ac","PHARMACY",258,null,null,null,409]
[" 2501476","NF-Spiriva Respimat Inh Spray 2.5MCG/1Ac","PHARMACY",258,null,null,null,447]
[" 2501512","NF-Spiriva Respimat Inh Spray 2.5MCG/1Ac","PHARMACY",258,null,null,null,447]
[" 2501001","NF-Linezolid Oral Tablet 600MG","PHARMACY",258,null,null,null,551]
[" 2501420","NF-Buprenorphine Patch ER 20MCG/1HR","PHARMACY",258,null,null,null,663]
[" 2500754","NF-Victoza Subcutaneous Solution 6MG/1ML","PHARMACY",258,null,null,null,774.3]
[" 2501203","NF-Combivent Respimat Inhalation Spray","PHARMACY",258,null,null,null,1064.42]
[" 2500921","NF-Asmanex Twisthaler Inh Pwd 0.22MG/1Ac","PHARMACY",258,null,null,null,1159]
[" 2500823","NF-Imbruvica Oral Tablet 140MG","PHARMACY",258,null,null,null,1461]
[" 1701510","IV HYDRATION EA ADD HOUR","IV THERAPY",260,"96361",null,null,110]
[" 1700010","IV INF-THER DX EA AD HR","IV THERAPY",260,"96366",null,null,150]
[" 1700008","IV INF THER AD SEQU 1HR","IV THERAPY",260,"96367",null,null,165]
[" 1701500","IV HYDRATION 31M TO 1 HR","IV THERAPY",260,"96360",null,null,375]
[" 1700009","IV INF-THER DX 1ST HR","IV THERAPY",260,"96365",null,null,430]
[" 6000020","SUCTION CATHETER 14FR","MEDICAL SUPPLIES",270,"A4628",null,null,3]
[" 6000026","EMESIS BASIN","MEDICAL SUPPLIES",270,null,null,null,3]
[" 6000117","O2 TUBING 9 FT","MEDICAL SUPPLIES",270,"A4616",null,null,3]
[" 6000019","O2 MASK AERO/ADULT","MEDICAL SUPPLIES",270,"A4620",null,null,4]
[" 6000046","YANK SUCT  BULB TIP","MEDICAL SUPPLIES",270,null,null,null,4]
[" 6000057","TUBING SECONDARY SET","MEDICAL SUPPLIES",270,null,null,null,4]
["90000107","BITE BLOCK ENDOSCOPIC 54 FR","MEDICAL SUPPLIES",270,null,null,null,4]
[" 2500515","SODIUM CHLORIDE FLUSH 0.9% 10ML IV","MEDICAL SUPPLIES",270,"A4216",null,null,5]
[" 6000006","O2 4 FT CANNULA","MEDICAL SUPPLIES",270,"A4606",null,null,5]
[" 6000009","O2 MASK AERO/CHILD","MEDICAL SUPPLIES",270,"A7015",null,null,5]
[" 6000022","DRESS TEGADERM 2X2","MEDICAL SUPPLIES",270,"A6257",null,null,5]
[" 6000108","NEB ADULT","MEDICAL SUPPLIES",270,"A7003",null,null,5]
[" 6000110","O2 CANNULA 10 FT","MEDICAL SUPPLIES",270,"A4616",null,null,5]
[" 6000112","O2 PED/INFANT CAN","MEDICAL SUPPLIES",270,"A4616",null,null,5]
[" 6000113","O2 MASK ADULT","MEDICAL SUPPLIES",270,"A4620",null,null,5]
[" 6000192","DRESS TEGADERM 4X4","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000193","DRESS TELFA ST 2X3","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000194","2X2 BORDERED GAUZE","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000224","HEMOCULT KIT","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000232","STAPLER EXTRACTOR","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000233","TINCTURE BENZOIN","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000290","4X4 BORDERED GAUZE","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000293","4X4 GAUZE 2 PK STERILE","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000294","ADAPTIC NON-ADHERANT","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000314","CUPS, SIPPY TODDLER","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000318","VASELINE INDIVIDUAL PACKS","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000322","6X6 BORDERED GAUZE","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000337","MEDIPORE WOUND DRESSING 2 3/8 X 4","MEDICAL SUPPLIES",270,null,null,null,5]
[" 6000017","U-PEDIATRIC BAG","MEDICAL SUPPLIES",270,"A4335",null,null,6]
[" 6000115","O2 SIMPLE MASK PED","MEDICAL SUPPLIES",270,"A4620",null,null,6]
[" 6000207","ET TUBES UNCUFFED 2.0","MEDICAL SUPPLIES",270,null,null,null,6]
[" 6000223","HEMATEST STAT","MEDICAL SUPPLIES",270,null,null,null,6]
[" 6000307","ADAPTIC NON-ADHERANT 3  x 8","MEDICAL SUPPLIES",270,null,null,null,6]
[" 6000338","SKINTEGRITY--HYDROGEL","MEDICAL SUPPLIES",270,null,null,null,6]
[" 6000340","TOOTHPASTE, 2.75 OZ -- GCC","MEDICAL SUPPLIES",270,null,null,null,6]
["80000233","SKINTEGRITY-- USE 06000338","MEDICAL SUPPLIES",270,null,null,null,6]
["90025002","SALIJET SINGLE DOSE SALINE","MEDICAL SUPPLIES",270,null,null,null,6]
[" 6000043","SUCTION BOTTLES","MEDICAL SUPPLIES",270,null,null,null,7]
[" 6000116","O2 TUBING 25 FT","MEDICAL SUPPLIES",270,"A4616",null,null,7]
[" 6000130","PEROXIDE 4OZ","MEDICAL SUPPLIES",270,"A4244",null,null,7]
[" 6000219","EXTENSION TUBING CATH","MEDICAL SUPPLIES",270,null,null,null,7]
[" 6000281","INVISION PLUS IV CONNECTOR","MEDICAL SUPPLIES",270,null,null,null,7]
[" 6000023","DRESS TEGADERM 6X8","MEDICAL SUPPLIES",270,"A6258",null,null,8]
[" 6000024","EYE SHIELD","MEDICAL SUPPLIES",270,"A6410",null,null,8]
[" 6000027","FRASIER TIP SUCTION","MEDICAL SUPPLIES",270,null,null,null,8]
[" 6000028","FRASIER TIP SUCTION","MEDICAL SUPPLIES",270,null,null,null,8]
[" 6000203","ET TUBES CUFFED 7.0","MEDICAL SUPPLIES",270,null,null,null,8]
[" 6000111","O2 CANNULA HIGH FLOW","MEDICAL SUPPLIES",270,"A4616",null,null,8.18]
[" 6000032","NU GAUZE 1/2  IOD","MEDICAL SUPPLIES",270,null,null,null,9]
[" 6000045","SUTURE REMOVAL KIT","MEDICAL SUPPLIES",270,null,null,null,9]
[" 6000114","O2 MASK N REBREATHER","MEDICAL SUPPLIES",270,"A4620",null,null,9]
[" 6000345","MOUTH MOISTURIZER","MEDICAL SUPPLIES",270,null,null,null,9]
[" 6000031","NU GAUZE 1  IDOFORM","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000034","NU GAUZE 1/2 PLAIN","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000049","IV INSYTE 18G","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000050","IV INSYTE 20G","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000051","IV INSYTE 22G","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000052","IV INSYTE 24G","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000053","IV PROT 18G","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000054","IV PROT 20G 1","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000055","IV PROT 22G","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000109","NEB PED","MEDICAL SUPPLIES",270,"A7003",null,null,10]
[" 6000237","WIPES UNSCENTED TENA","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000312","BABY BOTTLES 4 OZ","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000313","BABY BOTTLES 8 OZ","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000335","EYE SPEARS WECK-CEL CELLULOSE LIGHT","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000343","NASAL SPECULUM DISPOSABLE","MEDICAL SUPPLIES",270,null,null,null,10]
[" 6000042","SITZ PAN","MEDICAL SUPPLIES",270,null,null,null,11]
[" 6000056","IV PROT 24G","MEDICAL SUPPLIES",270,null,null,null,11]
[" 6000255","NASO AIRWAY 7.0 (28 FR)","MEDICAL SUPPLIES",270,null,null,null,11]
[" 6000310","MASTISOL ADHESIVE","MEDICAL SUPPLIES",270,null,null,null,11]
[" 6000346","DRESSING MEPILEX BORDER 3  X 3","MEDICAL SUPPLIES",270,null,null,null,11]
[" 1502601","STERI-STRIP 1/8X4","MEDICAL SUPPLIES",270,null,null,null,12]
[" 6000155","DRESSING MEPILEX","MEDICAL SUPPLIES",270,null,null,null,12]
[" 6000297","DRESSING AQUACEL  2X2 (420671)","MEDICAL SUPPLIES",270,null,null,null,12]
[" 6000315","PACIFIER BABY","MEDICAL SUPPLIES",270,null,null,null,12]
["90090001","SUTURE ETHILON 4.0 662G","MEDICAL SUPPLIES",270,null,null,null,12]
["90090004","SUTURE ETHILON 5.0 661G","MEDICAL SUPPLIES",270,null,null,null,12]
[" 6000002","LOPEZ VALVE","MEDICAL SUPPLIES",270,null,null,null,13]
[" 6000047","STOP COCK","MEDICAL SUPPLIES",270,"S1015",null,null,13]
[" 6000048","STOP COCK XRAY","MEDICAL SUPPLIES",270,"S1015",null,null,13]
[" 6000235","URINARY LEG BAG 32 OZ","MEDICAL SUPPLIES",270,null,null,null,13]
[" 6000344","DRESSING MEPILEX BORDER 4  X 4","MEDICAL SUPPLIES",270,null,null,null,13]
["90090021","SUTURE ETHILON 2.0 664G","MEDICAL SUPPLIES",270,null,null,null,13]
["90090028","SUTURE VICRYL 0 J473H","MEDICAL SUPPLIES",270,null,null,null,14]
[" 6000189","DRESSING MEPILEX 4X4","MEDICAL SUPPLIES",270,null,null,null,15]
[" 6000274","18 FR 10CC","MEDICAL SUPPLIES",270,null,null,null,15]
[" 6000352","NASO AIRWAY 7.5 MM  (30 FR)","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000353","NASO AIRWAY 8.0 (32 FR)","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000354","NASO AIRWAY 8.5 MM (34 FR)","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000380","NASO AIRWAY 5.0 MM  (20 FR)","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000381","NASO AIRWAY 5.5 MM  (22 FR)","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000382","NASO AIRWAY 9.0 MM  36 (FR)","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000384","CAVILON SPRAY SKIN FILM BARRIER","MEDICAL SUPPLIES",270,null,null,null,15.3]
[" 6000021","DRESSING POLYMEM 4X4","MEDICAL SUPPLIES",270,"A6209",null,null,16]
[" 6000035","NU GAUZE 1/4 PLAIN","MEDICAL SUPPLIES",270,null,null,null,16]
[" 6000149","DRESSING COVER ROLL","MEDICAL SUPPLIES",270,null,null,null,16]
[" 6000225","HIBICLENS 4OZ","MEDICAL SUPPLIES",270,null,null,null,16]
[" 6000291","OPTIFOAM","MEDICAL SUPPLIES",270,null,null,null,16]
[" 6000361","OPTIFOAM 3x3 BORDERED FOAM DRESSING","MEDICAL SUPPLIES",270,null,null,null,16]
[" 6000033","NU GAUZE 1/4 IOD","MEDICAL SUPPLIES",270,null,null,null,17]
[" 6000152","DRESSING SORBSAN","MEDICAL SUPPLIES",270,null,null,null,17]
[" 6000348","HEMOCULT ICT TEST DEVICE","MEDICAL SUPPLIES",270,null,null,null,17]
[" 6900001","ANES CIRCUIT OBV 3L","MEDICAL SUPPLIES",270,null,null,null,17]
[" 6900002","ANES CIRCUIT PEDIATRIC","MEDICAL SUPPLIES",270,null,null,null,17]
["90000114","MAGNETIC DRAPE 10 X 16","MEDICAL SUPPLIES",270,null,null,null,17]
["90090009","SUTURE PROLENE 3.0 8665G","MEDICAL SUPPLIES",270,null,null,null,17]
["90090017","SUTURE PERMA HAND SILK 683G","MEDICAL SUPPLIES",270,null,null,null,17]
["90090037","SUTURE PROLENE 2-0 8833H","MEDICAL SUPPLIES",270,null,null,null,17.149999999999999]
["90090038","SUTURE SILK 2-0 K833H","MEDICAL SUPPLIES",270,null,null,null,17.149999999999999]
[" 6000342","BARRIER PROTECTIVE SENSI-CARE CREAM","MEDICAL SUPPLIES",270,null,null,null,18]
["90090006","SUTURE PROLENE 4.0 8683G","MEDICAL SUPPLIES",270,null,null,null,18]
[" 6000058","NITRO TUBING","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000070","BIPAP DISPOSABLE CIRCUIT","MEDICAL SUPPLIES",270,"A4618",null,null,19]
[" 6000238","TEDS LG KNEE","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000239","TEDS MED KNEE","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000240","TEDS SMALL KNEE","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000241","TEDS XL KNEE","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000286","CAVILON DURABLE BARRIER CREAM","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000333","NU GAUZE 1  PLAIN PACKING STRIP","MEDICAL SUPPLIES",270,null,null,null,19]
["90090022","SUTURE PROLENE 5.0 8661G","MEDICAL SUPPLIES",270,null,null,null,19]
[" 6000264","IV CATH STABILIZATION DEVICE","MEDICAL SUPPLIES",270,null,null,null,20]
[" 6000036","SALEM SUMP 14FR","MEDICAL SUPPLIES",270,null,null,null,22]
[" 6000037","SALEM SUMP 16FR","MEDICAL SUPPLIES",270,null,null,null,22]
[" 6000038","SALEM SUMP 18FR","MEDICAL SUPPLIES",270,null,null,null,22]
[" 6000190","DRESSING MEPITEL 3  x 4","MEDICAL SUPPLIES",270,null,null,null,22]
[" 6000295","DRESSING AQUACEL  4X5 (420674)","MEDICAL SUPPLIES",270,null,null,null,22]
["90000113","ANOSCOPE SINGLE USE W/LIGHT","MEDICAL SUPPLIES",270,null,null,null,22]
["90090019","SUTURE CHROM GUT 2.0 637H","MEDICAL SUPPLIES",270,null,null,null,22]
["90090036","SUTURE SILK 2-0 C016D","MEDICAL SUPPLIES",270,null,null,null,22]
[" 6000154","UNNA BOOT DELUXE","MEDICAL SUPPLIES",270,null,null,null,23]
[" 6000326","DRESSING MEPILEX BORDER 6  X 6","MEDICAL SUPPLIES",270,null,null,null,23]
[" 6000339","MEFIX DRESSING RETENTION TAPE","MEDICAL SUPPLIES",270,null,null,null,23]
["90090000","SUTURE ETHILON 4.0 699G","MEDICAL SUPPLIES",270,null,null,null,23]
["90090003","SUTURE ETHILON 5.0 698G","MEDICAL SUPPLIES",270,null,null,null,23]
["90090005","SUTURE ETHILON 6.0 1698G","MEDICAL SUPPLIES",270,null,null,null,23]
["90090030","SUTURE VICRYL J258","MEDICAL SUPPLIES",270,null,null,null,23]
["90090035","SUTURE SILK 2.0 685G","MEDICAL SUPPLIES",270,null,null,null,23]
[" 6000374","TEDS KNEE 2XL","MEDICAL SUPPLIES",270,null,null,null,23.5]
[" 6000375","TEDS KNEE 3XL","MEDICAL SUPPLIES",270,null,null,null,23.5]
[" 6000186","DRESSING ALG/MAXORB","MEDICAL SUPPLIES",270,null,null,null,24]
[" 6000316","ELECTRODE, FETAL SCALP, QWIK CONNECT","MEDICAL SUPPLIES",270,null,null,null,25]
["90000111","SUCTION RESERVOIR BULB 100CC","MEDICAL SUPPLIES",270,null,null,null,25]
["90090016","SUTURE CHROM GUT 4.0 1654G","MEDICAL SUPPLIES",270,null,null,null,25]
[" 6000304","PATRIOT COLLARS -- ADULT","MEDICAL SUPPLIES",270,null,null,null,26]
[" 6000151","DRESSING POLYMEM 6X6","MEDICAL SUPPLIES",270,null,null,null,28]
[" 6000323","ADULT TRACH TUBE HOLDER","MEDICAL SUPPLIES",270,null,null,null,28]
[" 6000324","PED TRACH TUBE HOLDER","MEDICAL SUPPLIES",270,null,null,null,28]
["90090002","SUTURE ETHILON 4.0 1854G","MEDICAL SUPPLIES",270,null,null,null,28]
["90090008","SUTURE PROLENE 3.0 8663G","MEDICAL SUPPLIES",270,null,null,null,28]
["90090020","SUTURE VICRYL 4.0 7504G","MEDICAL SUPPLIES",270,null,null,null,28]
[" 4400303","CL ARM SLING W/PADDED STRAP","MEDICAL SUPPLIES",270,"A4565",null,null,29]
[" 6000145","Y-TYPE BLOOD TUBING","MEDICAL SUPPLIES",270,"A4755",null,null,29]
[" 6000156","DRESSING AQUACEL 2X2 (420675)","MEDICAL SUPPLIES",270,null,null,null,29]
["90090010","SUTURE PROLENE 5.0 8698G","MEDICAL SUPPLIES",270,null,null,null,29]
[" 6000185","CATH 22FR 30CC","MEDICAL SUPPLIES",270,null,null,null,30]
[" 6000243","TEDS THIGH MED","MEDICAL SUPPLIES",270,null,null,null,30]
[" 6000244","TEDS THIGH SM","MEDICAL SUPPLIES",270,null,null,null,30]
[" 6000336","MEPILEX BORDER SACRUM HEART SHAPED","MEDICAL SUPPLIES",270,null,null,null,30]
["90090007","SUTURE PROLENE 4.0 8699G","MEDICAL SUPPLIES",270,null,null,null,30]
["90090011","SUTURE PROLENE 5.0 8681G","MEDICAL SUPPLIES",270,null,null,null,30]
[" 1500321","STOPCOCK 3 WAY HIGH FLOW","MEDICAL SUPPLIES",270,null,null,null,31]
[" 5500024","AEROLSOL SET-UP KIT","MEDICAL SUPPLIES",270,null,null,null,31]
[" 6000305","PATRIOT COLLARS -- PEDIATRIC","MEDICAL SUPPLIES",270,null,null,null,31]
["90090012","SUTURE PROLENE 6.0 8695G","MEDICAL SUPPLIES",270,null,null,null,31]
[" 6000008","MEDIHONEY TUBE","MEDICAL SUPPLIES",270,null,null,null,32]
[" 6000147","DRESSING SILVERCELL  ALGINATE 4X4","MEDICAL SUPPLIES",270,null,null,null,33]
[" 6000242","TEDS THIGH   LG","MEDICAL SUPPLIES",270,null,null,null,33]
["90090024","SUTURE PROLENE 6.0 8697G","MEDICAL SUPPLIES",270,null,null,null,33]
["90090025","SUTURE PROLENE 7.0 8696G","MEDICAL SUPPLIES",270,null,null,null,33]
[" 6000362","THORACIC CATHETER 20 FR","MEDICAL SUPPLIES",270,null,null,null,33.6]
[" 6000377","THORACIC CATHETER 28 FR","MEDICAL SUPPLIES",270,null,null,null,33.6]
[" 6000378","THORACIC CATHETER 24 FR","MEDICAL SUPPLIES",270,null,null,null,33.6]
[" 6000341","DRESSING AQUACEL FOAM 6X6 (420635)","MEDICAL SUPPLIES",270,null,null,null,34]
[" 6000148","DRESSING AQUACEL  4X4 (420642)","MEDICAL SUPPLIES",270,null,null,null,35]
[" 6000283","19G X .75 POWERLOC INFUSION","MEDICAL SUPPLIES",270,null,null,null,35]
["90090023","SUTURE PROLENE 6.0 8636G","MEDICAL SUPPLIES",270,null,null,null,35]
["80000672","LACERATION KITS DISPOSABLE","MEDICAL SUPPLIES",270,null,null,null,35.450000000000003]
[" 6000321","LARYNGEAL MASK #5","MEDICAL SUPPLIES",270,null,null,null,36]
[" 6000385","LARYNGEAL MASK #4","MEDICAL SUPPLIES",270,null,null,null,36]
[" 6000299","NASAL PACKING STRING 4.5CM","MEDICAL SUPPLIES",270,null,null,null,37]
["90090031","SUTURE PROLENE 0 8412H","MEDICAL SUPPLIES",270,null,null,null,39]
[" 6000231","O2 SPO2 PROBE PED","MEDICAL SUPPLIES",270,null,null,null,40]
[" 6000300","TRIAD HYDROPHILIC WOUND DRESSING","MEDICAL SUPPLIES",270,null,null,null,40]
[" 6000301","O2 SPO2 PROBE INFANT","MEDICAL SUPPLIES",270,null,null,null,40]
[" 6000325","CO2 DETECTOR ADULT","MEDICAL SUPPLIES",270,null,null,null,41]
[" 6000350","ASHERMAN CHEST SEAL","MEDICAL SUPPLIES",270,"A7041",null,null,42]
["80000495","DRESSING 2X2 PURACOL + COLLAGEN","MEDICAL SUPPLIES",270,null,null,null,42]
["90090018","SUTURE CHROM GUT 5.0 687G","MEDICAL SUPPLIES",270,null,null,null,43]
[" 6000245","TEDS THIGH XL","MEDICAL SUPPLIES",270,null,null,null,44]
[" 6000302","FILTER LINE SET ADULT/PED","MEDICAL SUPPLIES",270,null,null,null,44]
[" 6000029","UNNA BOOT BASIC","MEDICAL SUPPLIES",270,null,null,null,45]
[" 6000298","DRESSING AQUACEL  4X10 (421153)","MEDICAL SUPPLIES",270,null,null,null,45]
["90000112","JP 10FR DRAIN 3/4 DUCTED STAR DRAIN","MEDICAL SUPPLIES",270,null,null,null,46]
["90000219","JP 19FR DRIAN WITH TROCAR","MEDICAL SUPPLIES",270,null,null,null,46]
[" 6001003","WOUND VAC LARGE WHITE FOAM DRESSING","MEDICAL SUPPLIES",270,null,null,null,49]
[" 6000003","LUMBAR TRAY","MEDICAL SUPPLIES",270,null,null,null,49.88]
[" 4400304","CL SPLINT","MEDICAL SUPPLIES",270,"A4570",null,null,51]
[" 4400302","CL FOLEY CATH W/BAG INDW/2-W","MEDICAL SUPPLIES",270,"A4314",null,null,52]
[" 5500022","O2 SPO2 PROBE","MEDICAL SUPPLIES",270,"A4606",null,null,55]
[" 6000303","NIV LINE ADULT","MEDICAL SUPPLIES",270,null,null,null,55]
[" 6000150","DRESSING STIMULEN/MULTIDEX","MEDICAL SUPPLIES",270,null,null,null,59]
["90000108","BIOPSY FORCEPS LARGE 2.8 MM","MEDICAL SUPPLIES",270,null,null,null,59]
[" 5500020","HYPERINFLATION BAG","MEDICAL SUPPLIES",270,null,null,null,60]
["90090013","SUTURE CHROME GUT 3.0 G122H","MEDICAL SUPPLIES",270,null,null,null,60]
[" 6000044","14 FR SUCTION CATH & GLOVE","MEDICAL SUPPLIES",270,null,null,null,61]
["90090014","SUTURE PERMA SILK 3.0 SA64H","MEDICAL SUPPLIES",270,null,null,null,61]
[" 6000357","COBAN 2 LAYER COMPRESSION SYSTEM","MEDICAL SUPPLIES",270,null,null,null,61.2]
["90090027","SUTURE VICRYL 2.0 J775D","MEDICAL SUPPLIES",270,null,null,null,65]
[" 1505130","BILIRUBIN LIGHTS/ISOLETTE","MEDICAL SUPPLIES",270,null,null,null,67]
["90090015","SUTURE ETHIBOND 0 CX41D","MEDICAL SUPPLIES",270,null,null,null,68]
[" 6000260","EMERGENCY BIRTH KIT","MEDICAL SUPPLIES",270,null,null,null,72]
[" 6000182","CATH 14FR 10ML  COUDE","MEDICAL SUPPLIES",270,null,null,null,73]
[" 6000327","E-Z IO STABILIZER","MEDICAL SUPPLIES",270,null,null,null,74]
["90000131","ENDOGATOR TUBING","MEDICAL SUPPLIES",270,null,null,null,74]
["90000142","SCOPE BUDDY UNIVERSAL HOOKUP TUBING","MEDICAL SUPPLIES",270,null,null,null,74]
["90000143","LEAK TEST HOOKUP CONNECTOR","MEDICAL SUPPLIES",270,null,null,null,74]
["90000149","RAPICIDE PA, ASSEMBLY -- FOR ENDOSCOPES","MEDICAL SUPPLIES",270,null,null,null,74]
["90000157","RAPICIDE TEST STRIPS FOR ENDOSCOPES","MEDICAL SUPPLIES",270,null,null,null,74]
["90000185","IRRIGATOR SUCTION TIP 5MM","MEDICAL SUPPLIES",270,null,null,null,74]
["90000193","ENDOGATOR TUBING 24 HOUR MULTI USE TUBE","MEDICAL SUPPLIES",270,null,null,null,74]
["90000194","INTERCEPT DETERGENT","MEDICAL SUPPLIES",270,null,null,null,74]
["90000224","HOOKUP, FUJI 700 SERIES WITH FWJ","MEDICAL SUPPLIES",270,null,null,null,74]
["90090033","SUTURE VICRYL 3.0 J774D","MEDICAL SUPPLIES",270,null,null,null,74]
[" 6000093","EGG CRATE","MEDICAL SUPPLIES",270,"E0199",null,null,76]
[" 6000229","NEEDLE IV ANGIOCATH 14G X 3","MEDICAL SUPPLIES",270,null,null,null,76]
["90000019","SNARE M00561831","MEDICAL SUPPLIES",270,null,null,null,76]
[" 6000364","ASPIRA DRESSING KIT","MEDICAL SUPPLIES",270,null,null,null,77.44]
[" 6000062","FOLEY CATH KIT 18FR","MEDICAL SUPPLIES",270,null,null,null,80]
[" 6000317","INTRODUCER BOUGIE ENDOTRACHEAL TUBE 15FR","MEDICAL SUPPLIES",270,null,null,null,80]
["90090029","SUTURE ETHIBOND 0 CX45D","MEDICAL SUPPLIES",270,null,null,null,80]
[" 6000311","INFANT FORMULA","MEDICAL SUPPLIES",270,null,null,null,82]
["90090034","SUTURE MONOCRYL 4.0 PS-2 Y426","MEDICAL SUPPLIES",270,null,null,null,82]
[" 6000386","LARYNGEAL MASK SUPRAGLOTTIC SIZE 5","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000387","LARYNGEAL MASK SUPRAGLOTTIC SIZE 4","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000388","LARYNGEAL MASK SUPRAGLOTTIC SIZE 3","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000394","LARYNGEAL MASK SUPRAGLOTTIC SIZE 1","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000395","LARYNGEAL MASK SUPRAGLOTTIC SIZE 1.5","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000396","LARYNGEAL MASK SUPRAGLOTTIC SIZE 2.0","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000397","LARYNGEAL MASK SUPRAGLOTTIC SIZE 2.5","MEDICAL SUPPLIES",270,null,null,null,88.61]
[" 6000347","NEEDLE IV ANGIOCATH 14G X 5.25","MEDICAL SUPPLIES",270,null,null,null,98]
[" 6000308","ANASEPT WOUND & SKIN GEL","MEDICAL SUPPLIES",270,null,null,null,102]
[" 5500200","PORTABLE PEAK FLOW METER","MEDICAL SUPPLIES",270,"S8096",null,null,105]
[" 6000061","FOLEY CATH KIT 16FR","MEDICAL SUPPLIES",270,null,null,null,113]
["90000126","ALLIANCE II SYRINGE/GAUGE ASSEMBLY","MEDICAL SUPPLIES",270,null,null,null,114]
["90000128","INJECTION NEEDLE","MEDICAL SUPPLIES",270,null,null,null,115]
["90090032","SUTURE PDS II 3-0 CR/SH VIL MONO","MEDICAL SUPPLIES",270,null,null,null,121]
[" 4400305","CL KNEE SPLINT","MEDICAL SUPPLIES",270,"L1830",null,null,123]
[" 6000030","NASOSTAT REG","MEDICAL SUPPLIES",270,null,null,null,127]
[" 6000319","PESSARY RING -- ASSORTED SIZES","MEDICAL SUPPLIES",270,null,null,null,127]
[" 6001001","WOUND VAC CANISTER WITH GEL","MEDICAL SUPPLIES",270,null,null,null,130]
[" 1502602","LARYNGEAL TUBE 5-6' KING","MEDICAL SUPPLIES",270,null,null,null,132]
[" 6000269","ACAPELLA VIBRATORY PEP","MEDICAL SUPPLIES",270,null,null,null,145.11000000000001]
[" 6000060","SURGICEL 1/2 X 2","MEDICAL SUPPLIES",270,null,null,null,153]
[" 6000091","CHEST DRAINAGE SYSTEM","MEDICAL SUPPLIES",270,"A7041",null,null,157]
[" 5500018","NON-ELEC OSCILLATORY PEP DVC","MEDICAL SUPPLIES",270,"E0484",null,null,161]
[" 5500025","FLUTTER DEVICE","MEDICAL SUPPLIES",270,null,null,null,161]
[" 6000320","IODOSORB GEL","MEDICAL SUPPLIES",270,null,null,null,172]
[" 6000360","BUTTON, BALLOON MINI 12 FR 2.0 CM","MEDICAL SUPPLIES",270,null,null,null,172]
[" 6000349","INTERDRY ANTI-MICROBIAL DRESSING","MEDICAL SUPPLIES",270,null,null,null,175]
[" 6001002","WOUND VAC LARGE BLACK FOAM","MEDICAL SUPPLIES",270,null,null,null,176]
["90000151","SURGIFOAM SPONGE 8 CM X 12.5 CM X 10 MM","MEDICAL SUPPLIES",270,null,null,null,187.92]
[" 6001000","WOUND VAC RENTAL","MEDICAL SUPPLIES",270,null,null,null,192]
["90090026","SUTURE PROLENE 7.0 8301H","MEDICAL SUPPLIES",270,null,null,null,201]
[" 6000262","INTRAUTERINE PRESSURE CATHETER","MEDICAL SUPPLIES",270,null,null,null,207]
[" 5500119","INCENTIVE SPIROMETRY","MEDICAL SUPPLIES",270,null,null,null,208]
[" 6000363","ASPIRA DRAINAGE KIT","MEDICAL SUPPLIES",270,null,null,null,227.4]
["  600286","THORACENTIS TRAY","MEDICAL SUPPLIES",270,null,null,null,240.3]
["90000119","VISCERA RETAINER","MEDICAL SUPPLIES",270,null,null,null,249]
["90000115","INSORB SKIN STAPLER ABSORBABLE 30 CT","MEDICAL SUPPLIES",270,null,null,null,298]
[" 6000011","PULSAVAC SPRAY KIT","MEDICAL SUPPLIES",270,null,null,null,319]
[" 6000221","E-Z IO 15G 25MM","MEDICAL SUPPLIES",270,null,null,null,343]
[" 6000284","GASTROSTOMY FEEDING TUBE","MEDICAL SUPPLIES",270,null,null,null,389]
[" 6000220","E-Z IO 15G 15MM","MEDICAL SUPPLIES",270,null,null,null,391]
[" 6000222","E-Z IO 15G 45MM","MEDICAL SUPPLIES",270,null,null,null,391]
[" 6000288","EPIDURAL TRAY","MEDICAL SUPPLIES",270,null,null,null,423.2]
["90000138","CRE BALLOON DILATOR 10-12 MM","MEDICAL SUPPLIES",270,null,null,null,424.26]
["90000139","CRE BALLOON DILATOR 12-15 MM","MEDICAL SUPPLIES",270,null,null,null,424.26]
["90000140","CRE BALLOON DILATOR 15-18 MM","MEDICAL SUPPLIES",270,null,null,null,424.26]
["90000141","CRE BALLOON DILATOR 18-20 MM","MEDICAL SUPPLIES",270,null,null,null,424.26]
["90000127","RESOLUTION 360 CLIP","MEDICAL SUPPLIES",270,null,null,null,488]
["90000117","SURGIMESH EASY PLUG TEALFIL-8","MEDICAL SUPPLIES",270,null,null,null,490]
[" 6000356","CRICOTHYROIDOTOMY KIT","MEDICAL SUPPLIES",270,null,null,null,491.98]
["90000116","SURGIMESH 10 X 15 T1015","MEDICAL SUPPLIES",270,null,null,null,602]
["90000118","BARD MESH VENTRALEX, ST LARGE CIRCLE","MEDICAL SUPPLIES",270,null,null,null,1018]
["90001554","HEMMORHOID STAPLER 35MM","MEDICAL SUPPLIES",270,null,null,null,1225.8399999999999]
["90000150","OMNI SURGICAL SYSTEM","MEDICAL SUPPLIES",270,null,null,null,2720]
[" 6000094","ENEMA BAG","NON-STERILE SUPPLIES",271,null,null,null,7]
["80000081","CASTSCOTCH PLUS 2  BLUE","NON-STERILE SUPPLIES",271,"A4580",null,null,7]
[" 5500141","OXYGEN HOURS SUBSEQUENT","NON-STERILE SUPPLIES",271,"A9999",null,null,13]
["80000082","CASTSCOTCH PLUS 3  BLUE","NON-STERILE SUPPLIES",271,"A4580",null,null,13]
["80000083","CASTSCOTCH PLUS 3  PINK","NON-STERILE SUPPLIES",271,null,null,null,13]
["80000079","CASTSCOTCH PLUS 2  PINK","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
["80000080","CASTSCOTCH PLUS 2  WHITE","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
["80000446","CASTSCOTCH PLUS 2  GREEN","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
["80000447","CASTSCOTCH PLUS 3  GREEN","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
["80000448","CASTSCOTCH PLUS 3  WHITE","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
["80000449","CASTSCOTCH PLUS 5  BLUE","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
["80000452","EAR WASH TIPS","NON-STERILE SUPPLIES",271,"A4580",null,null,14]
[" 6000001","SKIN STAPLER 35CT","NON-STERILE SUPPLIES",271,null,null,null,20]
[" 6000010","SKIN STAPLER 5CT","NON-STERILE SUPPLIES",271,null,null,null,20]
["80000084","CASTSCOTCH PLUS 4  WHITE","NON-STERILE SUPPLIES",271,"A4580",null,null,20]
[" 6000127","PAD GAYMOR 13X18","NON-STERILE SUPPLIES",271,"E0217",null,null,22]
[" 6000128","PAD GAYMOR 15X22","NON-STERILE SUPPLIES",271,"E0217",null,null,23]
[" 6000129","PAD GAYMOR 18X26","NON-STERILE SUPPLIES",271,"E0217",null,null,25]
["80000085","CASTSCOTCH PLUS 5  WHITE - DO NOT ORDER","NON-STERILE SUPPLIES",271,"A4580",null,null,25]
["80000078","CASTSCOTCH 1 STEP 3X12","NON-STERILE SUPPLIES",271,"A4580",null,null,27]
[" 6000369","CIRCUIT NON INVASIVE BIPAP/VENT","NON-STERILE SUPPLIES",271,null,null,null,28.09]
[" 5500170","OXYGEN HOURS INITIAL","NON-STERILE SUPPLIES",271,"A9999",null,null,54]
[" 6000332","VASOPRESS DVT CALF GARMET MEDIUM","NON-STERILE SUPPLIES",271,null,null,null,73]
[" 6000393","VASOPRESS DVT CALF GARMET LARGE","NON-STERILE SUPPLIES",271,null,null,null,73]
[" 6000370","HIGH FLOW NASAL CANNULA MASK (M)","NON-STERILE SUPPLIES",271,null,null,null,88.43]
[" 6000371","HIGH FLOW NASAL CANNULA MASK (L)","NON-STERILE SUPPLIES",271,null,null,null,88.43]
[" 6000329","PERFORMATRAK FULL SE MASK SMALL","NON-STERILE SUPPLIES",271,null,null,null,92]
[" 6000330","PERFORMATRAK FULL SE MASK MEDIUM","NON-STERILE SUPPLIES",271,null,null,null,92]
[" 6000331","PERFORMATRAK FULL SE MASK LARGE","NON-STERILE SUPPLIES",271,null,null,null,92]
[" 6000365","BIPAP/CPAP MASKS FOR VENT AND BIPAP (S)","NON-STERILE SUPPLIES",271,null,null,null,94.58]
[" 6000366","BIPAP/CPAP MASKS FOR VENT AND BIPAP (M)","NON-STERILE SUPPLIES",271,null,null,null,94.58]
[" 6000367","BIPAP/CPAP MASKS FOR VENT AND BIPAP (L)","NON-STERILE SUPPLIES",271,null,null,null,94.58]
[" 6000390","SCD KNEE MEDIUM FOR OR","NON-STERILE SUPPLIES",271,null,null,null,129.38]
[" 6000328","SKIN STAPLER 35CT","NON-STERILE SUPPLIES",271,null,null,null,151]
[" 6000391","SCD KNEE LARGE FOR OR","NON-STERILE SUPPLIES",271,null,null,null,163]
[" 6000368","CIRCUIT SINGLE LIMB HEATED BIPAP/VENT","NON-STERILE SUPPLIES",271,null,null,null,179.45]
[" 6000372","PELVIC BINDER, ADULT","NON-STERILE SUPPLIES",271,null,null,null,430]
[" 6000373","PELVIC BINDER, PEDIATRIC","NON-STERILE SUPPLIES",271,null,null,null,450]
[" 6000104","DRESSING KLING 3  NS","STERILE SUPPLIES",272,"A6216",null,null,3]
[" 6000123","OSTOMY FILTER","STERILE SUPPLIES",272,"A4368",null,null,3]
[" 6000136","DRESS TELFA ST 3X8","STERILE SUPPLIES",272,"A6219",null,null,3]
[" 6000101","DRESSING KLING 1  ST","STERILE SUPPLIES",272,"A6218",null,null,4]
[" 6000103","DRESSING KLING 2  ST","STERILE SUPPLIES",272,"A6218",null,null,4]
[" 6000105","DRESSING KLING 3  ST","STERILE SUPPLIES",272,"A6218",null,null,4]
[" 6000131","STERISTRIP 1/4 X 3","STERILE SUPPLIES",272,"A4450",null,null,4]
[" 6000132","STERISTRIP 1/8 X 3","STERILE SUPPLIES",272,"A4450",null,null,4]
[" 6000133","SUCTION TUBING 6'","STERILE SUPPLIES",272,"A7002",null,null,4]
[" 6000065","ACE 3  SINGLE","STERILE SUPPLIES",272,"A6449",null,null,5]
[" 6000095","EYE PAD ST MED","STERILE SUPPLIES",272,"A6410",null,null,5]
[" 6000099","DRESSING KERLIX","STERILE SUPPLIES",272,"A6216",null,null,5]
[" 6000106","DRESSING KLING 4  ST","STERILE SUPPLIES",272,"A6218",null,null,5]
[" 6000107","DRESSING KLING 6  ST","STERILE SUPPLIES",272,"A6218",null,null,5]
[" 6000135","DRESS TELFA ST 3X4","STERILE SUPPLIES",272,"A6219",null,null,5]
[" 6000140","VASELINE GAUZE 1X8","STERILE SUPPLIES",272,"A6222",null,null,5]
[" 6000142","XEROFORM GAUZE 4X4","STERILE SUPPLIES",272,"A6222",null,null,5]
[" 6000143","XEROFORM GUAZE 1X8","STERILE SUPPLIES",272,"A6222",null,null,5]
[" 6000144","XEROFORM GUAZE 5X9","STERILE SUPPLIES",272,"A6222",null,null,5]
[" 6000025","CATH PLUG","STERILE SUPPLIES",272,null,null,null,6]
[" 6000067","ACE 4  SINGLE","STERILE SUPPLIES",272,"A6449",null,null,6]
[" 6000098","IRRIGATION TRAYS","STERILE SUPPLIES",272,"A4320",null,null,6]
[" 6000153","STERISTRIP 1/2 X 4","STERILE SUPPLIES",272,null,null,null,6]
[" 6000376","CATH 30 FR 10 ML","STERILE SUPPLIES",272,"A4353",null,null,6.55]
[" 6000013","SPINAL NEEDLE 22 G 1 1/2","STERILE SUPPLIES",272,"A4215",null,null,7]
[" 6000014","SPINAL NEEDLE 22 G 3 1/2","STERILE SUPPLIES",272,"A4215",null,null,7]
[" 6000015","SPINAL NEEDLE 22 G 5","STERILE SUPPLIES",272,"A4215",null,null,7]
[" 6000016","SPINAL NEEDLE 20 G 3 1/2","STERILE SUPPLIES",272,"A4215",null,null,7]
[" 6000073","CATH EXTERNAL 29MM","STERILE SUPPLIES",272,"A4349",null,null,7]
[" 6000096","FEEDING TUBE 5 FR","STERILE SUPPLIES",272,"B4083",null,null,7]
[" 6000097","FEEDING TUBE 8 FR","STERILE SUPPLIES",272,"B4083",null,null,7]
[" 6000118","OSTOMY BAG 1 3/4","STERILE SUPPLIES",272,"A4417",null,null,7]
[" 6000119","OSTOMY BAG 2 1/4","STERILE SUPPLIES",272,"A4417",null,null,7]
[" 6000122","OSTOMY CLAMP","STERILE SUPPLIES",272,"A4363",null,null,7]
[" 6000134","SUCTION TUBING OR 12'","STERILE SUPPLIES",272,"A7002",null,null,7]
[" 6000141","VASELINE GAUZE 3 X 36","STERILE SUPPLIES",272,"A6223",null,null,7]
[" 2500567","VIAL-MATE ADAPTOR (Supply)  EA","STERILE SUPPLIES",272,"A4222",null,null,8]
[" 6000039","SCALPEL 11 SAFETY","STERILE SUPPLIES",272,null,null,null,8]
[" 6000040","SCALPEL 15 SAFETY","STERILE SUPPLIES",272,null,null,null,8]
[" 6000041","SCALPEL 10 SAFETY","STERILE SUPPLIES",272,"A4649",null,null,8]
[" 6000074","CATH TRAY","STERILE SUPPLIES",272,"A4354",null,null,8]
[" 6000121","OSTOMY BAG 4","STERILE SUPPLIES",272,"A4417",null,null,8]
[" 6000120","OSTOMY BAG 2 3/4","STERILE SUPPLIES",272,"A4417",null,null,9]
[" 6000383","OPTILOCK NON ADHESIVE WOUND DRESSING","STERILE SUPPLIES",272,"A4649",null,null,9]
[" 6000018","OSTOMY PASTE","STERILE SUPPLIES",272,"A4405",null,null,11]
[" 6000064","ACE 2  SINGLE","STERILE SUPPLIES",272,"A6448",null,null,11]
[" 6000124","OSTOMY FLANGE 2 1/4","STERILE SUPPLIES",272,"A4421",null,null,11]
[" 6000125","OSTOMY FLANGE 2 3/4","STERILE SUPPLIES",272,"A4421",null,null,11]
[" 6000358","CATH 28FR 30 CC","STERILE SUPPLIES",272,"A4353",null,null,11.07]
[" 6000068","ACE 6  DOUBLE","STERILE SUPPLIES",272,"A6455",null,null,12]
[" 6000072","CATH 14FR COUDE INTERMITTENT","STERILE SUPPLIES",272,"A4334",null,null,12]
[" 6000063","IV KITS","STERILE SUPPLIES",272,null,null,null,13]
[" 6000137","URINARY DRAINAGE BAGS","STERILE SUPPLIES",272,"A4358",null,null,13]
[" 6000306","UROSECURE FOLEY CATH SECUREMENT (GCC)","STERILE SUPPLIES",272,"A4334",null,null,13]
[" 6000012","SPINAL NEEDLE 18 G 3 1/2","STERILE SUPPLIES",272,"A4215",null,null,15]
[" 6000069","ACE 6  SINGLE","STERILE SUPPLIES",272,"A6450",null,null,15]
[" 6000092","DRESSING DUODERM","STERILE SUPPLIES",272,"A6257",null,null,15]
[" 6000071","CATH SECURE","STERILE SUPPLIES",272,"A4334",null,null,16]
[" 6000126","OSTOMY FLANGE 4","STERILE SUPPLIES",272,"A4421",null,null,16]
[" 6000075","CATH 6FR","STERILE SUPPLIES",272,"A4353",null,null,17]
[" 6000090","CATH 28FR 5 CC","STERILE SUPPLIES",272,"A4353",null,null,17]
[" 6000077","CATH 16FR 30ML","STERILE SUPPLIES",272,"A4353",null,null,18]
[" 6000081","CATH 18FR 30CC","STERILE SUPPLIES",272,"A4353",null,null,19]
[" 6000087","CATH 24FR 30CC","STERILE SUPPLIES",272,"A4353",null,null,19]
[" 6000138","URINARY LEG BG 500CC","STERILE SUPPLIES",272,"A4358",null,null,19]
[" 6000089","CATH 26FR 30CC","STERILE SUPPLIES",272,"A4353",null,null,20]
[" 6000100","DRESSING KLING 1  NS","STERILE SUPPLIES",272,"A6216",null,null,20]
[" 6000102","DRESSING KLING 2  NS","STERILE SUPPLIES",272,"A6216",null,null,20]
[" 6000066","ACE 4  DOUBLE","STERILE SUPPLIES",272,"A6451",null,null,23]
[" 6000086","CATH 24 FR 10 CC","STERILE SUPPLIES",272,"A4353",null,null,23]
[" 6000139","URINARY LEG BAG 25 OZ","STERILE SUPPLIES",272,"A4358",null,null,23]
["  500110","1ST STEP SELECT OVERLAY","STERILE SUPPLIES",272,"E0371",null,null,26]
[" 6000078","CATH 14FR 10ML","STERILE SUPPLIES",272,"A4353",null,null,26]
[" 6000079","CATH 16FR 10ML","STERILE SUPPLIES",272,"A4353",null,null,26]
[" 6000083","CATH 20FR 10ML","STERILE SUPPLIES",272,"A4353",null,null,26]
[" 6000351","STATLOCK IV STAB DEVICE","STERILE SUPPLIES",272,"A4334",null,null,27]
[" 6000084","CATH 20FR 30ML","STERILE SUPPLIES",272,"A4353",null,null,30]
[" 6000076","CATH 8FR 3ML","STERILE SUPPLIES",272,"A4353",null,null,39]
[" 6000085","CATH 22FR 30CC 3 WAY","STERILE SUPPLIES",272,"A4355",null,null,41]
[" 5500005","OXYGEN PROBE OXIMETER DEV","STERILE SUPPLIES",272,"A4606",null,null,48]
[" 6000157","DRESSING AQUACEL AG EXTRA (420677)","STERILE SUPPLIES",272,null,null,null,50]
[" 6000082","CATH 18FR 30CC 3WAY","STERILE SUPPLIES",272,"A4355",null,null,55]
[" 6000088","CATH 24FR 3WAY","STERILE SUPPLIES",272,"A4355",null,null,55]
[" 6000059","CENTRAL LINE DRESSING KIT","STERILE SUPPLIES",272,null,null,null,64]
[" 6000080","CATH 18FR 10ML COUDE TIP","STERILE SUPPLIES",272,"A4353",null,null,73]
[" 6000007","DERMABOND","STERILE SUPPLIES",272,null,null,null,86]
[" 6000389","CHEST TUBE KIT PLEURAGUIDE","STERILE SUPPLIES",272,"C1751",null,null,268.64999999999998]
[" 6000146","CENTRAL LINE 2 LUMEN","STERILE SUPPLIES",272,"C1751",null,null,420]
[" 1500039","ED CRICOTHYROTOMOY CATHET","STERILE SUPPLIES",272,null,null,null,843]
["  902632","LENS POSTERIOR","OR",276,"V2632",null,null,1327]
["90000090","MESH KEYHOLE 5/BX","OR",278,"C1781",null,null,1031]
["  905006","MESH T1015 10X15","OR",278,"C1781",null,null,1103]
["  905007","KEYHOLE MESH T613-85","OR",278,"C1781",null,null,1103]
["  905005","MESH T1415 5.6X6","OR",278,"C1781",null,null,1386]
["  905010","PORT CENTRAL VENOUS ACCESS","OR",278,"C1788",null,null,1486]
["  905004","MESH T1518-8","OR",278,"C1781",null,null,1500]
["  905002","MESH T221510 22X15X10","OR",278,"C1781",null,null,1615]
["  905003","MESH T3030 30X30","OR",278,"C1781",null,null,1671]
["  905009","OR MESH TINTRACK7","OR",278,"C1781",null,null,1719]
["  905001","MESH TINTRAS 14X15","OR",278,"C1781",null,null,2701]
["  905008","SURG MESH R/F03011A","OR",278,"C1781",null,null,2795]
[" 4400030","CL GLUCOMETER","LAB",300,"82962",null,null,20]
[" 2203783","MAGNESIUM  RANDOM  UR","LAB",300,"83735",null,null,25]
[" 2206940","PARAINFLUENZA 3","LAB",300,"87279",null,null,27]
[" 2206960","ADENOVIRUS","LAB",300,"87260",null,null,27]
[" 2206970","HUMAN METASPNEWMOVIRUS","LAB",300,"87299",null,null,27]
[" 2206081","CREA CALC","LAB",300,"82570",null,null,28]
[" 2201443","URINE DRUG COLLECTION","LAB",300,null,null,null,30]
[" 2203193","OSMOTIC GAP F","LAB",300,"84999",null,null,30]
[" 2205285","OSMOLALITY  F","LAB",300,"84999",null,null,30]
[" 2206920","PARAINFLUENZA 1","LAB",300,"87279",null,null,30]
[" 2206930","PARAINFLUENZA 2","LAB",300,"87279",null,null,30]
[" 4400026","CL URINE DIP","LAB",300,"81002",null,null,30]
[" 2206415","COLLECTION VENIPUNCTURE","LAB",300,"36415",null,null,33]
[" 4400028","CL OCCULT BLOOD","LAB",300,"82270",null,null,33]
[" 2202270","OCCULT BLOOD","LAB",300,"82270",null,null,35]
[" 2202230","SPECIFIC GRAVITY","LAB",300,"81003",null,null,36]
[" 2205881","BCID PERFORMED","LAB",300,"87150",null,null,36]
[" 2209853","IGG","LAB",300,"86001",null,null,38]
[" 2202091","NEWBORN THYROXINE","LAB",300,"84437",null,null,43]
[" 2202095","NEWBORN GALACTOSE","LAB",300,"82760",null,null,43]
[" 2202096","NEWBORN GAL-URIDYLTRANSFE","LAB",300,"82776",null,null,43]
[" 2202440","CHLORIDE  BLOOD","LAB",300,"82435",null,null,43]
[" 2200027","BELL PEPPER","LAB",300,"86003",null,null,44]
[" 2200028","CABBAGE","LAB",300,"86003",null,null,44]
[" 2200034","CHICKEN","LAB",300,"86003",null,null,44]
[" 2200035","GRAPE","LAB",300,"86003",null,null,44]
[" 2200036","LETTUCE","LAB",300,"86003",null,null,44]
[" 2200037","NAVY BEAN","LAB",300,"86003",null,null,44]
[" 2200038","ORANGE","LAB",300,"86003",null,null,44]
[" 2200039","POTATO","LAB",300,"86003",null,null,44]
[" 2200040","EGG WHITE","LAB",300,"86003",null,null,44]
[" 2200041","RYE","LAB",300,"86003",null,null,44]
[" 2200042","MILK","LAB",300,"86003",null,null,44]
[" 2200043","CARROT","LAB",300,"86003",null,null,44]
[" 2200044","OAT","LAB",300,"86003",null,null,44]
[" 2200046","SOYBEAN","LAB",300,"86003",null,null,44]
[" 2200047","RICE","LAB",300,"86003",null,null,44]
[" 2200048","WHEAT","LAB",300,"86003",null,null,44]
[" 2200049","TOMATO","LAB",300,"86003",null,null,44]
[" 2201447",".H PYLORI RAPID SCREEN, BLOOD","LAB",300,"86318",null,null,44]
[" 2202040","ALBUMIN  SERUM","LAB",300,"82040",null,null,44]
[" 2206003","ALLERGEN SPECIFIC IGE","LAB",300,"86003",null,null,44]
[" 2206004","HOUSE DUST MITES/DP IGE","LAB",300,"86003",null,null,44]
[" 2206005","HOUSE DUST MITES/DF IGE","LAB",300,"86003",null,null,44]
[" 2206006","CAT EPITHELIUM IGE","LAB",300,"86003",null,null,44]
[" 2206007","DOG DANDER IGE","LAB",300,"86003",null,null,44]
[" 2206008","BERMUDA GRASS  IGE","LAB",300,"86003",null,null,44]
[" 2206009","TIMOTHY GRASS IGE","LAB",300,"86003",null,null,44]
[" 2206010","COCKROACH IGE","LAB",300,"86003",null,null,44]
[" 2206011","PENICILLIUM IGE","LAB",300,"86003",null,null,44]
[" 2206012","CLADOSPORIUM IGE","LAB",300,"86003",null,null,44]
[" 2206014","ALTERNARIA TENUIS  IGE","LAB",300,"86003",null,null,44]
[" 2206015","BOX ELDER/MAPLE S IGE","LAB",300,"86003",null,null,44]
[" 2206016","GREY ALDER IGE","LAB",300,"86003",null,null,44]
[" 2206017","MOUNTAIN CEDAR  IGE","LAB",300,"86003",null,null,44]
[" 2206018","OAK IGE","LAB",300,"86003",null,null,44]
[" 2206019","ELM IGE","LAB",300,"86003",null,null,44]
[" 2206021","MULBERRY IGE","LAB",300,"86003",null,null,44]
[" 2206022","OLIVE TREE IGE","LAB",300,"86003",null,null,44]
[" 2206023","COTTONWOOD IGE","LAB",300,"86003",null,null,44]
[" 2206024","SHORT RAGWEED  IGE","LAB",300,"86003",null,null,44]
[" 2206025","MUGWORT IGE","LAB",300,"86003",null,null,44]
[" 2206026","RUSSIAN THISTLE  IGE","LAB",300,"86003",null,null,44]
[" 2206027","ROUGH PIGWEED  IGE","LAB",300,"86003",null,null,44]
[" 2206028","RED SORREL IGE","LAB",300,"86003",null,null,44]
[" 2207420","COCCIDIOIDES ANTIBODY","LAB",300,"86635",null,null,44]
[" 2209818","LEUKMS EACH ADDT'L MARKER","LAB",300,"88185",null,null,44]
[" 2204075","ALP","LAB",300,"84075",null,null,45]
[" 2204295","SODIUM","LAB",300,"84295",null,null,45]
[" 2200727","EGG WHITE IGE","LAB",300,"86003",null,null,46]
[" 2200729","MILK IGE","LAB",300,"86003",null,null,46]
[" 2200730","WHEAT IGE","LAB",300,"86003",null,null,46]
[" 2200731","SOYBEAN IGE","LAB",300,"86003",null,null,46]
[" 2200734","PEANUT IGE","LAB",300,"86003",null,null,46]
[" 2200735","CORN-FOOD IGE","LAB",300,"86003",null,null,46]
[" 2203380","CODFISH IGE","LAB",300,"86003",null,null,46]
[" 2203381","CRAB  IGE","LAB",300,"86003",null,null,46]
[" 2203382","SHRIMP  IGE","LAB",300,"86003",null,null,46]
[" 2203383","TUNA IGE","LAB",300,"86003",null,null,46]
[" 2203384","LOBSTER  IGE","LAB",300,"86003",null,null,46]
[" 2204140","POTASSIUM","LAB",300,"84132",null,null,46]
[" 2204460","ALT","LAB",300,"84460",null,null,46]
[" 2205282","SODIUM F","LAB",300,"84302",null,null,46]
[" 2205288","POTASSIUM F","LAB",300,"84999",null,null,46]
[" 2209190","EOSINOPHILS-NASAL SECRETI","LAB",300,"89190",null,null,46]
[" 2209856","IGE","LAB",300,"86003",null,null,46]
[" 2202243","SPECIFIC GRAVITY BODY FL","LAB",300,"84315",null,null,47]
[" 2204427","CONCENTRATION INFECTIOUS AGENT","LAB",300,"87177",null,null,47]
[" 2203849","PROTEIN  TOTAL  PLASMA","LAB",300,"84155",null,null,48]
[" 2204100","PHOSPHORUS","LAB",300,"84100",null,null,48]
[" 2204155","TOTAL PROTEIN","LAB",300,"84155",null,null,48]
[" 2202476","GLUCOSE 1 HOUR GEST","LAB",300,"82952",null,null,49]
[" 2202957","GLUCOSE 3 HOUR","LAB",300,"82952",null,null,49]
[" 2202310","CALCIUM TOTAL","LAB",300,"82310",null,null,50]
[" 2202335","CALCIUM TOTAL  RANDOM URINE","LAB",300,"82310",null,null,50]
[" 2204520","BUN (BLOOD UREA NITROGEN)","LAB",300,"84520",null,null,50]
[" 2202094","NEWBORN BIOTINADASE","LAB",300,"82261",null,null,51]
[" 2204330","GLUCOSE","LAB",300,"82947",null,null,51]
[" 2204626","INSULIN (HUMAN)  IGE","LAB",300,"86003",null,null,52]
[" 2205752","GLUTEN IGE","LAB",300,"86003",null,null,52]
[" 2200723","PORK IGE","LAB",300,"86003",null,null,54]
[" 2200724","EGG YOLK IGE","LAB",300,"86003",null,null,54]
[" 2200725","BEEF  IGE","LAB",300,"86003",null,null,54]
[" 2200726","COCOA IGE","LAB",300,"86003",null,null,54]
[" 2204300","SODIUM  RANDOM URINE","LAB",300,"84300",null,null,54]
[" 2204555","URIC ACID","LAB",300,"84550",null,null,54]
[" 2286003","BAKERS YEAST IGE SERUM","LAB",300,"86003",null,null,54]
[" 2202247","BILIRUBIN BODY FLUID","LAB",300,"82247",null,null,55]
[" 2202249","BILIRUBIN  DIRECT","LAB",300,"82248",null,null,55]
[" 2202250","BILIRUBIN  TOTAL","LAB",300,"82247",null,null,55]
[" 2205606","BABESIA MICROTI IGG AB","LAB",300,"86753",null,null,55]
[" 4400032","CL PROTHROMBIN TIME","LAB",300,"85610",null,null,56]
[" 2202565","CREATININE","LAB",300,"82565",null,null,57]
[" 2205378","OXYCODONE ADD ON CHG","LAB",300,"80365",null,null,57]
[" 2205377","OPIATE 1 OR MORE ADD ON","LAB",300,"80361",null,null,58]
[" 2208324","ALBUMIN  BODY FLUID","LAB",300,"82042",null,null,58]
[" 2202204","ALBUMIN 24 HOUR URINE","LAB",300,"82043",null,null,60]
[" 2204132","POTASSIUM  24 HR URINE","LAB",300,"84133",null,null,60]
[" 2205106","PLATELET COUNT","LAB",300,"85049",null,null,60]
[" 2206179","GLUCOSE TOLERANCE 1 HR (50mG GDM SCREEN)","LAB",300,"82950",null,null,60]
[" 2202225","PROTEIN TOTAL  BODY FLUID","LAB",300,"84157",null,null,61]
[" 2203545","IRON","LAB",300,"83540",null,null,61]
[" 2204475","TRIGLYCERIDE","LAB",300,"84478",null,null,61]
[" 2204477","TRIGLYCERIDE BODY FL","LAB",300,"84478",null,null,61]
[" 2205397","ANA SCREEN IFA W/ REFLEX TITER/PATTERN","LAB",300,"86038",null,null,61]
[" 2204450","AST","LAB",300,"84450",null,null,62]
[" 2202097","NEWBORN MCAD","LAB",300,"83788",null,null,63]
[" 2202226","CSF PROTEIN TOTAL","LAB",300,"84157",null,null,63]
[" 2202947","GLUCOSE BODY FL","LAB",300,"82945",null,null,63]
[" 2202954","URINE GLUCOSE","LAB",300,"82945",null,null,63]
[" 2204331","CSF GLUCOSE","LAB",300,"82945",null,null,63]
[" 2206082","PROTEIN  TOTAL","LAB",300,"84156",null,null,63]
[" 2203005","MONOCLONAL TOTAL PROTEIN","LAB",300,"84156",null,null,65]
[" 2204299","SODIUM  24 HR URINE","LAB",300,"84300",null,null,65]
[" 2204819","ZPROTEIN  TOTAL  RANDOM  URINE CHARGE","LAB",300,"84156",null,null,65]
[" 2205060","BLOOD SMEAR PERIPHERAL","LAB",300,"85060",null,null,65]
[" 2201793","RHEUMATOID FACTOR","LAB",300,"86431",null,null,66]
[" 2202977","GGT","LAB",300,"82977",null,null,66]
[" 2203615","LDH","LAB",300,"83615",null,null,66]
[" 2203631","LDH  BODY FLUID","LAB",300,"83615",null,null,66]
[" 2204104","PHOSPHORUS  24 HR URINE","LAB",300,"84105",null,null,66]
[" 2204106","PHOSPHOROUS RANDOM URINE","LAB",300,"84105",null,null,66]
[" 2204541","UREA  24 HOURE URINE","LAB",300,"84540",null,null,66]
[" 2204556","URIC ACID BODY FL","LAB",300,"84560",null,null,66]
[" 2204560","URIC ACID  RANDOM URINE","LAB",300,"84560",null,null,66]
[" 2204562","URIC ACID  24 HR URINE","LAB",300,"84560",null,null,66]
[" 2206431","RHEUMATOID FACTOR ADD ON CHARGE","LAB",300,"86431",null,null,66]
[" 2207410","BLASTOMYCES AB","LAB",300,"86612",null,null,66]
[" 2202465","CHOLESTEROL","LAB",300,"82465",null,null,67]
[" 2205283","POTASSIUM URINE RANDOM","LAB",300,"84133",null,null,67]
[" 2205287","PHOSPHORUS FLUID","LAB",300,"84999",null,null,68]
[" 2206711","JC VIRUS Ab STRATIFY w/INDEX w/REFLEX","LAB",300,"86711",null,null,68]
[" 2205548","METHYLENEDIOXY ADD ON CHARGE","LAB",300,"80359",null,null,70]
[" 2202570","CREATININE URINE RANDOM","LAB",300,"82570",null,null,71]
[" 2202571","CREATININE 24 HR URINE","LAB",300,"82570",null,null,71]
[" 2202572","CREATININE BODY FLUID","LAB",300,"82570",null,null,71]
[" 2202610","CYSTATIN C W/ GFR","LAB",300,"82610",null,null,71]
[" 2204340","CALCIUM  24 HR URINE","LAB",300,"82340",null,null,71]
[" 2208237","MUMPS IGM AB","LAB",300,"86735",null,null,71]
[" 2202227","PROTEIN TOTAL URINE","LAB",300,"84156",null,null,72]
[" 2203178","CHARGE ONLY -PROTEIN TOTAL URINE","LAB",300,"84156",null,null,72]
[" 2204543","T-CELL TOTAL COUNT","LAB",300,"86359",null,null,72]
[" 2205547","AMPHETAMINE BY LC-MS/MS","LAB",300,"80324",null,null,72]
[" 2205670","THROMBIN TIME (DON'T ORDER)","LAB",300,"85670",null,null,72]
[" 2208196","SURG PATH GROSS ONLY","LAB",300,"88300",null,null,72]
[" 2200025","NORTRIPTYLINE","LAB",300,"80335",null,null,73]
[" 2202209","PROTEIN  24 HOUR URINE","LAB",300,"84156",null,null,73]
[" 2203655","LEAD  BLOOD CAPILLARY","LAB",300,"83655",null,null,73]
[" 2203656","LEAD  BLOOD VENOUS","LAB",300,"83655",null,null,73]
[" 2207386","CULT  GARNERELLA VAG SCR","LAB",300,"87081",null,null,73]
[" 2203889","BRUCELLA AB SCREEN  IGG","LAB",300,"86622",null,null,74]
[" 2203890","BRUCELLA AB SCREEN  IGM S","LAB",300,"86622",null,null,74]
[" 2203455","T4 TOTAL","LAB",300,"84436",null,null,75]
[" 2205286","MAGNESIUM F","LAB",300,"83735",null,null,75]
[" 2207081","DIRECT COOMBS C3D","LAB",300,"86880",null,null,75]
[" 2204788","APPTT MIX 1:1","LAB",300,"85732",null,null,76]
[" 2205903","PT MIX 1:1","LAB",300,"85611",null,null,76]
[" 2206611","BARTONELLA AB IGG/IGM","LAB",300,"86611",null,null,76]
[" 2200831","IDENTIFICATION  FUNGUS","LAB",300,"87107",null,null,77]
[" 2201905","FAT FECAL QUALITATIVE","LAB",300,"82750",null,null,77]
[" 2203550","IRON BINDING CAPACITY","LAB",300,"83550",null,null,77]
[" 2203784","MAGNESIUM  24 HR URINE","LAB",300,"83735",null,null,77]
[" 2204738","VON WILLEBRAND FACTOR ACTIVITY","LAB",300,"85397",null,null,77]
[" 2209852","IMMOASSAY","LAB",300,"86331",null,null,77]
[" 2205284","CHLORIDE  F","LAB",300,"82438",null,null,78]
[" 2207072","DIRECT COOMBS IGG","LAB",300,"86880",null,null,78]
[" 2208018","MYCOPHENOLIC ACID SERUM","LAB",300,"80180",null,null,78]
[" 2306250","BB DIRECT COOMBS","LAB",300,"86880",null,null,78]
[" 2201847","TIS CULT ADDITIONAL STUDY","LAB",300,"87253",null,null,79]
[" 2207331","CULT  BLOOD FOR FUNGUS","LAB",300,"87103",null,null,79]
[" 2205265","EVEROLIMUS","LAB",300,"80169",null,null,81]
["22006629","CANDIDA ALBICANS IGG","LAB",300,"86628",null,null,81]
["22006630","CANDIDA ALBICANS IGA","LAB",300,"86628",null,null,81]
["22006631","CANDIDA ALBICANS IGM","LAB",300,"86628",null,null,81]
["22021000","STACHYBOTRYS CHARTARUM IGG","LAB",300,"86001",null,null,81]
["22021001","STACHYBOTRYS CHARTARUM IGE","LAB",300,"86003",null,null,81]
["22021002","STACHYBOTRYS CHARTARUM IGA","LAB",300,"83520",null,null,81]
[" 2205549","LYSOZYME SERUM","LAB",300,"85549",null,null,82]
[" 2209834","THROMBIN TIME","LAB",300,"85670",null,null,82]
[" 2202319","PYRUVIC ACID","LAB",300,"84210",null,null,83]
[" 2206045","SCL70 AB  IG G S","LAB",300,"86235",null,null,83]
[" 2206635","ANTIBODY COCCIDIOIDES","LAB",300,"86635",null,null,83]
[" 2200050","DAIRY &; GRAIN ALLERGEN PROFIL","LAB",300,null,null,null,85]
[" 2202987","ANTISTREPTOLYSIN O TITER","LAB",300,"86060",null,null,85]
[" 2203195","FRANCISELLA TULARENSIS AB (DO NOT ORDER)","LAB",300,"86668",null,null,86]
[" 2203986","PH  BODY FLUID","LAB",300,"83986",null,null,86]
["22026039","ANA PATTERN CHARGE","LAB",300,"86039",null,null,86]
[" 2204029","TREPONEMA PALLIDUM","LAB",300,"86780",null,null,87]
[" 2202550","CK","LAB",300,"82550",null,null,88]
[" 2202551","CK BODY FLUID","LAB",300,"82550",null,null,88]
[" 2202691","T3 UPTAKE","LAB",300,"84479",null,null,88]
[" 2204582","APTTB","LAB",300,"85730",null,null,88]
[" 4400037","CL INFLUENZA A TEST","LAB",300,"87804",null,null,88]
[" 4400039","CL INFLUENZA B TEST","LAB",300,"87804",null,null,88]
[" 2202770","IMMUNOGLOBULIN D","LAB",300,"82784",null,null,90]
[" 2202783","CELIAC DISEASE SEROLOGY CASCADE","LAB",300,"82784",null,null,90]
[" 2202784","GAMMAGLOBULIN IGA IGD IGG IGM","LAB",300,"82784",null,null,90]
[" 2202815","IGM","LAB",300,"82784",null,null,90]
[" 2203410","IGG","LAB",300,"82784",null,null,90]
[" 2203411","IGA","LAB",300,"82784",null,null,90]
[" 2203412","IGM","LAB",300,"82784",null,null,90]
[" 2200031","ALKALINE PHOS (BONE)","LAB",300,"84080",null,null,92]
[" 2200366","PREGABALIN, URINE","LAB",300,"80366",null,null,92]
[" 2202010","BETA-HYDROXYBUTYRATE","LAB",300,"82010",null,null,92]
[" 2203009","METANEPHRINES FRACTIONATED RAN","LAB",300,"83835",null,null,92]
[" 2209848","CORTISOL CORTISON QUANTITIVE E","LAB",300,"83789",null,null,92]
[" 2200836","CRYOGLOBULIN  SERUM","LAB",300,"82595",null,null,93]
[" 2203400","CRYOGLOBULIN(DON'T ORDER)","LAB",300,"82595",null,null,93]
[" 2203401","CRYOFIBRINOGEN","LAB",300,"82585",null,null,93]
[" 2203741","DAILY MAGNESIUM","LAB",300,"83735",null,null,93]
[" 2203821","FECAL WBC ANTIGEN","LAB",300,"83630",null,null,93]
[" 2203930","OSMOLATLITY  SERUM","LAB",300,"83930",null,null,93]
[" 2203935","OSMOLALITY  URINE","LAB",300,"83935",null,null,93]
[" 2205230","FACTOR VII ACTIVITY","LAB",300,"85230",null,null,93]
[" 2206160","COMPLIMENT AG EA COMPONENT ADD ON CHARGE","LAB",300,"86160",null,null,93]
[" 2206163","C3 COMPLEMENT","LAB",300,"86160",null,null,93]
[" 2206164","C4 COMPLEMENT","LAB",300,"86160",null,null,93]
[" 2200171","GABAPENTIN SERUM","LAB",300,"80171",null,null,94]
[" 2203297","HPV HIGH RISK","LAB",300,"87624",null,null,94]
[" 2203298","HPV LOW RISK","LAB",300,"87623",null,null,94]
[" 2205303","LAMOTRIGINE","LAB",300,"80175",null,null,94]
[" 2206225","GLIADIN AB, IGA","LAB",300,"83516",null,null,94]
[" 2206226","GLIADIN AB, IGG","LAB",300,"83516",null,null,94]
[" 2206228","DNA (ds) Ab ADD ON CHARGE","LAB",300,"86225",null,null,94]
[" 2208762","HPV HIGH RISK","LAB",300,"87624",null,null,94]
[" 2202150","AMYLASE","LAB",300,"82150",null,null,95]
[" 2202151","AMYLASE  BODY FLUID","LAB",300,"82150",null,null,95]
[" 2202152","DAILY AMYLASE","LAB",300,"82150",null,null,95]
[" 2202153","AMYLASE RANDOM URINE","LAB",300,"82150",null,null,95]
[" 2204428","COMPLEX STAIN OVA PARASITES","LAB",300,"87209",null,null,95]
[" 2204936","ORGANISM IDENT AEROBIC BEC","LAB",300,"87077",null,null,95]
[" 2205243","COAG FACTOR XII ACTIVITY ASSAY","LAB",300,"85280",null,null,95]
[" 2202007","(OBSELETE)MICROALBUMIN CREAT RATIO","LAB",300,"82043",null,null,96]
[" 2202466","CHOLESTEROL BODY FLUID","LAB",300,"84999",null,null,96]
[" 2202735","ALDOLASE  SERUM","LAB",300,"82085",null,null,96]
[" 2204135","POTASSIUM  BODY FL","LAB",300,"84999",null,null,96]
[" 2284100","PHOSPHORUS FECAL ADD ON","LAB",300,"84300",null,null,96]
[" 2202164","ANGIOTENSIN CONVERTING ENZYME","LAB",300,"82164",null,null,97]
[" 2202538","FRUCTOSAMINE","LAB",300,"82985",null,null,97]
[" 2202628","HIV 1/2 ANTIBODY EVAL (OBSOLETE)","LAB",300,"86703",null,null,97]
[" 2203725","LITHIUM","LAB",300,"80178",null,null,97]
[" 2206013","ASPERGILLUS FUMIGATUS IGG ANTIBODIES","LAB",300,"86003",null,null,97]
[" 2206776","TOXOPLASMA gondii AB IGM","LAB",300,"86778",null,null,97]
[" 2207400","ASPERGILLUS FUMIGATUS IGE AB","LAB",300,"86606",null,null,97]
[" 2203016","STRIATIONAL AB S","LAB",300,"82520",null,null,98]
[" 2203323","PARATHYROID HORMONE  (DON'T ORDER)","LAB",300,"83970",null,null,98]
[" 2204628","PIGEON BREEDERS DISEASE","LAB",300,"86001",null,null,98]
[" 2205242","COAG FACTOR XI ASSAY  P","LAB",300,"85270",null,null,98]
[" 2207380","GIARDIA EIA","LAB",300,"87329",null,null,98]
[" 2201792","C-REACTIVE PROTEIN","LAB",300,"86140",null,null,100]
[" 2203740","MAGNESIUM","LAB",300,"83735",null,null,100]
[" 2205375","FIBRINOGEN","LAB",300,"85384",null,null,100]
[" 2205732","HEMOGLOBIN A1C","LAB",300,"83036",null,null,100]
[" 2207381","GIARDIA","LAB",300,"87329",null,null,100]
[" 2202632","ANTINUCLEAR ANTIBODIES","LAB",300,"86038",null,null,101]
[" 2202682","IGA IMMUNOGLOBULIN","LAB",300,"82784",null,null,101]
[" 2204421","BORDETELLA PERTUSSIS AB IGG","LAB",300,"86615",null,null,101]
[" 2204422","BORDETELLA PERTUSSIS AB IGA","LAB",300,"86615",null,null,101]
[" 2204423","BORDETELLA PERTUSSIS AB IGM","LAB",300,"86615",null,null,101]
[" 2203369","SHIGA TOXIN 1 CHARGE","LAB",300,"87427",null,null,103]
[" 2207395","SHIGA TOXIN 2 CHARGE","LAB",300,"87427",null,null,103]
[" 2200239","FACTOR IX ASSAY","LAB",300,"85250",null,null,104]
[" 2202043","MICROALBUMIN CREATININE RATIO","LAB",300,"82043",null,null,105]
[" 2204981","VITAMIN B1  THIAMINE  WHOLE BL","LAB",300,"84425",null,null,105]
[" 2205267","HEMOSIDERIN URINE","LAB",300,"83070",null,null,105]
[" 2282525","COPPER  24 HR URINE","LAB",300,"82525",null,null,105]
[" 2201845","LDL DIRECT","LAB",300,"83701",null,null,106]
[" 2203303","C-REACTIVE PROTEIN  HIGH SENSI","LAB",300,"86141",null,null,106]
[" 2208185","ANTIBODY HERPES SIMPLEX TYPE1","LAB",300,"86695",null,null,106]
[" 2208186","HERPES SIMPLEX 2 IGG","LAB",300,"86696",null,null,106]
[" 2200384","SPOTTED FEVER IGG IGM","LAB",300,"86757",null,null,107]
[" 2200060","ALK ISOENZYMES CHARGE","LAB",300,"84075",null,null,109]
[" 2201958","THYROGLOBULIN ANTIBODY","LAB",300,"86800",null,null,109]
[" 2202330","CALCIUM  IONIZED iSTAT","LAB",300,"82330",null,null,109]
[" 2202575","CREATININE CLEARANCE","LAB",300,"82575",null,null,109]
[" 2202892","SJOGREN'S ANTI SS-A","LAB",300,"86235",null,null,109]
[" 2202893","SJOGREN'S ANTI SS-B","LAB",300,"86235",null,null,109]
[" 2205398","THYROGLOBULIN ANTIBODY SCREEN","LAB",300,"86800",null,null,109]
[" 2206329","TRANSFERRIN","LAB",300,"84466",null,null,109]
[" 2202740","ARSENIC 24 HR URINE","LAB",300,"82175",null,null,111]
[" 2204986","PHOSPHLIPID ABS IFF","LAB",300,"86147",null,null,111]
[" 2204987","PHOSPHOLIPID ABS IGM","LAB",300,"86147",null,null,111]
[" 2205620","ANTI-XA LMWH","LAB",300,"85520",null,null,111]
[" 1700803","TRIM DYSTROPH 6 OR MORE","LAB",300,"11721",null,null,112]
[" 2202093","NEWBORN HEMOGLOBINOPATH","LAB",300,"83020",null,null,112]
[" 2202918","JO 1 ANTIBODIES  IGG  SERUM","LAB",300,"86235",null,null,112]
[" 2204703","GONADOTROPIN CHORIAONIC (HCG)","LAB",300,"84703",null,null,112]
[" 2204740","RISTOCETIN COFACTOR  PLASMA","LAB",300,"85245",null,null,112]
[" 2207334","CULTURE  CATHETER TIP","LAB",300,"87070",null,null,112]
[" 2201937","AFP TRIPLE/QUAD","LAB",300,"82105",null,null,113]
[" 2201938","ESTRIOL TRIPLE/QUAD","LAB",300,"82677",null,null,113]
[" 2202412","ALPHA FETOPROTEIN SCREEN MATERNAL","LAB",300,"82105",null,null,113]
[" 2202619",".LYME IGG IMMUNOBLOT","LAB",300,"86617",null,null,113]
[" 2202620",".LYME IGM IMMUNOBLOT","LAB",300,"86617",null,null,113]
[" 2202786","RESPIRATORY PROFILE REGION 11","LAB",300,"82785",null,null,113]
[" 2202857","ZINC  SERUM","LAB",300,"84630",null,null,113]
[" 2205376","OPIATE CONFIMATION  URINE","LAB",300,"80361",null,null,113]
[" 2206243","AFP TUMOR MARKER","LAB",300,"82105",null,null,113]
[" 2206738",".MYCOPLASMA PNEUMONIAE IGG","LAB",300,"86738",null,null,113]
[" 2206739",".MYCOPLASMA PNEUMONIAE IGM","LAB",300,"86738",null,null,113]
[" 2209841","VOLATILE  SCREEN  BLOOD","LAB",300,"84600",null,null,113]
[" 2202626","T3  TOTAL","LAB",300,"84480",null,null,114]
[" 2203850","ELECTROPHORESIS  PROTEIN (CH)","LAB",300,"84165",null,null,114]
[" 2201848","CULTURE,HSV","LAB",300,null,null,null,116]
[" 2202724","HEPATITIS B CORE TOTAL ANTIBODIES","LAB",300,"86704",null,null,116]
[" 2203608","PSA TOTAL RWMC","LAB",300,"84153",null,null,116]
[" 2200818","MAGNESIUM RBC","LAB",300,"83735",null,null,117]
[" 2201957","THYROID PEROXIDASE ANTIBODY","LAB",300,"83516",null,null,117]
[" 2201959","PARIETAL CELL ANTIBODIES, IGG, SERUM","LAB",300,"83516",null,null,117]
[" 2203314","LIVER/KIDNEY MICROSOME AB","LAB",300,"86376",null,null,117]
[" 2203517","THYRO PEROX AB CHARGE","LAB",300,"83516",null,null,117]
[" 2204420","THEOPHYLLINE","LAB",300,"80198",null,null,117]
[" 2205471","BORDETELLA PERTUSSIS PCR","LAB",300,"87798",null,null,117]
[" 2205472","CHLAMYDOPHILA PNEUMONIAE","LAB",300,"87486",null,null,117]
[" 2206376","RIBAS P AB ADD ON CHARGE","LAB",300,"86376",null,null,117]
[" 2200257","ELECTROLYTES","LAB",300,"80051",null,null,118]
[" 2201778","PROGESTERONE","LAB",300,"84144",null,null,118]
[" 2202774","LEGIONELLA ANTIBODY","LAB",300,"86713",null,null,118]
[" 2204752","LAGU","LAB",300,"81268",null,null,118]
[" 2204817","ELECTROPHORESIS  PROTEIN URINE (CH)","LAB",300,null,null,null,118]
[" 2206324","CMV IGG ABS","LAB",300,"86644",null,null,118]
[" 2202417","CHROMOGRANIN A SERUM","LAB",300,"86316",null,null,119]
[" 2204935","NEISSERIA GONORRHOEAE AMPLIFIE","LAB",300,"87591",null,null,119]
[" 2200540","DIGOXIN","LAB",300,"80162",null,null,120]
[" 2202378","CARBAMAZEPINE-10 11-EPOXIDE","LAB",300,"80156",null,null,120]
[" 2202814","PARVOVIRUS B19 AB  IGG","LAB",300,"86747",null,null,120]
[" 2202816","PARVOVIRUS B19 AB  IGM  S","LAB",300,"86747",null,null,120]
[" 2203396","SEAFOOD ALLERGEN PROFILE","LAB",300,null,null,null,120]
[" 2204531","SEROTONIN  24HR U","LAB",300,"84260",null,null,120]
[" 2204760","CLONAZEPAM  SERUM","LAB",300,"80346",null,null,120]
[" 2283695","LIPOPROTEIN A, SERUM","LAB",300,"83695",null,null,120]
[" 2200472","HEP C MEDICARE SCREENING","LAB",300,"86803",null,null,121]
[" 2200783","FERRITIN","LAB",300,"82728",null,null,121]
[" 2202698","WEST NILE VIRUS IGG ABS","LAB",300,"86789",null,null,121]
[" 2202785","IGE IMMUNOGLOBULIN","LAB",300,"82785",null,null,121]
[" 2204145","PROCALCITONIN","LAB",300,"84145",null,null,121]
[" 2204995","PREALBUMIN","LAB",300,"84134",null,null,121]
[" 2205575","TRAMADOL AND METABOLITE, URINE","LAB",300,"80373",null,null,121]
[" 2207600","VOLATILE SCREEN URINE","LAB",300,"80320",null,null,121]
[" 2209854","IGE CHARGE","LAB",300,"82785",null,null,121]
[" 2201955","RNP IGG ANTIBODY","LAB",300,"86235",null,null,122]
[" 2202697","WEST NILE VIRUS IGM ABS","LAB",300,"86788",null,null,122]
[" 2204046","DRVVT","LAB",300,"85613",null,null,122]
[" 2209833","STACLOT CHARGE","LAB",300,"85598",null,null,122]
[" 2203006","MONO PROTEIN E'PHORESIS","LAB",300,"84166",null,null,123]
[" 2203179","PROTEIN ELECTROPHORESIS 24 HR URINE","LAB",300,"84166",null,null,123]
[" 2204518","PROTEIN ELECTROPHORESIS URINE","LAB",300,"84166",null,null,123]
[" 2205545","COCAINE CONF  U","LAB",300,"80353",null,null,123]
[" 2207383","STREPTOCOCCUS B BACT AG","LAB",300,"87899",null,null,123]
[" 2204324","HISTOPLASMA CAPSULATUM ANTIBOD","LAB",300,"86698",null,null,124]
[" 2208347","CIFA CHARGE IgA 2","LAB",300,"88346",null,null,124]
[" 2208352","CIFS CHARGE IgG 2","LAB",300,"88346",null,null,124]
[" 2209052","BFCNT CELL COUNT/DIFFERENTAL","LAB",300,"89051",null,null,124]
[" 2201810","SM ANTIBODIES  IGG  SERUM","LAB",300,"86235",null,null,125]
[" 2202382","CARBAMAZEPINE TOTAL","LAB",300,"80156",null,null,125]
[" 2203255","HERPES SIMPLEX VIRUS TYPE 2","LAB",300,"86696",null,null,125]
[" 2203819","CARBOXY-THC CONFIMATION  UR","LAB",300,"80349",null,null,125]
[" 2200923","PSA TOTAL (SCREEN)","LAB",300,"84153",null,null,126]
[" 2204242","SALICYLATE","LAB",300,"80329",null,null,126]
[" 2205700","PSA DIAGNOSTIC","LAB",300,"84153",null,null,126]
[" 2206777","TOXOPLASMA gondii AB IGG","LAB",300,"86777",null,null,126]
[" 2202708","HEPATITIS A IGG ANTIBODY","LAB",300,"86708",null,null,127]
[" 2203098","HEPATITIS A IGM ANTIBODY","LAB",300,"86709",null,null,127]
[" 2205308","OXCARBAZEPINE METABOLITE SERUM","LAB",300,"80183",null,null,127]
[" 2206256","(OBSOLETE) PHOSPHO A2 RECEP IGG","LAB",300,"86255",null,null,128]
[" 2201746","FOLLICLE STIMULATING HORMONE","LAB",300,"83001",null,null,129]
[" 2202100","INSULIN  120 MINUTES","LAB",300,"83525",null,null,129]
[" 2202753","EBV IGG AG EARLY ANTIGEN","LAB",300,"86663",null,null,129]
[" 2202812","OXALATE 24 HR URINE","LAB",300,"83945",null,null,129]
[" 2203078","CHLORIDE  URINE","LAB",300,"82436",null,null,129]
[" 2203525","INSULIN","LAB",300,"83525",null,null,129]
[" 2204934","CHLAMYDIA TRACHOMATIS AMPLIFIE","LAB",300,"87491",null,null,129]
["22084597","VITAMIN K1 SERUM","LAB",300,"84597",null,null,130]
[" 2202403","S. CEREVISIAE AB IGA","LAB",300,"86671",null,null,131]
[" 2205473","MYCOPLASMA PNEUMONIA","LAB",300,"87581",null,null,131]
[" 2200907","INFLUENZA A","LAB",300,"87804",null,null,132]
[" 2200908","INFLUENZA B","LAB",300,"87804",null,null,132]
[" 2202384","CARBAMAZEPINE FREE","LAB",300,"80157",null,null,132]
[" 2202655","PHENYTOIN","LAB",300,"80185",null,null,132]
[" 2202944","CMV IGM ANTIBODY","LAB",300,"86645",null,null,132]
[" 2203279","ENTAMOEBA HISTOLYTICA ANTIBODY","LAB",300,"86753",null,null,132]
[" 2203379","ANNA  TYPE1","LAB",300,"86256",null,null,132]
[" 2203385","PCA  TYPE TR","LAB",300,"86256",null,null,132]
[" 2203386","AMPHIPHYSIN","LAB",300,"86256",null,null,132]
[" 2203387","CRMP-5-IGG","LAB",300,"86256",null,null,132]
[" 2203393","ANNA TYPE2","LAB",300,"86256",null,null,132]
[" 2203395","ANNA  TYPE 3","LAB",300,"86256",null,null,132]
[" 2203397","AGNA  TYPE 1","LAB",300,"86256",null,null,132]
[" 2203399","PCA  TYPE 1","LAB",300,"86256",null,null,132]
[" 2203405","PCA  TPYE2","LAB",300,"86256",null,null,132]
[" 2204186","BARBITURATE CONFIRM UR","LAB",300,"80345",null,null,132]
[" 2202327","ESTRIOL UNCONJUGATED SERUM","LAB",300,"82677",null,null,133]
[" 2207379","CRYPTOSPORIDIUM","LAB",300,"87328",null,null,133]
[" 2209846","N-METHYLHISTAMINE 24 HR URINE","LAB",300,"83789",null,null,133]
[" 2202656","PHENOBARBITAL","LAB",300,"80184",null,null,134]
[" 2203944","FIBRINOLYSINS INTERP AND REPORT CHARGE","LAB",300,"85390",null,null,134]
[" 2204632","VITAMIN B 6","LAB",300,"84207",null,null,134]
[" 2208350","CIFA CHARGE IgA","LAB",300,"88350",null,null,134]
[" 2208351","CIFS CHARGE IgG","LAB",300,"88350",null,null,134]
[" 2209832","SPECIAL COAGULATION INTERPRETA","LAB",300,"85390",null,null,134]
[" 2201743","FOLATE","LAB",300,"82746",null,null,135]
[" 2201940","BHCG TRIPLE/QUAD","LAB",300,"84702",null,null,135]
[" 2202997","HCG QUANTITATIVE","LAB",300,"84702",null,null,135]
[" 2204439","T4 FREE","LAB",300,"84439",null,null,135]
[" 2204700","PORPHOBILINOGEN","LAB",300,"84110",null,null,135]
[" 2209825","BHCG TUMOR MARKER","LAB",300,"84702",null,null,135]
[" 2200939","RENAL FUNCTION PANEL","LAB",300,"80069",null,null,136]
[" 2204583","CHARGE STACLOT","LAB",300,"85598",null,null,136]
[" 2205546","AMPHETAMINES CONFIRMATION URINE","LAB",300,"80324",null,null,136]
[" 2209822","LEUKMS TC 1ST MARKER","LAB",300,"88184",null,null,136]
[" 2201744","CORTISOL","LAB",300,"82533",null,null,137]
[" 2201998","BETA-2-MICROGLOBULIN SERUM","LAB",300,"82232",null,null,137]
[" 2202375","CARBON MONOXIDE","LAB",300,"82375",null,null,137]
[" 2203112","TTGG","LAB",300,"83516",null,null,137]
[" 2202140","AMMONIA","LAB",300,"82140",null,null,138]
[" 2202372","CARBAMAZEPINE (TEGRETOL)","LAB",300,"80156",null,null,138]
[" 2202703","ALPHA-1 ANTITRYPSIN","LAB",300,"82103",null,null,138]
[" 2202908","INSULIN  FREE","LAB",300,"83527",null,null,138]
[" 2204270","SHBG","LAB",300,"84270",null,null,138]
[" 2204681","C-PEPTIDE","LAB",300,"84681",null,null,138]
[" 2208825","SHBG","LAB",300,"84270",null,null,138]
[" 2201742","B12","LAB",300,"82607",null,null,139]
[" 2205396","THYROGLOBULIN TUMOR MARKER","LAB",300,"84432",null,null,139]
[" 2202212","MYOGLOBIN URINE","LAB",300,"83874",null,null,140]
[" 2202820","HGB O2 AFFINITY CHARGE","LAB",300,"83021",null,null,140]
[" 2203497","24 HR 5-HIAA URINE","LAB",300,"83497",null,null,140]
[" 2204933","CHLAMYDIA TRACHOMATIS AND NEIS","LAB",300,null,null,null,140]
[" 2204715","SOLUABLE FIBRIN MONOMER","LAB",300,"85366",null,null,141]
[" 2209831","SOLUBLE FIBRIN MONOMER PARACOA","LAB",300,"85366",null,null,141]
[" 2200009","BMP iSTAT","LAB",300,"80048",null,null,142]
[" 2200942","DAILY BMP","LAB",300,"80048",null,null,142]
[" 2204432","THYROGLOBULIN MASS SPECTOMETRY","LAB",300,"84432",null,null,142]
[" 2202661","VALPROIC ACID","LAB",300,"80164",null,null,143]
[" 2206599","COLLECTION  ARTERIAL","LAB",300,"36600",null,null,143]
[" 2201809","NEUTROPHIL CYTOPLASMA IGG","LAB",300,"86255",null,null,144]
[" 2202985","SMOOTH MUSCLE AB SCREEN, SERUM","LAB",300,"86015",null,null,144]
[" 2203023","KAPPA FREE LIGHT CHAIN","LAB",300,"83520",null,null,144]
[" 2203024","LAMBDA FREE LIGHT CHAIN","LAB",300,"83520",null,null,144]
[" 2203408","NEUTROPHIL SPECIFIC ANTIBODIES","LAB",300,"86255",null,null,144]
[" 2206255","FLUORESCENT NON-INFEC AGENT AN","LAB",300,"86255",null,null,144]
[" 2209823","IMMUNOFIXATION SERUM","LAB",300,"86334",null,null,145]
["  221003","HOLOGIC SARSCOV2","LAB",300,"U0003",null,null,146]
[" 2201794","HEPATITIS B SURFACE ANTIBODY","LAB",300,"86706",null,null,146]
[" 2202726","ESTRONE (E1) SERUM","LAB",300,"82679",null,null,146]
[" 2204067","GENTAMYCIN  RANDOM","LAB",300,"80170",null,null,146]
[" 2204695","GENTAMYCIN (PEAK)","LAB",300,"80170",null,null,146]
[" 2204696","GENTAMYCIN (TROUGH)","LAB",300,"80170",null,null,146]
[" 2201912","KIDNEY STONE ANALYSIS","LAB",300,"82365",null,null,147]
[" 2202511","CCP ANTIBODIES","LAB",300,"86200",null,null,147]
[" 2203668","SULFATE  URINE","LAB",300,"84392",null,null,147]
[" 2203169","BENZODIAZEPINE CONF URINE","LAB",300,"80346",null,null,148]
[" 2203840","VITAMIN A","LAB",300,"84590",null,null,148]
[" 2204182","TOBRAMYCIN (TROUGH)","LAB",300,"80200",null,null,148]
[" 2201866","MITOCHONDRIAL AB M2 SERUM","LAB",300,"83516",null,null,149]
[" 2202677","TISSUE TRANSGLUTAMINASE IGA","LAB",300,"83516",null,null,149]
[" 2202729","TISSUE TRANS IGG ANTIBODY","LAB",300,"83516",null,null,149]
[" 2202910","ANCA (CYTOPLASMIC NEUTROPHIL ANTIBODIES)","LAB",300,"83516",null,null,149]
[" 2202911","PR3 IGG ANTIBODY","LAB",300,"83516",null,null,149]
[" 2200061","LIPID PANEL","LAB",300,"80061",null,null,150]
[" 2203606","LACTIC ACID (POC)","LAB",300,"83605",null,null,150]
[" 2201800","CEA (CARCINOEMBRYONIC AG)","LAB",300,"82378",null,null,151]
[" 2204758","PTH RELATED PEPTIDE","LAB",300,"82397",null,null,151]
[" 2200214","*GLUCOSE TOLERANCE CHARGE","LAB",300,"82951",null,null,152]
[" 2201802","HEPATITIS B CORE IGM ANTIBODY","LAB",300,"86705",null,null,152]
[" 2202530","NEWBORN CYSTIC FIBROSIS","LAB",300,"83516",null,null,152]
[" 2202912","MPO ANCA","LAB",300,"83516",null,null,152]
[" 2203069","TISSUE TRANSGLUTAMINASE AB IGA","LAB",300,"83516",null,null,152]
[" 2203070","TISSUE TRANSGLUTAMINASE AB IGA","LAB",300,"86364",null,null,152]
[" 2204625","PROTEINASE 3 ABS IGG","LAB",300,"83516",null,null,152]
[" 2205263","DILUTE RUSSELL VIPER VENOM TIM","LAB",300,"85613",null,null,153]
[" 2205264","DILUTE RUSSELL VIPER VENOM TIM","LAB",300,"85613",null,null,153]
[" 2203159","Q FEVER ANTIBODY  IGM","LAB",300,"86638",null,null,154]
[" 2203388","STRIATED MUSCLE ANTIBODY","LAB",300,"83520",null,null,154]
[" 2200116","THYROID RELEASING HORMONE","LAB",300,"84146",null,null,155]
[" 2200936","BMP","LAB",300,"80048",null,null,155]
[" 2201745","PROLACTIN","LAB",300,"84146",null,null,155]
[" 2203480","TSH","LAB",300,"84443",null,null,155]
[" 2208239","MUMPS IGG ANTIBODY","LAB",300,"86735",null,null,155]
[" 2201798","CA 125","LAB",300,"86304",null,null,156]
[" 2201947","INHIBIN A XTRA OR QUAD","LAB",300,"86336",null,null,156]
[" 2202633","ANA W/ REFLEX (ANAlyzer)","LAB",300,"86038",null,null,156]
[" 2202671","ESTRADIOL","LAB",300,"82670",null,null,156]
[" 2202798","MERCURY  URINE","LAB",300,"83825",null,null,156]
[" 2203158","Q FEVER ANTIBODY  IGG","LAB",300,"86638",null,null,156]
[" 2203609","PSA FREE CHARGE","LAB",300,"84154",null,null,157]
[" 2203853","PCP CONFIRMATION  UR","LAB",300,"83992",null,null,157]
[" 2205612","COMPLEMENT TOTAL SERUM","LAB",300,"86162",null,null,157]
[" 2206403","CLOSTRIDIUM DIFFICILE","LAB",300,"87324",null,null,159]
[" 2204231","DHEA SULFATE","LAB",300,"82627",null,null,161]
[" 2204585","VANILLYLMANDELIC ACID","LAB",300,"84585",null,null,161]
[" 2204711","ANTITHROMBIN ACTIVITY","LAB",300,"85300",null,null,161]
[" 2205107","MYCOBACTERIAL CULTURE","LAB",300,"87116",null,null,161]
[" 2205247","VON WILLEBRAND FACTOR MULTIMER","LAB",300,"85247",null,null,161]
[" 2205300","ANTITHROMBIN III","LAB",300,"85300",null,null,161]
[" 2205336","MYCOBACTERIAL CULTURE  BLOOD","LAB",300,"87116",null,null,161]
[" 2209835","AT ACTIVITY","LAB",300,"85300",null,null,161]
[" 2282017","ACYLCARNITINES QUANTITATIVE PLASMA","LAB",300,"82017",null,null,161]
[" 2202704","HISTONE ANTIBODY IGG","LAB",300,"83516",null,null,162]
[" 2201801","CERULOPLASMIN","LAB",300,"82390",null,null,163]
[" 2205604","EHRLICHIA CHAFFEENSIS AB  IGG","LAB",300,"86666",null,null,163]
[" 2205605","ANAPLASMA PHAGOCYTOPHILUM AB","LAB",300,"86666",null,null,163]
[" 2200272","CKMB ISOENZYMES","LAB",300,"82553",null,null,164]
[" 2201960","THYROTROPIN RECEPTOR AB","LAB",300,"83520",null,null,164]
[" 2202727","ESTRADIOL (E2)  SERUM (DON'T ORDER)","LAB",300,"82670",null,null,164]
[" 2203320","OTHER THAN INFECTIOUS AGENT AN","LAB",300,"83520",null,null,164]
[" 2203394","TRYPTASE  SERUM","LAB",300,"83520",null,null,164]
[" 2203916","STRIATIONAL ANTIBODIES","LAB",300,"83520",null,null,164]
[" 2205567",".FUNGAL ANTIBODIES BY ID CHARGE","LAB",300,null,null,null,164]
[" 2203605","LACTIC ACID","LAB",300,"83605",null,null,165]
[" 2202175",".ARSENIC HEAVY METAL CHARGE","LAB",300,"82175",null,null,166]
[" 2202300",".CADMIUM HEAVY METAL CHARGE","LAB",300,"82300",null,null,166]
[" 2202301",".LEAD HEAVY METAL CHARGE","LAB",300,"83655",null,null,166]
[" 2202644","ORGANIC ACIDS URINE","LAB",300,"83919",null,null,167]
[" 2202825",".MERCURY HEAVY METAL CHARGE","LAB",300,"83825",null,null,167]
[" 2203690","LIPASE","LAB",300,"83690",null,null,167]
[" 2203691","DAILY LIPASE","LAB",300,"83690",null,null,167]
[" 2204694","ECHINOCOCCUS ANTIBODY (IGG)  E","LAB",300,"86682",null,null,167]
[" 2204403","TESTOSTERONE TOTAL MALE ONLY","LAB",300,"84403",null,null,169]
[" 2207086","ANTIBODY ABSORPTION","LAB",300,"86978",null,null,169]
[" 2200319","COVID19 PCR PRE OP","LAB",300,"U0003",null,null,170]
[" 2201939","(DON'T ORDER)LYME ANTIBODIES W/REFLEX","LAB",300,"86618",null,null,170]
[" 2200024","VANCOMYCIN RANDOM","LAB",300,"80202",null,null,171]
[" 2200026","VANCOMYCIN TROUGH","LAB",300,"80202",null,null,171]
[" 2202534","CORTISOL FREE 24 HOUR URINE","LAB",300,"82530",null,null,172]
[" 2203373","CORTISOL  SALIVA","LAB",300,"82530",null,null,172]
[" 2203789","HGB VARIANT BY MS, BLOOD CHARGE","LAB",300,"83021",null,null,172]
[" 2203991","CORTISOL FREE RANDOM URINE","LAB",300,"82530",null,null,172]
[" 2209847","CORTISOL FREE","LAB",300,"82530",null,null,172]
[" 2202056","ETHANOL","LAB",300,"80320",null,null,173]
[" 2202057","DAILY ETHANOL","LAB",300,"80320",null,null,173]
[" 2200760","RIBOFLAVIN  VITAMIN B2","LAB",300,"84252",null,null,174]
[" 2201747","LUTEINIZING HORMONE","LAB",300,"83002",null,null,174]
[" 2201799","CA 19-9","LAB",300,"86301",null,null,174]
[" 2202157","ANDROSTENEDIONE, SERUM","LAB",300,"82157",null,null,174]
[" 2203274","NICOTINE AND METABOLITES SERUM","LAB",300,"80323",null,null,174]
[" 2203498","17-HYDROXYPROGESTERONE","LAB",300,"83498",null,null,174]
[" 2201448","D-DIMER","LAB",300,"85378",null,null,175]
[" 2203883","C1 ESTERASE INHIBITOR ANTIGEN","LAB",300,"83883",null,null,175]
[" 2203520","ANTI-SLA","LAB",300,"83520",null,null,177]
[" 2201870","H PYLORI BREATH TEST","LAB",300,"83013",null,null,178]
[" 2202941","GASTRIN SERUM","LAB",300,"82941",null,null,178]
[" 2202525","COPPER  SERUM","LAB",300,"82525",null,null,179]
[" 2203584","COAGULATION FACTOR II ACTIVITY","LAB",300,"85210",null,null,179]
[" 2200937","CMP","LAB",300,"80053",null,null,180]
[" 2200941","DAILY CMP","LAB",300,"80053",null,null,180]
[" 2202432","TESTOSTERONE FREE","LAB",300,"84402",null,null,180]
[" 2205305","PHOSPHOLIPID ABS (CARDIOLIPIN) IGA","LAB",300,"86147",null,null,180]
[" 2205550","GABAPENTIN UR","LAB",300,"80307",null,null,180]
[" 2202020","HYPOGLYCEMIS AGENT SERUM","LAB",300,"80307",null,null,181]
[" 2202725","ESTROGENS  FRACTIONATED","LAB",300,null,null,null,181]
[" 2204693","MANGANESE","LAB",300,"83785",null,null,181]
[" 2200938","HEPATIC FUNCTION PANEL","LAB",300,"80076",null,null,182]
[" 2205007","EPO","LAB",300,"82668",null,null,182]
[" 2204244","RENIN ACTIVITY","LAB",300,"84244",null,null,183]
[" 2202736","CYCLOSPORINE","LAB",300,"80158",null,null,184]
[" 2206687","HTLV1 & 2 ANTIBODIES, SERUM","LAB",300,"86790",null,null,184]
[" 2204162","SELENIUM","LAB",300,"84255",null,null,188]
[" 2204581","DRVVT MIX & CONFIRM CHARGE","LAB",300,"85613",null,null,188]
[" 2206404","C DIFF TOXIN BY PCR","LAB",300,"87493",null,null,188]
[" 2202386","CAARBAMAZEPINE-10  11-EPOXIDE","LAB",300,"80299",null,null,189]
[" 2203007","MONOCLONAL IMMUNOFIXATION","LAB",300,"86335",null,null,189]
[" 2204311","PORPHYRINS, TOTAL PLASMA","LAB",300,"84311",null,null,190]
[" 2205729","HSV 1&2 PCR (SOURCE VARIES)","LAB",300,"87529",null,null,192]
[" 2201846","TISSUE CULT INOCULATION","LAB",300,"87252",null,null,194]
[" 2203389","PCA  TPYE2","LAB",300,"83519",null,null,194]
[" 2203390","N-TYPE CA CHANNEL AB","LAB",300,"83519",null,null,194]
[" 2203391","ACHR BINDING ANTIBODY","LAB",300,"83519",null,null,194]
[" 2203392","ACHR GANGLIONIC NEURO AB","LAB",300,"83519",null,null,194]
[" 2203667","VIRAL CULTURE  RESPIRATORY TIS","LAB",300,"87252",null,null,194]
[" 2204782","NEURONAL VGKC AUTO-AB","LAB",300,"83519",null,null,194]
[" 2207252","VIRAL CULTURE NON RESPIRATORY","LAB",300,"87252",null,null,194]
[" 2202732","VITAMIN D  25 HYDROXY","LAB",300,"82306",null,null,195]
[" 2201592","ACTIVATED PROTEIN C RESISTANCE","LAB",300,"85307",null,null,196]
[" 2202625","T3 FREE","LAB",300,"84481",null,null,196]
[" 2203625","LDH ISOENZYME CHARGE","LAB",300,"83625",null,null,196]
[" 2206165","C1 Q COMPLEMENT FUNCTIONAL","LAB",300,"86161",null,null,196]
[" 2203695","HANTAVIRUS AB IGG ELISA","LAB",300,"86790",null,null,197]
[" 2203696","HANTAVIRUS AB IGM ELISA","LAB",300,"86790",null,null,197]
[" 2202531","NEWBORN ADRENAL HYPERPLAS","LAB",300,"83498",null,null,199]
[" 2209845","11 BETA PROSTAGLANDIN F2 ALPHA","LAB",300,"84150",null,null,199]
[" 2203462","ARGININE VASOPRESSIN HORMONE","LAB",300,"84588",null,null,201]
[" 2200277","CATECHOLAMINES  PLASMA","LAB",300,"82384",null,null,202]
[" 2201445","TEST DRUG SCREEN-NO ORDER","LAB",300,"80305",null,null,202]
[" 2200212",".TROPONIN I (Q6)-DISCONTINUED","LAB",300,"84484",null,null,203]
["22023520","INTERLEUKIN 6, PLASMA","LAB",300,"83520",null,null,203]
[" 2202627","HOMOCYSTEINE PLASMA","LAB",300,"83090",null,null,204]
[" 2201875","H PYLORI W/ CLARITHROMYCIN STOOL PCR","LAB",300,"87798",null,null,205]
[" 2203669","PAROXETINE SERUM","LAB",300,"80299",null,null,205]
[" 2203881","AMIODARONE SERUM","LAB",300,"80299",null,null,205]
[" 2200058","PROTEIN C ACTIVITY","LAB",300,"85303",null,null,207]
[" 2203144","PROINSULIN PLASMA","LAB",300,"84206",null,null,207]
[" 2205268","HOMOCYSTEINE SERUM","LAB",300,"83090",null,null,207]
[" 2209828","PROTEIN C ACTIVITY CHARGE","LAB",300,"85303",null,null,207]
[" 2202717","CHLAMYDIA/GC BY AMP DNA","LAB",300,null,null,null,209]
[" 2202751","CITRATE 24 HR URINE","LAB",300,"82507",null,null,209]
[" 2206356","CD20 ON B CELLS","LAB",300,"86356",null,null,209]
[" 2282180","VITAMIN C PLASMA","LAB",300,"82180",null,null,210]
[" 2205607","LYME DISEASE SEROLOGY","LAB",300,"86618",null,null,211]
[" 2206980",".RESPIRATORY VIRUSES DFA","LAB",300,null,null,null,211]
[" 2202617","GLOMERULAR BASEMENT MEMBRANE IgG AB","LAB",300,"82951",null,null,212]
[" 2202634","IGF BINDING PROTEIN 3","LAB",300,"84305",null,null,212]
[" 2201903","FLECAINIDE","LAB",300,"80299",null,null,213]
[" 2202003","ACETAMINOPHEN","LAB",300,"80329",null,null,213]
[" 2202891","ARTERIAL BLOOD GAS","LAB",300,"82803",null,null,213]
[" 2202900","VENOUS BLOOD GAS","LAB",300,"82803",null,null,213]
[" 2202901","VENOUS BLOOD GAS i-STAT","LAB",300,"82803",null,null,213]
[" 2202902","ARTERIAL BLOOD GAS i-STAT","LAB",300,"82803",null,null,213]
[" 2203071","AMIODARONE","LAB",300,"80299",null,null,213]
[" 2203010","HAPTOGLOBIN","LAB",300,"83010",null,null,214]
[" 2203884","C1 ESTERASE INHIBITOR FUNCTIONAL ASSAY","LAB",300,"83520",null,null,215]
[" 2202435","TESTOSTERONE FEMALE/CHILD","LAB",300,"84403",null,null,218]
["22082600","CYANIDE WHOLE BLOOD","LAB",300,"82600",null,null,218]
[" 2200211","iSTAT TROPONIN I","LAB",300,"84484",null,null,219]
[" 2200308","ETHYL GLUCURONIDE, URINE","LAB",300,"80307",null,null,220]
[" 2201444","URINE DRUG SCREEN","LAB",300,"80305",null,null,220]
[" 2202955","GLUCOSE 6 PHOSPHATE DEHYDROGENASE","LAB",300,"82955",null,null,220]
["22084446","VITAMIN E SERUM","LAB",300,"84446",null,null,220]
["22084484","TROPONIN HIGH SENSITIVITY","LAB",300,"84484",null,null,220]
[" 2207385","INFECTIOUS AGENT ANTIGEN DETEC","LAB",300,"87385",null,null,221]
[" 2206769","SARS-CoV2, SPIKE AB, SEMI QUANT","LAB",300,"86769",null,null,223]
[" 2206770","SARS COV2 TOTAL ANTIBODY","LAB",300,"86769",null,null,223]
[" 2200571","FACTOR V LEIDEN (R506Q) MUTATI","LAB",300,"81241",null,null,224]
[" 2201732","DHEA","LAB",300,"82626",null,null,224]
[" 2201811","TACROLIMUS","LAB",300,"80197",null,null,225]
[" 2206235","EX NUCLEAR AG AB METHOD ADD ON CHARG","LAB",300,"86235",null,null,225]
[" 2282379","CARNITINE PLASMA","LAB",300,"82379",null,null,225]
[" 2201901","SEROTONIN SERUM","LAB",300,"84260",null,null,226]
[" 2203516","ANTI- LC1","LAB",300,"86376",null,null,226]
[" 2205335","ALK PHOS TOTAL & ISOENZYMES","LAB",300,"84080",null,null,226]
[" 2200278","CATECHOLAMINES UR FREE","LAB",300,"82384",null,null,227]
[" 2204714","ACT PROTEIN RESISTANCE","LAB",300,"85307",null,null,227]
[" 2201673","ISLET CELL ANTIBODY  IGG SERUM","LAB",300,"86341",null,null,228]
[" 2202650","FECAL FAT RANDOM","LAB",300,"82705",null,null,228]
[" 2205551","FENTANYL SCREEN, URINE","LAB",300,"80307",null,null,228]
[" 2206337","INSULIN ANTIBODIES SERUM","LAB",300,"86337",null,null,228]
[" 2206341","ISLET ANTIGEN 2 (IA-2) ANTIBODY SERUM","LAB",300,"86341",null,null,228]
[" 2206342","GLUTAMIC ACID DECARBOXYLASE AB ASSAY","LAB",300,"86341",null,null,228]
[" 2204429","LEVETIRACETAM  SERUM","LAB",300,"80299",null,null,229]
[" 2204544","ABSOLUTE CD4/CD8","LAB",300,"86360",null,null,229]
[" 2202983","METANEPHRINES  24HR URINE","LAB",300,"83835",null,null,232]
[" 2209829","PROTEIN S ANTIGEN FREE","LAB",300,"85306",null,null,232]
[" 2209830","ACTIVATED PROTEIN RESISTANCE","LAB",300,"85307",null,null,232]
[" 2210059","T3 REVERSE (REVERSE T3)","LAB",300,"84482",null,null,234]
[" 2204436","TOPIRAMATE SERUM","LAB",300,"80201",null,null,236]
[" 2205502","LEGIONELLA GUAN","LAB",300,"87798",null,null,236]
[" 2203196","FRANCISELLA TULARENSIS B","LAB",300,"86000",null,null,240]
[" 2203845","VITAMIN B1  PLASMA","LAB",300,"84425",null,null,240]
[" 2209851",".IGE ASSAY","LAB",300,null,null,null,240]
[" 2202614","ENDOMYSIAL AB  IGA SERUM","LAB",300,"86256",null,null,241]
[" 2208205","IMMUNOFIXATION (OBSELETE) ORDER MALD","LAB",300,"86334",null,null,241]
[" 2208206","M-PROTEIN ISOTYPE MALDI-TOF-MS","LAB",300,"86334",null,null,241]
[" 2202899","PROTEIN C ANTIGEN","LAB",300,"85302",null,null,244]
[" 2204757","PARATHYROID HORMONE, INTACT","LAB",300,"83970",null,null,244]
["22086255","FLOURESENT AB SCREEN CHARGE","LAB",300,"86255",null,null,244]
[" 2202089","ALDOSTERONE URINE","LAB",300,"82088",null,null,245]
[" 2202051","FACTOR V ACTIVITY","LAB",300,"85220",null,null,246]
[" 2200032","HLA TYPING A B C","LAB",300,"86812",null,null,247]
[" 2206812","HLA B27 BLOOD","LAB",300,"86812",null,null,247]
[" 2203579","CYSTINE QUANTITATIVE URINE","LAB",300,"82131",null,null,248]
[" 2204528","COAG FACTOR VII ASSAY","LAB",300,"85230",null,null,249]
[" 2204001","QUANTIFERON-TB GOLD","LAB",300,"86480",null,null,250]
[" 2286671","ANTI-SACCHAROMYCES ABS","LAB",300,"86671",null,null,250]
[" 2200307","PAIN CLINIC DRUG SCREEN URINE","LAB",300,"80307",null,null,257]
[" 2203104","REDUCING SUBSTANCE FECES","LAB",300,"84376",null,null,257]
[" 2203192","FRANCISELLA TULARENSIS AB IGM & IGG ELIS","LAB",300,"86000",null,null,257]
[" 2202024","ACTH","LAB",300,"82024",null,null,265]
[" 2202643","VON WILLEBRAND FACTOR ANTIGEN","LAB",300,"85246",null,null,266]
[" 2202792","CELIAC ASSOCIATED HLA-DQ ALPHA","LAB",300,"81376",null,null,268]
[" 2202794","CELIAC ASSOCIATED HLA DQ BETA","LAB",300,"81376",null,null,268]
[" 2204259","REPTILASE PLASMA","LAB",300,"85635",null,null,268]
[" 2207798","VARICELLA ZOSTER VIRUS, PCR","LAB",300,"87798",null,null,268]
[" 2200180","MYCOPHENOLATE","LAB",300,"80180",null,null,268.02999999999997]
[" 2203398","BK VIRUS DNA BY RAPID PCR","LAB",300,"87799",null,null,270]
[" 2207799","JC POLYOMA VIRUS DNA QN PCR","LAB",300,"87799",null,null,270]
[" 2209817","HISTAMINE PLASMA","LAB",300,"83088",null,null,271]
[" 2201973","TSH RECEPTOR ANTIBODIES","LAB",300,"83519",null,null,278]
[" 2203012","ACH RECEPTOR (MUSCLE) BINDING ANTIBODY","LAB",300,"83519",null,null,278]
[" 2203014","ACH RECEPTOR 9MUSCLE0 MODULATI","LAB",300,"83519",null,null,278]
[" 2203018","ACHR GANGLIONIC NEURONAL AB S","LAB",300,"83519",null,null,278]
[" 2203020","NEURONAL K+ CHANNEL AB  S","LAB",300,"83519",null,null,278]
[" 2203315","ACH RECEPTOR (MUSCLE) BINDING","LAB",300,"83519",null,null,278]
[" 2203318","ACH RECEPTOR MUSCLE MODULATING AB","LAB",300,"83519",null,null,278]
[" 2201877","PROTEIN S ACTIVITY","LAB",300,"85306",null,null,281]
[" 2203021","HPLC HB VARIANT CHARGE","LAB",300,"83021",null,null,285]
[" 2209991","ETHONAL CONF UR","LAB",300,"80320",null,null,291]
[" 2209850","MYELOPEROXIDASE ANTIBODIES","LAB",300,"83516",null,null,292]
[" 2204141","PREGNENOLONE","LAB",300,"84140",null,null,294]
[" 2203876","LAMOTRIGINE(DON'T ORDER)","LAB",300,"80299",null,null,295]
[" 2204235","INSULIN-LIKE GROWTH FACTOR-1 MS","LAB",300,"84305",null,null,295]
[" 2203544","ADOMPS 13 INHIBITOR","LAB",300,"83540",null,null,304]
[" 2205608","TICK-BORNE PANEL PCR","LAB",300,"87798",null,null,305]
[" 2202499","OXYCODONE CONFIRM URINE","LAB",300,"80365",null,null,306]
[" 2203404","S. CEREVISIAE AB IGG","LAB",300,"86671",null,null,307]
[" 2282542","FATTY ACID PROFILE SERUM ESSENTIAL","LAB",300,"82542",null,null,307]
[" 2202092","NEWBORN PHENYLALANINE","LAB",300,"84030",null,null,309]
[" 2202088","ALDOSTERONE  SERUM","LAB",300,"82088",null,null,311]
[" 2209849","AEROBE ID BY SEQUENCING","LAB",300,"87153",null,null,312]
[" 2283520","INSULIN-LIKE GF BP-3","LAB",300,"83520",null,null,323.75]
["22008352","FLOURESCENT AB TITER CHARGE","LAB",300,"83520",null,null,324]
[" 2200580","MTHFR C677T MUTATION","LAB",300,"81291",null,null,325]
[" 2207428","COVID SARS ANTIGEN & FLU A&B","LAB",300,"87428",null,null,325]
[" 2202437",".BORDETELLA PCR","LAB",300,"87801",null,null,326]
[" 2204646","HISTOPLASMA AG URINE","LAB",300,"87385",null,null,327]
[" 2207430","HISTOPLASMA ANTIBODY SERUM","LAB",300,"87385",null,null,327]
[" 2200940","ACUTE HEPATITIS PANEL","LAB",300,"80074",null,null,337]
[" 2201842","METHYLMALONIC ACID SERUM","LAB",300,"83921",null,null,337]
[" 2202801","METHYLMALONIC ACID URINE","LAB",300,"83921",null,null,337]
[" 2202126","ZONISAMIDE","LAB",300,"80299",null,null,345]
[" 2207004","TESTOSTERONE FREE/TOTAL","LAB",300,"84403",null,null,345]
[" 2202652","VITAMIN D 1 25 DIHYDROXY","LAB",300,"82652",null,null,346]
[" 2203519","21-HYDROXYLASE ANTIBODIES","LAB",300,"83519",null,null,348]
[" 2202701","PHOSPHOLIPASE A2 RECEPTOR IFA CHARGE","LAB",300,"83520",null,null,353]
[" 2202702","PHOSPHOLIPASE A2 RECEPTOR ELISA CHARGE","LAB",300,"86255",null,null,353]
[" 2202520","SIROLIMUS (RAPAMUNE)","LAB",300,"80195",null,null,362]
[" 2200995","TRILEPTAL (OXCARBAZEPINE)","LAB",300,"80299",null,null,363]
[" 2202542","BILE ACID PROFILE SERUM","LAB",300,"82542",null,null,366]
[" 2204634",".VITAMIN B 6  PYRIDOXIC ACID","LAB",300,"82542",null,null,366]
["22083520","ANTIMULLERIAN HORMONE SERUM","LAB",300,"83520",null,null,370]
[" 2202080","ALDOSTERONE W/SODIUM 24HR U","LAB",300,"82088",null,null,381]
[" 2204803","PANCREATIC ELASTASE STOOL","LAB",300,"82656",null,null,382]
["  220020","ERYTHROCYTOSIS INTERP & HGB CHARGE","LAB",300,"83020",null,null,392]
[" 2205241","FACTOR VIII ACTIVITY ASSAY","LAB",300,"85240",null,null,393]
[" 2203611","NOROVIRUS G1 PCR","LAB",300,"87798",null,null,403]
[" 2203612","NOROVIRUS G2 PCR","LAB",300,"87798",null,null,403]
[" 2204593","CALPROTECTIN FECES","LAB",300,"83993",null,null,409]
[" 2202535","COSYNTROPIN STIMULATION TEST","LAB",300,"82533",null,null,410]
[" 2202596","FIBRO-TEST-ACTITEST, SERUM","LAB",300,"81596",null,null,422]
[" 2204445","THYROID STIMULATING IMMUNOGLOBULIN","LAB",300,"84445",null,null,426]
[" 2207006","BETA 2 GLYCOPROTEIN IGA","LAB",300,"86146",null,null,434]
[" 2209819","LEUKMS 2-8 MARKERS","LAB",300,"88187",null,null,437]
[" 2209820","LEUKMS 9-15 MARKERS","LAB",300,"88188",null,null,437]
[" 2209821","LEUKMS 16 OR MORE MARKERS","LAB",300,"88189",null,null,437]
[" 2209827","F2 GENE ANAYSIS","LAB",300,"81240",null,null,440]
[" 2200582","PROTHROMBIN G20210A MUTATION ARUP","LAB",300,"81240",null,null,448]
[" 2202646","AMINO ACIDS  QUAN","LAB",300,"82139",null,null,457]
[" 2200030","QUAD SCREEN","LAB",300,"81511",null,null,461]
[" 2200240","FACTOR X ACTIVITY, CHRROMOGENIC","LAB",300,"85260",null,null,463]
[" 2200015","BNP iSTAT","LAB",300,"83880",null,null,464]
[" 2282172","APOLIPOROTEIN B, SERUM","LAB",300,"82172",null,null,472.5]
[" 2200770","PROTEIN ISOTYPE MALDI-TOF","LAB",300,"0077U",null,null,473]
[" 2209843","ALLERGEN PED PROGRESSION PROFILE","LAB",300,"86003",null,null,483]
[" 2202622","BNP","LAB",300,"83880",null,null,500]
[" 2203086","CMV DNA QUANT RAPID PCR","LAB",300,"87497",null,null,505]
[" 2200222","HCV RNA QUANT PCR","LAB",300,"87522",null,null,531]
[" 2200223","HCV RNA QUANT PCR W/ RFX TO GENOTYPE","LAB",300,"87522",null,null,531]
[" 2200225","HEP C VIRAL","LAB",300,"87521",null,null,536]
[" 2201714","METANEPHRINES FRACTIONATED,FREE,PLASMA","LAB",300,"83835",null,null,540]
[" 2202533","HEMOCHROMATOSIS HFE GENE","LAB",300,"81256",null,null,548]
[" 2203378","PARANEOPLASTIC ANTIBODIES","LAB",300,null,null,null,603]
[" 2201805","FFRWB FRIEDREICH ATAXIA  TRATE","LAB",300,"83520",null,null,606]
[" 2209842","REGION 9","LAB",300,"86003",null,null,624]
[" 2281207",".BRCA/ABL MINOR CHRG","LAB",300,"81207",null,null,665]
[" 2204873","RESPIRATORY PROFILE  REGION 9","LAB",300,null,null,null,681]
[" 2204990","HEPATITIS C VIRUS GENOTYPING","LAB",300,"87902",null,null,742]
[" 2205470","RESP VIRUS 12-25 TARGETS","LAB",300,"87633",null,null,776]
[" 2205562","GI PATHOGEN PANEL","LAB",300,"87507",null,null,781]
["22081206",".BCR/ABL MAJOR CHRG","LAB",300,"81206",null,null,835]
[" 2281376","HLA-DQB1 NARCOLEPSY ASSOCIATED AG","LAB",300,"81376",null,null,836.5]
[" 2204304","JAK2 GENE V617F (ABN)","LAB",300,"81270",null,null,843]
[" 2204305","POLYCYTHEMIA VERA JAK2 V617F W/ REFLEX","LAB",300,"81270",null,null,843]
[" 2204750","CYTOCHROME P4502D6 COMPREHENSIVE CASCADE","LAB",300,"0070U",null,null,862]
[" 2209816","KIT ASP816VAL MUTATION","LAB",300,"81402",null,null,904]
[" 2203920","MUSCLE-SPECIFIC KINASE AUTOANI","LAB",300,"83519",null,null,966]
[" 2203319","MUSK AUTOANTIBODY","LAB",300,"83519",null,null,972]
[" 2201219","MYELOPROLIFERATIVE NEOPLASM CHARGE","LAB",300,"81219",null,null,1041]
[" 2205469","RESPIRATORY PANEL BIOFIRE W/ SARS CoV-2","LAB",300,"0202U",null,null,1126]
[" 2281227","CYTOCHROME P450 2C9 GENPTYPE","LAB",300,"81227",null,null,1284]
[" 2201380","HLA B HIGH RESOLUTION","LAB",300,"81380",null,null,1667]
[" 2281404","CARNITINE FULL GENE ANALYSIS","LAB",300,"81404",null,null,1667]
[" 2281208",".BCR/ABL OTHER CHRG","LAB",300,"81208",null,null,2140]
[" 2206000","BRCA1/BRCA2 GENES, FULL ANALYSIS","LAB",300,"81206",null,null,2424]
[" 2201803","MITOP MITROCHANDRAL FULL GENOM","LAB",300,"81460",null,null,2940]
[" 2201807","SNCA ALPHA SYNUCLEIN DNA SEQUE","LAB",300,"81479",null,null,3524]
[" 2203114","TISSUE TRANSGLUTAMINASE IGG","LAB",301,"83516",null,null,149]
[" 2203295","METHADONE CONFIRMATION URINE","LAB",301,"80358",null,null,210]
[" 2306100","BB RH TYPE","LAB",302,"86901",null,null,54]
[" 2206405","RPR","LAB",302,"86592",null,null,55]
[" 2306080","BB ABO GROUP TYPE","LAB",302,"86900",null,null,57]
[" 2205998","RUBELLA","LAB",302,"86762",null,null,75]
[" 2206422","ANTIGEN TYPING ON UNITS","LAB",302,null,null,null,80]
[" 2200579","HIV (OBSELETE) HIV 1/2 RAPID SCREEN","LAB",302,"86701",null,null,86]
[" 2206300","MONOSPOT","LAB",302,"86308",null,null,86]
[" 2206040","DNA DOUBLE STRANDED","LAB",302,"86225",null,null,88]
[" 2206666","EBV AB CAPSID AN  IGM","LAB",302,"86665",null,null,93]
[" 2200924","HIV1/HIV2 ABS COMBO","LAB",302,"86703",null,null,97]
[" 2200925","HIV COMBO","LAB",302,"86703",null,null,97]
[" 2306020","BB ANTIBODY SCREEN","LAB",302,"86850",null,null,97]
[" 2206274","EBV IGG AB VIR CAPSID AG","LAB",302,"86665",null,null,100]
[" 2206665","EBV IGM AB VIR CAPSID AG","LAB",302,"86665",null,null,100]
[" 2206664","EBV AB TO NUCLEAR AG  IGG","LAB",302,"86664",null,null,106]
[" 2208182","HERPES SIMPLEX 1 IGG","LAB",302,"86695",null,null,106]
[" 2206264","RUBEOLA (MEASLES) IGG ABS","LAB",302,"86765",null,null,107]
[" 2201733","HEPATITIS C ANTIBODY","LAB",302,"86803",null,null,116]
[" 2204624","AB; HISTOPLASMA","LAB",302,"86698",null,null,124]
[" 2201739","B-2 GLYCOPROTEIN IGG","LAB",302,"86146",null,null,129]
[" 2201740","B-2 GLYCOPROTEIN IGA","LAB",302,"86146",null,null,129]
[" 2201741","B-2 GLYCOPROTEIN IGM","LAB",302,"86146",null,null,129]
[" 2206267","VARICELLA ZOSTER  IGG","LAB",302,"86787",null,null,134]
[" 2206323","VARICELLA ZOSTER  IGM","LAB",302,"86787",null,null,134]
[" 2286300","CA 15-3, SERUM","LAB",302,"86300",null,null,144]
[" 2300911","BB CROSSMATCH IMMED SPIN","LAB",302,"86920",null,null,152]
[" 2206311","PATIENT ANTIGEN","LAB",302,"86905",null,null,158]
[" 2206182","ANTIBODY IDENTIFICATION","LAB",302,"86870",null,null,162]
[" 2208225","ACLIP PHOSPHOLIPID ANTIBODIE I","LAB",302,"86147",null,null,166]
[" 2206148","CARDIOLIPIN IGM ABS","LAB",302,"86147",null,null,168]
[" 2206147","PHOSPHOLIPID (CARDIOLIPIN) IGG ANTIBODY","LAB",302,"86147",null,null,180]
[" 2206209","CA 27.29","LAB",302,"86300",null,null,183]
[" 2300982","BB FFP-THAWING UNIT","LAB",302,"86927",null,null,202]
[" 2201598","ANTIPH SYND PHOS/SER IGA","LAB",302,"86148",null,null,203]
[" 2201599","ANTIPH SYND PHOS/SER IGG","LAB",302,"86148",null,null,203]
[" 2201600","ANTIPH SYND PHOS/SER IGM","LAB",302,"86148",null,null,203]
[" 2300913","BB CROSSMATCH ALL PHASES","LAB",302,"86922",null,null,391]
[" 4400031","CL HEMOGLOBIN","LAB",305,"85018",null,null,36]
[" 2205017","HEMOGLOBIN","LAB",305,"85018",null,null,40]
[" 2205020","HEMATOCRIT","LAB",305,"85014",null,null,40]
[" 2205048","WBC","LAB",305,"85048",null,null,42]
[" 2201441","ERYTHROCYTE SEDIMENTATION RATE","LAB",305,"85651",null,null,65]
[" 2205611","DAILY PT/INR","LAB",305,"85610",null,null,67]
[" 2205610","PT/INR","LAB",305,"85610",null,null,70]
[" 2200736","RETICULOCYTE COUNT","LAB",305,"85045",null,null,78]
[" 2205730","PTT","LAB",305,"85730",null,null,91]
[" 2205015","CBC W/O DIFF","LAB",305,"85027",null,null,115]
[" 2205016","DAILY CBC W/O DIFF","LAB",305,"85027",null,null,115]
[" 2205028","CBC W/DIFF","LAB",305,"85025",null,null,115]
[" 2205029","DAILY CBC W/DIFF","LAB",305,"85025",null,null,115]
[" 2201597","ANTIPH SYND LUP ANTICOAG","LAB",305,"85613",null,null,203]
[" 2205460","FETAL SCREEN","LAB",305,"85461",null,null,264]
[" 2206317","STREP PNEUMO ANTIBODIES","LAB",305,"86317",null,null,289]
[" 2203937","SS CALCIUM 24 HR","LAB",306,"82340",null,null,22]
[" 2203938","SS CHLORIDE 24 HR","LAB",306,"82436",null,null,22]
[" 2203940","SS CITRATE EXCRETION 24 HR","LAB",306,"82507",null,null,22]
[" 2203941","SS CREATININE 24 HR","LAB",306,"82570",null,null,22]
[" 2203942","SS MAGNESIUM 24 HR","LAB",306,"83735",null,null,22]
[" 2203943","SS OSMOLALITY 24 HR","LAB",306,"83935",null,null,22]
[" 2203945","SS PH URINE24 HR","LAB",306,"83986",null,null,22]
[" 2203946","SS PHOS 24 HR","LAB",306,"84105",null,null,22]
[" 2203947","SS POTASSIUM 24 HR","LAB",306,"84133",null,null,22]
[" 2203948","SS SODIUM 24 HR","LAB",306,"84300",null,null,22]
[" 2203949","SS SULFATE 24 HR","LAB",306,"84392",null,null,22]
[" 2203950","SS URIC ACID24 HR","LAB",306,"84560",null,null,22]
[" 2203951","SS AMMONIUM 24 HR","LAB",306,"82140",null,null,22]
[" 2203952","SS UEAN NITROGEN 24 HR","LAB",306,"84540",null,null,22]
[" 2203953","SS OXALATE 24 HR","LAB",306,"83945",null,null,22]
["22087811","CL COVID RAPID ANTIGEN QUICK VIEW","LAB",306,"87811",null,null,30]
[" 4400029","CL HEMATEST X 1","LAB",306,"82272",null,null,33]
[" 2207208","PINWORM TEST","LAB",306,"87172",null,null,44]
[" 2207220","KOH PREP","LAB",306,"87220",null,null,52]
[" 4400033","CL SEDIMENTATION RATE","LAB",306,"85651",null,null,54]
[" 2207010","GRAM STAIN","LAB",306,"87205",null,null,57]
[" 2207211","WET PREP GENITAL ONLY","LAB",306,"87210",null,null,59]
[" 2207367","CULTURE  STOOL EA ADD'L P","LAB",306,"87046",null,null,67]
[" 2207355","GROUP B SCREEN","LAB",306,"87081",null,null,73]
[" 2207356","CULTURE STREP SCR THROAT","LAB",306,"87081",null,null,73]
[" 2207357","GC CULTURE","LAB",306,"87081",null,null,73]
[" 2207360","CULTURE YEAST SCREEN","LAB",306,"87081",null,null,73]
[" 2207363","E COLI 0157 SCREEN","LAB",306,"87081",null,null,73]
[" 2207364","CAMPYLOBACTER ONLY","LAB",306,"87081",null,null,73]
[" 2207377","CULT CONFIRM-RAPID STRP","LAB",306,"87081",null,null,73]
[" 2207389","CULTURE  MRSA SCREEN ONLY","LAB",306,"87081",null,null,73]
[" 2200824","ID-AEROBIC UR","LAB",306,"87077",null,null,82]
[" 2200825","ID-AEROBIC ROUTINE","LAB",306,"87076",null,null,82]
[" 2200830","BC-AEROBIC-ADDLT ID  MANUAL","LAB",306,"87077",null,null,82]
[" 2207206","AFB SMEAR","LAB",306,"87206",null,null,87]
[" 2207359","CULT SETUP URN ORG ID ONL","LAB",306,"87088",null,null,90]
[" 4400034","CL STREP, GROUP A RAPID","LAB",306,"87430",null,null,90]
[" 2200826","ID VITEK ANAEROBE CHARGE","LAB",306,"87076",null,null,93]
[" 2207348","URINE CULTURE","LAB",306,"87086",null,null,95]
[" 2200802","SENSITIVITY  KIRBY BAUER","LAB",306,"87184",null,null,97]
[" 2206001","HEPATITIS B SURF ANTIGEN","LAB",306,"87340",null,null,102]
[" 2207083","STREP  GROUP A RAPID","LAB",306,"87430",null,null,104]
[" 2200803","SENSITIVITY  MIC CHARGE","LAB",306,"87186",null,null,110]
[" 2207370","STOOL CULTURE","LAB",306,"87045",null,null,111]
[" 2207327","ABSCESS CULTURE","LAB",306,"87070",null,null,112]
[" 2207329","CULTURE  BILE","LAB",306,"87070",null,null,112]
[" 2207332","BODY FLUID CULTURE","LAB",306,"87070",null,null,112]
[" 2207333","CULTURE  BONE MARROW/BACT","LAB",306,"87070",null,null,112]
[" 2207335","CSF CULTURE","LAB",306,"87070",null,null,112]
[" 2207337","EAR CULTURE","LAB",306,"87070",null,null,112]
[" 2207338","EYE CULTURE","LAB",306,"87070",null,null,112]
[" 2207339","CULTURE SYNOVIAL FLUID","LAB",306,"87070",null,null,112]
[" 2207341","GENITAL CULTURE","LAB",306,"87070",null,null,112]
[" 2207342","CULTURE JOINT BONE","LAB",306,"87070",null,null,112]
[" 2207343","CULTURE PERITONEAL FLUID (OBSELETE)","LAB",306,"87070",null,null,112]
[" 2207344","CULTURE RESPIRATORY","LAB",306,"87070",null,null,112]
[" 2207346","THROAT CULTURE","LAB",306,"87070",null,null,112]
[" 2207347","CULTURE TISSUE","LAB",306,"87070",null,null,112]
[" 2207351","WOUND CULTURE","LAB",306,"87070",null,null,112]
[" 2201403","MOPATH PROCEDURE CHARGE","LAB",306,"81403",null,null,117]
[" 2207328","CULTURE, ANAEROBIC","LAB",306,"87075",null,null,118]
[" 2200827","IDENTIFICATION  YEAST","LAB",306,"87106",null,null,119]
[" 2207358","FUNGUS CULTURE","LAB",306,"87102",null,null,121]
[" 2201319","PMS GENE LARGE DEL/DUP CHARGE","LAB",306,"81319",null,null,128]
[" 2201062","GC AMPLIFIED","LAB",306,"87591",null,null,140]
[" 2201061","CHLAMYDIA AMPLIFIED","LAB",306,"87491",null,null,143]
[" 2207001","ROTAVIRUS ANTIGEN SCREEN","LAB",306,"87425",null,null,143]
[" 2206227","RESPIRATORY SYNCYTIAL VIR","LAB",306,"87420",null,null,171]
[" 2207330","BLOOD CULTURE","LAB",306,"87040",null,null,187]
[" 2202005","CMV MOLECULAR DETECTION  PCR","LAB",306,"87496",null,null,226]
[" 2201295","MSH2 GENE FULL SEQUENCE CHARGE","LAB",306,"81295",null,null,241]
[" 2200804","SENSITIVITY YEAST CHARGE","LAB",306,"87186",null,null,264]
["22087154","PCR BLOOD CULTURE ID","LAB",306,"87154",null,null,275]
[" 2201293","MLH1 GENE FULL SEQUENCE CHARGE","LAB",306,"81292",null,null,337]
[" 2201298","MSH6 GENE FULL SEQUENCE CHARGE","LAB",306,"81298",null,null,403]
[" 2201317","PMS2 GENE FULL SEQUENCE CHARGE","LAB",306,"81317",null,null,445]
[" 2201228","CYTOGEN MICRARRAY COPY CHARGE","LAB",306,"81228",null,null,566]
[" 2201005","URINALYSIS REFLEX TO MICRO","LAB",307,"81003",null,null,40]
[" 2201015","URINALYSIS MICROSCOPIC","LAB",307,"81015",null,null,45]
[" 4400027","CL PREGNANCY TEST, URINE","LAB",307,"81025",null,null,54]
[" 2201000","DON'T ORDER. SEE UA W REFLEX","LAB",307,"81001",null,null,61]
[" 2203160","HCG URINE","LAB",307,"81025",null,null,87]
[" 2209335","CYRSTAL EXAM BODY FLUID","LAB",310,"89060",null,null,72]
[" 2200029","HLA-DRB 1 LOCUS","LAB",310,"81376",null,null,123]
[" 2200082","CSF COUNT & DIFF","LAB",310,"89051",null,null,152]
[" 2209051","CELL CT W/DIFF BODY FL","LAB",310,"89051",null,null,152]
[" 2208221","SEMI-QUANTITATIVE IMMUNOHISTOC","LAB",310,"88360",null,null,173]
[" 2208220","IMMUNOHISTO ANTIBODY SLIDE","LAB",310,"88341",null,null,184]
[" 2204332","MTHFR 2 MUTATIONS","LAB",310,"81291",null,null,289]
[" 2200033","CFBP","LAB",310,"81220",null,null,345]
[" 2208827","FCLL CHRONIC","LAB",310,"88275",null,null,377]
[" 2208124","CYTOPATH  SMEAR  OTHER","LAB",311,"88160",null,null,74]
[" 2208140","CYTOPATH SMEAR  NONGYN","LAB",311,"88112",null,null,107]
[" 2208291","CYTOGENETICS AND MOLECULAR CYT","LAB",311,"88291",null,null,233]
[" 2208283","ADDITIONAL SPECIALIZED BANDING","LAB",311,"88283",null,null,418]
[" 2208285","CHROMOSOME ANALYSIS ADDT CELLS","LAB",311,"88285",null,null,418]
[" 2208280","CHROMOSOME ANALYSIS ADDTNL KAR","LAB",311,"88280",null,null,478]
[" 2208230","TISSUE CULTURE NON NEOPLASTIC","LAB",311,"88230",null,null,534]
[" 2208262","CHROMOSOME ANALYSIS COUNT 15-2","LAB",311,"88262",null,null,1463]
["22081229","CHROMOSOME MICROARRAY POSTNATAL","LAB",311,"81229",null,null,4912]
[" 2208202","DECALCIFICATION PROCEDURE","LAB",312,"88311",null,null,55]
[" 2208197","LVLII SUR PATH GR & MICR","LAB",312,"88302",null,null,101]
[" 2208200","SPECIAL STAIN  GROUP 2 88313","LAB",312,"88313",null,null,103]
[" 2208190","SPECIAL STAIN GROUP 1 88312","LAB",312,"88312",null,null,124]
[" 2208198","LVLIII SUR PATH GR & MICR","LAB",312,"88304",null,null,166]
[" 2208201","SURGICAL 1 PX (FIRST AB)","LAB",312,"88342",null,null,183]
[" 2208199","LVLIV SUR PATH GR & MICR","LAB",312,"88305",null,null,198]
[" 2208193","LVLV SUR PATH GR & MICR","LAB",312,"88307",null,null,336]
[" 2208189","PATH CONSULT FROZ SCT R/D","LAB",312,"88331",null,null,338]
[" 2208194","LVLVI SUR PATH GR & MICR","LAB",312,"88309",null,null,342]
[" 3003522","XR HIP BI 3-4 VIEWS","RADIOLOGY",320,"73522",null,null,190]
[" 3000006","XR INFANT UP EXT LT","RADIOLOGY",320,"73092",null,null,203]
[" 3000007","XR INFANT UP EXT RT","RADIOLOGY",320,"73092",null,null,203]
[" 3003096","XR INFANT LOW EXT RT","RADIOLOGY",320,"73592",null,null,207]
[" 3003098","XR INFANT LOW EXT LT","RADIOLOGY",320,"73592",null,null,207]
[" 3003285","XR FOOT LT GREAT TOE","RADIOLOGY",320,"73660",null,null,207]
[" 3003286","XR FOOT LT 2ND DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003287","XR FOOT LT 3RD DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003288","XR FOOT LT 4TH DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003289","XR FOOT LT 5TH DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003290","XR FOOT RT GREAT TOE","RADIOLOGY",320,"73660",null,null,207]
[" 3003291","XR FOOT RT 2ND DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003292","XR FOOT RT 3RD DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003293","XR FOOT RT 4TH DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003294","XR FOOT RT 5TH DIGIT","RADIOLOGY",320,"73660",null,null,207]
[" 3003140","XR FINGERS LT","RADIOLOGY",320,"73140",null,null,210]
[" 3003141","XR FINGERS RT","RADIOLOGY",320,"73140",null,null,210]
[" 3003272","XR HAND LT THUMB","RADIOLOGY",320,"73140",null,null,210]
[" 3003273","XR HAND LT 2ND DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003274","XR HAND LT 3RD DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003275","XR HAND LT 4TH DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003276","XR HAND LT 5TH DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003277","XR HAND RT THUMB","RADIOLOGY",320,"73140",null,null,210]
[" 3003278","XR HAND RT 2ND DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003279","XR HAND RT 3RD DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003280","XR HAND RT 4TH DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3003281","XR HAND RT 5TH DIGIT","RADIOLOGY",320,"73140",null,null,210]
[" 3001007","XR CALCANEOUS RT","RADIOLOGY",320,"73650",null,null,212]
[" 3001008","XR CALCANEOUS LT","RADIOLOGY",320,"73650",null,null,212]
[" 3003144","XR HIP RT 1 V","RADIOLOGY",320,"73501LT","LT",null,213]
[" 3003145","XR HIP LT 1 V","RADIOLOGY",320,"73501RT","RT",null,213]
[" 3003100","XR WRIST LT 2 V","RADIOLOGY",320,"73100",null,null,214]
[" 3003101","XR WRIST RT 2 V","RADIOLOGY",320,"73100",null,null,214]
[" 3003660","XR TOES LT","RADIOLOGY",320,"73660",null,null,215]
[" 3003661","XR TOES RT","RADIOLOGY",320,"73660",null,null,215]
[" 3003502","XR UNI 2-3VIEWS","RADIOLOGY",320,"73502",null,null,220]
[" 3003503","XR HIP UNI 4 VIEWS","RADIOLOGY",320,"73503",null,null,220]
[" 3003575","XR KNEES STAND BILAT/AP ONLY","RADIOLOGY",320,"73565",null,null,223]
[" 3000030","XR ORBITS EYES 1-2 V","RADIOLOGY",320,"70030",null,null,230]
[" 3007003","XR PRE MRI ORBIT FB","RADIOLOGY",320,"70030",null,null,230]
[" 3000210","XR SINUSES 1 V","RADIOLOGY",320,"70210",null,null,232]
[" 3006020","XR BONE AGE STUDIES","RADIOLOGY",320,"77072",null,null,234]
[" 3003020","XR SHOULDER LT 1 V","RADIOLOGY",320,"73020LT","LT",null,235]
[" 3003021","XR SHOULDER RT 1 V","RADIOLOGY",320,"73020RT","RT",null,235]
[" 3003120","XR HAND LT 2 V","RADIOLOGY",320,"73120",null,null,235]
[" 3003121","XR HAND RT 2 V","RADIOLOGY",320,"73120",null,null,235]
[" 3003070","XR ELBOW LT 2 V","RADIOLOGY",320,"73070",null,null,238]
[" 3003071","XR ELBOW RT 2 V","RADIOLOGY",320,"73070",null,null,238]
[" 3000031","XR FACIAL BONES MAX 3 V","RADIOLOGY",320,"70140",null,null,240]
[" 3003090","XR FOREARM LT","RADIOLOGY",320,"73090LT","LT",null,270]
[" 3003091","XR FOREARM RT","RADIOLOGY",320,"73090RT","RT",null,270]
[" 3003050","XR AC JOINTS BILATERAL","RADIOLOGY",320,"73050",null,null,271]
[" 3000010","XR RIBS UNI 2 V","RADIOLOGY",320,"71100",null,null,281]
[" 3000250","XR SKULL 3 V","RADIOLOGY",320,"70250",null,null,281]
[" 3007025","XR SKULL SHUNT/ANEURYSMCLIP PLACE","RADIOLOGY",320,"70250",null,null,281]
[" 3003060","XR HUMERUS LT","RADIOLOGY",320,"73060LT","LT",null,284]
[" 3003061","XR HUMERUS RT","RADIOLOGY",320,"73060RT","RT",null,284]
[" 3002041","XR CERVICAL SPINE 1 V","RADIOLOGY",320,"72020",null,null,285]
[" 3002200","XR SACROILIAC JOINTS","RADIOLOGY",320,"72200",null,null,286]
[" 3003620","XR FOOT LT 2 V","RADIOLOGY",320,"73620LT","LT",null,286]
[" 3003621","XR FOOT RT 2 V","RADIOLOGY",320,"73620RT","RT",null,286]
[" 3003590","XR TIBIA LT","RADIOLOGY",320,"73590LT","LT",null,290]
[" 3003591","XR TIBIA RT","RADIOLOGY",320,"73590",null,null,290]
[" 3003000","XR CLAVICLE LT","RADIOLOGY",320,"73000LT","LT",null,294]
[" 3003001","XR CLAVICLE RT","RADIOLOGY",320,"73000RT","RT",null,294]
[" 3003110","XR WRIST LT COMP","RADIOLOGY",320,"73110",null,null,294]
[" 3003111","XR WRIST RT COMP","RADIOLOGY",320,"73110",null,null,294]
[" 3002220","XR SACRUM COCCYX","RADIOLOGY",320,"72220",null,null,296]
[" 3000360","XR NECK SOFT TISSUE","RADIOLOGY",320,"70360",null,null,297]
[" 3003080","XR ELBOW LT COMP","RADIOLOGY",320,"73080",null,null,299]
[" 3003081","XR ELBOW RT COMP","RADIOLOGY",320,"73080",null,null,299]
[" 3003631","XR FOOT R MIN 3 V","RADIOLOGY",320,"73630RT","RT",null,300]
[" 3003560","XR KNEE LT 2 V","RADIOLOGY",320,"73560LT","LT",null,302]
[" 3003561","XR KNEE RT 2 V","RADIOLOGY",320,"73560RT","RT",null,302]
[" 3003500","XR PELVIS 1-2 V","RADIOLOGY",320,"72170",null,null,305]
[" 3000004","XR BONE LENGTH STUDY","RADIOLOGY",320,"77073",null,null,306]
[" 3002040","XR C SPINE 2-3 V","RADIOLOGY",320,"72040",null,null,308]
[" 3003600","XR ANKLE LT 2 V","RADIOLOGY",320,"73600LT","LT",null,311]
[" 3003601","XR ANKLE RT 2 V","RADIOLOGY",320,"73600RT","RT",null,311]
[" 3003630","XR FOOT LT MIN 3 V","RADIOLOGY",320,"73630LT","LT",null,315]
[" 3003010","XR SCAPULA LT","RADIOLOGY",320,"73010",null,null,317]
[" 3003011","XR SCAPULA RT","RADIOLOGY",320,"73010",null,null,317]
[" 3000160","XR NASAL BONES","RADIOLOGY",320,"70160",null,null,318]
[" 3003550","XR FEMUR LT 2 V","RADIOLOGY",320,"73552LT","LT",null,321]
[" 3003551","XR FEMUR RT 2 V","RADIOLOGY",320,"73552RT","RT",null,321]
[" 3000330","XR TM JOINTS","RADIOLOGY",320,"70330",null,null,324]
[" 3003570","XR KNEE LT MIN 4 V","RADIOLOGY",320,"73564LT","LT",null,325]
[" 3003571","XR KNEE RT MIN 4 V","RADIOLOGY",320,"73564RT","RT",null,325]
[" 3003610","XR ANKLE LT COMP","RADIOLOGY",320,"73610",null,null,325]
[" 3003611","XR ANKLE RT COMP","RADIOLOGY",320,"73610",null,null,325]
[" 3004000","XR ABD KUB 1V","RADIOLOGY",320,"74018",null,null,330]
[" 3003131","XR HAND RT 3 V","RADIOLOGY",320,"73130",null,null,332]
[" 3003130","XR HAND LT 3 V","RADIOLOGY",320,"73130",null,null,340]
[" 3002070","XR T SPINE AP LAT","RADIOLOGY",320,"72070",null,null,343]
[" 3003510","XR HIP UNI 2-3 V L","RADIOLOGY",320,"73502LT","LT",null,345]
[" 3003030","XR SHOULDER LT MIN 2 V","RADIOLOGY",320,"73030LT","LT",null,350]
[" 3003031","XR SHOULDER RT MIN 2 V","RADIOLOGY",320,"73030RT","RT",null,350]
[" 3003511","XR HIP UNI 2-3 V R","RADIOLOGY",320,"73502RT","RT",null,350]
[" 3000220","XR SINUS MINIMUM 3 V","RADIOLOGY",320,"70220",null,null,357]
[" 3001023","XR RIBS W PA CHEST MIN 3 V","RADIOLOGY",320,"71101",null,null,358]
[" 3003564","XR KNEE LT 3 V","RADIOLOGY",320,"73562LT","LT",null,361]
[" 3003565","XR KNEE RT 3 V","RADIOLOGY",320,"73562RT","RT",null,361]
[" 3001110","XR RIBS BILATERAL 3 V","RADIOLOGY",320,"71110",null,null,392]
[" 3004020","XR ABD 2 V","RADIOLOGY",320,"74021",null,null,400]
[" 3000260","XR SKULL 4 V MIN COMP","RADIOLOGY",320,"70260",null,null,406]
[" 3001120","XR STERNUM 2 V","RADIOLOGY",320,"71120",null,null,425]
[" 3002020","XR SCOLIOSIS SURVEY (LMT)","RADIOLOGY",320,"72090",null,null,426.3]
[" 3000150","XR FACIAL BONES","RADIOLOGY",320,"70150",null,null,427]
[" 3003146","XR HIP BILAT 2 V","RADIOLOGY",320,"73521",null,null,437]
[" 3000110","XR MANDIBLE","RADIOLOGY",320,"70110",null,null,442]
[" 3002071","XR T SPINE 3 V","RADIOLOGY",320,"72072",null,null,443]
[" 3002110","XR L SPINE MIN 4 V","RADIOLOGY",320,"72110",null,null,450]
[" 3002052","XR C SPINE 4 V","RADIOLOGY",320,"72050",null,null,460]
[" 3002083","XR ENTIRE SPINE 4-5 VIEWS","RADIOLOGY",320,"72083",null,null,470]
[" 3003520","XR PELVIS 3 V MIN","RADIOLOGY",320,"72190",null,null,476]
[" 3002100","XR L SPINE 2-3 V","RADIOLOGY",320,"72100",null,null,500]
[" 3006021","XR VP SHUNT SURVEY","RADIOLOGY",320,"75809",null,null,505]
[" 3004022","XR MULT ABD W PA CHEST","RADIOLOGY",320,"74022",null,null,516]
[" 3002121","XR L SPINE AP LAT FLEX EXT","RADIOLOGY",320,"72120",null,null,525]
[" 3002010","XR SPINE AP LAT","RADIOLOGY",320,"72010",null,null,528]
[" 3001112","XR RIBS W PA CHEST 4 V MIN","RADIOLOGY",320,"71111",null,null,539]
[" 3002084","XR ENTIRE SPINE 6 VIEW","RADIOLOGY",320,"72084",null,null,563]
[" 3000009","XR FLOUR 1HR W/O FILM","RADIOLOGY",320,"76000",null,null,578]
[" 3002120","XR L SPINE COMP W BENDING","RADIOLOGY",320,"72114",null,null,578]
[" 3004305","XR CHOLANGIO INTRA-OP","RADIOLOGY",320,"74300",null,null,583]
[" 3004324","XR T-TUBE POST OP  (CHEST)","RADIOLOGY",320,"74305",null,null,597]
[" 3004220","XR ESOPHAGUS","RADIOLOGY",320,"74220",null,null,609]
[" 3007354","XR FEMUR 1 RT","RADIOLOGY",320,"73551RT","RT",null,622]
[" 3007355","XR FEMUR 1 LT","RADIOLOGY",320,"73551LT","LT",null,622]
[" 3002044","XR C SPINE COMP OBL FLEX EXT","RADIOLOGY",320,"72052",null,null,641]
[" 3000005","XR BONE SURVEY METAS","RADIOLOGY",320,"77074",null,null,775]
[" 3001009","XR SKELETON BONE STUDY COMP","RADIOLOGY",320,"77075",null,null,843]
[" 3004400","XR IV PYELOGRAM","RADIOLOGY",320,"74400",null,null,877]
[" 3001010","XR CHEST 1 V","RADIOLOGY",324,"71045",null,null,325]
[" 3001022","XR CHEST WITH OBLIQUES","RADIOLOGY",324,"71048",null,null,353]
[" 3001020","XR CHEST 2 V","RADIOLOGY",324,"71046",null,null,375]
[" 3500001","DX AXIAL SKELETON BD","RADIOLOGY",329,"77080",null,null,727]
[" 3200438","US ABD PARACENTESIS W GUIDE","RADIOLOGY",329,"49083",null,null,1367]
[" 1700402","CHEMOTHERAPY ADMINISTRATION HO","RADIOLOGY",331,"96402",null,null,214]
[" 1700505","CHEMO ADMIN SUBQ/IM","RADIOLOGY",331,"96401",null,null,262]
[" 1501500","CHEMO ADM IV INFUS 1ST HR","RADIOLOGY",335,"96413",null,null,717]
[" 3307029","CT LOW DOSE LUNG SCREEN","RADIOLOGY",350,"71271",null,null,321]
["33071271","CT LOW DOSE LUNG SCREENING WO","RADIOLOGY",350,"71271",null,null,400]
[" 3300486","CT SINUS COMP","RADIOLOGY",350,"70486",null,null,1856]
[" 3300488","CT FACIAL BONES","RADIOLOGY",350,"70486",null,null,1856]
[" 3306432","CT SINUS LMT","RADIOLOGY",350,"70486",null,null,1856]
[" 3310006","CT PARANASAL SINUSES WO","RADIOLOGY",350,"70486",null,null,1856]
[" 3303201","CT UPPER EXT LT WO","RADIOLOGY",350,"73200LT","LT",null,2054]
[" 3307716","CT UPPER EXT RT WO","RADIOLOGY",350,"73200RT","RT",null,2054]
[" 3307718","CT LOW EXT RT WO","RADIOLOGY",350,"73700RT","RT",null,2065]
[" 3306417","CT PELVIS WO","RADIOLOGY",350,"72192",null,null,2091]
[" 3306409","CT ABDOMEN WO","RADIOLOGY",350,"74150",null,null,2113]
[" 3300484","CT LOW EXT LT W","RADIOLOGY",350,"73701",null,null,2151]
[" 3307719","CT LOW EXT RT W","RADIOLOGY",350,"73701RT","RT",null,2151]
[" 3307721","CT UPPER EXT RT W","RADIOLOGY",350,"73701RT","RT",null,2151]
[" 3307717","CT UPPER EXT RT W","RADIOLOGY",350,"73201RT","RT",null,2152]
[" 3307720","CT UPPER EXT LT W","RADIOLOGY",350,"73201LT","LT",null,2152]
[" 3303701","CT LOW EXT LT WO","RADIOLOGY",350,"73700LT","LT",null,2176]
[" 3307723","CT ANGIO HEART W 3D IMAGE","RADIOLOGY",350,"75574",null,null,2196]
[" 3306403","CT NECK WO","RADIOLOGY",350,"70490",null,null,2215]
[" 3306450","CT ORBIT WO","RADIOLOGY",350,"70480",null,null,2223]
[" 3306451","CT INNER EAR","RADIOLOGY",350,"70480",null,null,2223]
[" 3310004","CT INNER AUDITORY CANAL WO","RADIOLOGY",350,"70480",null,null,2223]
[" 3310009","CT TEMPORAL BONES WO","RADIOLOGY",350,"70480",null,null,2223]
[" 3306401","CT HEAD WO","RADIOLOGY",350,"70450",null,null,2250]
[" 3302128","CT SPINE THORACIC WO","RADIOLOGY",350,"72128",null,null,2327]
[" 3302131","CT SPINE LUMBAR WO","RADIOLOGY",350,"72131",null,null,2354]
[" 3306418","CT PELVIS W","RADIOLOGY",350,"72193",null,null,2356]
[" 3300483","CT HEAD W","RADIOLOGY",350,"70460",null,null,2370]
[" 3310003","CT HEAD W","RADIOLOGY",350,"70460",null,null,2370]
[" 3300485","CT SPINE CERV W","RADIOLOGY",350,"72126",null,null,2379]
[" 3300297","CT LOW DOSE LUNG CA SCREEN WO","RADIOLOGY",350,"71271",null,null,2397]
[" 3306405","CT CHEST WO","RADIOLOGY",350,"71250",null,null,2397]
[" 3300498","CT ANGIO NECK","RADIOLOGY",350,"70498",null,null,2450]
[" 3306404","CT ANGIO NECK W CAROTIDS","RADIOLOGY",350,"70491",null,null,2450]
[" 3310007","CT NECK W","RADIOLOGY",350,"70491",null,null,2450]
[" 3302132","CT SPINE LUMBAR W","RADIOLOGY",350,"72132",null,null,2458]
[" 3300496","CT ANGIO HEAD","RADIOLOGY",350,"70496",null,null,2477]
[" 3306423","CT HEAD WO W","RADIOLOGY",350,"70470",null,null,2477]
[" 3310008","CT STROKE WO W","RADIOLOGY",350,"70470",null,null,2477]
[" 3310011","CT ANGIO HEAD COW WO/W","RADIOLOGY",350,"70470",null,null,2477]
[" 3310023","CT TEMPORAL BONES WITH","RADIOLOGY",350,"70481",null,null,2544]
[" 3304151","CT UPPER EXT LT WO W","RADIOLOGY",350,"73202LT","LT",null,2570]
[" 3306419","CT CHEST W","RADIOLOGY",350,"71260",null,null,2584]
[" 3301270","CT THORAX WO W","RADIOLOGY",350,"71270",null,null,2593]
[" 3302125","CT SPINE CERVICAL WO","RADIOLOGY",350,"72125",null,null,2600]
[" 3306410","CT ABD LIVER W","RADIOLOGY",350,"74160",null,null,2638]
[" 3306414","CT PANCREAS W","RADIOLOGY",350,"74160",null,null,2638]
[" 3300487","CT NECK WO W","RADIOLOGY",350,"70492",null,null,2651]
[" 3300489","CT ANGIO CHEST W","RADIOLOGY",350,"71275",null,null,2800]
[" 3310001","CT CHEST PE W","RADIOLOGY",350,"71275",null,null,2800]
[" 3310010","CT ANGIO AORTIC DISSECTION W","RADIOLOGY",350,"71260",null,null,2800]
[" 3306427","CT ABD LIVER WO W","RADIOLOGY",350,"74170",null,null,2993]
[" 3306408","CT ANGIO W RUNOFF","RADIOLOGY",350,"73706",null,null,3746]
[" 3309101","CT ANGIO STROKE WO W","RADIOLOGY",350,"70498",null,null,3769]
[" 3300482","CT ABD PELVIS WO","RADIOLOGY",350,"74176",null,null,3852]
[" 3310005","CT KIDNEY STONE WO","RADIOLOGY",350,"74176",null,null,3852]
[" 3300481","CT ABD PELVIS W","RADIOLOGY",350,"74177",null,null,4435]
[" 3310002","CT ENTEROGRAPHY (CROHNS) W","RADIOLOGY",350,"74177",null,null,4435]
[" 3310012","CT ANGIO KIDNEY DONOR W","RADIOLOGY",350,"74177",null,null,4435]
[" 3310013","CT ANGIO MESENTERIC GI BLEED W","RADIOLOGY",350,"74177",null,null,4435]
[" 3307725","CT CHEST WO W","RADIOLOGY",350,"71270",null,null,4544]
[" 3302192","CT APPY PROTOCOL W","RADIOLOGY",350,"74177",null,null,4600]
[" 3300480","CT ABD PELVIS WO W","RADIOLOGY",350,"74178",null,null,5377]
[" 3306406","CT LUNG W","RADIOLOGY",350,"71260",null,null,28000]
[" 3307012","CT GUIDANCE NEEDLE PLACEMENT","RADIOLOGY",352,"77012",null,null,718]
[" 3307731","CT UROGRAPHY W/WO KUB","RADIOLOGY",352,"74400",null,null,995]
[" 3307750","CT CHEST HI RESOLUTION WO","RADIOLOGY",352,"71250",null,null,2397]
[" 3307726","CT ANGIO PELVIS WO W","RADIOLOGY",352,"72191",null,null,2441]
[" 3307751","CT UPPER EXT RT WO W","RADIOLOGY",352,"73202RT","RT",null,2477]
[" 3307722","CT THORAX W/WO CONTRAST","RADIOLOGY",352,"71270",null,null,2593]
[" 3307730","CT ABD W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310014","CT ADRENALS PROTOCOL","RADIOLOGY",352,"74160",null,null,2638]
[" 3310015","CT BIPHASIC LIVER W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310016","CT KIDNEY MASS W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310017","CT LIVER VOLUME W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310018","CT LIVER W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310019","CT PANCREATIC MASS W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310020","CT TRIPHASIC LIVER W","RADIOLOGY",352,"74160",null,null,2638]
[" 3310021","CT ANGIO LIVER DONOR W","RADIOLOGY",352,"74160",null,null,2638]
[" 3307734","CT ANGIO ABD WO W","RADIOLOGY",352,"74175",null,null,2980]
[" 3307724","CT ANGIO ABD ARTERIES","RADIOLOGY",352,"75635",null,null,3157]
[" 3307727","CT ANGIO ABD PELV W","RADIOLOGY",352,"74174",null,null,3942]
[" 3307733","CT ANGIO ABD PELVIS WO W","RADIOLOGY",352,"74174",null,null,3942]
[" 3307729","CT ABD & PELV 1/> REGNS","RADIOLOGY",352,"74178",null,null,5377]
[" 3307732","CT UROGRAM","RADIOLOGY",352,"74178",null,null,5377]
["  902747","OR LEVEL 1","OR",360,null,null,null,19]
["  902748","OR LEVEL 2","OR",360,null,null,null,39]
["  902749","OR LEVEL 3","OR",360,null,null,null,58]
[" 1701542","DRESSING CHANGE","OR",360,null,null,null,96]
[" 1700006","MULTI LAYER THIGH LEG ANK","OR",360,"29582",null,null,203]
[" 1700021","MULTI LAYER UPPER ARM FOR","OR",360,"29583",null,null,214]
[" 1700022","MULTI LAYER ARM HAND FING","OR",360,"29584",null,null,228]
[" 1501552","CIRCUMCISION","OR",360,null,null,null,268]
["  900300","FINE NEEDLE ASPIRATION W/OGUID","OR",360,"10021",null,null,318]
[" 1500242","CL TX FX GT PHALANX(S); WO MAN","OR",360,"28490",null,null,439]
[" 1002320","EPIDURAL CERVICAL THORACIC W/O","OR",360,"62320",null,null,484]
[" 1500823","INJ ANESTH; OTHR PERIPHERAL NR","OR",360,"64450",null,null,514]
["  900031","OR A MINOR 1-15","OR",360,null,null,null,674]
["  900010","CYSTOSCOPY","OR",360,null,null,null,767]
["  900032","OR A MINOR 16-30","OR",360,null,null,null,835]
[" 1500822","DELIVERY OF PLACENTA","OR",360,"59414",null,null,856]
["  900033","OR A MINOR 31-45","OR",360,null,null,null,1070]
[" 1002322","EPIDURAL LUMBAR/SACRAL W/O GUI","OR",360,"62322",null,null,1107]
["  900034","OR A MINOR 46-60","OR",360,null,null,null,1214]
[" 1500028","INJ LUMBAR SACRAL SINGLE","OR",360,"64483",null,null,1266]
["  900035","OR A MINOR 61-75","OR",360,null,null,null,1428]
["  900011","OR A 1-15","OR",360,null,null,null,1498]
[" 1500826","CL TX ULNAR SHFT FX W MANIP","OR",360,"25535",null,null,1533]
["  900036","OR A MINOR 76-90","OR",360,null,null,null,1552]
["  903001","INSERTION PICC>5 YEARS AGE","OR",360,"36569",null,null,1615]
[" 1506083","INCISE THROMBOSED HEMORRHOID E","OR",360,"46083",null,null,1663]
["  900012","OR A 16-30","OR",360,null,null,null,1712]
["  900037","OR A MINOR 91-105","OR",360,null,null,null,1744]
["  900038","OR A MINOR 106-120","OR",360,null,null,null,1851]
["  900013","OR A 31-45","OR",360,null,null,null,1915]
["  900014","OR A 46-60","OR",360,null,null,null,2087]
["  900015","OR A 61-75","OR",360,null,null,null,2236]
["  900016","OR A 76-90","OR",360,null,null,null,2354]
["  900017","OR A 91-105","OR",360,null,null,null,2461]
["  900018","OR A 106-120","OR",360,null,null,null,2568]
["  900019","OR A 121-135","OR",360,null,null,null,2675]
["  900020","OR A 136-150","OR",360,null,null,null,2782]
["  900051","OR B 1-15","OR",360,null,null,null,2996]
["  900052","OR B 16-30","OR",360,null,null,null,3237]
["  900053","OR B 31-45","OR",360,null,null,null,3424]
["  900054","OR B 46-60","OR",360,null,null,null,3585]
["  900055","OR B 61-75","OR",360,null,null,null,3745]
["  900056","OR B 76-90","OR",360,null,null,null,3895]
["  900057","OR B 91-105","OR",360,null,null,null,4039]
["  900058","OR B 106-120","OR",360,null,null,null,4194]
["  900059","OR B 121-135","OR",360,null,null,null,4301]
["  900060","OR B 136-150","OR",360,null,null,null,4494]
["  900081","OR C 1-15","OR",360,null,null,null,4521]
["  900061","OR B 151-165","OR",360,null,null,null,4644]
["  900082","OR C 16-30","OR",360,null,null,null,4735]
["  900062","OR B 166-180","OR",360,null,null,null,4788]
[" 1501000","C-SECTION DELIVERY","OR",360,null,null,null,4815]
["  900083","OR C 31-45","OR",360,null,null,null,4922]
["  900084","OR C 46-60","OR",360,null,null,null,5099]
["  900063","OR B 181-195","OR",360,null,null,null,5243]
["  900085","OR C 61-75","OR",360,null,null,null,5270]
["  900086","OR C 76-90","OR",360,null,null,null,5441]
["  900064","OR B 196-210","OR",360,null,null,null,5537]
["  900087","OR C 91-105","OR",360,null,null,null,5612]
["  900088","OR C 106-120","OR",360,null,null,null,5778]
["  900089","OR C 121-135","OR",360,null,null,null,5955]
["  900090","OR C 136-150","OR",360,null,null,null,6126]
["  900091","OR C 151-165","OR",360,null,null,null,6297]
["  900092","OR C 166-180","OR",360,null,null,null,6468]
["  900093","OR C 181-195","OR",360,null,null,null,6634]
["  900094","OR C 196-210","OR",360,null,null,null,6811]
["  900095","OR C 211-215","OR",360,null,null,null,6982]
["  900096","OR C 216-230","OR",360,null,null,null,7153]
["  900097","OR C 231-245","OR",360,null,null,null,7324]
["  900111","OR D 1-15","OR",360,null,null,null,7533]
["  900112","OR D 16-30","OR",360,null,null,null,7747]
["  900113","OR D 31-45","OR",360,null,null,null,8132]
["  900114","OR D 46-60","OR",360,null,null,null,8325]
["  900115","OR D 61-75","OR",360,null,null,null,8517]
["  900116","OR D 76-90","OR",360,null,null,null,8710]
["  900117","OR D 91-105","OR",360,null,null,null,8902]
["  900118","OR D 106-120","OR",360,null,null,null,9095]
["  900119","OR D 121-135","OR",360,null,null,null,9288]
["  900120","OR D 136-150","OR",360,null,null,null,9480]
["  900121","OR D 151-165","OR",360,null,null,null,9673]
["  900122","OR D 166-180","OR",360,null,null,null,10828]
["  900123","OR D 181-195","OR",360,null,null,null,11021]
["  900124","OR D 196-210","OR",360,null,null,null,11406]
["  900021","OR D 211-225","OR",360,null,null,null,11599]
["  900022","OR D 226-240","OR",360,null,null,null,11791]
["  900023","OR D 241-255","OR",360,null,null,null,12947]
["  900024","OR D 256-270","OR",360,null,null,null,13525]
[" 5500007","NASOTRACHEAL SUCTIONING","OR",361,"31720",null,null,161]
[" 1700001","DECLOT OF VAD OR CATHETER","OR",361,"36593",null,null,448]
[" 1700159","LUMBAR PUNCTURE-DX","OR",361,"62270",null,null,803]
[" 1700003","INJ BLOOD OR CLOT PATCH","OR",361,"62273",null,null,1338]
[" 1100005","ANESTH MINOR 0-30","OR",370,null,null,null,250]
[" 1100006","ANESTH MINOR 31-60","OR",370,null,null,null,325]
[" 1100001","ANESTHESIA LEVEL 1","OR",370,null,null,null,348]
[" 1100007","ANESTH MINOR 61-90","OR",370,null,null,null,400]
[" 1100011","ANESTH MAJOR 0-30","OR",370,null,null,null,450]
[" 1100008","ANESTH MINOR 91-120","OR",370,null,null,null,475]
[" 1100104","ANESTH MINOR 151 - 180","OR",370,null,null,null,492]
[" 1100009","ANESTH MINOR 121-150","OR",370,null,null,null,550]
[" 1100102","ANESTH MINOR 211 - 240","OR",370,null,null,null,578]
[" 1100012","ANESTH MAJOR 31-60","OR",370,null,null,null,600]
[" 1100010","ANESTH MINOR 151-180","OR",370,null,null,null,625]
[" 1100013","ANESTH MAJOR 61-90","OR",370,null,null,null,700]
[" 1100103","ANESTH MINOR 181 - 210","OR",370,null,null,null,700]
[" 1100014","ANESTH MAJOR 91-120","OR",370,null,null,null,800]
[" 1100015","ANESTH MAJOR 121-150","OR",370,null,null,null,900]
[" 1100105","ANESTH MAJOR 151 -180","OR",370,null,null,null,979]
[" 1100016","ANESTH MAJOR 151-180","OR",370,null,null,null,1000]
[" 1100101","ANESTH MAJOR 181 -210","OR",370,null,null,null,1100]
[" 1100106","ANESTH MAJOR 211 - 240","OR",370,null,null,null,1156]
[" 1100002","ANESTHESIA LEVEL 2","OR",370,null,null,null,1284]
[" 1100017","ANEST MAJOR 241-270","OR",370,null,null,null,1311]
[" 1100003","ANESTHESIA LEVEL 3","OR",370,null,null,null,2568]
[" 1100004","ANESTHESIA LEVEL 4","OR",370,null,null,null,3451]
[" 2306420","BB FR FROZEN PLASMA EA UNIT","LAB",390,"P9017",null,null,308]
[" 2301440","BB RBC  LEUKOREDUCED EA UNIT","LAB",390,"P9016",null,null,814]
[" 1700500","BLOOD TRANSFUSION","LAB",391,"36430",null,null,924]
[" 3077065","MA DIAGNOSTIC LEFT MAMMOGRAM","RADIOLOGY",401,"77065",null,null,415]
[" 3077605","MA DIAGNOSTIC RT MAMMOGRAM","RADIOLOGY",401,"77065",null,null,415]
[" 3077066","MA DIAGNOSTIC BILT MAMMOGRAM","RADIOLOGY",401,"77066",null,null,471]
[" 3200429","US BLADDER CAPACITY POST","RADIOLOGY",402,"51798",null,null,192]
[" 3200430","US 1ST TRIMESTER TWINS","RADIOLOGY",402,"76802",null,null,306]
[" 3200439","US PERICARDIOCENTESIS","RADIOLOGY",402,"76930",null,null,338]
[" 3276642","US BREAST RIGHT LIMITED","RADIOLOGY",402,"76642",null,null,360]
["32076642","US BREAST LEFT LIMITED","RADIOLOGY",402,"76642",null,null,360]
[" 3206999","US MISC","RADIOLOGY",402,"76999",null,null,373]
[" 3276641","US BREAST RIGHT COMPLETE","RADIOLOGY",402,"76641",null,null,415]
["32076641","US BREAST LEFT COMPLETE","RADIOLOGY",402,"76641",null,null,415]
[" 3200431","US OB BIOPHYSICAL PROFILE","RADIOLOGY",402,"76818",null,null,419]
[" 3200428","US PELVIC BLADDER LIMITED","RADIOLOGY",402,"76857",null,null,428]
[" 3206851","US PELVIC NON OB LMT","RADIOLOGY",402,"76857",null,null,428]
[" 3200445","US OB LIMITED  EMERGENT","RADIOLOGY",402,"76815",null,null,471]
[" 3200437","US CHEST","RADIOLOGY",402,"76604",null,null,478]
["  506517","OPHTHALMIC US DX","RADIOLOGY",402,"76512",null,null,501]
[" 3200444","US EXT NON-VASC LMT","RADIOLOGY",402,"76882",null,null,519]
[" 3206706","US SCREENING ABDOMINAL AORTIC","RADIOLOGY",402,"76706",null,null,535]
[" 3206535","US THYROID","RADIOLOGY",402,"76536",null,null,589]
[" 3206810","US OB TRANSVAGINAL","RADIOLOGY",402,"76817",null,null,616]
[" 3200447","US EXT NON-VASCULAR","RADIOLOGY",402,"76881",null,null,625]
[" 3206730","US RENAL LTD","RADIOLOGY",402,"76775",null,null,642]
[" 3206765","US RETROPERITONEAL LMT","RADIOLOGY",402,"76775",null,null,642]
[" 3206870","US SCROTUM","RADIOLOGY",402,"76870",null,null,646]
[" 3200436","US NECK","RADIOLOGY",402,"76536",null,null,658]
[" 3210001","US SUPERFICIAL LUMP HEAD NECK","RADIOLOGY",402,"76536",null,null,698]
[" 3206830","US TRANSVAG PELVIS NON-OB","RADIOLOGY",402,"76830",null,null,708]
[" 3206811","US MIN 14 WEEKS OB EACH ADDL","RADIOLOGY",402,"76810",null,null,733]
[" 3206812","US OB 1ST TRIMESTER","RADIOLOGY",402,"76801",null,null,733]
[" 3206814","US OB 2ND 3RD TRIMESTER","RADIOLOGY",402,"76805",null,null,733]
[" 3200446","US GUIDE NEEDLE PLACEMENT","RADIOLOGY",402,"76942",null,null,753]
[" 3203962","US RENAL COMP","RADIOLOGY",402,"76770",null,null,770]
[" 3200440","US LMT ABDOMINAL","RADIOLOGY",402,"76705",null,null,775]
[" 3206850","US PELVIC COMP","RADIOLOGY",402,"76856",null,null,813]
[" 3206700","US ABDOMEN COMP","RADIOLOGY",402,"76700",null,null,840]
[" 3207003","US GUIDE ABSCESS","RADIOLOGY",402,"75989",null,null,1519]
[" 3000067","MA SCREEN BILATERAL ANNUAL","RADIOLOGY",403,"77067",null,null,403]
[" 3000066","MA  ANNUAL SCREENING BILATERAL","RADIOLOGY",403,"77067",null,null,450]
[" 5500010","PULMONARY REHAB 15MIN OTHE","RESPIRATORY THERAPY",410,"G0238",null,null,90]
[" 5500134","CHEST PHYSIO SUBSEQU","RESPIRATORY THERAPY",410,"94668",null,null,128]
[" 5500016","NEBULIZER TX INITIAL","RESPIRATORY THERAPY",410,"94664",null,null,151]
[" 5500026","MDI TX INITIAL","RESPIRATORY THERAPY",410,"94664",null,null,151]
[" 5500120","AEROSOL TRTMNT 1 DAILY","RESPIRATORY THERAPY",410,"94664",null,null,151]
[" 5500015","CHEST PHYSIO INITIAL","RESPIRATORY THERAPY",410,"94667",null,null,193]
[" 5500017","PULMONARY REHAB 15-MIN 1","RESPIRATORY THERAPY",410,"94799",null,null,214]
[" 5500011","PULMONARY REHAB GROUP","RESPIRATORY THERAPY",410,"G0239",null,null,251]
[" 5500023","NEBULIZER SUB 2ND MED FREQ","RESPIRATORY THERAPY",410,"94640",null,null,278]
[" 5500027","NEBULIZER MDI SUBSEQUENT","RESPIRATORY THERAPY",410,"94640",null,null,278]
[" 5500118","NEBULIZER SUBSEQUENT","RESPIRATORY THERAPY",410,"94640",null,null,278]
[" 5500165","BI-PAP/C-PAP PULMONARY TH","RESPIRATORY THERAPY",410,"94660",null,null,786]
[" 5500166","BI-PAP/C-PAP INITIAL","RESPIRATORY THERAPY",410,"94660",null,null,786]
[" 5500167","DAILY BI-PAP/C-PAP PULMON","RESPIRATORY THERAPY",410,"94660",null,null,786]
[" 5500111","VENT VOLUME SUBSEQUENT","RESPIRATORY THERAPY",410,"94003",null,null,1926]
[" 5500006","VENT VOLUME INITIAL","RESPIRATORY THERAPY",410,"94002",null,null,2140]
[" 5600001","PT  MOBILITY CURRENT STATUS","PHYSICAL THERAPY",420,"G8978",null,"GP",1]
[" 5600002","PT  MOBILTY PROJECT GOAL STATUS","PHYSICAL THERAPY",420,"G8979",null,"GP",1]
[" 5600003","PT  MOBILTY DISCHARGE STATUS","PHYSICAL THERAPY",420,"G8980",null,"GP",1]
[" 5600004","PT  CHG/MAINT CURRENT STATUS","PHYSICAL THERAPY",420,"G8981",null,"GP",1]
[" 5600005","PT  CHG/MAINT PROJECTED STATUS","PHYSICAL THERAPY",420,"G8982",null,"GP",1]
[" 5600006","PT  CHG/MAINT DISCHARGE STATUS","PHYSICAL THERAPY",420,"G8983",null,"GP",1]
[" 5600007","PT  CARRY/MOVE CURRENT STATUS","PHYSICAL THERAPY",420,"G8984",null,"GP",1]
[" 5600008","PT  CARRY/MOVE PROJECTED STATUS","PHYSICAL THERAPY",420,"G8985",null,"GP",1]
[" 5600009","PT  CARRY/MOVE DISCHARGE STATUS","PHYSICAL THERAPY",420,"G8986",null,null,1]
[" 5600010","PT  SELF CARE CURRENT STATUS","PHYSICAL THERAPY",420,"G8987",null,"GP",1]
[" 5600011","PT  SELF CARE PROJECTED STATUS","PHYSICAL THERAPY",420,"G8988",null,"GP",1]
[" 5600012","PT  SELF CARE DISCHARGE STATUS","PHYSICAL THERAPY",420,"G8989",null,"GP",1]
[" 5600013","PT  OTHER PT CURRENT STATUS","PHYSICAL THERAPY",420,"G8990",null,"GP",1]
[" 5600014","PT  OTHER PT PROJECTED STATUS","PHYSICAL THERAPY",420,"G8991",null,"GP",1]
[" 5600015","PT  OTHER PT DISCHARGE STATUS","PHYSICAL THERAPY",420,"G8992",null,"GP",1]
[" 5600016","PT  OTHER PT SUBSEQUENT CURRENT","PHYSICAL THERAPY",420,"G8993",null,"GP",1]
[" 5600017","PT  OTHER PT SUBSEQUENT PROJECT STATUS","PHYSICAL THERAPY",420,"G8994",null,"GP",1]
[" 5600018","PT  OTHER PT SUBSEQUENT DISCHARGE","PHYSICAL THERAPY",420,"G8995",null,"GP",1]
[" 5604333","PT  BODY POS CURRENT G8981-CH","PHYSICAL THERAPY",420,"G8981CHGP","CHGP",null,1]
[" 5604334","PT  BODY POS CURRENT G8981-CI","PHYSICAL THERAPY",420,"G8981CIGP","CIGP",null,1]
[" 5604335","PT  BODY POS CURRENT G8981-CJ","PHYSICAL THERAPY",420,"G8981CJGP","CJGP",null,1]
[" 5604336","PT  BODY POS CURRENT G8981-CK","PHYSICAL THERAPY",420,"G8981CKGP","CKGP",null,1]
[" 5604337","PT  BODY POS CURRENT G8981-CL","PHYSICAL THERAPY",420,"G8981CLGP","CLGP",null,1]
[" 5604338","PT  BODY POS CURRENT G8981-CM","PHYSICAL THERAPY",420,"G8981CMGP","CMGP",null,1]
[" 5604339","PT  BODY POS CURRENT G8981-CN","PHYSICAL THERAPY",420,"G8981CNGP","CNGP",null,1]
[" 5604340","PT  CARRY DC G8986-CH","PHYSICAL THERAPY",420,"G8986CHGP","CHGP",null,1]
[" 5604341","PT  CARRY DC G8986-CI","PHYSICAL THERAPY",420,"G8986CIGP","CIGP",null,1]
[" 5604342","PT  CARRY DC G8986-CJ","PHYSICAL THERAPY",420,"G8986CJGP","CJGP",null,1]
[" 5604343","PT  CARRY DC G8986-CK","PHYSICAL THERAPY",420,"G8986CKGP","CKGP",null,1]
[" 5604344","PT  CARRY DC G8986-CL","PHYSICAL THERAPY",420,"G8986CLGP","CLGP",null,1]
[" 5604345","PT  CARRY DC G8986-CM","PHYSICAL THERAPY",420,"G8986CMGP","CMGP",null,1]
[" 5604346","PT  CARRY DC G8986-CN","PHYSICAL THERAPY",420,"G8986CNGP","CNGP",null,1]
[" 5604347","PT  CARRY GOAL G8985-CH","PHYSICAL THERAPY",420,"G8985CHGP","CHGP",null,1]
[" 5604348","PT  CARRY GOAL G8985-CI","PHYSICAL THERAPY",420,"G8985CIGP","CIGP",null,1]
[" 5604349","PT  CARRY GOAL G8985-CJ","PHYSICAL THERAPY",420,"G8985CJGP","CJGP",null,1]
[" 5604350","PT  CARRY GOAL G8985-CK","PHYSICAL THERAPY",420,"G8985CKGP","CKGP",null,1]
[" 5604351","PT  CARRY GOAL G8985-CL","PHYSICAL THERAPY",420,"G8985CLGP","CLGP",null,1]
[" 5604352","PT  CARRY GOAL G8985-CM","PHYSICAL THERAPY",420,"G8985CMGP","CMGP",null,1]
[" 5604353","PT  CARRY GOAL G8985-CN","PHYSICAL THERAPY",420,"G8985CNGP","CNGP",null,1]
[" 5604354","PT  SELF-CARE DC G8989-CH","PHYSICAL THERAPY",420,"G8989CHGP","CHGP",null,1]
[" 5604355","PT  SELF-CARE DC G8989-CI","PHYSICAL THERAPY",420,"G8989CIGP","CIGP",null,1]
[" 5604356","PT  SELF-CARE DC G8989-CJ","PHYSICAL THERAPY",420,"G8989CJGP","CJGP",null,1]
[" 5604357","PT  SELF-CARE DC G8989-CK","PHYSICAL THERAPY",420,"G8989CKGP","CKGP",null,1]
[" 5604358","PT  SELF-CARE DC G8989-CL","PHYSICAL THERAPY",420,"G8989CLGP","CLGP",null,1]
[" 5604359","PT  SELF-CARE DC G8989-CM","PHYSICAL THERAPY",420,"G8989CMGP","CMGP",null,1]
[" 5604360","PT  SELF-CARE DC G8989-CN","PHYSICAL THERAPY",420,"G8989CNGP","CNGP",null,1]
[" 5604361","PT  SELF-CARE GOAL G8988-CH","PHYSICAL THERAPY",420,"G8988CHGP","CHGP",null,1]
[" 5604362","PT  SELF-CARE GOAL G8988-CI","PHYSICAL THERAPY",420,"G8988CIGP","CIGP",null,1]
[" 5604363","PT  SELF-CARE GOAL G8988-CJ","PHYSICAL THERAPY",420,"G8988CJGP","CJGP",null,1]
[" 5604364","PT  SELF-CARE GOAL G8988-CK","PHYSICAL THERAPY",420,"G8988CKGP","CKGP",null,1]
[" 5604365","PT  SELF-CARE GOAL G8988-CL","PHYSICAL THERAPY",420,"G8988CLGP","CLGP",null,1]
[" 5604366","PT  SELF-CARE GOAL G8988-CM","PHYSICAL THERAPY",420,"G8988CMGP","CMGP",null,1]
[" 5604367","PT  SELF-CARE GOAL G8988-CN","PHYSICAL THERAPY",420,"G8988CNGP","CNGP",null,1]
[" 5604368","PT  SUB PT/OT GOAL G8994-CH","PHYSICAL THERAPY",420,"G8994CHGP","CHGP",null,1]
[" 5604369","PT  SUB PT/OT GOAL G8994-CI","PHYSICAL THERAPY",420,"G8994CIGP","CIGP",null,1]
[" 5604370","PT  SUB PT/OT GOAL G8994-CJ","PHYSICAL THERAPY",420,"G8994CJGP","CJGP",null,1]
[" 5604371","PT  SUB PT/OT GOAL G8994-CK","PHYSICAL THERAPY",420,"G8994CKGP","CKGP",null,1]
[" 5604372","PT  SUB PT/OT GOAL G8994-CL","PHYSICAL THERAPY",420,"G8994CLGP","CLGP",null,1]
[" 5604373","PT  SUB PT/OT GOAL G8994-CM","PHYSICAL THERAPY",420,"G8994CMGP","CMGP",null,1]
[" 5604374","PT  SUB PT/OT GOAL G8994-CN","PHYSICAL THERAPY",420,"G8994CNGP","CNGP",null,1]
[" 5604375","PT  BODY POS DC G8983-CH","PHYSICAL THERAPY",420,"G8983CHGP","CHGP",null,1]
[" 5604376","PT  BODY POS DC G8983-CI","PHYSICAL THERAPY",420,"G8983CIGP","CIGP",null,1]
[" 5604377","PT  BODY POS DC G8983-CJ","PHYSICAL THERAPY",420,"G8983CJGP","CJGP",null,1]
[" 5604378","PT  BODY POS DC G8983-CK","PHYSICAL THERAPY",420,"G8983CKGP","CKGP",null,1]
[" 5604379","PT  BODY POS DC G8983-CL","PHYSICAL THERAPY",420,"G8983CLGP","CLGP",null,1]
[" 5604380","PT  BODY POS DC G8983-CM","PHYSICAL THERAPY",420,"G8983CMGP","CMGP",null,1]
[" 5604381","PT  BODY POS DC G8983-CN","PHYSICAL THERAPY",420,"G8983CNGP","CNGP",null,1]
[" 5604382","PT  BODY POS GOAL G8982-CH","PHYSICAL THERAPY",420,"G8982CHGP","CHGP",null,1]
[" 5604383","PT  BODY POS GOAL G8982-CI","PHYSICAL THERAPY",420,"G8982CIGP","CIGP",null,1]
[" 5604384","PT  BODY POS GOAL G8982-CJ","PHYSICAL THERAPY",420,"G8982CJGP","CJGP",null,1]
[" 5604385","PT  BODY POS GOAL G8982-CK","PHYSICAL THERAPY",420,"G8982CKGP","CKGP",null,1]
[" 5604386","PT  BODY POS GOAL G8982-CL","PHYSICAL THERAPY",420,"G8982CLGP","CLGP",null,1]
[" 5604387","PT  BODY POS GOAL G8982-CM","PHYSICAL THERAPY",420,"G8982CMGP","CMGP",null,1]
[" 5604388","PT  BODY POS GOAL G8982-CN","PHYSICAL THERAPY",420,"G8982CNGP","CNGP",null,1]
[" 5604389","PT  CARRY CURRENT G8984 -CH","PHYSICAL THERAPY",420,"G8984CHGP","CHGP",null,1]
[" 5604390","PT  CARRY CURRENT G8984 -CI","PHYSICAL THERAPY",420,"G8984CIGP","CIGP",null,1]
[" 5604391","PT  CARRY CURRENT G8984 -CJ","PHYSICAL THERAPY",420,"G8984CJGP","CJGP",null,1]
[" 5604392","PT  CARRY CURRENT G8984 -CK","PHYSICAL THERAPY",420,"G8984CKGP","CKGP",null,1]
[" 5604393","PT  CARRY CURRENT G8984 -CL","PHYSICAL THERAPY",420,"G8984CLGP","CLGP",null,1]
[" 5604394","PT  CARRY CURRENT G8984 -CM","PHYSICAL THERAPY",420,"G8984CMGP","CMGP",null,1]
[" 5604395","PT  CARRY CURRENT G8984 -CN","PHYSICAL THERAPY",420,"G8984CNGP","CNGP",null,1]
[" 5604396","PT  MOBILITY CURRENT G8978- CH","PHYSICAL THERAPY",420,"G8978CHGP","CHGP",null,1]
[" 5604397","PT  MOBILITY CURRENT G8978- CI","PHYSICAL THERAPY",420,"G8978CIGP","CIGP",null,1]
[" 5604398","PT  MOBILITY CURRENT G8978- CJ","PHYSICAL THERAPY",420,"G8978CJGP","CJGP",null,1]
[" 5604399","PT  MOBILITY CURRENT G8978- CK","PHYSICAL THERAPY",420,"G8978CKGP","CKGP",null,1]
[" 5604400","PT  MOBILITY CURRENT G8978- CL","PHYSICAL THERAPY",420,"G8978CLGP","CLGP",null,1]
[" 5604401","PT  MOBILITY CURRENT G8978- CM","PHYSICAL THERAPY",420,"G8978CMGP","CMGP",null,1]
[" 5604402","PT  MOBILITY CURRENT G8978- CN","PHYSICAL THERAPY",420,"G8978CNGP","CNGP",null,1]
[" 5604403","PT  MOBILITY DC G8980-CH","PHYSICAL THERAPY",420,"G8980CHGP","CHGP",null,1]
[" 5604404","PT  MOBILITY DC G8980-CI","PHYSICAL THERAPY",420,"G8980CIGP","CIGP",null,1]
[" 5604405","PT  MOBILITY DC G8980-CJ","PHYSICAL THERAPY",420,"G8980CJGP","CJGP",null,1]
[" 5604406","PT  MOBILITY DC G8980-CK","PHYSICAL THERAPY",420,"G8980CKGP","CKGP",null,1]
[" 5604407","PT  MOBILITY DC G8980-CL","PHYSICAL THERAPY",420,"G8980CLGP","CLGP",null,1]
[" 5604408","PT  MOBILITY DC G8980-CM","PHYSICAL THERAPY",420,"G8980CMGP","CMGP",null,1]
[" 5604409","PT  MOBILITY DC G8980-CN","PHYSICAL THERAPY",420,"G8980CNGP","CNGP",null,1]
[" 5604410","PT  MOBILITY GOAL G8979-CH","PHYSICAL THERAPY",420,"G8979CHGP","CHGP",null,1]
[" 5604411","PT  MOBILITY GOAL G8979-CI","PHYSICAL THERAPY",420,"G8979CIGP","CIGP",null,1]
[" 5604412","PT  MOBILITY GOAL G8979-CJ","PHYSICAL THERAPY",420,"G8979CJGP","CJGP",null,1]
[" 5604413","PT  MOBILITY GOAL G8979-CK","PHYSICAL THERAPY",420,"G8979CKGP","CKGP",null,1]
[" 5604414","PT  MOBILITY GOAL G8979-CL","PHYSICAL THERAPY",420,"G8979CLGP","CLGP",null,1]
[" 5604415","PT  MOBILITY GOAL G8979-CM","PHYSICAL THERAPY",420,"G8979CMGP","CMGP",null,1]
[" 5604416","PT  MOBILITY GOAL G8979-CN","PHYSICAL THERAPY",420,"G8979CNGP","CNGP",null,1]
[" 5604417","PT  OTHER PT/OT CURRENT G8990-CH","PHYSICAL THERAPY",420,"G8990CHGP","CHGP",null,1]
[" 5604418","PT  OTHER PT/OT CURRENT G8990-CI","PHYSICAL THERAPY",420,"G8990CIGP","CIGP",null,1]
[" 5604419","PT  OTHER PT/OT CURRENT G8990-CJ","PHYSICAL THERAPY",420,"G8990CJGP","CJGP",null,1]
[" 5604420","PT  OTHER PT/OT CURRENT G8990-CK","PHYSICAL THERAPY",420,"G8990CKGP","CKGP",null,1]
[" 5604421","PT  OTHER PT/OT CURRENT G8990-CL","PHYSICAL THERAPY",420,"G8990CLGP","CLGP",null,1]
[" 5604422","PT  OTHER PT/OT CURRENT G8990-CM","PHYSICAL THERAPY",420,"G8990CMGP","CMGP",null,1]
[" 5604423","PT  OTHER PT/OT CURRENT G8990-CN","PHYSICAL THERAPY",420,"G8990CNGP","CNGP",null,1]
[" 5604424","PT  OTHER PT/OT DC G8992-CH","PHYSICAL THERAPY",420,"G8992CHGP","CHGP",null,1]
[" 5604425","PT  OTHER PT/OT DC G8992-CI","PHYSICAL THERAPY",420,"G8992CIGP","CIGP",null,1]
[" 5604426","PT  OTHER PT/OT DC G8992-CJ","PHYSICAL THERAPY",420,"G8992CJGP","CJGP",null,1]
[" 5604427","PT  OTHER PT/OT DC G8992-CK","PHYSICAL THERAPY",420,"G8992CKGP","CKGP",null,1]
[" 5604428","PT  OTHER PT/OT DC G8992-CL","PHYSICAL THERAPY",420,"G8992CLGP","CLGP",null,1]
[" 5604429","PT  OTHER PT/OT DC G8992-CM","PHYSICAL THERAPY",420,"G8992CMGP","CMGP",null,1]
[" 5604430","PT  OTHER PT/OT DC G8992-CN","PHYSICAL THERAPY",420,"G8992CNGP","CNGP",null,1]
[" 5604431","PT  OTHER PT/OT GOAL G8991-CH","PHYSICAL THERAPY",420,"G8991CHGP","CHGP",null,1]
[" 5604432","PT  OTHER PT/OT GOAL G8991-CI","PHYSICAL THERAPY",420,"G8991CIGP","CIGP",null,1]
[" 5604433","PT  OTHER PT/OT GOAL G8991-CJ","PHYSICAL THERAPY",420,"G8991CJGP","CJGP",null,1]
[" 5604434","PT  OTHER PT/OT GOAL G8991-CK","PHYSICAL THERAPY",420,"G8991CKGP","CKGP",null,1]
[" 5604435","PT  OTHER PT/OT GOAL G8991-CL","PHYSICAL THERAPY",420,"G8991CLGP","CLGP",null,1]
[" 5604436","PT  OTHER PT/OT GOAL G8991-CM","PHYSICAL THERAPY",420,"G8991CMGP","CMGP",null,1]
[" 5604437","PT  OTHER PT/OT GOAL G8991-CN","PHYSICAL THERAPY",420,"G8991CNGP","CNGP",null,1]
[" 5604438","PT  SELF-CARE CURRENT G8987-CH","PHYSICAL THERAPY",420,"G8987CHGP","CHGP",null,1]
[" 5604439","PT  SELF-CARE CURRENT G8987-CI","PHYSICAL THERAPY",420,"G8987CIGP","CIGP",null,1]
[" 5604440","PT  SELF-CARE CURRENT G8987-CJ","PHYSICAL THERAPY",420,"G8987CJGP","CJGP",null,1]
[" 5604441","PT  SELF-CARE CURRENT G8987-CK","PHYSICAL THERAPY",420,"G8987CKGP","CKGP",null,1]
[" 5604442","PT  SELF-CARE CURRENT G8987-CL","PHYSICAL THERAPY",420,"G8987CLGP","CLGP",null,1]
[" 5604443","PT  SELF-CARE CURRENT G8987-CM","PHYSICAL THERAPY",420,"G8987CMGP","CMGP",null,1]
[" 5604444","PT  SELF-CARE CURRENT G8987-CN","PHYSICAL THERAPY",420,"G8987CNGP","CNGP",null,1]
[" 5604445","PT  SUB PT/OT CURRENT G8993-CH","PHYSICAL THERAPY",420,"G8993CHGP","CHGP",null,1]
[" 5604446","PT  SUB PT/OT CURRENT G8993-CI","PHYSICAL THERAPY",420,"G8993CIGP","CIGP",null,1]
[" 5604447","PT  SUB PT/OT CURRENT G8993-CJ","PHYSICAL THERAPY",420,"G8993CJGP","CJGP",null,1]
[" 5604448","PT  SUB PT/OT CURRENT G8993-CK","PHYSICAL THERAPY",420,"G8993CKGP","CKGP",null,1]
[" 5604449","PT  SUB PT/OT CURRENT G8993-CL","PHYSICAL THERAPY",420,"G8993CLGP","CLGP",null,1]
[" 5604450","PT  SUB PT/OT CURRENT G8993-CM","PHYSICAL THERAPY",420,"G8993CMGP","CMGP",null,1]
[" 5604451","PT  SUB PT/OT CURRENT G8993-CN","PHYSICAL THERAPY",420,"G8993CNGP","CNGP",null,1]
[" 5604452","PT  SUB PT/OT DC G8995-CH","PHYSICAL THERAPY",420,"G8995CHGP","CHGP",null,1]
[" 5604453","PT  SUB PT/OT DC G8995-CI","PHYSICAL THERAPY",420,"G8995CIGP","CIGP",null,1]
[" 5604454","PT  SUB PT/OT DC G8995-CJ","PHYSICAL THERAPY",420,"G8995CJGP","CJGP",null,1]
[" 5604455","PT  SUB PT/OT DC G8995-CK","PHYSICAL THERAPY",420,"G8995CKGP","CKGP",null,1]
[" 5604456","PT  SUB PT/OT DC G8995-CL","PHYSICAL THERAPY",420,"G8995CLGP","CLGP",null,1]
[" 5604457","PT  SUB PT/OT DC G8995-CM","PHYSICAL THERAPY",420,"G8995CMGP","CMGP",null,1]
[" 5604458","PT  SUB PT/OT DC G8995-CN","PHYSICAL THERAPY",420,"G8995CNGP","CNGP",null,1]
[" 5601204","PT BODY FAT COMPOSITN TEST 15 MIN","PHYSICAL THERAPY",420,null,null,null,28]
[" 5600057","PT MASSAGE 15 MIN","PHYSICAL THERAPY",420,"97124",null,"GP",75]
[" 5600058","ULTRASOUND 15MIN","PHYSICAL THERAPY",420,"97035",null,"GP",75]
[" 5600055","UNATTENDED ELEC STIM","PHYSICAL THERAPY",420,"97014",null,"GP",77]
[" 5602207","ATTENDED ELEC STIM 15MIN","PHYSICAL THERAPY",420,"97032",null,"GP",77]
[" 5600042","PT MASSAGE 15 MIN","PHYSICAL THERAPY",420,"97124",null,"GP",80]
[" 5600044","THERA ACTIVITY 1ON1 15MIN","PHYSICAL THERAPY",420,"97530",null,"GP",80]
[" 5600035","PT PARAFFIN TREATMENT","PHYSICAL THERAPY",420,"97018",null,"GP",82]
[" 5600030","PT NEUROSTIMULATOR/TENS","PHYSICAL THERAPY",420,"64550",null,"GP",85]
[" 5600034","PT UNATTENDED E-STIM","PHYSICAL THERAPY",420,"97014",null,"GP",85]
[" 5600048","PT ULTRASOUND THERAPY","PHYSICAL THERAPY",420,"97035",null,"GP",85]
[" 5600098","WC ASSESS/FIT/TRAIN 15M","PHYSICAL THERAPY",420,"97542",null,"GP",90]
[" 5600121","GAIT TRAINING 15MIN","PHYSICAL THERAPY",420,"97116",null,"GP",90]
[" 5600036","PT ATTENDED E-STIM 15 MIN","PHYSICAL THERAPY",420,"97032",null,"GP",92]
[" 5601203","NEUROMUSCULAR RE-ED 15 MIN","PHYSICAL THERAPY",420,"97112",null,"GP",92]
[" 5600038","THER EX 1OR MORE 15MIN","PHYSICAL THERAPY",420,"97110",null,"GP",93]
[" 5600045","PT WHEELCHAIR MANAGEMENT","PHYSICAL THERAPY",420,"97542",null,"GP",93]
[" 5600174","PT WHIRLPOOL EXTREMITY","PHYSICAL THERAPY",420,"97022",null,"GP",93]
[" 5600310","PT TELE WHEELCHAIR MANAGEMENT","PHYSICAL THERAPY",420,"9754295","95","GP95",93]
[" 5600080","MANUAL THERAPY 15MIN","PHYSICAL THERAPY",420,"97140",null,"GP",95]
[" 5600306","PT TELE CANALITH REPOSITIONING","PHYSICAL THERAPY",420,"9599295","95","GP95",96]
[" 5600308","PT TELE THERAPEUTIC ACTIVITY 15 MIN","PHYSICAL THERAPY",420,"9753095","95","GP95",96]
[" 5600309","PT TELE GAIT TRAINING 15 MIN","PHYSICAL THERAPY",420,"9711695","95","GP95",96]
[" 5600992","PT CANALITH REPOSITIONING","PHYSICAL THERAPY",420,"95992",null,"GP",96]
[" 5600033","PT MECHANICAL TRACTION","PHYSICAL THERAPY",420,"97012",null,"GP",97]
[" 5600311","PT TELE NEUROMUSCULAR RE-ED 15 MIN","PHYSICAL THERAPY",420,"9711295","95","GP95",98]
[" 5600041","PT GAIT TRAINING 15 MIN","PHYSICAL THERAPY",420,"97116",null,"GP",100]
[" 5600049","IONTOPHORESIS 15 MIN","PHYSICAL THERAPY",420,"97033",null,"GP",102]
[" 5600305","PT TELE THERAPEUTIC EXERCISE 15 MIN","PHYSICAL THERAPY",420,"9711095","95","GP95",102]
[" 5600307","PT TELE MANUAL THERAPY 15 MIN","PHYSICAL THERAPY",420,"9714095","95","GP95",102]
[" 5600040","PT AQUATIC THERAPY","PHYSICAL THERAPY",420,"97113",null,"GP",107]
[" 5600039","PT NEUROMUSCULAR RE-ED 15 MIN","PHYSICAL THERAPY",420,"97112",null,"GP",110]
[" 5600043","PT MANUAL THERAPY 15 MIN","PHYSICAL THERAPY",420,"97140",null,"GP",110]
[" 5600116","PT THERAPEUTIC EXERCISE 15 MIN","PHYSICAL THERAPY",420,"97110",null,"GP",110]
[" 5600208","PT THERAPEUTIC ACTIVITY 15 MIN","PHYSICAL THERAPY",420,"97530",null,"GP",110]
[" 5600037","PT IONTOPHORESIS 15 MIN","PHYSICAL THERAPY",420,"97033",null,"GP",118]
[" 5600047","PT ORTHOTICS FIT AND TRAIN","PHYSICAL THERAPY",420,"97760",null,"GP",118]
[" 5800543","OT ORTHOTICS FIT AND TRAIN","PHYSICAL THERAPY",420,"97760",null,"GO",118]
[" 5600046","PT NON-SELECTIVE DEBRIDEMENT","PHYSICAL THERAPY",420,"97602",null,"GP",193]
[" 5800200","OT NON-SELECTIVE DEBRIDEMENT","PHYSICAL THERAPY",420,"97602",null,"GO",193]
[" 5600023","PT E-VISIT 5-10 MIN","PHYSICAL THERAPY",424,"G2061",null,"GP",39]
[" 5600024","PT E- VISIT 11-20 MINUTES","PHYSICAL THERAPY",424,"G2062",null,"GP",68]
[" 5600304","PT TELE SELF CARE HOME MGT TRAINING 15 M","PHYSICAL THERAPY",424,"9753595","95","GP95",91]
[" 5604164","PT RE-EVALUATION","PHYSICAL THERAPY",424,"97164",null,"GP",105]
[" 5600025","PT E-VISIT >21 MINS","PHYSICAL THERAPY",424,"G2063",null,"GP",107]
[" 5600535","PT SELF CARE HOME MGMT TRAINING 15 MIN","PHYSICAL THERAPY",424,"97535",null,"GP",110]
[" 5600022","PT RE-EVALUATION","PHYSICAL THERAPY",424,"97164",null,"GP",112]
[" 5600303","PT TELE RE-EVALUATION","PHYSICAL THERAPY",424,"9716495","95","GP95",112]
[" 5604161","PT EVAL OF LOW COMPLEX 20 MINS","PHYSICAL THERAPY",424,"97161",null,"GP",140]
[" 5600300","PT TELE EVAL LOW COMPLEXITY","PHYSICAL THERAPY",424,"9716195","95","GP95",150]
[" 5600019","PT EVAL LOW COMPLEXITY","PHYSICAL THERAPY",424,"97161",null,"GP",160]
[" 5600200","PT EVAL MODERATE COMPLEXITY","PHYSICAL THERAPY",424,"97162",null,"GP",160]
[" 5604162","PT EVAL OF MOD COMPLEX 30 MINS","PHYSICAL THERAPY",424,"97162",null,"GP",160]
[" 5600020","PT EVAL MODERATE COMPLEXITY","PHYSICAL THERAPY",424,"97162",null,"GP",171]
[" 5600301","PT TELE EVAL MODERATE COMPLEXITY","PHYSICAL THERAPY",424,"9716295","95","GP95",171]
[" 5604163","PT EVAL OF HIGH COMPLEX 45 MIN","PHYSICAL THERAPY",424,"97163",null,"GP",180]
[" 5600021","PT EVAL HIGH COMPLEXITY","PHYSICAL THERAPY",424,"97163",null,"GP",193]
[" 5600302","PT TELE EVAL HIGH COMPLEXITY","PHYSICAL THERAPY",424,"9716395","95","GP95",193]
[" 5604165","OT  OTHER PT/OT CURRENT G8990-CH","OCCUPATIONAL THERAPY",430,"G8990CHGO","CHGO",null,1]
[" 5604166","OT  OTHER PT/OT CURRENT G8990-CI","OCCUPATIONAL THERAPY",430,"G8990CIGO","CIGO",null,1]
[" 5604167","OT  OTHER PT/OT CURRENT G8990-CJ","OCCUPATIONAL THERAPY",430,"G8990CJGO","CJGO",null,1]
[" 5604168","OT  OTHER PT/OT CURRENT G8990-CK","OCCUPATIONAL THERAPY",430,"G8990CKGO","CKGO",null,1]
[" 5604169","OT  OTHER PT/OT CURRENT G8990-CL","OCCUPATIONAL THERAPY",430,"G8990CLGO","CLGO",null,1]
[" 5604170","OT  OTHER PT/OT CURRENT G8990-CM","OCCUPATIONAL THERAPY",430,"G8990CMGO","CMGO",null,1]
[" 5604171","OT  OTHER PT/OT CURRENT G8990-CN","OCCUPATIONAL THERAPY",430,"G8990CNGO","CNGO",null,1]
[" 5604172","OT  ATTEN CURRENT G9165-CH","OCCUPATIONAL THERAPY",430,"G9165CHGO","CHGO",null,1]
[" 5604173","OT  ATTEN CURRENT G9165-CI","OCCUPATIONAL THERAPY",430,"G9165CIGO","CIGO",null,1]
[" 5604174","OT  ATTEN CURRENT G9165-CJ","OCCUPATIONAL THERAPY",430,"G9165CJGO","CJGO",null,1]
[" 5604175","OT  ATTEN CURRENT G9165-CK","OCCUPATIONAL THERAPY",430,"G9165CKGO","CKGO",null,1]
[" 5604176","OT  ATTEN CURRENT G9165-CL","OCCUPATIONAL THERAPY",430,"G9165CLGO","CLGO",null,1]
[" 5604177","OT  ATTEN CURRENT G9165-CM","OCCUPATIONAL THERAPY",430,"G9165CMGO","CMGO",null,1]
[" 5604178","OT  ATTEN CURRENT G9165-CN","OCCUPATIONAL THERAPY",430,"G9165CNGO","CNGO",null,1]
[" 5604179","OT  ATTEN GOAL G9166-CH","OCCUPATIONAL THERAPY",430,"G9166CHGO","CHGO",null,1]
[" 5604180","OT  ATTEN GOAL G9166-CI","OCCUPATIONAL THERAPY",430,"G9166CIGO","CIGO",null,1]
[" 5604181","OT  ATTEN GOAL G9166-CJ","OCCUPATIONAL THERAPY",430,"G9166CJGO","CJGO",null,1]
[" 5604182","OT  ATTEN GOAL G9166-CK","OCCUPATIONAL THERAPY",430,"G9166CKGO","CKGO",null,1]
[" 5604183","OT  ATTEN GOAL G9166-CL","OCCUPATIONAL THERAPY",430,"G9166CLGO","CLGO",null,1]
[" 5604184","OT  ATTEN GOAL G9166-CM","OCCUPATIONAL THERAPY",430,"G9166CMGO","CMGO",null,1]
[" 5604185","OT  ATTEN GOAL G9166-CN","OCCUPATIONAL THERAPY",430,"G9166CNGO","CNGO",null,1]
[" 5604186","OT  BODY POS CURRENT G8981-CH","OCCUPATIONAL THERAPY",430,"G8981CHGO","CHGO",null,1]
[" 5604187","OT  BODY POS CURRENT G8981-CI","OCCUPATIONAL THERAPY",430,"G8981CIGO","CIGO",null,1]
[" 5604188","OT  BODY POS CURRENT G8981-CJ","OCCUPATIONAL THERAPY",430,"G8981CJGO","CJGO",null,1]
[" 5604189","OT  BODY POS CURRENT G8981-CK","OCCUPATIONAL THERAPY",430,"G8981CKGO","CKGO",null,1]
[" 5604190","OT  BODY POS CURRENT G8981-CL","OCCUPATIONAL THERAPY",430,"G8981CLGO","CLGO",null,1]
[" 5604191","OT  BODY POS CURRENT G8981-CM","OCCUPATIONAL THERAPY",430,"G8981CMGO","CMGO",null,1]
[" 5604192","OT  BODY POS CURRENT G8981-CN","OCCUPATIONAL THERAPY",430,"G8981CNGO","CNGO",null,1]
[" 5604193","OT  CARRY DC G8986-CH","OCCUPATIONAL THERAPY",430,"G8986CHGO","CHGO",null,1]
[" 5604194","OT  CARRY DC G8986-CI","OCCUPATIONAL THERAPY",430,"G8986CIGO","CIGO",null,1]
[" 5604195","OT  CARRY DC G8986-CJ","OCCUPATIONAL THERAPY",430,"G8986CJGO","CJGO",null,1]
[" 5604196","OT  CARRY DC G8986-CK","OCCUPATIONAL THERAPY",430,"G8986CKGO","CKGO",null,1]
[" 5604197","OT  CARRY DC G8986-CL","OCCUPATIONAL THERAPY",430,"G8986CLGO","CLGO",null,1]
[" 5604198","OT  CARRY DC G8986-CM","OCCUPATIONAL THERAPY",430,"G8986CMGO","CMGO",null,1]
[" 5604199","OT  CARRY DC G8986-CN","OCCUPATIONAL THERAPY",430,"G8986CNGO","CNGO",null,1]
[" 5604200","OT  CARRY GOAL G8985-CH","OCCUPATIONAL THERAPY",430,"G8985CHGO","CHGO",null,1]
[" 5604201","OT  CARRY GOAL G8985-CI","OCCUPATIONAL THERAPY",430,"G8985CIGO","CIGO",null,1]
[" 5604202","OT  CARRY GOAL G8985-CJ","OCCUPATIONAL THERAPY",430,"G8985CJGO","CJGO",null,1]
[" 5604203","OT  CARRY GOAL G8985-CK","OCCUPATIONAL THERAPY",430,"G8985CKGO","CKGO",null,1]
[" 5604204","OT  CARRY GOAL G8985-CL","OCCUPATIONAL THERAPY",430,"G8985CLGO","CLGO",null,1]
[" 5604205","OT  CARRY GOAL G8985-CM","OCCUPATIONAL THERAPY",430,"G8985CMGO","CMGO",null,1]
[" 5604206","OT  CARRY GOAL G8985-CN","OCCUPATIONAL THERAPY",430,"G8985CNGO","CNGO",null,1]
[" 5604207","OT  MEMORY CURRENT G9168-CH","OCCUPATIONAL THERAPY",430,"G9168CHGO","CHGO",null,1]
[" 5604208","OT  MEMORY CURRENT G9168-CI","OCCUPATIONAL THERAPY",430,"G9168CIGO","CIGO",null,1]
[" 5604209","OT  MEMORY CURRENT G9168-CJ","OCCUPATIONAL THERAPY",430,"G9168CJGO","CJGO",null,1]
[" 5604210","OT  MEMORY CURRENT G9168-CK","OCCUPATIONAL THERAPY",430,"G9168CKGO","CKGO",null,1]
[" 5604211","OT  MEMORY CURRENT G9168-CL","OCCUPATIONAL THERAPY",430,"G9168CLGO","CLGO",null,1]
[" 5604212","OT  MEMORY CURRENT G9168-CM","OCCUPATIONAL THERAPY",430,"G9168CMGO","CMGO",null,1]
[" 5604213","OT  MEMORY CURRENT G9168-CN","OCCUPATIONAL THERAPY",430,"G9168CNGO","CNGO",null,1]
[" 5604214","OT  MEMORY DC G9170-CH","OCCUPATIONAL THERAPY",430,"G9170CHGO","CHGO",null,1]
[" 5604215","OT  MEMORY DC G9170-CI","OCCUPATIONAL THERAPY",430,"G9170CIGO","CIGO",null,1]
[" 5604216","OT  MEMORY DC G9170-CJ","OCCUPATIONAL THERAPY",430,"G9170CJGO","CJGO",null,1]
[" 5604217","OT  MEMORY DC G9170-CK","OCCUPATIONAL THERAPY",430,"G9170CKGO","CKGO",null,1]
[" 5604218","OT  MEMORY DC G9170-CL","OCCUPATIONAL THERAPY",430,"G9170CLGO","CLGO",null,1]
[" 5604219","OT  MEMORY DC G9170-CM","OCCUPATIONAL THERAPY",430,"G9170CMGO","CMGO",null,1]
[" 5604220","OT  MEMORY DC G9170-CN","OCCUPATIONAL THERAPY",430,"G9170CNGO","CNGO",null,1]
[" 5604221","OT  MEMORY GOAL G9169-CH","OCCUPATIONAL THERAPY",430,"G9169CHGO","CHGO",null,1]
[" 5604222","OT  MEMORY GOAL G9169-CI","OCCUPATIONAL THERAPY",430,"G9169CIGO","CIGO",null,1]
[" 5604223","OT  MEMORY GOAL G9169-CJ","OCCUPATIONAL THERAPY",430,"G9169CJGO","CJGO",null,1]
[" 5604224","OT  MEMORY GOAL G9169-CK","OCCUPATIONAL THERAPY",430,"G9169CKGO","CKGO",null,1]
[" 5604225","OT  MEMORY GOAL G9169-CL","OCCUPATIONAL THERAPY",430,"G9169CLGO","CLGO",null,1]
[" 5604226","OT  MEMORY GOAL G9169-CM","OCCUPATIONAL THERAPY",430,"G9169CMGO","CMGO",null,1]
[" 5604227","OT  MEMORY GOAL G9169-CN","OCCUPATIONAL THERAPY",430,"G9169CNGO","CNGO",null,1]
[" 5604228","OT  SELF-CARE DC G8989-CH","OCCUPATIONAL THERAPY",430,"G8989CHGO","CHGO",null,1]
[" 5604229","OT  SELF-CARE DC G8989-CI","OCCUPATIONAL THERAPY",430,"G8989CIGO","CIGO",null,1]
[" 5604230","OT  SELF-CARE DC G8989-CJ","OCCUPATIONAL THERAPY",430,"G8989CJGO","CJGO",null,1]
[" 5604231","OT  SELF-CARE DC G8989-CK","OCCUPATIONAL THERAPY",430,"G8989CKGO","CKGO",null,1]
[" 5604232","OT  SELF-CARE DC G8989-CL","OCCUPATIONAL THERAPY",430,"G8989CLGO","CLGO",null,1]
[" 5604233","OT  SELF-CARE DC G8989-CM","OCCUPATIONAL THERAPY",430,"G8989CMGO","CMGO",null,1]
[" 5604234","OT  SELF-CARE DC G8989-CN","OCCUPATIONAL THERAPY",430,"G8989CNGO","CNGO",null,1]
[" 5604235","OT  SELF-CARE GOAL G8988-CH","OCCUPATIONAL THERAPY",430,"G8988CHGO","CHGO",null,1]
[" 5604236","OT  SELF-CARE GOAL G8988-CI","OCCUPATIONAL THERAPY",430,"G8988CIGO","CIGO",null,1]
[" 5604237","OT  SELF-CARE GOAL G8988-CJ","OCCUPATIONAL THERAPY",430,"G8988CJGO","CJGO",null,1]
[" 5604238","OT  SELF-CARE GOAL G8988-CK","OCCUPATIONAL THERAPY",430,"G8988CKGO","CKGO",null,1]
[" 5604239","OT  SELF-CARE GOAL G8988-CL","OCCUPATIONAL THERAPY",430,"G8988CLGO","CLGO",null,1]
[" 5604240","OT  SELF-CARE GOAL G8988-CM","OCCUPATIONAL THERAPY",430,"G8988CMGO","CMGO",null,1]
[" 5604241","OT  SELF-CARE GOAL G8988-CN","OCCUPATIONAL THERAPY",430,"G8988CNGO","CNGO",null,1]
[" 5604242","OT  SUB PT/OT GOAL G8994-CH","OCCUPATIONAL THERAPY",430,"G8994CHGO","CHGO",null,1]
[" 5604243","OT  SUB PT/OT GOAL G8994-CI","OCCUPATIONAL THERAPY",430,"G8994CIGO","CIGO",null,1]
[" 5604244","OT  SUB PT/OT GOAL G8994-CJ","OCCUPATIONAL THERAPY",430,"G8994CJGO","CJGO",null,1]
[" 5604245","OT  SUB PT/OT GOAL G8994-CK","OCCUPATIONAL THERAPY",430,"G8994CKGO","CKGO",null,1]
[" 5604246","OT  SUB PT/OT GOAL G8994-CL","OCCUPATIONAL THERAPY",430,"G8994CLGO","CLGO",null,1]
[" 5604247","OT  SUB PT/OT GOAL G8994-CM","OCCUPATIONAL THERAPY",430,"G8994CMGO","CMGO",null,1]
[" 5604248","OT  SUB PT/OT GOAL G8994-CN","OCCUPATIONAL THERAPY",430,"G8994CNGO","CNGO",null,1]
[" 5604249","OT  ATTEN DC G9167-CH","OCCUPATIONAL THERAPY",430,"G9167CHGO","CHGO",null,1]
[" 5604250","OT  ATTEN DC G9167-CI","OCCUPATIONAL THERAPY",430,"G9167CIGO","CIGO",null,1]
[" 5604251","OT  ATTEN DC G9167-CJ","OCCUPATIONAL THERAPY",430,"G9167CJGO","CJGO",null,1]
[" 5604252","OT  ATTEN DC G9167-CK","OCCUPATIONAL THERAPY",430,"G9167CKGO","CKGO",null,1]
[" 5604253","OT  ATTEN DC G9167-CL","OCCUPATIONAL THERAPY",430,"G9167CLGO","CLGO",null,1]
[" 5604254","OT  ATTEN DC G9167-CM","OCCUPATIONAL THERAPY",430,"G9167CMGO","CMGO",null,1]
[" 5604255","OT  ATTEN DC G9167-CN","OCCUPATIONAL THERAPY",430,"G9167CNGO","CNGO",null,1]
[" 5604256","OT  BODY POS DC G8983-CH","OCCUPATIONAL THERAPY",430,"G8983CHGO","CHGO",null,1]
[" 5604257","OT  BODY POS DC G8983-CI","OCCUPATIONAL THERAPY",430,"G8983CIGO","CIGO",null,1]
[" 5604258","OT  BODY POS DC G8983-CJ","OCCUPATIONAL THERAPY",430,"G8983CJGO","CJGO",null,1]
[" 5604259","OT  BODY POS DC G8983-CK","OCCUPATIONAL THERAPY",430,"G8983CKGO","CKGO",null,1]
[" 5604260","OT  BODY POS DC G8983-CL","OCCUPATIONAL THERAPY",430,"G8983CLGO","CLGO",null,1]
[" 5604261","OT  BODY POS DC G8983-CM","OCCUPATIONAL THERAPY",430,"G8983CMGO","CMGO",null,1]
[" 5604262","OT  BODY POS DC G8983-CN","OCCUPATIONAL THERAPY",430,"G8983CNGO","CNGO",null,1]
[" 5604263","OT  BODY POS GOAL G8982-CH","OCCUPATIONAL THERAPY",430,"G8982CHGO","CHGO",null,1]
[" 5604264","OT  BODY POS GOAL G8982-CI","OCCUPATIONAL THERAPY",430,"G8982CIGO","CIGO",null,1]
[" 5604265","OT  BODY POS GOAL G8982-CJ","OCCUPATIONAL THERAPY",430,"G8982CJGO","CJGO",null,1]
[" 5604266","OT  BODY POS GOAL G8982-CK","OCCUPATIONAL THERAPY",430,"G8982CKGO","CKGO",null,1]
[" 5604267","OT  BODY POS GOAL G8982-CL","OCCUPATIONAL THERAPY",430,"G8982CLGO","CLGO",null,1]
[" 5604268","OT  BODY POS GOAL G8982-CM","OCCUPATIONAL THERAPY",430,"G8982CMGO","CMGO",null,1]
[" 5604269","OT  BODY POS GOAL G8982-CN","OCCUPATIONAL THERAPY",430,"G8982CNGO","CNGO",null,1]
[" 5604270","OT  CARRY CURRENT G8984 -CH","OCCUPATIONAL THERAPY",430,"G8984CHGO","CHGO",null,1]
[" 5604271","OT  CARRY CURRENT G8984 -CI","OCCUPATIONAL THERAPY",430,"G8984CIGO","CIGO",null,1]
[" 5604272","OT  CARRY CURRENT G8984 -CJ","OCCUPATIONAL THERAPY",430,"G8984CJGO","CJGO",null,1]
[" 5604273","OT  CARRY CURRENT G8984 -CK","OCCUPATIONAL THERAPY",430,"G8984CKGO","CKGO",null,1]
[" 5604274","OT  CARRY CURRENT G8984 -CL","OCCUPATIONAL THERAPY",430,"G8984CLGO","CLGO",null,1]
[" 5604275","OT  CARRY CURRENT G8984 -CM","OCCUPATIONAL THERAPY",430,"G8984CMGO","CMGO",null,1]
[" 5604276","OT  CARRY CURRENT G8984 -CN","OCCUPATIONAL THERAPY",430,"G8984CNGO","CNGO",null,1]
[" 5604277","OT  MOBILITY CURRENT G8978- CH","OCCUPATIONAL THERAPY",430,"G8978CHGO","CHGO",null,1]
[" 5604278","OT  MOBILITY CURRENT G8978- CI","OCCUPATIONAL THERAPY",430,"G8978CIGO","CIGO",null,1]
[" 5604279","OT  MOBILITY CURRENT G8978- CJ","OCCUPATIONAL THERAPY",430,"G8978CJGO","CJGO",null,1]
[" 5604280","OT  MOBILITY CURRENT G8978- CK","OCCUPATIONAL THERAPY",430,"G8978CKGO","CKGO",null,1]
[" 5604281","OT  MOBILITY CURRENT G8978- CL","OCCUPATIONAL THERAPY",430,"G8978CLGO","CLGO",null,1]
[" 5604282","OT  MOBILITY CURRENT G8978- CM","OCCUPATIONAL THERAPY",430,"G8978CMGO","CMGO",null,1]
[" 5604283","OT  MOBILITY CURRENT G8978- CN","OCCUPATIONAL THERAPY",430,"G8978CNGO","CNGO",null,1]
[" 5604284","OT  MOBILITY DC G8980-CH","OCCUPATIONAL THERAPY",430,"G8980CHGO","CHGO",null,1]
[" 5604285","OT  MOBILITY DC G8980-CI","OCCUPATIONAL THERAPY",430,"G8980CIGO","CIGO",null,1]
[" 5604286","OT  MOBILITY DC G8980-CJ","OCCUPATIONAL THERAPY",430,"G8980CJGO","CJGO",null,1]
[" 5604287","OT  MOBILITY DC G8980-CK","OCCUPATIONAL THERAPY",430,"G8980CKGO","CKGO",null,1]
[" 5604288","OT  MOBILITY DC G8980-CL","OCCUPATIONAL THERAPY",430,"G8980CLGO","CLGO",null,1]
[" 5604289","OT  MOBILITY DC G8980-CM","OCCUPATIONAL THERAPY",430,"G8980CMGO","CMGO",null,1]
[" 5604290","OT  MOBILITY DC G8980-CN","OCCUPATIONAL THERAPY",430,"G8980CNGO","CNGO",null,1]
[" 5604291","OT  MOBILITY GOAL G8979-CH","OCCUPATIONAL THERAPY",430,"G8979CHGO","CHGO",null,1]
[" 5604292","OT  MOBILITY GOAL G8979-CI","OCCUPATIONAL THERAPY",430,"G8979CIGO","CIGO",null,1]
[" 5604293","OT  MOBILITY GOAL G8979-CJ","OCCUPATIONAL THERAPY",430,"G8979CJGO","CJGO",null,1]
[" 5604294","OT  MOBILITY GOAL G8979-CK","OCCUPATIONAL THERAPY",430,"G8979CKGO","CKGO",null,1]
[" 5604295","OT  MOBILITY GOAL G8979-CL","OCCUPATIONAL THERAPY",430,"G8979CLGO","CLGO",null,1]
[" 5604296","OT  MOBILITY GOAL G8979-CM","OCCUPATIONAL THERAPY",430,"G8979CMGO","CMGO",null,1]
[" 5604297","OT  MOBILITY GOAL G8979-CN","OCCUPATIONAL THERAPY",430,"G8979CNGO","CNGO",null,1]
[" 5604298","OT  OTHER PT/OT DC G8992-CH","OCCUPATIONAL THERAPY",430,"G8992CHGO","CHGO",null,1]
[" 5604299","OT  OTHER PT/OT DC G8992-CI","OCCUPATIONAL THERAPY",430,"G8992CIGO","CIGO",null,1]
[" 5604300","OT  OTHER PT/OT DC G8992-CJ","OCCUPATIONAL THERAPY",430,"G8992CJGO","CJGO",null,1]
[" 5604301","OT  OTHER PT/OT DC G8992-CK","OCCUPATIONAL THERAPY",430,"G8992CKGO","CKGO",null,1]
[" 5604302","OT  OTHER PT/OT DC G8992-CL","OCCUPATIONAL THERAPY",430,"G8992CLGO","CLGO",null,1]
[" 5604303","OT  OTHER PT/OT DC G8992-CM","OCCUPATIONAL THERAPY",430,"G8992CMGO","CMGO",null,1]
[" 5604304","OT  OTHER PT/OT DC G8992-CN","OCCUPATIONAL THERAPY",430,"G8992CNGO","CNGO",null,1]
[" 5604305","OT  OTHER PT/OT GOAL G8991-CH","OCCUPATIONAL THERAPY",430,"G8991CHGO","CHGO",null,1]
[" 5604306","OT  OTHER PT/OT GOAL G8991-CI","OCCUPATIONAL THERAPY",430,"G8991CIGO","CIGO",null,1]
[" 5604307","OT  OTHER PT/OT GOAL G8991-CJ","OCCUPATIONAL THERAPY",430,"G8991CJGO","CJGO",null,1]
[" 5604308","OT  OTHER PT/OT GOAL G8991-CK","OCCUPATIONAL THERAPY",430,"G8991CKGO","CKGO",null,1]
[" 5604309","OT  OTHER PT/OT GOAL G8991-CL","OCCUPATIONAL THERAPY",430,"G8991CLGO","CLGO",null,1]
[" 5604310","OT  OTHER PT/OT GOAL G8991-CM","OCCUPATIONAL THERAPY",430,"G8991CMGO","CMGO",null,1]
[" 5604311","OT  OTHER PT/OT GOAL G8991-CN","OCCUPATIONAL THERAPY",430,"G8991CNGO","CNGO",null,1]
[" 5604312","OT  SELF-CARE CURRENT G8987-CH","OCCUPATIONAL THERAPY",430,"G8987CHGO","CHGO",null,1]
[" 5604313","OT  SELF-CARE CURRENT G8987-CI","OCCUPATIONAL THERAPY",430,"G8987CIGO","CIGO",null,1]
[" 5604314","OT  SELF-CARE CURRENT G8987-CJ","OCCUPATIONAL THERAPY",430,"G8987CJGO","CJGO",null,1]
[" 5604315","OT  SELF-CARE CURRENT G8987-CK","OCCUPATIONAL THERAPY",430,"G8987CKGO","CKGO",null,1]
[" 5604316","OT  SELF-CARE CURRENT G8987-CL","OCCUPATIONAL THERAPY",430,"G8987CLGO","CLGO",null,1]
[" 5604317","OT  SELF-CARE CURRENT G8987-CM","OCCUPATIONAL THERAPY",430,"G8987CMGO","CMGO",null,1]
[" 5604318","OT  SELF-CARE CURRENT G8987-CN","OCCUPATIONAL THERAPY",430,"G8987CNGO","CNGO",null,1]
[" 5604319","OT  SUB PT/OT CURRENT G8993-CH","OCCUPATIONAL THERAPY",430,"G8993CHGO","CHGO",null,1]
[" 5604320","OT  SUB PT/OT CURRENT G8993-CI","OCCUPATIONAL THERAPY",430,"G8993CIGO","CIGO",null,1]
[" 5604321","OT  SUB PT/OT CURRENT G8993-CJ","OCCUPATIONAL THERAPY",430,"G8993CJGO","CJGO",null,1]
[" 5604322","OT  SUB PT/OT CURRENT G8993-CK","OCCUPATIONAL THERAPY",430,"G8993CKGO","CKGO",null,1]
[" 5604323","OT  SUB PT/OT CURRENT G8993-CL","OCCUPATIONAL THERAPY",430,"G8993CLGO","CLGO",null,1]
[" 5604324","OT  SUB PT/OT CURRENT G8993-CM","OCCUPATIONAL THERAPY",430,"G8993CMGO","CMGO",null,1]
[" 5604325","OT  SUB PT/OT CURRENT G8993-CN","OCCUPATIONAL THERAPY",430,"G8993CNGO","CNGO",null,1]
[" 5604326","OT  SUB PT/OT DC G8995-CH","OCCUPATIONAL THERAPY",430,"G8995CHGO","CHGO",null,1]
[" 5604327","OT  SUB PT/OT DC G8995-CI","OCCUPATIONAL THERAPY",430,"G8995CIGO","CIGO",null,1]
[" 5604328","OT  SUB PT/OT DC G8995-CJ","OCCUPATIONAL THERAPY",430,"G8995CJGO","CJGO",null,1]
[" 5604329","OT  SUB PT/OT DC G8995-CK","OCCUPATIONAL THERAPY",430,"G8995CKGO","CKGO",null,1]
[" 5604330","OT  SUB PT/OT DC G8995-CL","OCCUPATIONAL THERAPY",430,"G8995CLGO","CLGO",null,1]
[" 5604331","OT  SUB PT/OT DC G8995-CM","OCCUPATIONAL THERAPY",430,"G8995CMGO","CMGO",null,1]
[" 5604332","OT  SUB PT/OT DC G8995-CN","OCCUPATIONAL THERAPY",430,"G8995CNGO","CNGO",null,1]
[" 5800165","OT  ATTEN CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G9165",null,"GO",1]
[" 5800166","OT  ATTEN GOAL STATUS","OCCUPATIONAL THERAPY",430,"G9166",null,"GO",1]
[" 5800167","OT  ATTEN D/C STATUS","OCCUPATIONAL THERAPY",430,"G9167",null,"GO",1]
[" 5800978","OT  MOBILITY CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G8978",null,"GO",1]
[" 5800979","OT  MOBILITY PROJECTED GOAL STATUS","OCCUPATIONAL THERAPY",430,"G8979",null,"GO",1]
[" 5800980","OT  MOBILITY DISCHARGE STATUS","OCCUPATIONAL THERAPY",430,"G8980",null,"GO",1]
[" 5800981","OT  CHG/MAINT CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G8981",null,"GO",1]
[" 5800982","OT  CHG/MAINT PROJECTED STATUS","OCCUPATIONAL THERAPY",430,"G8982",null,"GO",1]
[" 5800983","OT  CHG/MAINT DISCHARGE STATUS","OCCUPATIONAL THERAPY",430,"G8983",null,"GO",1]
[" 5800984","OT  CARRY/MOVE CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G8984",null,"GO",1]
[" 5800985","OT  CARRY/MOVE-PROJECTED STATUS","OCCUPATIONAL THERAPY",430,"G8985",null,"GO",1]
[" 5800986","OT  CARRY/MOVE-DISCHARGE STATUS","OCCUPATIONAL THERAPY",430,"G8986",null,"GO",1]
[" 5800987","OT  SELF CARE CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G8987",null,"GO",1]
[" 5800988","OT  SELF CARE PROJECTED STATUS","OCCUPATIONAL THERAPY",430,"G8988",null,"GO",1]
[" 5800989","OT  SELF CARE DISCHARGE STATUS","OCCUPATIONAL THERAPY",430,"G8989",null,"GO",1]
[" 5800990","OT  OTHER OT PRIMARY CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G8990",null,"GO",1]
[" 5800991","OT  OTHER OT PRIMARY PROJECTED STATUS","OCCUPATIONAL THERAPY",430,"G8991",null,"GO",1]
[" 5800992","OT  OTHER OT PRIMARY DISCHARGE STATUS","OCCUPATIONAL THERAPY",430,"G8992",null,"GO",1]
[" 5800993","OT  OTHER OT SUBSEQUENT CURRENT","OCCUPATIONAL THERAPY",430,"G8993",null,"GO",1]
[" 5800994","OT  OTHER OT SUBSEQUENT PROJECTED","OCCUPATIONAL THERAPY",430,"G8994",null,"GO",1]
[" 5800995","OT  OTHER OT SUBSEQUENT DISCHARGE","OCCUPATIONAL THERAPY",430,"G8995",null,"GO",1]
[" 5809168","OT  MEMORY CURRENT STATUS","OCCUPATIONAL THERAPY",430,"G9168",null,"GO",1]
[" 5809169","OT  MEMORY GOAL STATUS","OCCUPATIONAL THERAPY",430,"G9169",null,"GO",1]
[" 5809170","OT  MEMORY D/C STATUS","OCCUPATIONAL THERAPY",430,null,null,null,1]
[" 5800010","OT APPLICATION MODALITY","OCCUPATIONAL THERAPY",430,"97010",null,"GO",37]
[" 5800035","OT PARAFFIN TREATMENT","OCCUPATIONAL THERAPY",430,"97018",null,"GO",82]
[" 5800014","OT UNATTENDED E-STIM","OCCUPATIONAL THERAPY",430,"97014",null,"GO",85]
[" 5800048","OT ULTRASOUND THERAPY","OCCUPATIONAL THERAPY",430,"97035",null,"GO",85]
[" 5809179","OT TELE THERAPEUTIC ACTIVITIES 15 MIN","OCCUPATIONAL THERAPY",430,"9753095","95","GO95",88]
[" 5800542","OT WHEELCHAIR MGMT 15 MIN","OCCUPATIONAL THERAPY",430,"97542",null,"GO",93]
[" 5809184","OT TELE WHEELCHAIR MGMT 15 MIN","OCCUPATIONAL THERAPY",430,"9754295","95","GO95",93]
[" 5809181","OT TELE COGNITIVE SKILL DEVELOPMENT","OCCUPATIONAL THERAPY",430,"9712995","95","GO95",95]
[" 5809185","OT TELE SELF CARE HOME MANAGEMENT 15 MIN","OCCUPATIONAL THERAPY",430,"9753595","95","GO95",96]
[" 5809183","OT TELE NEUROMUSCULAR REEDUCATION 15 MIN","OCCUPATIONAL THERAPY",430,"9711295","95","GO95",98]
[" 5809182","OT TELE COGNITIVE SKILL DEVELOP 15 min","OCCUPATIONAL THERAPY",430,"9713095","95","GO95",100]
[" 5800113","OT COGNITIVE SKILL DEVELOP 15 min","OCCUPATIONAL THERAPY",430,"97130",null,"GO",102]
[" 5800532","OT COGNITIVE SKILL DEVELOPMENT","OCCUPATIONAL THERAPY",430,"97129",null,"GO",102]
[" 5809178","OT TELE THERAPEUTIC EXERCISE 15 MIN","OCCUPATIONAL THERAPY",430,"9711095","95","GO95",102]
[" 5809180","OT TELE MANUAL THERAPY 15 MIN","OCCUPATIONAL THERAPY",430,"9714095","95","GO95",102]
[" 5800110","OT THERAPEUTIC EXERCISE 15 MIN","OCCUPATIONAL THERAPY",430,"97110",null,"GO",110]
[" 5800112","OT NEUROMUSCULAR RE-EDUCATION 15 MIN","OCCUPATIONAL THERAPY",430,"97112",null,"GO",110]
[" 5800140","OT MANUAL THERAPY 15 MIN","OCCUPATIONAL THERAPY",430,"97140",null,"GO",110]
[" 5800530","OT THERAPEUTIC ACTIVITIES 15 MIN","OCCUPATIONAL THERAPY",430,"97530",null,"GO",110]
[" 5800535","OT SELF CARE HOME MANAGEMENT 15 MIN","OCCUPATIONAL THERAPY",430,"97535",null,"GO",110]
[" 5800037","OT IONTOPHORESIS 15 MIN","OCCUPATIONAL THERAPY",430,"97033",null,"GO",118]
[" 5809171","OT E VISIT 5-10 MINUTES","OCCUPATIONAL THERAPY",434,"G2061",null,"GO",39]
[" 5809172","OT E VISIT 11-20 MINUTES","OCCUPATIONAL THERAPY",434,"G2062",null,"GO",68]
[" 5809177","OT TELE RE-EVALUATION","OCCUPATIONAL THERAPY",434,"9716895","95","GO95",89]
[" 5809173","OT E-VISIT > 21 MINUTES","OCCUPATIONAL THERAPY",434,"G2063",null,"GO",107]
[" 5800168","OT RE-EVALUATION","OCCUPATIONAL THERAPY",434,"97168",null,"GO",112]
[" 5809174","OT TELE HEALTH EVAL LOW COMPLEXITY","OCCUPATIONAL THERAPY",434,"9716595","95","GO95",150]
[" 5800004","OT EVAL LOW COMPLEXITY","OCCUPATIONAL THERAPY",434,"97165",null,"GO",160]
[" 5800005","OT EVAL MODERATE COMPLEXITY","OCCUPATIONAL THERAPY",434,"97166",null,"GO",171]
[" 5809175","OT TELE EVAL MODERATE COMPLEXITY","OCCUPATIONAL THERAPY",434,"9716695","95","GO95",171]
[" 5800006","OT EVAL HIGH COMPLEXITY","OCCUPATIONAL THERAPY",434,"97167",null,"GO",193]
[" 5809176","OT TELE EVAL HIGH COMPLEXITY","OCCUPATIONAL THERAPY",434,"9716795","95","GO95",193]
[" 5604459","ST  LANG COMP CURRENT G9159-CH","SPEECH THERAPY",440,"G9159CHGN","CHGN",null,1]
[" 5604460","ST  LANG COMP CURRENT G9159-CI","SPEECH THERAPY",440,"G9159CIGN","CIGN",null,1]
[" 5604461","ST  LANG COMP CURRENT G9159-CJ","SPEECH THERAPY",440,"G9159CJGN","CJGN",null,1]
[" 5604462","ST  LANG COMP CURRENT G9159-CK","SPEECH THERAPY",440,"G9159CKGN","CKGN",null,1]
[" 5604463","ST  LANG COMP CURRENT G9159-CL","SPEECH THERAPY",440,"G9159CLGN","CLGN",null,1]
[" 5604464","ST  LANG COMP CURRENT G9159-CM","SPEECH THERAPY",440,"G9159CMGN","CMGN",null,1]
[" 5604465","ST  LANG COMP CURRENT G9159-CN","SPEECH THERAPY",440,"G9159CNGN","CNGN",null,1]
[" 5604466","ST  LANG COMP DC G9161-CH","SPEECH THERAPY",440,"G9161CHGN","CHGN",null,1]
[" 5604467","ST  LANG COMP DC G9161-CI","SPEECH THERAPY",440,"G9161CIGN","CIGN",null,1]
[" 5604468","ST  LANG COMP DC G9161-CJ","SPEECH THERAPY",440,"G9161CJGN","CJGN",null,1]
[" 5604469","ST  LANG COMP DC G9161-CK","SPEECH THERAPY",440,"G9161CKGN","CKGN",null,1]
[" 5604470","ST  LANG COMP DC G9161-CL","SPEECH THERAPY",440,"G9161CLGN","CLGN",null,1]
[" 5604471","ST  LANG COMP DC G9161-CM","SPEECH THERAPY",440,"G9161CMGN","CMGN",null,1]
[" 5604472","ST  LANG COMP DC G9161-CN","SPEECH THERAPY",440,"G9161CNGN","CNGN",null,1]
[" 5604473","ST  LANG COMP GOAL G9160-CH","SPEECH THERAPY",440,"G9160CHGN","CHGN",null,1]
[" 5604474","ST  LANG COMP GOAL G9160-CI","SPEECH THERAPY",440,"G9160CIGN","CIGN",null,1]
[" 5604475","ST  LANG COMP GOAL G9160-CJ","SPEECH THERAPY",440,"G9160CJGN","CJGN",null,1]
[" 5604476","ST  LANG COMP GOAL G9160-CK","SPEECH THERAPY",440,"G9160CKGN","CKGN",null,1]
[" 5604477","ST  LANG COMP GOAL G9160-CL","SPEECH THERAPY",440,"G9160CLGN","CLGN",null,1]
[" 5604478","ST  LANG COMP GOAL G9160-CM","SPEECH THERAPY",440,"G9160CMGN","CMGN",null,1]
[" 5604479","ST  LANG COMP GOAL G9160-CN","SPEECH THERAPY",440,"G9160CNGN","CNGN",null,1]
[" 5604480","ST  LANG EXPRESS CURRENT G9162-CH","SPEECH THERAPY",440,"G9162CHGN","CHGN",null,1]
[" 5604481","ST  LANG EXPRESS CURRENT G9162-CI","SPEECH THERAPY",440,"G9162CIGN","CIGN",null,1]
[" 5604482","ST  LANG EXPRESS CURRENT G9162-CJ","SPEECH THERAPY",440,"G9162CJGN","CJGN",null,1]
[" 5604483","ST  LANG EXPRESS CURRENT G9162-CK","SPEECH THERAPY",440,"G9162CKGN","CKGN",null,1]
[" 5604484","ST  LANG EXPRESS CURRENT G9162-CL","SPEECH THERAPY",440,"G9162CLGN","CLGN",null,1]
[" 5604485","ST  LANG EXPRESS CURRENT G9162-CM","SPEECH THERAPY",440,"G9162CMGN","CMGN",null,1]
[" 5604486","ST  LANG EXPRESS CURRENT G9162-CN","SPEECH THERAPY",440,"G9162CNGN","CNGN",null,1]
[" 5604487","ST  LANG EXPRESS GOAL G9163-CH","SPEECH THERAPY",440,"G9163CHGN","CHGN",null,1]
[" 5604488","ST  LANG EXPRESS GOAL G9163-CI","SPEECH THERAPY",440,"G9163CIGN","CIGN",null,1]
[" 5604489","ST  LANG EXPRESS GOAL G9163-CJ","SPEECH THERAPY",440,"G9163CJGN","CJGN",null,1]
[" 5604490","ST  LANG EXPRESS GOAL G9163-CK","SPEECH THERAPY",440,"G9163CKGN","CKGN",null,1]
[" 5604491","ST  LANG EXPRESS GOAL G9163-CL","SPEECH THERAPY",440,"G9163CLGN","CLGN",null,1]
[" 5604492","ST  LANG EXPRESS GOAL G9163-CM","SPEECH THERAPY",440,"G9163CMGN","CMGN",null,1]
[" 5604493","ST  LANG EXPRESS GOAL G9163-CN","SPEECH THERAPY",440,"G9163CNGN","CNGN",null,1]
[" 5604494","ST  MOTOR SPEECH GOAL G9186-CH","SPEECH THERAPY",440,"G9186CHGN","CHGN",null,1]
[" 5604495","ST  MOTOR SPEECH GOAL G9186-CI","SPEECH THERAPY",440,"G9186CIGN","CIGN",null,1]
[" 5604496","ST  MOTOR SPEECH GOAL G9186-CJ","SPEECH THERAPY",440,"G9186CJGN","CJGN",null,1]
[" 5604497","ST  MOTOR SPEECH GOAL G9186-CK","SPEECH THERAPY",440,"G9186CKGN","CKGN",null,1]
[" 5604498","ST  MOTOR SPEECH GOAL G9186-CL","SPEECH THERAPY",440,"G9186CLGN","CLGN",null,1]
[" 5604499","ST  MOTOR SPEECH GOAL G9186-CM","SPEECH THERAPY",440,"G9186CMGN","CMGN",null,1]
[" 5604500","ST  MOTOR SPEECH GOAL G9186-CN","SPEECH THERAPY",440,"G9186CNGN","CNGN",null,1]
[" 5604501","ST  SPEECH LANG CURRENT G9174-CH","SPEECH THERAPY",440,"G9174CHGN","CHGN",null,1]
[" 5604502","ST  SPEECH LANG CURRENT G9174-CI","SPEECH THERAPY",440,"G9174CIGN","CIGN",null,1]
[" 5604503","ST  SPEECH LANG CURRENT G9174-CJ","SPEECH THERAPY",440,"G9174CJGN","CJGN",null,1]
[" 5604504","ST  SPEECH LANG CURRENT G9174-CK","SPEECH THERAPY",440,"G9174CKGN","CKGN",null,1]
[" 5604505","ST  SPEECH LANG CURRENT G9174-CL","SPEECH THERAPY",440,"G9174CLGN","CLGN",null,1]
[" 5604506","ST  SPEECH LANG CURRENT G9174-CM","SPEECH THERAPY",440,"G9174CMGN","CMGN",null,1]
[" 5604507","ST  SPEECH LANG CURRENT G9174-CN","SPEECH THERAPY",440,"G9174CNGN","CNGN",null,1]
[" 5604508","ST  SPEECH LANG DC G9176-CH","SPEECH THERAPY",440,"G9176CHGN","CHGN",null,1]
[" 5604509","ST  SPEECH LANG DC G9176-CI","SPEECH THERAPY",440,"G9176CIGN","CIGN",null,1]
[" 5604510","ST  SPEECH LANG DC G9176-CJ","SPEECH THERAPY",440,"G9176CJGN","CJGN",null,1]
[" 5604511","ST  SPEECH LANG DC G9176-CK","SPEECH THERAPY",440,"G9176CKGN","CKGN",null,1]
[" 5604512","ST  SPEECH LANG DC G9176-CL","SPEECH THERAPY",440,"G9176CLGN","CLGN",null,1]
[" 5604513","ST  SPEECH LANG DC G9176-CM","SPEECH THERAPY",440,"G9176CMGN","CMGN",null,1]
[" 5604514","ST  SPEECH LANG DC G9176-CN","SPEECH THERAPY",440,"G9176CNGN","CNGN",null,1]
[" 5604515","ST  SPEECH LANG GOAL G9175-CH","SPEECH THERAPY",440,"G9175CHGN","CHGN",null,1]
[" 5604516","ST  SPEECH LANG GOAL G9175-CI","SPEECH THERAPY",440,"G9175CIGN","CIGN",null,1]
[" 5604517","ST  SPEECH LANG GOAL G9175-CJ","SPEECH THERAPY",440,"G9175CJGN","CJGN",null,1]
[" 5604518","ST  SPEECH LANG GOAL G9175-CK","SPEECH THERAPY",440,"G9175CKGN","CKGN",null,1]
[" 5604519","ST  SPEECH LANG GOAL G9175-CL","SPEECH THERAPY",440,"G9175CLGN","CLGN",null,1]
[" 5604520","ST  SPEECH LANG GOAL G9175-CM","SPEECH THERAPY",440,"G9175CMGN","CMGN",null,1]
[" 5604521","ST  SPEECH LANG GOAL G9175-CN","SPEECH THERAPY",440,"G9175CNGN","CNGN",null,1]
[" 5604522","ST  SWALLOW GOAL G8997-CH","SPEECH THERAPY",440,"G8997CHGN","CHGN",null,1]
[" 5604523","ST  SWALLOW GOAL G8997-CI","SPEECH THERAPY",440,"G8997CIGN","CIGN",null,1]
[" 5604524","ST  SWALLOW GOAL G8997-CJ","SPEECH THERAPY",440,"G8997CJGN","CJGN",null,1]
[" 5604525","ST  SWALLOW GOAL G8997-CK","SPEECH THERAPY",440,"G8997CKGN","CKGN",null,1]
[" 5604526","ST  SWALLOW GOAL G8997-CL","SPEECH THERAPY",440,"G8997CLGN","CLGN",null,1]
[" 5604527","ST  SWALLOW GOAL G8997-CM","SPEECH THERAPY",440,"G8997CMGN","CMGN",null,1]
[" 5604528","ST  SWALLOW GOAL G8997-CN","SPEECH THERAPY",440,"G8997CNGN","CNGN",null,1]
[" 5604529","ST  VOICE CURRENT G9171-CH","SPEECH THERAPY",440,"G9171CHGN","CHGN",null,1]
[" 5604530","ST  VOICE CURRENT G9171-CI","SPEECH THERAPY",440,"G9171CIGN","CIGN",null,1]
[" 5604531","ST  VOICE CURRENT G9171-CJ","SPEECH THERAPY",440,"G9171CJGN","CJGN",null,1]
[" 5604532","ST  VOICE CURRENT G9171-CK","SPEECH THERAPY",440,"G9171CKGN","CKGN",null,1]
[" 5604533","ST  VOICE CURRENT G9171-CL","SPEECH THERAPY",440,"G9171CLGN","CLGN",null,1]
[" 5604534","ST  VOICE CURRENT G9171-CM","SPEECH THERAPY",440,"G9171CMGN","CMGN",null,1]
[" 5604535","ST  VOICE CURRENT G9171-CN","SPEECH THERAPY",440,"G9171CNGN","CNGN",null,1]
[" 5604536","ST  VOICE DC G9173-CH","SPEECH THERAPY",440,"G9173CHGN","CHGN",null,1]
[" 5604537","ST  VOICE DC G9173-CI","SPEECH THERAPY",440,"G9173CIGN","CIGN",null,1]
[" 5604538","ST  VOICE DC G9173-CJ","SPEECH THERAPY",440,"G9173CJGN","CJGN",null,1]
[" 5604539","ST  VOICE DC G9173-CK","SPEECH THERAPY",440,"G9173CKGN","CKGN",null,1]
[" 5604540","ST  VOICE DC G9173-CL","SPEECH THERAPY",440,"G9173CLGN","CLGN",null,1]
[" 5604541","ST  VOICE DC G9173-CM","SPEECH THERAPY",440,"G9173CMGN","CMGN",null,1]
[" 5604542","ST  VOICE DC G9173-CN","SPEECH THERAPY",440,"G9173CNGN","CNGN",null,1]
[" 5604543","ST  LANG EXPRESS DC G9164 -CH","SPEECH THERAPY",440,"G9164CHGN","CHGN",null,1]
[" 5604544","ST  LANG EXPRESS DC G9164 -CI","SPEECH THERAPY",440,"G9164CIGN","CIGN",null,1]
[" 5604545","ST  LANG EXPRESS DC G9164 -CJ","SPEECH THERAPY",440,"G9164CJGN","CJGN",null,1]
[" 5604546","ST  LANG EXPRESS DC G9164 -CK","SPEECH THERAPY",440,"G9164CKGN","CKGN",null,1]
[" 5604547","ST  LANG EXPRESS DC G9164 -CL","SPEECH THERAPY",440,"G9164CLGN","CLGN",null,1]
[" 5604548","ST  LANG EXPRESS DC G9164 -CM","SPEECH THERAPY",440,"G9164CMGN","CMGN",null,1]
[" 5604549","ST  LANG EXPRESS DC G9164 -CN","SPEECH THERAPY",440,"G9164CNGN","CNGN",null,1]
[" 5604550","ST  MOTOR SPEECH CURRENT G8999-CH","SPEECH THERAPY",440,"G8999CHGN","CHGN",null,1]
[" 5604551","ST  MOTOR SPEECH CURRENT G8999-CI","SPEECH THERAPY",440,"G8999CIGN","CIGN",null,1]
[" 5604552","ST  MOTOR SPEECH CURRENT G8999-CJ","SPEECH THERAPY",440,"G8999CJGN","CJGN",null,1]
[" 5604553","ST  MOTOR SPEECH CURRENT G8999-CK","SPEECH THERAPY",440,"G8999CKGN","CKGN",null,1]
[" 5604554","ST  MOTOR SPEECH CURRENT G8999-CL","SPEECH THERAPY",440,"G8999CLGN","CLGN",null,1]
[" 5604555","ST  MOTOR SPEECH CURRENT G8999-CM","SPEECH THERAPY",440,"G8999CMGN","CMGN",null,1]
[" 5604556","ST  MOTOR SPEECH CURRENT G8999-CN","SPEECH THERAPY",440,"G8999CNGN","CNGN",null,1]
[" 5604557","ST  MOTOR SPEECH DC G9158-CH","SPEECH THERAPY",440,"G9158CHGN","CHGN",null,1]
[" 5604558","ST  MOTOR SPEECH DC G9158-CI","SPEECH THERAPY",440,"G9158CIGN","CIGN",null,1]
[" 5604559","ST  MOTOR SPEECH DC G9158-CJ","SPEECH THERAPY",440,"G9158CJGN","CJGN",null,1]
[" 5604560","ST  MOTOR SPEECH DC G9158-CK","SPEECH THERAPY",440,"G9158CKGN","CKGN",null,1]
[" 5604561","ST  MOTOR SPEECH DC G9158-CL","SPEECH THERAPY",440,"G9158CLGN","CLGN",null,1]
[" 5604562","ST  MOTOR SPEECH DC G9158-CM","SPEECH THERAPY",440,"G9158CMGN","CMGN",null,1]
[" 5604563","ST  MOTOR SPEECH DC G9158-CN","SPEECH THERAPY",440,"G9158CNGN","CNGN",null,1]
[" 5604564","ST  SWALLOW CURRENT G8996-CH","SPEECH THERAPY",440,"G8996CHGN","CHGN",null,1]
[" 5604565","ST  SWALLOW CURRENT G8996-CI","SPEECH THERAPY",440,"G8996CIGN","CIGN",null,1]
[" 5604566","ST  SWALLOW CURRENT G8996-CJ","SPEECH THERAPY",440,"G8996CJGN","CJGN",null,1]
[" 5604567","ST  SWALLOW CURRENT G8996-CK","SPEECH THERAPY",440,"G8996CKGN","CKGN",null,1]
[" 5604568","ST  SWALLOW CURRENT G8996-CL","SPEECH THERAPY",440,"G8996CLGN","CLGN",null,1]
[" 5604569","ST  SWALLOW CURRENT G8996-CM","SPEECH THERAPY",440,"G8996CMGN","CMGN",null,1]
[" 5604570","ST  SWALLOW CURRENT G8996-CN","SPEECH THERAPY",440,"G8996CNGN","CNGN",null,1]
[" 5604571","ST  SWALLOW DC G8998-CH","SPEECH THERAPY",440,"G8998CHGN","CHGN",null,1]
[" 5604572","ST  SWALLOW DC G8998-CI","SPEECH THERAPY",440,"G8998CIGN","CIGN",null,1]
[" 5604573","ST  SWALLOW DC G8998-CJ","SPEECH THERAPY",440,"G8998CJGN","CJGN",null,1]
[" 5604574","ST  SWALLOW DC G8998-CK","SPEECH THERAPY",440,"G8998CKGN","CKGN",null,1]
[" 5604575","ST  SWALLOW DC G8998-CL","SPEECH THERAPY",440,"G8998CLGN","CLGN",null,1]
[" 5604576","ST  SWALLOW DC G8998-CM","SPEECH THERAPY",440,"G8998CMGN","CMGN",null,1]
[" 5604577","ST  SWALLOW DC G8998-CN","SPEECH THERAPY",440,"G8998CNGN","CNGN",null,1]
[" 5604578","ST  VOICE GOAL G9172-CH","SPEECH THERAPY",440,"G9172CHGN","CHGN",null,1]
[" 5604579","ST  VOICE GOAL G9172-CI","SPEECH THERAPY",440,"G9172CIGN","CIGN",null,1]
[" 5604580","ST  VOICE GOAL G9172-CJ","SPEECH THERAPY",440,"G9172CJGN","CJGN",null,1]
[" 5604581","ST  VOICE GOAL G9172-CK","SPEECH THERAPY",440,"G9172CKGN","CKGN",null,1]
[" 5604582","ST  VOICE GOAL G9172-CL","SPEECH THERAPY",440,"G9172CLGN","CLGN",null,1]
[" 5604583","ST  VOICE GOAL G9172-CM","SPEECH THERAPY",440,"G9172CMGN","CMGN",null,1]
[" 5604584","ST  VOICE GOAL G9172-CN","SPEECH THERAPY",440,"G9172CNGN","CNGN",null,1]
[" 1500209","IRRIGATION IMP CERUMEN","ER",450,"69209",null,null,55]
[" 1500656","NASOGASTRIC TUBE PLACEMENT","ER",450,"43754",null,null,83]
[" 1200205","INTERP ONLY FETAL MONI ER","ER",450,"59051",null,null,104]
[" 1500503","ANTIBIOTIC INJECTION  IM","ER",450,"96372",null,null,109]
[" 1500510","IV HYDRATION EA ADD HOUR","ER",450,"96361",null,null,110]
[" 6000004","EYE IRR (MORGAN LENS)","ER",450,"92019",null,null,110]
[" 1500290","ED/STRAP ANKLE","ER",450,"29540",null,null,111]
[" 1500291","ED/STRAP TOES","ER",450,"29550",null,null,112]
[" 1500009","EACH ADDTL NAIL PLATE","ER",450,"11732",null,null,113]
[" 1200014","LEGAL BLOOD ALCOHOL VISIT","ER",450,"99282",null,null,118]
[" 1502469","EYE EXAM W/ANESTH LIMITED","ER",450,"92019",null,null,118]
[" 1500288","STRAP HAND/FINGER","ER",450,"29280",null,null,120]
[" 1500289","STRAP KNEE","ER",450,"29530",null,null,121]
[" 1500219","ED/EAR  IMPACTED CERUMEN","ER",450,"69210",null,null,134]
[" 1500400","APP OF WOUND ADHESIVE","ER",450,"G0168",null,null,137]
[" 1500147","STRAP ELBOW/WRIST","ER",450,"29260",null,null,139]
[" 1500016","IV INFUSION ADD 1 HOUR ED","ER",450,"96366",null,null,140]
[" 1500501","INJECTIONS  SC/IM","ER",450,"96372",null,null,140]
[" 1500018","TX/PROPH/DG ADDL SEQ IV INF NE","ER",450,"96367",null,null,150]
[" 1500222","ED/EVAC/SUBUNGUAL HEMAT","ER",450,"11740",null,null,150]
[" 1500146","STRAP SHOULDER","ER",450,"29240",null,null,158]
[" 1500019","IV PUSH SAME DRUG ADDON SEQ","ER",450,"96376",null,null,160]
[" 1502468","INSERT BLADDER CATHETER","ER",450,"51701",null,null,161]
[" 1500224","ASPIRATION/INJ SMALL JOINT BUR","ER",450,"20600",null,null,180]
[" 1500552","INJ TRIGGER POINT 1/2 MUSCL","ER",450,"20552",null,null,180]
[" 1500225","ASSPIRATION/INJ INTERMED JOINT","ER",450,"20605",null,null,186]
[" 1500191","CATEGORY I (BRIEF) 2","ER",450,"9928125","25",null,187]
[" 1500008","REPAIR FULL ARM CAST","ER",450,"29705",null,null,189]
[" 1500140","ED/SPLINT SHORT LEG","ER",450,"29515",null,null,189]
[" 1500509","IV PUSH EACH ADD NEW DRUG SEQ","ER",450,"96375",null,null,190]
[" 1500218","CORNEAL W/SLIT LAMP","ER",450,"65222",null,null,193]
[" 1500216","REM FB CONJUNCTIVA; EMBEDDED","ER",450,"65205",null,null,199]
[" 1500010","CATEGORY I (BRIEF)","ER",450,"99281",null,null,200]
[" 1500304","CONSCIOUS SEDATION > 5 YR EACH 14MIN","ER",450,"99157",null,null,201]
[" 1510216","REM FB CONJUNCTIVE; EMBEDDED","ER",450,"65210",null,null,203]
[" 1501101","IVP INITIAL SUBSTANCE/DRUG","ER",450,"9637459","59",null,218]
[" 1500145","ED/SPLINT FINGER","ER",450,"29130",null,null,224]
[" 1500502","INJECTN IV PUSH SING/INIT DRUG","ER",450,"9637459","59",null,225]
[" 1500217","ED/CORNEAL W/O SLIT LAMP","ER",450,"65220",null,null,226]
[" 1500118","ED/F/B EYE-CONJUNCT/SUPER","ER",450,"65205",null,null,235]
[" 1500138","ED/SPLINT SHORT ARM","ER",450,"29125",null,null,239]
[" 1500051","ANOSCOPY DIAGNOSTIC W/WO","ER",450,"46600",null,null,241]
[" 1500038","UNNABOOT APPLICATION","ER",450,"29580",null,null,251]
[" 1500293","PROCTOSIGMOIDOSCOPY","ER",450,"45300",null,null,251]
[" 1500139","ED/SPLINT LONG LEG","ER",450,"29505",null,null,266]
[" 1500124","ED/I&D ASPIRATION OF ABSC","ER",450,"10160",null,null,268]
[" 1500221","ED/AVULSION  SIMPLE","ER",450,"11730",null,null,268]
[" 1500303","CONSCIOUS SEDATION OTHER PROV >5 YRS","ER",450,"99156",null,null,268]
[" 1500226","ED/MAJR JOINT/CHOU/HIP/KN","ER",450,"20610",null,null,277]
[" 1500130","ED/BURN  FIRST DEGREE","ER",450,"16000",null,null,278]
[" 1500137","ED/SPLINT LONG ARM","ER",450,"29105",null,null,278]
[" 1500228","SLCTV WND DEBRIDEM 20 CM OR <","ER",450,"97597",null,null,278]
[" 1506084","INJECTION ANESTHETIC AGENT  FA","ER",450,"64402",null,null,278]
[" 1500297","ED APPLY SHORT LEG CAST","ER",450,"29405",null,null,294]
[" 1500134","ED/NASAL HEMORAGE-ANTERI","ER",450,"30901",null,null,309]
[" 1500652","CYSTOSTOMY TUBE SIMPLE","ER",450,"51705",null,null,311]
[" 1500553","INJECT TRIGGER POINTS 3/>","ER",450,"20553",null,null,312]
[" 1500120","ED/F/B EAR AUDITORY CANAL","ER",450,"69200",null,null,321]
[" 1500123","ED/I&D ABSCESS  SIMPLE","ER",450,"10060",null,null,324]
[" 1500052","REP COMPLX TRUNK 1.1-2.5","ER",450,"13100",null,null,335]
[" 1500105","ED/UP TO 2.5 CM-W & L","ER",450,"12001",null,null,340]
[" 1501310","C REP TRUNK; EA ADDTL 5 CM/<","ER",450,"13102",null,null,342]
[" 1500186","ED/COMPLEX  ADD 5 CM","ER",450,"13122",null,null,349]
[" 1500504","IV HYDRATION INT 31 - 60 MINU","ER",450,"9636059","59",null,350]
[" 1500231","ED/ELBOW-NURSEMAID W/MA","ER",450,"24640",null,null,361]
[" 1500164","ED/REPAIR-UP TO 2.5 CM","ER",450,"12011",null,null,364]
[" 1500017","THER/PROPH/DIAG IV INF INIT =<","ER",450,"9636559","59",null,365]
[" 1500132","ED/BURN DRESSING MEDIUM","ER",450,"16025",null,null,366]
[" 1500012","CAST: ELBOW - FINGER","ER",450,"29075",null,null,369]
[" 1501850","DESTROY LESION (NOT EXCISION)","ER",450,"41850",null,null,371]
[" 1500106","ED/W/L 2.6CM TO 7.5CM","ER",450,"12002",null,null,380]
[" 1500061","APPLICATION OF LONG CAST","ER",450,"29345",null,null,387]
[" 1500048","DRAIN EXT EAR SIMP ABSCES","ER",450,"69000",null,null,396]
[" 1500165","ED/2.6 - 5.0 CM-REPAIR","ER",450,"12013",null,null,396]
[" 1500011","CATEGORY II (LIMITED)","ER",450,"99282",null,null,400]
[" 1500192","CATEGORY II (LIMITED) 2","ER",450,"9928225","25",null,400]
[" 1500651","ED/URETH STRICTURE - MALE","ER",450,"53600",null,null,400]
[" 1501008","I&D PILONIDAL CYST SIM","ER",450,"10080",null,null,417]
[" 1500243","ED/CLSD PHALANX(S)NO GRT","ER",450,"28510",null,null,422]
[" 1500036","INSERT TEMP INDWELL BLADD","ER",450,"51702",null,null,425]
[" 1500119","ED/F/B INTRANASAL","ER",450,"30300",null,null,428]
[" 1500220","ED/COMPLEX  ANTERIOR","ER",450,"30903",null,null,428]
[" 1500112","APP LONG ARM CAST","ER",450,"29065",null,null,437]
[" 1500033","CLSD TRT FX GREAT TOE W/O","ER",450,"28490",null,null,439]
[" 1507197","CLSD TRT POSTERIOR PELVIC RING","ER",450,"27197",null,null,446]
[" 1500107","EC/W/L 7.6CM TO 12.5CM","ER",450,"12004",null,null,450]
[" 1500074","REMOVAL OF IUD","ER",450,"58301",null,null,461]
[" 1500171","ED/UP TO 2.5 CM-REPAIR","ER",450,"12031",null,null,471]
[" 1500239","ED/CLOSED PHALANGEAL SHA","ER",450,"26720",null,null,508]
[" 1500240","ED/CLOSED DISTAL PHALANG","ER",450,"26750",null,null,508]
[" 1500177","ED/UP TO 2.5 CM-REPAIR","ER",450,"12041",null,null,517]
[" 1500166","ED/5.1 - 7.5 CM-REPAIR","ER",450,"12014",null,null,524]
[" 1500080","CLSD TRT FX W/O MANIP EAC","ER",450,"28515",null,null,535]
[" 1500268","ED/FINGER ABSCESS-SIMPLE","ER",450,"26010",null,null,535]
[" 1502871","DR ABSC CYST HEMAOM DENTOALVEO","ER",450,"41800",null,null,538]
[" 1500277","CLOSED FX COCCYGEAL","ER",450,"27200",null,null,540]
[" 1500172","ED/2.6 - 7.5 CM-REPAIR","ER",450,"12032",null,null,561]
[" 1500167","ED/7.6 -12.5 CM-REPAIR","ER",450,"12015",null,null,562]
[" 1502866","INTPHALAN DISLOCATE W/ANES","ER",450,"28665",null,null,568]
[" 1500234","ED/PATELLA","ER",450,"27560",null,null,585]
[" 1500034","REP SIMP 12.6 TO 20 CM LA","ER",450,"12005",null,null,589]
[" 1506087","INTRAOSSEOUS INF NEEDLE PLACEMENT","ER",450,"36680",null,null,592]
[" 1500121","ED/SUBCUTANEOUS-SIMPLE","ER",450,"10120",null,null,593]
[" 1500554","CHANGE GASTROSTOMY TUBE","ER",450,"43760",null,null,606]
[" 1500555","CHANGE GASTROSTOMY TUBE","ER",450,"43762",null,null,606]
[" 1500252","ED/W & L-1.1CM TO 2.5 CM","ER",450,"13120",null,null,610]
[" 1500178","ED/2.6 - 7.5 CM-REPAIR","ER",450,"12042",null,null,615]
[" 1500183","ED/UP TO 2.5 REPAIR","ER",450,"12051",null,null,615]
[" 1502006","SREP S/N/A/G/TR/E; 20.1-30.0CM","ER",450,"12006",null,null,642]
[" 1500160","ED/GASTRIC LAVAGE","ER",450,"43753",null,null,655]
[" 1500254","ED/W & L-1.1CM TO 2.5 CM","ER",450,"13131",null,null,660]
[" 1500286","ED/F-B SUBCUTANEOUS","ER",450,"28190",null,null,664]
[" 1500029","INJ GREATER OCCIPITAL NER","ER",450,"64405",null,null,668]
[" 1506440","INJ TRIGEMINAL NERVE","ER",450,"64400",null,null,669]
[" 1500116","ED/DISLOC FINGER","ER",450,"26770",null,null,677]
[" 1500232","ED/METACARPOPALANGEAL","ER",450,"26700",null,null,677]
[" 1500265","ED/TRANSCUTANEOUS PACIN","ER",450,"92953",null,null,692]
[" 1500238","ED/CLOSED CLAVICULAR","ER",450,"23500",null,null,694]
[" 1500184","ED/2.6 -5.0 CM REPAIR","ER",450,"12052",null,null,698]
[" 1500162","CLSD TRT PROX HUMERAL FX","ER",450,"23600",null,null,721]
[" 1500113","ED CLSD TRT VERTEBRAL PRO","ER",450,"22305",null,null,724]
[" 1500179","ED/7.6 - 12.5 CM-REPAIR","ER",450,"12044",null,null,727]
[" 1500159","ED/LUMBAR PUNCTURE","ER",450,"62270",null,null,737]
[" 1500054","CLSD TRT CMETACARP DISLOC","ER",450,"26670",null,null,745]
[" 1500023","CL TX KNEE DISLOC WO ANES","ER",450,"27550",null,null,747]
[" 1500047","CLSD TRT PROX FIBULA/SHAF","ER",450,"27780",null,null,748]
[" 1500135","ED/NASAL HEMORAGE-POSTE","ER",450,"30905",null,null,770]
[" 1500046","CLSD TRT ARTICULAR FX W/O","ER",450,"26740",null,null,779]
[" 1500278","ED/CLOSED METATARSAL  EA","ER",450,"28470",null,null,779]
[" 1500230","ED/AC SEPARATION W/O MANI","ER",450,"23540",null,null,794]
[" 1500001","CATEGORY III (INTERMED)","ER",450,"99283",null,null,800]
[" 1500193","CATEGORY III (INTERMED) 2","ER",450,"9928325","25",null,800]
[" 1500185","ED/5.1 -7.5 CM REPAIR","ER",450,"12053",null,null,810]
[" 1500173","ED/7.6 - 12.5 CM-REPAIR","ER",450,"12034",null,null,824]
[" 1500024","CL TX PATELLAR FX W/O MAN","ER",450,"27520",null,null,828]
[" 1500153","ED/RESUSCITATION","ER",450,"92950",null,null,829]
["15046320","ED EXC THROMBOSED HEMORRHOIDS","ER",450,"46320",null,null,833]
[" 1500025","CL TX UNAR SHAFT FX W/O","ER",450,"25530",null,null,843]
[" 1500612","ED/CLOSED RAD SHAFT FRACT","ER",450,"25500",null,null,843]
[" 1500613","ED/CLOSED ULN SHAFT FRACT","ER",450,"25530",null,null,843]
[" 1500210","CRITICAL CARE EACH ADDITIONAL 30 MINUTES","ER",450,"99292",null,null,850]
[" 1501203","SUTURE INTEMD 12.60-20.0 CM","ER",450,"12035",null,null,852]
[" 1500059","I&D ABSCESS COMPLICATED","ER",450,"10061",null,null,859]
[" 1509082","ABDOMINAL PARACENTESIS","ER",450,"49082",null,null,861]
[" 1500007","W/WO SKIN OR SKEL TRAC TI","ER",450,"26725",null,null,881]
[" 1500256","ED/W & L-1.1 CM TO 2.5","ER",450,"13151",null,null,893]
[" 1500253","ED/W & L-2.6CM TO 7.5 CM","ER",450,"13121",null,null,899]
[" 1700506","ABDOMINAL PARACENTESIS","ER",450,"49082",null,null,910]
[" 1500270","ED/THUMB-CARPOMET-W/MA","ER",450,"26641",null,null,914]
[" 1500244","CLSD TRT CARPAL FX W/O","ER",450,"25630",null,null,919]
[" 1500614","ED/CLSD RAD/ULN SHAFT FRA","ER",450,"25560",null,null,919]
[" 1500063","CLSD TRT METACARPAL FX W/","ER",450,"26605",null,null,920]
[" 1500022","CL TX TRIM ANKLE FX W/O","ER",450,"27816",null,null,924]
[" 1500035","CLSD TRT GRT HUMERAL TUBE","ER",450,"23620",null,null,926]
[" 1500037","CLSD TRT HUMERAL CONDYLAR","ER",450,"24576",null,null,933]
[" 1502867","REPAIR INT WND 12.6 TO 20.0CM","ER",450,"12045",null,null,949]
[" 1500114","ED/SHOULDER W/MANIPULATI","ER",450,"23650",null,null,963]
[" 1500615","ED/CLSD DISTAL RAID FX","ER",450,"25600",null,null,970]
[" 1500511","BLOOD TRANSFUSION PER DAY","ER",450,"36430",null,null,975]
[" 1500014","CL TX FX W8 BRG WO ANT WO","ER",450,"27824",null,null,979]
[" 1500020","CL TX BIMAL ANK FX WO MAN","ER",450,"27808",null,null,979]
[" 1500021","CL TX MALLEOLUS FX W/O MA","ER",450,"27760",null,null,979]
[" 1500619","ED/CLOSED DIST FIB FRACT","ER",450,"27786",null,null,979]
[" 1502870","UNLISTED PROCEDURE","ER",450,"45399",null,null,982]
[" 1500275","CLSD TRT SCAPULAR FX W/O MA","ER",450,"23570",null,null,993]
[" 1500056","CLSD TRT FX PHALANG W/MAN","ER",450,"26755",null,null,998]
[" 1500512","CL TX HUMERAL SFT FX WO","ER",450,"24500",null,null,999]
[" 1500032","CLTX MTCARPHLNGL W/ANES","ER",450,"26705",null,null,1015]
[" 1500006","CL TX META FX WO MAN EA B","ER",450,"26600",null,null,1022]
[" 1500015","CLSD TX SCAPHOID FX W/O","ER",450,"25622",null,null,1022]
[" 1500245","CLSD TRT FX ORBIT WO MANI","ER",450,"21400",null,null,1027]
[" 1500004","ADD 5CM OR LESS FACE","ER",450,"13133",null,null,1030]
[" 1500617","ED/CLOSED TIB SHAFT FRACT","ER",450,"27750",null,null,1033]
[" 1500042","CLSD TRT CALCANEAL FX W/O","ER",450,"28400",null,null,1037]
[" 1500154","ED/ENDOTRACHEAL INTUBATI","ER",450,"31500",null,null,1070]
[" 1500259","TUBE THORACOSTOMY","ER",450,"32551",null,null,1070]
[" 1500653","CLSD TRT METATARSAL FX W/MANIP","ER",450,"28475",null,null,1070]
[" 1500091","CLSD TRT TIB FX W/O MAM","ER",450,"27530",null,null,1076]
[" 1500611","CLSD TRT RADIAL HEAD NECK FX W","ER",450,"24650",null,null,1083]
[" 1500279","THROMBOLYSIS CORON; IV INFUS","ER",450,"92977",null,null,1098]
[" 1502054","REPAIR 7.6 TO 12.5 CM WOUND","ER",450,"12054",null,null,1113]
[" 1512868","REPAIR 7.6 TO 12.5CM WOUND","ER",450,"12054",null,null,1113]
[" 1507198","CLSD TRT POSTERIOR PELVIC RING","ER",450,"27198",null,null,1134]
[" 1500002","CATEGORY IV (EXTENDED)","ER",450,"99284",null,null,1150]
[" 1500194","CATEGORY IV (EXTENDED) 2","ER",450,"9928425","25",null,1150]
[" 1500111","ED/W.L 2.6CM TO 7.5CM","ER",450,"1310159","59",null,1155]
[" 1500128","ED/I&D HEMATOMA  SIMPLE","ER",450,"10140",null,null,1181]
[" 1500280","ED/W&L 1.0CM OR LESS","ER",450,"12051",null,null,1190]
[" 1500055","TRT CLSD ELBOW DISLO W/O","ER",450,"24600",null,null,1260]
[" 1500600","ED/ELBOW DISLOC W/O ANES","ER",450,"24600",null,null,1260]
[" 1500281","CLSD TRT POST HIP ARTHROP","ER",450,"27265",null,null,1269]
[" 1500272","CLSD TRT FEMORAL FX W/O MANIP","ER",450,"27238",null,null,1294]
[" 1502868","CLSD TRT ARTICULAR FX W/MANIP","ER",450,"26742",null,null,1346]
[" 1500255","ED/W & L-2.6 CM TO 7.5 CM","ER",450,"13132",null,null,1354]
[" 1502466","CLSD TRT FEMORAL FX PROX END W","ER",450,"27230",null,null,1357]
[" 1500152","REM TUNN CVC W/O PORT/PUMP","ER",450,"36589",null,null,1426]
[" 1500151","LIGATION MAJ ARTERY EXTRE","ER",450,"37618",null,null,1471]
[" 1500043","THORACENTESIS PLEURAL CAV","ER",450,"32555",null,null,1478]
[" 1500003","CATEGORY V (COMPLEX)","ER",450,"99285",null,null,1500]
[" 1500195","CATEGORY V (COMPLEX) 2","ER",450,"9928525","25",null,1500]
[" 1500044","CLSD TRT DISTAL FIBULAR F","ER",450,"27788",null,null,1523]
[" 1500053","CLSD TRT IP JOINT ANEST","ER",450,"26775",null,null,1531]
[" 1500266","ED/ELECTIVE CARDIOVERSION","ER",450,"92960",null,null,1548]
[" 1500269","ED/FINGER ABSCESS - COMP","ER",450,"26011",null,null,1592]
[" 1500302","EXPLORE TRAUM WOUND EXTRE","ER",450,"20103",null,null,1603]
[" 1500030","CLSD TX ANKLE FX W/MANIP","ER",450,"27818",null,null,1607]
[" 1500257","ED/W & L-2.6CM TO 7.5CM","ER",450,"13152",null,null,1620]
[" 1506085","INSERT PLEURA DRAINAGE CATH W/O IMAGING","ER",450,"32556",null,null,1620]
[" 1500637","ED/CLOSED BIMAL ANK FRACT","ER",450,"27810",null,null,1631]
[" 1500214","ED/MUSCLE  DEEP/COMPLICA","ER",450,"20525",null,null,1639]
[" 1500616","ED/CLOSED FEM SHAFT FRACT","ER",450,"27500",null,null,1639]
[" 1200163","VAGINAL DELIVERY ONLY  AFTER P","ER",450,"59612",null,null,1640]
[" 1505505","CL TX RADIAL SHFT FX W MANIP","ER",450,"25505",null,null,1739]
[" 1500040","CLSD TRT FEMORAL FX W/O M","ER",450,"27508",null,null,1758]
[" 1500634","ED/CLSD DISTAL RADIAL FRA","ER",450,"25605",null,null,1788]
[" 1500005","CATEG VI (CRITICAL)30-74M","ER",450,"99291",null,null,1800]
[" 1500031","TX OF NASAL BONE FX W/O M","ER",450,"21310",null,null,1809]
[" 1500633","ED/CLSD RAD/ULN SHAFT FRA","ER",450,"25565",null,null,1838]
[" 1502470","TX TIB SHFT FX W MANIP","ER",450,"27752",null,null,2012]
[" 1506086","INSERT DRAINAGE PLEURA CATH W/IMAGING","ER",450,"32557",null,null,2074]
[" 1500115","ED/DISLO SLD W/AN","ER",450,"23655",null,null,2092]
[" 1500212","ED/SUBCUTANEOUS-COMPLIC","ER",450,"10121",null,null,2160]
[" 1502467","UNLISTED PROCEDURE ANT SEG OF","ER",450,"66999",null,null,2253]
[" 1500236","PARTIAL EXCISION DISTAL PHALAN","ER",450,"26236",null,null,2273]
[" 1500090","UNLISTED VASC PROCEDURE","ER",450,"37799",null,null,2366]
[" 1500062","AMP FINGER THUMB DIRECT C","ER",450,"26951",null,null,2503]
[" 1500827","CLSD TX HIP DISLOCATION W/ANES","ER",450,"27252",null,null,2951]
[" 1201899","UNLISTED PROCEDURE DENTOALVEOL","ER",450,"41899",null,null,2961]
[" 1500092","AMP METATAR W/TOE SINGLE","ER",450,"28810",null,null,3051]
[" 1500057","REM FOREIGN BODY MOUTH SI","ER",450,"40804",null,null,4022]
[" 1500058","REM FOREIGN BODY MOUTH","ER",450,"40804",null,null,4022]
[" 1500049","VAGINAL DELIVERY ONLY","ER",450,"59409",null,null,4500]
[" 1501120","REP TENDON/MUSCLE EXTENSO","ER",450,"25270",null,null,4854]
[" 1500060","HEMORRHOIDECTOMY  INT/EXT","ER",450,"46255",null,null,5414]
[" 5500198","EAR-OXIMETRY-SGL","PULMONARY FUNCTION",460,"94760",null,null,139]
[" 5502713","VITAL CAPACITY SCREENING","PULMONARY FUNCTION",460,"94150",null,null,139]
[" 4001143","PULMON REHAB SESSION","PULMONARY FUNCTION",460,"94799",null,null,214]
[" 5500199","OXIMETRY/EXERCISE","PULMONARY FUNCTION",460,"94761",null,null,268]
[" 5500197","SPIROMETRY","PULMONARY FUNCTION",460,"94010",null,null,300]
[" 5500013","PULMONARY STRESS TEST","PULMONARY FUNCTION",460,"94620",null,null,432]
[" 5500123","EAR OX W CONT OVERNIGHT M","PULMONARY FUNCTION",460,"94762",null,null,556]
[" 5500196","PRE AND POST SPIROMETRY","PULMONARY FUNCTION",460,"94060",null,null,642]
[" 5500014","CARDIOVASCULAR STRESS TEST","STRESS TEST",482,"93015",null,null,1031]
[" 4207000","US ECHOCARDIOGRAM","RADIOLOGY",483,"93307",null,null,1917]
[" 4207006","US ECHO DOPPLER","RADIOLOGY",483,"93306",null,null,2300]
[" 1700007","SPECIALTY CLINIC","CLINIC",510,"99202",null,null,54]
[" 4400043","CL SPORTS PHYSICAL","CLINIC",510,"SPPX",null,null,55]
[" 1700023","SPECIALTY CLINIC 99202","CLINIC",510,"99202",null,null,65]
[" 1900100","WC LEVEL 1","CLINIC",510,null,null,null,66]
[" 1700802","TRIM DYSTROPHIC NAILS 1-5","CLINIC",510,"11720",null,null,112]
[" 1700804","LEVEL 2 PROBLEM FOCUS","CLINIC",510,"99212",null,null,118]
[" 4400042","CL DOT PHYSICAL","CLINIC",510,"DOTPX",null,null,164]
[" 1700020","APP MULTI-LAYER VENOUS CO","CLINIC",510,"29581",null,null,268]
[" 1700805","AVULSION NAIL PLATE","CLINIC",510,"11730",null,null,268]
[" 1700801","I&D FINGER ABSCESS SIMPLE","CLINIC",510,"26010",null,null,515]
[" 4400025","CL VENIPUNCTURE, SPEC COLL","RURAL HEALTH CLINIC",521,"36415",null,null,14]
[" 4400009","CL ADMINISTRATION ALLERGEN","RURAL HEALTH CLINIC",521,"95115",null,null,22]
[" 4400010","CL ADMIN ALLERGEN: MULTIPLE","RURAL HEALTH CLINIC",521,"95117",null,null,37]
[" 4400235","CL DESTRUCTION ANY METHOD 2-","RURAL HEALTH CLINIC",521,"17003",null,null,40]
[" 4400045","CL ELECTROCARDIOGRAM, TRACIN","RURAL HEALTH CLINIC",521,null,null,null,44]
[" 4400210","CL TRIM NONDYSTROPHIC NAILS","RURAL HEALTH CLINIC",521,"11719",null,null,48]
[" 4400501","CL E VISIT HEALTH 5-10 MINUTES","RURAL HEALTH CLINIC",521,"99421",null,null,49]
[" 4400068","CL THERAPEUTIC INJ SUBC/IM","RURAL HEALTH CLINIC",521,"96372",null,null,50]
[" 4400281","CL CATHETERIZATION, SIMPLE","RURAL HEALTH CLINIC",521,"53670",null,null,50]
[" 4400036","CL TB SKIN TEST","RURAL HEALTH CLINIC",521,"86580",null,null,54]
[" 4400295","CL DEBRIDEMENT, DIABETIC FOO","RURAL HEALTH CLINIC",521,"97602",null,null,54]
[" 4400059","CL COUNSELING CT LUNG SCREEN LOW DOSE","RURAL HEALTH CLINIC",521,"G0296",null,null,59]
[" 4400040","CL EKG 12-LEADS INTERP REPORT","RURAL HEALTH CLINIC",521,"93010",null,null,60]
[" 4400079","CL MEDICAL E/M, MINIMALJ-EST","RURAL HEALTH CLINIC",521,"99211",null,null,76]
[" 4400502","CL E VISIT HEALTH 11-20 MINUTES","RURAL HEALTH CLINIC",521,"99422",null,null,82]
[" 4400035","CL PHLEBOTOMY","RURAL HEALTH CLINIC",521,"99195",null,null,83]
[" 4400064","CL VISUAL FIELD EXAMINATION","RURAL HEALTH CLINIC",521,"92081",null,null,85]
[" 4400307","CL OBTAINING SCREEN PAP SMEAR","RURAL HEALTH CLINIC",521,"Q0091",null,null,92]
[" 4400173","CL PARING OR CUTTING OF BENIGN","RURAL HEALTH CLINIC",521,"11055",null,null,93]
[" 4400298","CL AVULSION NAIL PLATE; EACH","RURAL HEALTH CLINIC",521,"11732",null,null,94]
[" 4400171","CL DEBRIDEMENT OF EXTENSIVE","RURAL HEALTH CLINIC",521,"11000",null,null,100]
[" 4400211","CL EVAC SUBUNGUAL HEMATOMA","RURAL HEALTH CLINIC",521,"11740",null,null,102]
[" 4400290","CL FB EXTERNAL EYE, CONJUNCT","RURAL HEALTH CLINIC",521,"65205",null,null,107]
[" 4400294","CL CERUMEN REMOVAL","RURAL HEALTH CLINIC",521,"69210",null,null,113]
[" 4400300","CL DEBRIDE WOUND 20CM/LESS","RURAL HEALTH CLINIC",521,"97597",null,null,113]
[" 4400293","CL REMOVE IMPACTED EAR WAX","RURAL HEALTH CLINIC",521,"69209",null,null,115]
[" 4400509","CL TELEHEALTH LEVEL 2 VISIT","RURAL HEALTH CLINIC",521,"9921295","95",null,118]
[" 4400081","CL PHYSICIAN E/M, PHYFEE/PHYFEE/SF","RURAL HEALTH CLINIC",521,"99212",null,null,120]
[" 4400176","CL BIOPSY SKIN EACH ADDITION","RURAL HEALTH CLINIC",521,"11101",null,null,120]
[" 4400351","CLPUNCH BIOPSY EACH ADDITION","RURAL HEALTH CLINIC",521,"11105",null,null,120]
[" 4400999","DOT PHYSICAL","RURAL HEALTH CLINIC",521,null,null,null,120]
[" 4400006","CL FETAL NON-STRESS TEST","RURAL HEALTH CLINIC",521,"59025",null,null,124]
[" 4400291","CL FB EYE CORNEAL","RURAL HEALTH CLINIC",521,"65220",null,null,124]
[" 4400069","CL PHYSICIAN E/M, PHYFEE/PHYFEE/SF","RURAL HEALTH CLINIC",521,"99201",null,null,131]
[" 4400070","CL PHYSICIAN E/M, PHYFEE/PHYFEE/SF","RURAL HEALTH CLINIC",521,"99201",null,null,131]
[" 4400503","CL E-VISIT HEALTH  >21 MINUTES","RURAL HEALTH CLINIC",521,"99423",null,null,137]
[" 4400174","CL PARING, CUTTING LESION 2-4","RURAL HEALTH CLINIC",521,"11056",null,null,139]
[" 4400239","CL ASPIRATION BREAST CYST E","RURAL HEALTH CLINIC",521,"19001",null,null,140]
[" 4400510","CL TELEHEALTH LEVEL 3 VISIT","RURAL HEALTH CLINIC",521,"9921395","95",null,144]
[" 4400172","CL DEBRIDEMENT/SKIN/FULL THI","RURAL HEALTH CLINIC",521,"11041",null,null,146]
[" 4400265","CL APPLY SHORT LEG SPLINT","RURAL HEALTH CLINIC",521,"29515",null,null,146]
[" 4400083","CL PHYSICIAN E/M, EPHYFEE/EPHYFEE/LC","RURAL HEALTH CLINIC",521,"99213",null,null,150]
[" 4400245","CL ARTHROCENT ASPIRA/INJ SM","RURAL HEALTH CLINIC",521,"20600",null,null,156]
[" 4400242","CL INJ TENDON/LIGA/TRG POINT","RURAL HEALTH CLINIC",521,"20550",null,null,161]
[" 4400299","CL ARTHROCENTESIS IJ","RURAL HEALTH CLINIC",521,"20605",null,null,162]
[" 4400234","CL DESTRUCTION LESIONS BY AN","RURAL HEALTH CLINIC",521,"17000",null,null,169]
[" 4400243","CL INJ; TRIGGER PTS 1 OR 2 MUSC","RURAL HEALTH CLINIC",521,"20552",null,null,171]
[" 4400247","CL ASPIRAT/INJ GANGLION CYST","RURAL HEALTH CLINIC",521,"20612",null,null,171]
[" 4400177","CL SKIN TAGS/EXCISE/UP TO 15","RURAL HEALTH CLINIC",521,"11200",null,null,175]
[" 4400178","CL REMOVE SKIN TAGES ADD-ON = <10 LESION","RURAL HEALTH CLINIC",521,"11201",null,null,175]
[" 4400275","CL ANOSCOPY, DIAGNOSTIC","RURAL HEALTH CLINIC",521,"46600",null,null,177]
[" 4400179","CL SHAVE EPID/DERM LES <.5CM","RURAL HEALTH CLINIC",521,"11300",null,null,178]
[" 4400287","CL DILATION OF CERVICAL CANA","RURAL HEALTH CLINIC",521,"57800",null,null,181]
[" 4400105","CL E/M HEALTHY INFANT-EST PT","RURAL HEALTH CLINIC",521,"99391",null,null,190]
[" 4400071","CL PHYSICIAN E/M, EPHYFEE/EPHYFEE/SF","RURAL HEALTH CLINIC",521,"99202",null,null,193]
[" 4400165","CL ACNE SURGERY","RURAL HEALTH CLINIC",521,"10040",null,null,194]
[" 4400276","CL INSERTION/NON-INDWELLING","RURAL HEALTH CLINIC",521,"51701",null,null,197]
[" 4400181","CL SHAVING LESION .6 TO 1 CM","RURAL HEALTH CLINIC",521,"11306",null,null,199]
[" 4400246","CL ARTHROCENTESIS MJ","RURAL HEALTH CLINIC",521,"20610",null,null,200]
[" 4400297","CL AVULSION, NAIL","RURAL HEALTH CLINIC",521,"11730",null,null,201]
[" 4400175","CL BIOPSY SKIN-SUBQ","RURAL HEALTH CLINIC",521,"11100",null,null,208]
[" 4400335","CL BIOPSY SKIN-SUBQ","RURAL HEALTH CLINIC",521,"11104",null,null,208]
[" 4400106","CL E/M HEALTHY (1-4) EST PT","RURAL HEALTH CLINIC",521,"99392",null,null,210]
[" 4400259","CL APPLY SHORT ARM SPLINT","RURAL HEALTH CLINIC",521,"29125",null,null,211]
[" 4400260","CL APP FINGER SPLINT STATIC","RURAL HEALTH CLINIC",521,"29130",null,null,211]
[" 4400269","CL LARYNGOSCOPY, INDIRECT","RURAL HEALTH CLINIC",521,"31505",null,null,211]
[" 4400272","CL CHANGE GASTROSTOMY TUBE","RURAL HEALTH CLINIC",521,"43760",null,null,213]
[" 4400098","CL E/M HEALTHY INFANTJ-NEW","RURAL HEALTH CLINIC",521,"99381",null,null,214]
[" 4400280","CL DILATION OF URETHRA","RURAL HEALTH CLINIC",521,"53660",null,null,214]
[" 4400511","CL TELE HEALTH LEVEL 4 VISIT","RURAL HEALTH CLINIC",521,"9921495","95",null,214]
[" 4400107","CL E/M HEALTHY (5-11) EST PT","RURAL HEALTH CLINIC",521,"99393",null,null,215]
[" 4400099","CL E/M HEALTHY (1-4)-NEW","RURAL HEALTH CLINIC",521,"99382",null,null,219]
[" 4400182","CL SHAVE LESION FACE 0.5CM","RURAL HEALTH CLINIC",521,"11310",null,null,219]
[" 4400237","CL DESTRUCTION FLAT WARTS 1-","RURAL HEALTH CLINIC",521,"17110",null,null,219]
[" 4400084","CL PHYSICIAN E/M, D/D/MC","RURAL HEALTH CLINIC",521,"99214",null,null,220]
[" 4400267","CL EPISTAXIS CONTROL/SIMPLE","RURAL HEALTH CLINIC",521,"30901",null,null,221]
[" 4400277","CL INSERTION/TEMP INDWELLING","RURAL HEALTH CLINIC",521,"51702",null,null,221]
[" 4400183","CL EXC BENIGN TRUNK TO 0.5CM","RURAL HEALTH CLINIC",521,"11400",null,null,228]
[" 4400189","CL EXC BEN SCALP ETC TO 0.5","RURAL HEALTH CLINIC",521,"11420",null,null,228]
[" 4400108","CL E/M HEALTHY (12-17) EST P","RURAL HEALTH CLINIC",521,"99394",null,null,230]
[" 4400052","CL POSTPARTUM CARE VISIT ONLY","RURAL HEALTH CLINIC",521,"59430",null,null,236]
[" 4400166","CL I & D ABSCESS","RURAL HEALTH CLINIC",521,"10060",null,null,240]
[" 4400266","CL UNNA BOOT APPLICATION","RURAL HEALTH CLINIC",521,"29580",null,null,240]
[" 4400073","CL PHYSICIAN E/M, D/D/LC","RURAL HEALTH CLINIC",521,"99203",null,null,241]
[" 4400100","CL E/M HEALTHY (5-11)-NEW","RURAL HEALTH CLINIC",521,"99383",null,null,241]
[" 4400238","CL ASPIRATION BREAST CYST","RURAL HEALTH CLINIC",521,"19000",null,null,246]
[" 4400353","BLADDER INSTILLATION IRRIGATION","RURAL HEALTH CLINIC",521,"51700",null,null,246]
[" 4400213","CL WEDGE EXCISION/SKIN OF NA","RURAL HEALTH CLINIC",521,"11765",null,null,247]
[" 4400264","CL APPLICATION OF LONG LEG SPLINT","RURAL HEALTH CLINIC",521,"29505",null,null,249]
[" 4400109","CL E/M HEALTHY (18-39) EST P","RURAL HEALTH CLINIC",521,"99395",null,null,250]
[" 4400170","CL ASPIRATE, ABSCESS/HEMATOMA","RURAL HEALTH CLINIC",521,"10160",null,null,253]
[" 4400101","CL E/M HEALTHY (12-17)-NEW","RURAL HEALTH CLINIC",521,"99384",null,null,257]
[" 4400063","CL AWV PPPS SUBSEQUENT VISIT","RURAL HEALTH CLINIC",521,"G0439",null,null,260]
[" 4400180","CL SHAV EPID/DERMAL 1.1-2.0","RURAL HEALTH CLINIC",521,"11302",null,null,260]
[" 4400233","CL BURN TREATMENT DRESSING W","RURAL HEALTH CLINIC",521,"16020",null,null,268]
[" 4400262","CL APPLY SHORT LEG CAST","RURAL HEALTH CLINIC",521,"29405",null,null,268]
[" 4400193","CL EXC BEN FACE-EARS TO 0.5","RURAL HEALTH CLINIC",521,"11440",null,null,272]
[" 4400057","CL WORK RELATED, MEDICAL DIS","RURAL HEALTH CLINIC",521,"99455",null,null,275]
[" 4400285","CL BIOPSY CERVIX OR EXCISION","RURAL HEALTH CLINIC",521,"57500",null,null,275]
[" 4400258","CL APPLY LONG ARM SPLINT","RURAL HEALTH CLINIC",521,"29105",null,null,276]
[" 4400289","CL INJ ANESTH; FACIAL NERVE","RURAL HEALTH CLINIC",521,"64402",null,null,279]
[" 4400102","CL E/M HEALTHY (18-39)-NEW","RURAL HEALTH CLINIC",521,"99385",null,null,284]
[" 4400288","CL ENDOMETRIAL BIOPSY","RURAL HEALTH CLINIC",521,"58100",null,null,287]
[" 4400190","CL EXC BEN SCALP ETC 0.6-1.0","RURAL HEALTH CLINIC",521,"11421",null,null,292]
[" 4400184","CL EXC BENIGN TRUNK 0.6-1.0","RURAL HEALTH CLINIC",521,"11401",null,null,296]
[" 4400256","CL APPLY SHORT ARM CAST","RURAL HEALTH CLINIC",521,"29075",null,null,299]
[" 4400194","CL EXC BEN FACE-EAR 0.6-1.0","RURAL HEALTH CLINIC",521,"11441",null,null,301]
[" 4400001","CL REMOVAL CONTRACEPTIVE CAP","RURAL HEALTH CLINIC",521,"11976",null,null,302]
[" 4400104","CL E/M HEALTHY (65+)-NEW","RURAL HEALTH CLINIC",521,"99387",null,null,305]
[" 4400257","CL CAST HAND & LOWER FOREARM","RURAL HEALTH CLINIC",521,"29085",null,null,308]
[" 4400044","CL EKG","RURAL HEALTH CLINIC",521,"93005",null,null,310]
[" 4400061","CL EKG FOR IPPE","RURAL HEALTH CLINIC",521,"G0403",null,null,310]
[" 4400263","CL APPLY SHORT LEG WALKING C","RURAL HEALTH CLINIC",521,"29425",null,null,314]
[" 4400076","CL PHYSICIAN E/M, C/C/MC","RURAL HEALTH CLINIC",521,"99204",null,null,321]
[" 4400279","CL BLADDER INSTILL ANTI-CA A","RURAL HEALTH CLINIC",521,"51720",null,null,323]
[" 4400261","CL APPLY LONG LEG CAST","RURAL HEALTH CLINIC",521,"29345",null,null,324]
[" 4400110","CL E/M HEALTHY (40-64) EST P","RURAL HEALTH CLINIC",521,"99396",null,null,325]
[" 4400214","CL SUTURE TRUNK ETC TO 2.5 C","RURAL HEALTH CLINIC",521,"12001",null,null,327]
[" 4400002","CL REM NON BIODEGRADE DRUG DELIVE","RURAL HEALTH CLINIC",521,"11982",null,null,335]
[" 4400164","CL FINE NEEDLE ASPIRAT W/O","RURAL HEALTH CLINIC",521,"10021",null,null,340]
[" 4400352","INJECTION PERIPHERAL NERVE OR BRANCH","RURAL HEALTH CLINIC",521,"64450",null,null,340]
[" 4400236","CL DESTRUCTION ANY METHOD 15","RURAL HEALTH CLINIC",521,"17004",null,null,341]
[" 4400286","CL CRYOCAUTERY, CERVIX","RURAL HEALTH CLINIC",521,"57511",null,null,341]
[" 4400060","CL IPPE","RURAL HEALTH CLINIC",521,"G0402",null,null,343]
[" 4400185","CL EXC BENIGN TRUNK 1.1-2.0","RURAL HEALTH CLINIC",521,"11402",null,null,347]
[" 4400111","CL E/M HEALTHY (65+) EST PT","RURAL HEALTH CLINIC",521,"99397",null,null,353]
[" 4400512","CLTELEHEALTH LEVEL 5","RURAL HEALTH CLINIC",521,"9921595","95",null,353]
[" 4400086","CL PHYSICIAN E/M, C/C/HC","RURAL HEALTH CLINIC",521,"99215",null,null,355]
[" 4400270","CL I & D ABSCESS, PERITONSIL","RURAL HEALTH CLINIC",521,"42700",null,null,364]
[" 4400169","CL I&D HEMATOMA, SEROMA","RURAL HEALTH CLINIC",521,"10140",null,null,365]
[" 4400206","CL PHYFEE EX MALIG LESION .5CM/L","RURAL HEALTH CLINIC",521,"11640",null,null,367]
[" 4400283","CL FIT/INSERT PESSARY","RURAL HEALTH CLINIC",521,"57160",null,null,367]
[" 4400191","CL EXC BEN SCALP ETC 1.1-2.0","RURAL HEALTH CLINIC",521,"11422",null,null,368]
[" 4400284","CL COLPOSCOPY W/BIOPSIES","RURAL HEALTH CLINIC",521,"57454",null,null,370]
[" 4400292","CL EAR PIERCING; EXTERNAL","RURAL HEALTH CLINIC",521,"69090",null,null,370]
[" 4400062","CL AWV PPPS FIRST VISIT","RURAL HEALTH CLINIC",521,"G0438",null,null,375]
[" 4400103","CL E/M HEALTHY (40-64)-NEW","RURAL HEALTH CLINIC",521,"99386",null,null,375]
[" 4400197","CL EXC MALIG LESION <0.5CM","RURAL HEALTH CLINIC",521,"11600",null,null,386]
[" 4400255","CL APPLY LONG ARM CAST","RURAL HEALTH CLINIC",521,"29065",null,null,386]
[" 4400215","CL SUTURE TRUNK ETC 2.6-7.5","RURAL HEALTH CLINIC",521,"12002",null,null,388]
[" 4400217","CL SUTURE FACE-EAR TO 2.5 CM","RURAL HEALTH CLINIC",521,"12011",null,null,388]
[" 4400278","CL INSERT BLADDER CATH, COMP","RURAL HEALTH CLINIC",521,"51703",null,null,400]
[" 4400212","CL EXCISION OF NAIL BED","RURAL HEALTH CLINIC",521,"11750",null,null,417]
[" 4400240","CL BREAST NEEDLE BIOPSY","RURAL HEALTH CLINIC",521,"19100",null,null,421]
[" 4400198","CL EXCISE MALIG >0.6 <1.0 CM","RURAL HEALTH CLINIC",521,"11601",null,null,422]
[" 4400203","CL EXC MAL SCALP-NECK 0.6-1.","RURAL HEALTH CLINIC",521,"11621",null,null,422]
[" 4400268","CL EPISTAXIS CONTROL/COMPLEX","RURAL HEALTH CLINIC",521,"30903",null,null,427]
[" 4400274","CL EXC THROMB HEMMRHOID XTRN","RURAL HEALTH CLINIC",521,"46320",null,null,427]
[" 4400207","CL EXC MAL FACE-EARS 0.6-1.0","RURAL HEALTH CLINIC",521,"11641",null,null,432]
[" 4400219","CL SUTURE IMTERMEDIATE SCALP","RURAL HEALTH CLINIC",521,"12031",null,null,442]
[" 4400186","CL EXC BENIGN TRUNK 2.1-3.0","RURAL HEALTH CLINIC",521,"11403",null,null,444]
[" 4400218","CL SUTURE FACE-EAR 2.6-5.0 C","RURAL HEALTH CLINIC",521,"12013",null,null,455]
[" 4400195","CL EXC BEN FACE-EAR 1.1-2.0","RURAL HEALTH CLINIC",521,"11442",null,null,477]
[" 4400167","CL I & D ABSCESS COMPLICATED","RURAL HEALTH CLINIC",521,"10061",null,null,479]
[" 4400216","CL SUTURE TRUNK ETC 7.6-12.5","RURAL HEALTH CLINIC",521,"12004",null,null,482]
[" 4400004","CL IUD INSERTION","RURAL HEALTH CLINIC",521,"58300",null,null,492]
[" 4400077","CL PHYSICIAN E/M, C/C/HC","RURAL HEALTH CLINIC",521,"99205",null,null,492]
[" 4400229","CL SUTURE COMPLEX 1.1-2.5 CM","RURAL HEALTH CLINIC",521,"13131",null,null,496]
[" 4400204","CL GC EXCIS MALIGSCALP 1.1-2","RURAL HEALTH CLINIC",521,"11622",null,null,509]
[" 4400231","CL REPAIR COMPLEX TRUNK ADD'L 5CM","RURAL HEALTH CLINIC",521,"13133",null,null,515]
[" 4400273","CL GC INCISE HEMORRHOID EXT","RURAL HEALTH CLINIC",521,"46083",null,null,519]
[" 4400282","CL CIRCUMCISION NEWBORN","RURAL HEALTH CLINIC",521,"54150",null,null,520]
[" 4400208","CL EXC MAL FACE-EARS 1.1-2.0","RURAL HEALTH CLINIC",521,"11642",null,null,522]
[" 4400222","CL REP INTEMED WOUND =<2.5CM","RURAL HEALTH CLINIC",521,"12041",null,null,528]
[" 4400168","CL I & D REMOVAL FOREIGN BODY","RURAL HEALTH CLINIC",521,"10120",null,null,533]
[" 4400192","CL EXC BENIGN SCALP 2.1-3.0","RURAL HEALTH CLINIC",521,"11423",null,null,541]
[" 4400227","CL REP COMPLEX 1.1CM-2.5CM","RURAL HEALTH CLINIC",521,"13120",null,null,553]
[" 4400220","CL SUTURE LAY CLOSE 2.6-7.5","RURAL HEALTH CLINIC",521,"12032",null,null,569]
[" 4400244","CL INJ;INJECT TRIGGER POINTS 3/>","RURAL HEALTH CLINIC",521,"20553",null,null,569]
[" 4400196","CL EXC BEN FACE-EAR 2.1-3.0","RURAL HEALTH CLINIC",521,"11443",null,null,595]
[" 4400336","CL SPHENOPALATINE BLOCK","RURAL HEALTH CLINIC",521,"64505",null,null,595]
[" 4400187","CL EXC BENIGN TRUNK 3.1-4.0 CM","RURAL HEALTH CLINIC",521,"11404",null,null,609]
[" 4400223","CL SUTURE LAYER CLOSURE 2.6-","RURAL HEALTH CLINIC",521,"12042",null,null,626]
[" 4400225","CL SUTURE LAYER CLOSURE FACE","RURAL HEALTH CLINIC",521,"12051",null,null,626]
[" 4400205","CL EXC MAL SCALP 2.1-3.0 CM","RURAL HEALTH CLINIC",521,"11623",null,null,632]
[" 4400515","CL MANIPULATION SHOULDER","RURAL HEALTH CLINIC",521,"23929",null,null,637]
[" 4400209","CL EXC MAL FACE-EARS 2.1-3.0","RURAL HEALTH CLINIC",521,"11643",null,null,638]
[" 4400050","CL ANTEPARTUM CARE ONLY 4-6","RURAL HEALTH CLINIC",521,"59425",null,null,643]
[" 4400271","CL CONTROL THROAT BLEEDING","RURAL HEALTH CLINIC",521,"42962",null,null,649]
[" 4400252","CL CLSD TRT METACARPOPHALANGEAL W/MANIP","RURAL HEALTH CLINIC",521,"26700",null,null,660]
[" 4400254","CL FB REMOVAL FOOT SUBCUTANE","RURAL HEALTH CLINIC",521,"28190",null,null,669]
[" 4400306","CL ABDOMINAL PARACENTESIS","RURAL HEALTH CLINIC",521,"OW9G3ZZ","ZZ",null,669]
[" 4400003","CL REP INTERMEDIATE WOUND SCALP 7","RURAL HEALTH CLINIC",521,"12034",null,null,672]
[" 4400005","CL IUD REMOVAL","RURAL HEALTH CLINIC",521,"58301",null,null,696]
[" 4400226","CL REP WOUND FACE 2.6-5.0CM","RURAL HEALTH CLINIC",521,"12052",null,null,701]
[" 4400296","CL EXC MAL SCALP,NECK 3.1-4.","RURAL HEALTH CLINIC",521,"11624",null,null,728]
[" 4400188","CL EXCISN BEGIGN LES OV 4.0","RURAL HEALTH CLINIC",521,"11406",null,null,779]
[" 4400354","CL REPAIR INTERM WNDS 12.6CM-20. CM","RURAL HEALTH CLINIC",521,"12035",null,null,852]
[" 4400053","CL TREATMENT OF MISSED ABORT","RURAL HEALTH CLINIC",521,"59820",null,null,865]
[" 4400054","CL CPR/HEART/RESUSCITAT","RURAL HEALTH CLINIC",521,"92950",null,null,877]
[" 4400350","CLSD TRT METACARPAL FX W/MANIPULATION","RURAL HEALTH CLINIC",521,"26605",null,null,881]
[" 4400228","CL REP COMPLEX 2.6CM-7.5CM","RURAL HEALTH CLINIC",521,"13121",null,null,951]
[" 4400224","CL REPAIR WNDS 12.6CM-20. CM","RURAL HEALTH CLINIC",521,"12045",null,null,968]
[" 4400200","CL EXCIS MALIG LESION 2.1-3","RURAL HEALTH CLINIC",521,"11603",null,null,1029]
[" 4400251","CL CLOSED TX RADIOCARPAL DIS","RURAL HEALTH CLINIC",521,"25660",null,null,1081]
[" 4400201","CL REM OF LESION 3.1 TO 4.0C","RURAL HEALTH CLINIC",521,"11604",null,null,1170]
[" 4400221","CL REP INTERMED WOUND >30.0C","RURAL HEALTH CLINIC",521,"12037",null,null,1199]
[" 4400230","CL SUTURE COMPLEX 2.6-7.5 CM","RURAL HEALTH CLINIC",521,"13132",null,null,1298]
[" 4408092","CL EXCISION LESION, TENDON TOE EA","RURAL HEALTH CLINIC",521,"11624",null,null,1304]
[" 4400199","CL EXC MALIG NEO 1.1-2.0","RURAL HEALTH CLINIC",521,"11602",null,null,1390]
[" 4400241","CL EXC TUMOR/CYST BREAST","RURAL HEALTH CLINIC",521,"19120",null,null,1401]
[" 4400253","CL TREATMT HIP DISLOCAT W/AN","RURAL HEALTH CLINIC",521,"27266",null,null,1508]
[" 4400202","CL REM OF LESION > 4.0 DIAME","RURAL HEALTH CLINIC",521,"11606",null,null,1685]
[" 4400250","CL FX CL DIST RADIUS W/MANIP","RURAL HEALTH CLINIC",521,"25605",null,null,1719]
[" 4400249","CL FX CLOS RADIAL & ULNA W/M","RURAL HEALTH CLINIC",521,"25565",null,null,1769]
[" 4400051","CL ANTEPARTUM 7 OR MORE VISI","RURAL HEALTH CLINIC",521,"59426",null,null,1797]
[" 4400248","CL DISLOC CL/SHOULDER W/M &","RURAL HEALTH CLINIC",521,"23655",null,null,2238]
[" 4400120","CL OBSTETRIC CARE","RURAL HEALTH CLINIC",521,"59400",null,null,3492]
[" 4400232","CL COMPLEX 2.6-7.5","RURAL HEALTH CLINIC",521,"13152",null,null,4030]
[" 4400056","CL HOME VISIT LOW/MODERATE","HOME",522,"99348",null,null,158]
[" 4400090","CL SUBSEQ NF PHYFEE/PHYFEE/SF","OTHER",525,"99307",null,null,88]
[" 4400091","CL NH VISIT LEVEL 1","OTHER",525,"99307",null,null,88]
[" 4400504","NH TELE HEALTH VISIT LEVEL 1","OTHER",525,"9930795","95",null,88]
[" 4400089","CL INIT SNF D/D/LC OR C/C/LC","OTHER",525,"99304",null,null,98]
[" 4400113","CL NH VISIT LEVEL 5","OTHER",525,"99318",null,null,117]
[" 4400508","NH TELE HEALTH ANNUAL VISIT","OTHER",525,"9931895","95",null,117]
[" 4400092","CL SUBSEQ NF EPHYFEE/EPHYFEE/LC","OTHER",525,"99308",null,null,125]
[" 4400093","CL NH VISIT LEVEL 2","OTHER",525,"99308",null,null,125]
[" 4400505","NH TELE HEALTH VISIT LEVEL 2","OTHER",525,"9930895","95",null,125]
[" 4400094","CL SUBSEQ NF D/D/MC","OTHER",525,"99309",null,null,172]
[" 4400095","CL NH VISIT LEVEL 3","OTHER",525,"99309",null,null,172]
[" 4400112","CL E/M D/C/LC OR D/C/MC","OTHER",525,"99318",null,null,172]
[" 4400506","NH TELE HEALTH VISIT LEVEL 3","OTHER",525,"9930995","95",null,172]
[" 4400153","CL NH VISIT INIT","OTHER",525,"99305",null,null,230]
[" 4400513","CL NH VISIT INITIAL","OTHER",525,"99305",null,null,230]
[" 4400096","CL SUBSEQ NF C/C/HC","OTHER",525,"99310",null,null,245]
[" 4400097","CL NH VISIT LEVEL 4","OTHER",525,"99310",null,null,245]
[" 4400507","NH TELE HEALTH VISIT LEVEL 4","OTHER",525,"9931095","95",null,245]
[" 4400156","CL NH VISIT INITIAL 2","OTHER",525,"99306",null,null,294]
[" 4400514","CL NH VISIT INITIAL COMP","OTHER",525,"99306",null,null,294]
[" 3403220","MR UPPER EXT L WO","RADIOLOGY",610,"73218",null,null,2622]
[" 3403223","MR UPPER EXT R WO","RADIOLOGY",610,"73218",null,null,2622]
[" 3402196","MR PELVIS WO","RADIOLOGY",610,"72195",null,null,2636]
[" 3403221","MR UPPER EXT L W","RADIOLOGY",610,"73219",null,null,2644]
[" 3403224","MR UPPER EXT R W","RADIOLOGY",610,"73219",null,null,2644]
[" 3400571","MR HIPS BILAT W","RADIOLOGY",610,"73722",null,null,2656]
[" 3405567","MR JOINT LT LOWER W","RADIOLOGY",610,"73722",null,null,2656]
[" 3405568","MR JOINT RT LOWER W","RADIOLOGY",610,"73722",null,null,2656]
[" 3400574","MR SACRUM W","RADIOLOGY",610,"72196",null,null,2686]
[" 3402197","MR PELVIS W","RADIOLOGY",610,"72196",null,null,2686]
[" 3405573","MR JOINT LT UPPER WO","RADIOLOGY",610,"73221",null,null,2702]
[" 3405574","MR JOINT R UPPER WO","RADIOLOGY",610,"73221",null,null,2702]
[" 3405571","MR JOINT LT UPPER W","RADIOLOGY",610,"73222",null,null,2720]
[" 3405572","MR JOINT RT UPPER W","RADIOLOGY",610,"73222",null,null,2720]
[" 3405565","MR JOINT LT LOWER WO","RADIOLOGY",610,"73721",null,null,2729]
[" 3405566","MR JOINT R LOWER WO","RADIOLOGY",610,"73721",null,null,2729]
[" 3407721","MR LOW EXT JOINT","RADIOLOGY",610,"73721",null,null,2729]
[" 3400573","MR HIPS BILAT WO","RADIOLOGY",610,"73721",null,null,2766]
[" 3403721","MR LOW EXT LT W","RADIOLOGY",610,"73719",null,null,2869]
[" 3403723","MR LOW EXT RT W","RADIOLOGY",610,"73719",null,null,2869]
[" 3403720","MR LOW EXT LT WO","RADIOLOGY",610,"73718",null,null,2889]
[" 3403724","MR LOW EXT RT WO","RADIOLOGY",610,"73718",null,null,2889]
[" 3400570","MR UE W WO","RADIOLOGY",610,"73220",null,null,2907]
[" 3403222","MR UPPER EXT L WO W","RADIOLOGY",610,"73220",null,null,2907]
[" 3407222","MR UPPER EXT R WO W","RADIOLOGY",610,"73220",null,null,2907]
[" 3400576","MR SACRUM WO","RADIOLOGY",610,"72195",null,null,2916]
[" 3400539","MR NECK WO","RADIOLOGY",610,"70540",null,null,2997]
[" 3400540","MR FACIAL ROUTINE","RADIOLOGY",610,"70540",null,null,2997]
[" 3402180","MR ORBIT WO","RADIOLOGY",610,"70540",null,null,2997]
[" 3400336","MR TMJ EXTENDED","RADIOLOGY",610,"70336",null,null,3047]
[" 3401553","MR CHEST W","RADIOLOGY",610,"71551",null,null,3087]
[" 3403722","MR LOW EXT LT WO W","RADIOLOGY",610,"73720",null,null,3157]
[" 3407722","MR LOW EXT RT WO W","RADIOLOGY",610,"73720",null,null,3157]
[" 3404183","MR ABD WO","RADIOLOGY",610,"74181",null,null,3190]
[" 3400338","MR ANGIO NECK WO","RADIOLOGY",610,"70547",null,null,3221]
[" 3400335","MR ANGIO HEAD WO","RADIOLOGY",610,"70544",null,null,3232]
[" 3400572","MR HIPS BILAT WO W","RADIOLOGY",610,"73723",null,null,3304]
[" 3405569","MR JOINT LT LOWER WO W","RADIOLOGY",610,"73723",null,null,3304]
[" 3405570","MR JOINT RT LOWER WO W","RADIOLOGY",610,"73723",null,null,3304]
[" 3404185","MR ABDOMEN W/WO CONTRAST","RADIOLOGY",610,"74185",null,null,3324]
[" 3400553","MR BRAIN W","RADIOLOGY",610,"70552",null,null,3420]
[" 3404181","MR ABD W","RADIOLOGY",610,"74182",null,null,3495]
[" 3401550","MR CHEST HILAR MEDIASTEIN","RADIOLOGY",610,"71550",null,null,3551]
[" 3401552","MR CHEST WO","RADIOLOGY",610,"71550",null,null,3551]
[" 3400551","MR BRAIN ROUTINE WO","RADIOLOGY",610,"70551",null,null,3606]
[" 3405575","MR JOINT LT UPPER WO W","RADIOLOGY",610,"73223",null,null,3638]
[" 3405576","MR JOINT RT UPPER WO W","RADIOLOGY",610,"73223",null,null,3638]
[" 3400337","MR ANGIO NECK W","RADIOLOGY",610,"70548",null,null,3643]
[" 3400533","MR NECK WO W","RADIOLOGY",610,"70543",null,null,3746]
[" 3400541","MR FACIAL EXTENDED WO W","RADIOLOGY",610,"70543",null,null,3746]
[" 3402181","MR ORBIT WO W","RADIOLOGY",610,"70543",null,null,3746]
[" 3400532","MR NECK W","RADIOLOGY",610,"70542",null,null,3822]
[" 3400538","MR ORBIT W","RADIOLOGY",610,"70542",null,null,3822]
[" 3401551","MR CHEST WO W","RADIOLOGY",610,"71552",null,null,4078]
[" 3400552","MR BRAIN WO W","RADIOLOGY",610,"70553",null,null,4250]
[" 3400575","MR SACRUM WO W","RADIOLOGY",610,"72197",null,null,4317]
[" 3402198","MR PELVIS WO W","RADIOLOGY",610,"72197",null,null,4317]
[" 3404182","MR ABD WO W","RADIOLOGY",610,"74183",null,null,4341]
[" 3400339","MR ANGIO NECK WO W","RADIOLOGY",610,"70549",null,null,4675]
[" 3400334","MR ANGIO HEAD WO W","RADIOLOGY",610,"70546",null,null,4741]
[" 3405580","MR TOTAL SPINE","RADIOLOGY",610,"72148",null,null,9584]
[" 3400567","MR PITUITARY W","RADIOLOGY",611,"70552",null,null,3106]
[" 3400569","MR INNER AUDITORY CANAL W","RADIOLOGY",611,"70552",null,null,3106]
[" 3400566","MR PITUITARY WO","RADIOLOGY",611,"70551",null,null,3606]
[" 3400568","MR INNER AUDITORY CANAL WO","RADIOLOGY",611,"70551",null,null,3606]
[" 3400554","MR PITUITARY WO W","RADIOLOGY",611,"70553",null,null,4093]
[" 3400555","MR INNER AUDITORY CANAL WO W","RADIOLOGY",611,"70553",null,null,4093]
[" 3402149","MR SPINE LUMBAR W","RADIOLOGY",612,"72149",null,null,2869]
[" 3402139","MR SPINE CERV W","RADIOLOGY",612,"72142",null,null,3079]
[" 3402144","MR SPINE LUMBAR WO","RADIOLOGY",612,"72148",null,null,3400]
[" 3402141","MR SPINE CERV WO","RADIOLOGY",612,"72141",null,null,3461]
[" 3402143","MR SPINE THOR ROUTINE WO","RADIOLOGY",612,"72146",null,null,3568]
[" 3402147","MR SPINE THORACIC W","RADIOLOGY",612,"72147",null,null,3677]
[" 3402157","MR SPINE THORACIC WO W","RADIOLOGY",612,"72157",null,null,4005]
[" 3402158","MR SPINE LUMBAR WO W","RADIOLOGY",612,"72158",null,null,4141]
[" 3402156","MR SPINE CERV WO W","RADIOLOGY",612,"72156",null,null,4280]
[" 3401555","MR ANGIO CHEST W","RADIOLOGY",618,"71555",null,null,2636]
[" 3401556","MR ANGIO CHEST WO","RADIOLOGY",618,"71555",null,null,2636]
[" 2500266","IOPAMIDOL 300MG/ML INJ","PHARMACY",636,"Q9967",null,null,2]
[" 2500080","CARBIDOPA/LEVODOPA 25/100MG *ER* TAB","PHARMACY",636,"J8499",null,"GY",4]
[" 2500949","CL-METOCLOPRAMIDE 10MG/2ML VIAL","PHARMACY",636,"J2765",null,null,8]
[" 2500261","INFLUENZA QUAD VAC PEDIATRIC 0.25ML SYRN","PHARMACY",636,"90685",null,null,15.18]
[" 2500407","ONDANSETRON 4 MG/2 ML VIAL","PHARMACY",636,"J2405",null,null,20.72]
[" 2500565","VERSED 2MG/2ML VIAL","PHARMACY",636,"J2250",null,null,20.78]
[" 2500961","LEVETIRACETAM 100MG/ML 5ML VIAL","PHARMACY",636,"J1953",null,null,22.1]
[" 2501083","MORPHINE 4MG/ML SYRINGE","PHARMACY",636,"J2270",null,null,22.34]
[" 2500365","MORPHINE 2MG/1ML SYRINGE","PHARMACY",636,"J2270",null,null,22.56]
[" 2500814","MEPERIDINE 25MG/ML 1ML VIAL","PHARMACY",636,"J2175",null,null,23.04]
[" 2500815","fentaNYL 250MCG/5ML AMPULE","PHARMACY",636,"J3010",null,null,23.04]
[" 2500845","LIDOCAINE 1% 10MG/ML 2ML VIAL - PF","PHARMACY",636,"J2001",null,null,23.08]
[" 2501342","BUPIVACAINE 0.25% 50ML VIAL","PHARMACY",636,"J3490",null,null,23.52]
[" 2501090","BUMETANIDE 2.5MG/10ML VIAL","PHARMACY",636,"J3490",null,null,23.58]
[" 2500846","LIDOCAINE 1% 10MG/ML 5ML VIAL - PF","PHARMACY",636,"J2001",null,null,29.07]
[" 2500462","PROPOFOL 200MG/20ML VIAL","PHARMACY",636,"J2704",null,null,32.200000000000003]
[" 2501210","NF-Valproate Sodium 500mg/5mL Vial","PHARMACY",636,null,null,null,33.04]
[" 2500330","MAGNESIUM SULF/D5W:1GM/100ML IV PREMIX","PHARMACY",636,"J3475",null,null,34.770000000000003]
[" 2500260","INFLUENZA QUAD VACCINE 0.5ML SYRINGE","PHARMACY",636,"90686",null,null,35]
[" 2507064","CL-MORPHINE 2MG/1ML SYRINGE","PHARMACY",636,"J2270",null,null,40.75]
[" 2500401","OCTREOTIDE 100 MCG/ML 1ML VIAL","PHARMACY",636,"J2354",null,null,47.72]
[" 2500891","CEFEPIME 2GM VIAL","PHARMACY",636,"J0692",null,null,48]
[" 2500463","PROPRANOLOL 1 MG/ML VIAL 1 ML","PHARMACY",636,"J1800",null,null,48.34]
[" 2501540","CLINDAMYCIN/NS : 600MG/50ML IVPB PREMIX","PHARMACY",636,"J3490",null,null,51.26]
[" 2501155","TRANEXAMIC ACID 1000MG/10ML VIAL","PHARMACY",636,null,null,null,57.6]
[" 4400008","CL TD=>7 YRS INTRAMUSCULAR USE","PHARMACY",636,"90714",null,null,62]
[" 2501558","CLINDAMYCIN/D5W : 900MG/50ML IVPB PREMIX","PHARMACY",636,"J3490",null,null,62.64]
[" 2501468","NF-Fluconazole 400mg/200mL IVPB","PHARMACY",636,"J1450",null,null,67.2]
[" 3008610","CONTRAST 10CC 100-199MG 1","PHARMACY",636,null,null,null,69]
[" 2500914","EPINEPHRINE 1MG/ML AMPULE","PHARMACY",636,"J0171",null,null,70]
[" 2501286","POTASSIUM PHOSPHATE 66MEQ/15ML VIAL","PHARMACY",636,null,null,null,70.28]
[" 2500960","ORPHENADRINE 60MG/2ML VIAL","PHARMACY",636,"J2360",null,null,77.7]
[" 2500998","MEROPENEM 1GM VIAL","PHARMACY",636,"J2185",null,null,84]
[" 2501526","SODIUM BICARBONATE 4.2% VIAL 5ML","PHARMACY",636,null,null,null,86.69]
[" 2500808","ACETAMINOPHEN IV 1000MG/100ML IVPB","PHARMACY",636,"J0131",null,null,88.2]
[" 3008616","CONTRAST 50CC 320MG","PHARMACY",636,null,null,null,93]
[" 2500943","FLUAD ADJUVANTED 0.5ML SYRINGE","PHARMACY",636,"90694",null,null,100]
[" 2500532","TETANUS/DIPHTHERIA VACCINE 0.5ML SYRINGE","PHARMACY",636,"90714",null,null,145.11000000000001]
[" 2501102","NF-Celestone Soluspan 30mg/5mL Vial","PHARMACY",636,"J0702",null,null,157.08000000000001]
[" 2500531","TETANUS/DIPHTH/ACELL/PERTUSS VAC 0.5ML","PHARMACY",636,"90715",null,null,173.26]
[" 2501140","NF-TOBRAMYCIN 2GM/50ML VIAL","PHARMACY",636,null,null,null,186.62]
[" 2500317","LINEZOLID 600MG/300ML PREMIX IVPB","PHARMACY",636,"J2020",null,null,187.53]
[" 2501122","NF-Daptomycin 350mg Vial","PHARMACY",636,"J0878",null,null,234]
[" 2501275","LANTUS SOLOSTAR 300UNITS/3ML PEN","PHARMACY",636,"J1815",null,null,255.2]
[" 2501280","HUMULIN 70/30 300UNITS/3ML KWIKPEN","PHARMACY",636,"J1815",null,null,282.77999999999997]
[" 2501281","HUMULIN N 300UNITS/3ML KWIKPEN","PHARMACY",636,"J1815",null,null,282.77999999999997]
[" 2500944","OMNIPAQUE 300MG/ML INJECTION","PHARMACY",636,null,null,null,300]
[" 2500617","CL-PNEUMOVAX-23 25MCG/ML  0.5ML VIAL","PHARMACY",636,"90732",null,null,316.13]
[" 2501276","HUMALOG 300UNITS/3ML KWIKPEN","PHARMACY",636,"J1815",null,null,318.24]
[" 2500217","FOSPHENYTOIN 500MG PE/10ML VIAL","PHARMACY",636,"Q2009",null,null,330.06]
[" 2501170","RETACRIT 10000UNIT/ML VIAL","PHARMACY",636,"Q5106",null,null,330.9]
[" 2501474","SUGAMMADEX 200MG/2ML VIAL *ANESTHESIA*","PHARMACY",636,null,null,null,348.75]
[" 2501499","NF-Ertapenem 1000mg Vial","PHARMACY",636,"J1335",null,null,351.21]
[" 2500438","PNEUMOVAX-23 25MCG/ML 0.5ML SYRINGE","PHARMACY",636,"90732",null,null,351.25]
[" 2500131","DARBEPOETEN ALFA 25MCG/0.42ML INJ","PHARMACY",636,"J0881",null,null,372.4]
[" 2500965","EPINEPHRINE 0.15MG/0.3ML SYRINGE *PEDS*","PHARMACY",636,"J0171",null,null,375]
[" 2501002","SYMJEPI 0.3MG/0.3ML SYRINGE","PHARMACY",636,"J0171",null,null,375]
[" 2500905","TPN FORMULATION IVPB","PHARMACY",636,null,null,null,400]
[" 2501258","BCG LIVE INTRAVESICAL SDV","PHARMACY",636,"J9030",null,null,471.2]
[" 2501552","PENICILLIN G BENZATHINE 1.2MU/2ML SYR","PHARMACY",636,"J0561",null,null,562.44000000000005]
[" 2501444","PREVNAR-20 VACCINE 0.5ML SYRINGE","PHARMACY",636,"90677",null,null,671.96]
[" 1700004","RABAVERT (RABIES) VACCINE","PHARMACY",636,"90675",null,null,696]
[" 2501284","ZARXIO 300MCG/0.5ML SYRINGE","PHARMACY",636,"Q5101",null,null,740.77]
[" 2501560","ARANESP 40MCG/0.4ML SYRINGE","PHARMACY",636,"J0881",null,null,835.92]
[" 2500576","ZOLEDRONIC ACID IV 5 MG/100 ML IVPB","PHARMACY",636,"J3489",null,null,945]
[" 2500475","RABIES VACCINE 2.5IU 1ML VIAL","PHARMACY",636,"90675",null,null,1040.58]
[" 1700002","RABIES IMMUNE GLOBULIN","PHARMACY",636,"90375",null,null,1064]
[" 2501430","NF-Daptomycin 500mg Vial","PHARMACY",636,"J0878",null,null,1201.5]
[" 2500968","NF-OnabotulinumtoxinA 100U VIAL","PHARMACY",636,null,null,null,1221.2]
[" 2500195","ESMOLOL HCL/NS:2000MG/100ML IV PREMIX","PHARMACY",636,"J3490",null,null,1360.55]
[" 2501172","REMDESIVIR 100MG VIAL","PHARMACY",636,"J0248",null,null,1404]
[" 2500189","NF-Epoetin Alfa 20,000 Units/mL 1mL Vial","PHARMACY",636,"J0885",null,null,1443.15]
[" 2501003","RITUXIMAB 100MG/10ML VIAL","PHARMACY",636,null,null,null,1627.42]
[" 2501362","GAMUNEX-C 10% 50ML VIAL","PHARMACY",636,"J1561",null,null,1756.62]
[" 2501451","RABIES IMMUNE GLOBULIN 300IU/ML VIAL","PHARMACY",636,"90375",null,null,1810.19]
[" 2501515","CYANOKIT 5GM VIAL","PHARMACY",636,null,null,null,1882.92]
[" 2501274","CL-SYNVISC ONE 48MG/6ML SYRINGE","PHARMACY",636,"J7325",null,null,2054.4299999999998]
[" 2500474","RABIES IMMUNE GLOB 150IU/ML 2ML SOLN","PHARMACY",636,"90375",null,null,2150.8200000000002]
[" 2501179","XOLAIR 150MG SYRINGE","PHARMACY",636,"J2357",null,null,2442.31]
[" 2501111","INJECTAFER 750MG/15ML VIAL","PHARMACY",636,"J1439",null,null,2466.5300000000002]
[" 2501363","GAMUNEX-C 10% 100ML VIAL","PHARMACY",636,"J1561",null,null,2498.3000000000002]
[" 2500285","LEUPROLIDE 3.75MG SYRINGE KIT","PHARMACY",636,"J1950",null,null,2681.47]
[" 2500456","PROLIA 60MG/1ML INJECTION","PHARMACY",636,"J0897",null,null,2753.55]
[" 2500256","IDARUCIZUMAB 2.5GM/50ML VIAL","PHARMACY",636,"J3490",null,null,2800]
[" 2500467","PROTHROMBIN COMPLEX CONC 1000 UNIT VIAL","PHARMACY",636,"J7168",null,null,3026.98]
[" 2501201","ELIGARD 30MG INJECTABLE SUSPENSION","PHARMACY",636,"J9217",null,null,3252.17]
[" 2501456","NF-Micafungin Sodium 100mg Vial","PHARMACY",636,"J2248",null,null,3366]
[" 2500966","SIMPONI ARIA 50MG/4ML VIAL","PHARMACY",636,"J1602",null,null,3433.71]
[" 2501455","INVEGA SUSTENNA 156MG/1ML SYRINGE","PHARMACY",636,"J2426",null,null,3718.61]
[" 2500542","TOCILIZUMAB 400MG/20ML VIAL","PHARMACY",636,"J3262",null,null,3873.74]
[" 2500552","TRIPTORELIN 11.25 MG INJECTION","PHARMACY",636,"J3315",null,null,4098.72]
[" 2501364","GAMUNEX-C 10% 200ML VIAL","PHARMACY",636,"J1561",null,null,4372.03]
[" 2501386","SYNAGIS 100MG/ML VIAL","PHARMACY",636,"90378",null,null,5165.41]
[" 2501454","INVEGA SUSTENNA 234MG/1.5ML SYRINGE","PHARMACY",636,"J2426",null,null,5205.93]
[" 2501292","UDENYCA 6MG/0.6ML SYRINGE","PHARMACY",636,"Q5111",null,null,6513]
[" 2501389","ZIEXTENZO 6MG/0.6ML SYRINGE","PHARMACY",636,"Q5120",null,null,6594.9]
[" 2501119","LUPRON DEPOT 11.25MG SYRINGE KIT","PHARMACY",636,"J1950",null,null,7281.52]
[" 2501202","TRELSTAR 22.5 MG INJECTION","PHARMACY",636,"J3315",null,null,7611.93]
[" 2500286","LEUPROLIDE ACETATE 22.5MG SYRINGE KIT","PHARMACY",636,"J9217",null,null,8676.9500000000007]
[" 2501127","NF-SANDOSTATIN LAR DEPOT KIT 30MG","PHARMACY",636,"J2353",null,null,9962.3799999999992]
[" 2500380","NATALIZUMAB 300MG/15ML VIAL","PHARMACY",636,"J2323",null,null,10688.91]
[" 2501216","OCRELIZUMAB 300MG/10ML VIAL","PHARMACY",636,"J2350",null,null,26695.18]
[" 2500005","ACETAMINOPHEN 325 MG/10.15 ML SOLUTION","PHARMACY",637,null,null,null,0.5]
[" 2500107","NF-Chlorpromazine Oral Tablet 25MG","PHARMACY",637,null,null,null,0.5]
[" 2500647","NF-Levemir 100U/1ML","PHARMACY",637,null,null,null,1]
[" 2500652","NF-NovoLOG Injection 100U/ML","PHARMACY",637,null,null,null,1]
[" 2500656","NF-NovoLOG Injection 100U/ML","PHARMACY",637,null,null,null,1]
[" 2500657","NF-NovoLOG Injection 100U/ML","PHARMACY",637,null,null,null,1]
[" 2500658","NF-NovoLOG FlexPen SQ Soln 100U/ML","PHARMACY",637,null,null,null,1]
[" 2500659","NF-Levemir 100UNITS/ML","PHARMACY",637,null,null,null,1]
[" 2507061","CL-MECLIZINE 25 MG TABLET","PHARMACY",637,null,null,null,1.69]
[" 2500001","ACETAMINOPHEN 120 MG SUPPOSITORY","PHARMACY",637,null,null,null,2]
[" 2500002","ACETAMINOPHEN 160MG/5ML UD SOLN","PHARMACY",637,"J8499",null,null,2]
[" 2500003","ACETAMINOPHEN 325 MG SUPPOSITORY","PHARMACY",637,null,null,null,2]
[" 2500004","ACETAMINOPHEN 325 MG TABLET","PHARMACY",637,"J3490",null,null,2]
[" 2500006","ACETAMINOPHEN 650 MG SUPPOSITORY","PHARMACY",637,null,null,null,2]
[" 2500041","ASCORBIC ACID 500 MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500042","ASPIRIN CHEWABLE 81MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500043","ASPIRIN EC 325 MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500073","CALCIUM 600MG/VITAMIN D 400IU TAB","PHARMACY",637,null,null,null,2]
[" 2500074","CALCIUM CARBONATE 500 MG CHEW TAB","PHARMACY",637,null,null,null,2]
[" 2500076","NF-Calcium Polycarbophil 625mg Tablet","PHARMACY",637,null,null,null,2]
[" 2500087","CASTOR OIL 118 ML BOTTLE","PHARMACY",637,null,null,null,2]
[" 2500097","CEPACOL LOZENGE","PHARMACY",637,null,null,null,2]
[" 2500102","CETIRIZINE 10 MG TABLET","PHARMACY",637,"J8499",null,null,2]
[" 2500108","CHOLECALCIFEROL (VIT D3) 1000IU TABLET","PHARMACY",637,null,null,null,2]
[" 2500126","CULTURELLE CAPSULE","PHARMACY",637,"J8499",null,null,2]
[" 2500162","diphenhydrAMINE 12.5 MG/5 ML ELIXER","PHARMACY",637,"J8499",null,null,2]
[" 2500163","diphenhydrAMINE 25 MG CAPSULE","PHARMACY",637,"J8499",null,null,2]
[" 2500171","DOCUSATE SODIUM 100 MG CAPSULE","PHARMACY",637,null,null,null,2]
[" 2500175","DULCOLAX 5MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500176","DULCOLAX 10MG SUPPOSITORY","PHARMACY",637,"J3490",null,null,2]
[" 2500203","FERROUS SULFATE 325MG TABLET","PHARMACY",637,"J3490",null,null,2]
[" 2500214","FOLIC ACID 1 MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500234","guaiFENesin 100 mg/5 mL Oral SOLN","PHARMACY",637,null,null,null,2]
[" 2500235","guaiFENesin ER 600 MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500255","IBUPROFEN 100MG/5ML ORAL SUSPENSION","PHARMACY",637,"A9270",null,null,2]
[" 2500322","LOPERAMIDE 2 MG CAPSULE","PHARMACY",637,null,null,null,2]
[" 2500323","LORATADINE 10 MG TABLET","PHARMACY",637,"J8499",null,null,2]
[" 2500327","MAG OX 400MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500328","MAGNESIUM CHLOR WITH CALCIUM 64MG TAB","PHARMACY",637,null,null,null,2]
[" 2500329","MAGNESIUM CITRATE 296ML BOTTLE","PHARMACY",637,null,null,null,2]
[" 2500361","MIRALAX 17GM POWDER","PHARMACY",637,null,null,null,2]
[" 2500370","IBUPROFEN 400 MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500371","IBUPROFEN 800 MG TABLET","PHARMACY",637,"J1741",null,null,2]
[" 2500374","MULTIVITAMIN TABLET","PHARMACY",637,null,null,null,2]
[" 2500402","OCUVITE CAPSULE","PHARMACY",637,null,null,null,2]
[" 2500406","OMEPRAZOLE DR 20 MG CAPSULE","PHARMACY",637,"J8499",null,null,2]
[" 2500469","Pseudoephedrine 120MG EXT REL TABLET","PHARMACY",637,null,null,null,2]
[" 2500471","PSYLLIUM POWDER 5.8GM PACKET","PHARMACY",637,"J3490",null,null,2]
[" 2500490","SENNA 8.6 MG TABLET","PHARMACY",637,"J3490",null,null,2]
[" 2500491","SENNA-PLUS TABLET","PHARMACY",637,null,null,null,2]
[" 2500495","SIMETHICONE 80 MG CHEW TABLET","PHARMACY",637,null,null,null,2]
[" 2500534","THERMOTAB  TABLET","PHARMACY",637,null,null,null,2]
[" 2500535","THIAMINE 100MG TABLET","PHARMACY",637,null,null,null,2]
[" 2500725","CL-LIDOCAINE 2% LIQUID 15ML","PHARMACY",637,null,null,null,2]
[" 2500727","CL-SILVER NITRATE STICKS","PHARMACY",637,null,null,null,2]
[" 2500385","NICODERM 14MG PATCH","PHARMACY",637,null,null,null,2.14]
[" 2500386","NICOTINE 21MG/24HR TRANSDERMAL PATCH","PHARMACY",637,null,null,null,2.14]
[" 2500387","NICOTINE 7 MG /24 HR PATCH","PHARMACY",637,"J3490",null,null,2.14]
[" 2500624","LANOLIN HYDROUS TOP LUBRICANT 28GM","PHARMACY",637,null,null,null,2.16]
[" 2507068","CL-XANAX 0.25MG TABLET","PHARMACY",637,null,null,null,2.2799999999999998]
[" 2500363","MOM 30ML SUSPENSION","PHARMACY",637,null,null,null,2.34]
[" 2500236","GUAIFENESIN/DEXTROMETH10/100MG/5ML SYRUP","PHARMACY",637,null,null,null,2.5]
[" 2500571","WITCH HAZEL PADS","PHARMACY",637,null,null,null,2.59]
[" 2500426","PHENAZOPYRIDINE 100 MG TABLET","PHARMACY",637,null,null,null,2.7]
[" 2500642","CUREL LOTION","PHARMACY",637,null,null,null,3.32]
[" 2500488","SALINE NASAL SPRAY 44 ML BOTTLE","PHARMACY",637,null,null,null,3.59]
[" 2500326","MAG HYDROX/AL HYDROX/SIMETH 30ML","PHARMACY",637,"J8499",null,null,3.78]
[" 2500136","DEXTROSE 40% GEL 15GM TUBE","PHARMACY",637,"J3490",null,null,3.95]
[" 2500418","OXYMETAZOLINE 0.05% 30 ML NASAL SPRAY","PHARMACY",637,null,null,null,3.99]
[" 2500007","ACETAMINOPHEN/CODEINE 300/30MG TAB","PHARMACY",637,"J8499",null,null,4]
[" 2500016","ALBUTEROL 0.083% 2.5MG/3ML NEB SOLN","PHARMACY",637,"J7613",null,null,4]
[" 2500018","ALLOPURINOL 100MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500021","AMIODARONE 200 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500023","AMITRIPTYLINE 10 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500024","AMITRIPTYLINE 25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500028","AMOXICILLIN 250MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500029","AMOXICILLIN 500MG CAPSULE","PHARMACY",637,"J8499",null,null,4]
[" 2500038","ARICEPT 10MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500044","ATENOLOL 25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500045","ATIVAN 0.5MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500056","BACLOFEN 10 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500058","BACTRIM DS TABLET","PHARMACY",637,null,null,null,4]
[" 2500071","BuPROPion XL 150 MG TAB ER 24H","PHARMACY",637,null,null,null,4]
[" 2500072","busPIRone 5 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500081","CARBIDOPA/LEVODOPA 25/250 MG *IR* TAB","PHARMACY",637,null,null,null,4]
[" 2500082","CARBIDOPA/LEVODOPA 50/200MG *ER* TABLET","PHARMACY",637,null,null,null,4]
[" 2500083","CARBIDOPA/LEVODOPA 25/100MG *IR* TABLET","PHARMACY",637,null,null,null,4]
[" 2500105","chlordiazePOXIDE 25 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500111","CIPROFLOXACIN 500 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500113","CLINDAMYCIN 150 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500115","clonazePAM 0.5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500116","cloNIDine 0.1 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500119","COGENTIN 1MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500121","NF-Conjugated Estrogens Tablet 0.625MG","PHARMACY",637,null,null,null,4]
[" 2500122","WARFARIN 2MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500123","WARFARIN 3MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500124","WARFARIN 5MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500128","CYCLOBENZAPRINE 10 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500130","NF-Cyproheptadine Oral Table 4MG","PHARMACY",637,null,null,null,4]
[" 2500151","DIAZEPAM 2 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500152","DIAZEPAM 5 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500153","DICYCLOMINE 20 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500158","DILTIAZEM 30 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500160","DILTIAZEM ER 120 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500161","DILTIAZEM ER 180 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500166","DIPHENOXYLATE/ATROPINE 0.0025/2.5MG TAB","PHARMACY",637,null,null,null,4]
[" 2500168","DITROPAN 5MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500170","NF-Divalproex Sodium ER Tablet 500MG","PHARMACY",637,null,null,null,4]
[" 2500193","NF-Erythromycin Base Oral Filmtab 250MG","PHARMACY",637,null,null,null,4]
[" 2500205","FLAGYL 500MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500218","FUROSEMIDE 20 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500219","FUROSEMIDE 40 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500220","GABAPENTIN 100 MG CAPSULE","PHARMACY",637,"J8499",null,null,4]
[" 2500221","GABAPENTIN 300 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500227","glipiZIDE 5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500228","glipiZIDE ER 5 MG TAB","PHARMACY",637,null,null,null,4]
[" 2500230","glyBURIDE (MICRONIZED) 3 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500231","glyBURIDE 5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500237","HALOPERIDOL 1 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500245","hydrALAZINE 25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500246","HYDROCHLOROTHIAZIDE 25 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500248","HYDROcodone/ACETAMINOPHEN 5/325MG TAB","PHARMACY",637,"J8499",null,null,4]
[" 2500253","HYDROXYZINE 25 MG CAPSULE","PHARMACY",637,"J8499",null,null,4]
[" 2500258","INDERAL 10MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500259","INDOMETHACIN 25 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500279","LABETALOL 100 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500293","LEVOTHYROXINE 100 MCG TABLET","PHARMACY",637,null,null,null,4]
[" 2500295","LEVOTHYROXINE 112 MCG TABLET","PHARMACY",637,null,null,null,4]
[" 2500296","LEVOTHYROXINE 25 MCG TABLET","PHARMACY",637,null,null,null,4]
[" 2500297","LEVOTHYROXINE 50 MCG TABLET","PHARMACY",637,null,null,null,4]
[" 2500298","LEVOTHYROXINE 88 MCG TABLET","PHARMACY",637,null,null,null,4]
[" 2500318","LIPITOR 20MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500319","LISINOPRIL 10 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500320","LISINOPRIL 5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500321","LITHIUM CARBONATE 300MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500333","MECLIZINE 25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500335","NF-MEDROXYPROGESTERONE ACETATE 2.5MG TAB","PHARMACY",637,null,null,null,4]
[" 2500337","NF-Memantine Oral Tablet 5MG","PHARMACY",637,"J8499",null,null,4]
[" 2500341","metFORMIN 500 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500342","METHOCARBAMOL 750 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500349","METOCLOPRAMIDE 10 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500354","METOPROLOL TARTRATE 25MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500356","METOPROLOL TARTRATE 50MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500364","MONTELUKAST 10 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500369","NF-Ibuprofen Oral Tablet 200MG","PHARMACY",637,null,null,null,4]
[" 2500381","NEOMYCIN/POLYMYXIN B/BACITRACIN OINTMENT","PHARMACY",637,null,null,null,4]
[" 2500394","NITROGLYCERIN EXT REL 2.5 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500416","oxyCODONE IR 5 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500425","PEN-VK 250MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500432","PHENYTOIN ER 100 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500443","POTASSIUM CHLORIDE 10MEQ ER TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500450","predniSONE 1 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500451","predniSONE 10 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500452","predniSONE 5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500455","PRIMIDONE 50 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500458","PROMETHAZINE 25 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500460","PROMETHAZINE 6.25 MG/5 ML UD SYRUP","PHARMACY",637,"J8499",null,null,4]
[" 2500473","QUEtiapine 25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500492","SERTRALINE 50 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500509","SODIUM CHLORIDE 0.9% 3ML NEB SOLN","PHARMACY",637,null,null,null,4]
[" 2500519","SPIRONOLACTONE 25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500525","SUCRALFATE 1 GM TABLET","PHARMACY",637,null,null,null,4]
[" 2500529","TERAZOSIN 1 MG CAPSULE","PHARMACY",637,null,null,null,4]
[" 2500544","NF-Tolterodine ER Oral Capsule 4MG","PHARMACY",637,null,null,null,4]
[" 2500546","traMADol 50 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500547","traZODone 50 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500550","TRIAMTERENE/HCTZ 37.5 MG/25 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500551","TRIPHROCAPS 1 MG SOFTGEL","PHARMACY",637,null,null,null,4]
[" 2500563","VERAPAMIL 80 MG TABLET","PHARMACY",637,"J8499",null,null,4]
[" 2500569","VITAMIN A & D OINT PACKAGE 5 GM","PHARMACY",637,null,null,null,4]
[" 2500570","NF-Warfarin Oral Tablet 7.5MG","PHARMACY",637,null,null,null,4]
[" 2500572","XANAX 0.25MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500573","NF-Zantac 150mg Oral Tablet","PHARMACY",637,null,null,null,4]
[" 2500577","ZOLPIDEM 5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500582","FINASTERIDE 5 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500591","DAKIN'S FULL STRENGTH SOLUTION","PHARMACY",637,null,null,null,4]
[" 2500610","MEMANTINE 10 MG TABLET","PHARMACY",637,null,null,null,4]
[" 2500611","POTASSIUM CHLORIDE 20MEQ ER TAB","PHARMACY",637,null,null,null,4]
[" 2501471","NF-PHENobarbital Oral Tab 60MG","PHARMACY",637,null,null,null,4]
[" 2507004","CL-ALBUTEROL 0.083% 2.5MG/3ML NEB SOLN","PHARMACY",637,"J7613",null,null,4]
[" 2500173","DOXAZOSIN 2 MG TABLET","PHARMACY",637,null,null,null,4.08]
[" 2500169","DIVALPROEX SODIUM 125MG SPRINKLE CAP","PHARMACY",637,null,null,null,4.28]
[" 2500721","CL-EYE WASH 120ML","PHARMACY",637,null,null,null,4.32]
[" 2500250","HYDROCORTISONE 20 MG TABLET","PHARMACY",637,null,null,null,4.3600000000000003]
[" 2500078","carBAMazepine 200 MG TABLET","PHARMACY",637,"J8499",null,null,4.4800000000000004]
[" 2500625","BENZOCAINE 20% ORAL  ANALGESIC GEL","PHARMACY",637,null,null,null,4.6399999999999997]
[" 2500352","METOPROLOL SUCCINATE ER 25MG TABLET","PHARMACY",637,null,null,null,4.68]
[" 2500132","DECADRON 4MG TABLET","PHARMACY",637,null,null,null,4.8]
[" 2500353","METOPROLOL SUCCINATE ER 50MG TABLET","PHARMACY",637,null,null,null,4.96]
[" 2500174","DOXYCYCLINE MONO 100MG CAPSULE","PHARMACY",637,null,null,null,5.12]
[" 2500470","Pseudoephedrine 30 MG/5 ML UD","PHARMACY",637,null,null,null,5.15]
[" 2500556","VALSARTAN 80MG TABLET","PHARMACY",637,null,null,null,5.16]
[" 2500379","NAPROXEN 500 MG TABLET","PHARMACY",637,"J8499",null,null,5.36]
[" 2500100","CEPHALEXIN 500 MG CAPSULE","PHARMACY",637,null,null,null,5.4]
[" 2500360","MINERAL OIL 25ML SOLUTION","PHARMACY",637,null,null,null,5.45]
[" 2500417","OXYCODONE/ACETAMINOPHEN 5/325MG TAB","PHARMACY",637,"J8499",null,null,5.56]
[" 2500063","BIOTENE ORAL BALANCE GEL 42GM","PHARMACY",637,null,null,null,5.65]
[" 2500050","AZITHROMYCIN 250 MG TABLET","PHARMACY",637,"J8499",null,null,5.93]
[" 2500067","BUMETANIDE 1 MG TABLET","PHARMACY",637,null,null,null,6]
[" 2500178","ENALAPRIL 5 MG TABLET","PHARMACY",637,null,null,null,6.16]
[" 2500400","NYSTATIN 500,000 UNITS/5 ML UD SUSP","PHARMACY",637,null,null,null,6.16]
[" 2500447","PRAZOSIN 1 MG CAPSULE","PHARMACY",637,null,null,null,6.48]
[" 2500025","amLODIPine 5 MG TABLET","PHARMACY",637,null,null,null,6.56]
[" 2500154","DIGOXIN 125 MCG TABLET","PHARMACY",637,null,null,null,6.72]
[" 2500155","DIGOXIN 250 MCG TABLET","PHARMACY",637,null,null,null,6.72]
[" 2500271","ISOSORBIDE MONONITRATE ER 30 MG TAB","PHARMACY",637,"J8499",null,null,6.72]
[" 2500564","VERAPAMIL ER 120 MG TABLET","PHARMACY",637,null,null,null,6.76]
[" 2500581","NF-Captopril Oral Tablet 12.5MG","PHARMACY",637,null,null,null,6.88]
[" 2500389","NIFEDIPINE ER 30 MG TAB","PHARMACY",637,null,null,null,7.16]
[" 2500537","TIMOLOL/DORZOLAMIDE 0.5%/2% OPHTH DROPS","PHARMACY",637,null,null,null,7.16]
[" 2500358","MICONAZOLE 2% CREAM 28 GM TUBE","PHARMACY",637,null,null,null,7.2]
[" 2500476","RACEPINEPHRINE 2.25% NEB AMPULE","PHARMACY",637,"J7699",null,null,7.2]
[" 2507065","CL-RACEPINEPHRINE 2.25% NEB AMPUL","PHARMACY",637,null,null,null,7.2]
[" 2500104","CHLORASEPTIC 6OZ SPRAY","PHARMACY",637,null,null,null,7.25]
[" 2507056","CL-GI COCKTAIL SUSPENSION","PHARMACY",637,null,null,null,7.29]
[" 2500453","PREPARATION H OINTMENT 30GM TUBE","PHARMACY",637,null,null,null,7.36]
[" 2500040","ARTIFICIAL TEARS OPHTH SOLUTION","PHARMACY",637,null,null,null,7.41]
[" 2500338","MENTHOL/ZINC OXIDE OINTMENT 113GM","PHARMACY",637,null,null,null,7.5]
[" 2500449","PrednisoLONE SOD PHOSPHATE 15MG/5ML SOLN","PHARMACY",637,"J8499",null,null,7.52]
[" 2500272","ISOSORBIDE MONONITRATE ER 60MG TAB","PHARMACY",637,null,null,null,7.98]
[" 2500226","GI COCKTAIL SUSPENSION","PHARMACY",637,null,null,null,8]
[" 2500638","LEVALBUTEROL 1.25MG/3ML VIAL","PHARMACY",637,"J7614",null,null,8]
[" 2500079","CARBAMIDE PEROXIDE 6.5% OTIC SUSP","PHARMACY",637,"J3490",null,null,8.02]
[" 2500197","EUCERIN LOTION BOTTLE 500 ML","PHARMACY",637,null,null,null,8.1999999999999993]
[" 2500351","METOLAZONE 2.5 MG TABLET","PHARMACY",637,null,null,null,8.2799999999999994]
[" 2500085","CARVEDILOL 25 MG TABLET","PHARMACY",637,"J8499",null,null,8.4]
[" 2500086","CARVEDILOL 3.125 MG TABLET","PHARMACY",637,null,null,null,8.4]
[" 2500391","NITROGLYCERIN 0.4 MG/HR PATCH","PHARMACY",637,null,null,null,8.69]
[" 2500494","SILVER SULFADIAZINE (SSD) 1% CREAM","PHARMACY",637,"J3490",null,null,8.99]
[" 2500325","LOSARTAN 50 MG TABLET","PHARMACY",637,null,null,null,9]
[" 2500684","BISOPROLOL FUMARATE 5MG TABLET","PHARMACY",637,null,null,null,9]
[" 2500269","IPRATROPIUM/ALBUTEROL SULFATE NEB 3ML","PHARMACY",637,"J7620",null,null,9.19]
[" 2507018","CL-IPRATROPIUM/ALBUTEROL SULFATE NEB","PHARMACY",637,"J7620",null,null,9.19]
[" 2500065","BOUDREAUX'S BUTT PASTE TOP OINTMENT","PHARMACY",637,null,null,null,9.2799999999999994]
[" 2500222","GEMFIBROZIL 600 MG TABLET","PHARMACY",637,"J8499",null,null,9.2799999999999994]
[" 2500312","LIDOCAINE VISCOUS 2% 15ML UD CUP","PHARMACY",637,"J8499",null,null,9.44]
[" 2500454","PIPERONYL/PYRETHRIN SHAMPOO 118ML BOTTLE","PHARMACY",637,null,null,null,9.49]
[" 2500464","PROPRANOLOL ER 80 MG CAPSULE","PHARMACY",637,null,null,null,9.52]
[" 2500461","PROMETHAZINE/CODEINE 6.25/10MG 5ML SYRUP","PHARMACY",637,null,null,null,9.7200000000000006]
[" 2500468","PROZAC 20MG CAPSULE","PHARMACY",637,null,null,null,9.92]
[" 2500446","PRAVASTATIN 20MG TABLET","PHARMACY",637,"J8499",null,null,10]
[" 2500630","MORPHINE 5 MG/ML INJ","PHARMACY",637,null,null,null,10]
[" 2500477","REFRESH PM OPHTH OINTMENT 3.5GM","PHARMACY",637,"J3490",null,null,10.3]
[" 2500273","KEPPRA 250MG TABLET","PHARMACY",637,null,null,null,10.36]
[" 2500112","CITALOPRAM 20 MG TABLET","PHARMACY",637,null,null,null,10.76]
[" 2500478","REMERON 15MG TABLET","PHARMACY",637,null,null,null,10.88]
[" 2500639","LANOLIN/PETROLATUM OINTMENT","PHARMACY",637,null,null,null,11]
[" 2500393","NITROGLYCERIN 1 GM OINT UD","PHARMACY",637,null,null,null,11.02]
[" 2500590","DAKIN'S FULL STRENGTH SOLUTION","PHARMACY",637,null,null,null,11.34]
[" 2500555","valACYclovir 500 MG TABLET","PHARMACY",637,null,null,null,11.68]
[" 2500423","PARoxetine 20 MG TABLET","PHARMACY",637,"J8499",null,null,11.76]
[" 2500020","AMANTADINE 100 MG CAP","PHARMACY",637,"J8499",null,null,11.77]
[" 2500048","AVAPRO 150MG TABLET","PHARMACY",637,null,null,null,12.28]
[" 2500336","MELOXICAM 7.5 MG TABLET","PHARMACY",637,null,null,null,12.4]
[" 2500539","TOBRAMYCIN 0.3% OPHTH SOLUTION","PHARMACY",637,null,null,null,12.5]
[" 2500720","CL-Lidocaine 2% Jelly 5ML TUBE","PHARMACY",637,null,null,null,12.6]
[" 2500553","TROPICAMIDE OPHTH SOLN 15 ML","PHARMACY",637,null,null,null,13]
[" 2500109","CHOLESTYRAMINE 4 GM POWDER PACK","PHARMACY",637,null,null,null,13.4]
[" 2500390","NITROFURANTOIN MONO 100 MG CAP","PHARMACY",637,null,null,null,13.78]
[" 2500054","BACITRACIN/POLYMYXIN B ANTIBIOTIC OINT","PHARMACY",637,null,null,null,14.4]
[" 2500011","ACYCLOVIR 400 MG TABLET","PHARMACY",637,"J8499",null,null,15]
[" 2500031","AMOXICILLIN/CLAV/POTASSIUM 500-125MG TAB","PHARMACY",637,"J8499",null,null,15.14]
[" 2500032","AMOXICILLIN/CLAV/POTASSIUM 875-125MG TAB","PHARMACY",637,"J8499",null,null,15.15]
[" 2500062","CLARITHROMYCIN 500MG TABLET","PHARMACY",637,"J8499",null,null,15.59]
[" 2500482","risperiDONE 0.5 MG TABLET","PHARMACY",637,null,null,null,15.72]
[" 2500421","PANTOPRAZOLE 40 MG TABLET.DR","PHARMACY",637,null,null,null,15.81]
[" 2500026","AMOXICILLIN 125 MG/5 ML ORAL SUSP(150ML)","PHARMACY",637,"J8499",null,null,16.440000000000001]
[" 2500580","CEFUROXIME 250 MG TABLET","PHARMACY",637,null,null,null,16.5]
[" 2500561","VENLAFAXINE ER 75 MG CAPSULE","PHARMACY",637,null,null,null,16.8]
[" 2500528","TAMSULOSIN 0.4 MG CAPSULE","PHARMACY",637,null,null,null,16.84]
[" 2500262","INSULIN humaLOG 100 UNITS/ML VIAL","PHARMACY",637,null,null,null,17]
[" 2500263","INSULIN ISOPHANE/REG 70/30 100U/ML VIAL","PHARMACY",637,null,null,null,17]
[" 2500264","INSULIN NPH 100UNITS/ML VIAL","PHARMACY",637,null,null,null,17]
[" 2500265","INSULIN REGULAR 100UNITS/ML VIAL","PHARMACY",637,"J1815",null,null,17]
[" 2500283","LANTUS 100 UNITS/ML VIAL","PHARMACY",637,"J1815",null,null,17]
[" 2507058","CL-INSULIN REG (humuLIN R) 100UN/ML VIAL","PHARMACY",637,"J1815",null,null,17]
[" 2500414","OXYCODONE HCL 10MG ER TABLET","PHARMACY",637,null,null,null,17.22]
[" 2500117","CLOPIDOGREL 75 MG TABLET","PHARMACY",637,"J8499",null,null,17.440000000000001]
[" 2500096","CELECOXIB 100MG CAPSULE","PHARMACY",637,null,null,null,17.48]
[" 2500548","TRIAMCINOLONE ACETONIDE 0.1% CREAM 15GM","PHARMACY",637,"J3490",null,null,17.489999999999998]
[" 2500628","NF-Dutasteride Oral Capsule 0.5MG","PHARMACY",637,null,null,null,18]
[" 2500027","AMOXICILLIN 250 MG/5 ML ORAL SUSP(100ML)","PHARMACY",637,"J8499",null,null,18.27]
[" 2500715","CL-ERYTHROMYCIN OPHTH OINT 1GM UD","PHARMACY",637,null,null,null,18.62]
[" 2500165","NF-DIPHEN/ZINC ACETATE ANTI-ITCH CRM","PHARMACY",637,"J3490",null,null,19.559999999999999]
[" 2500247","HYDROcodone/ACETAMIN 7.5/325MG 15ML ELXR","PHARMACY",637,null,null,null,19.68]
[" 2500496","SIMVASTATIN 20 MG TABLET","PHARMACY",637,null,null,null,19.68]
[" 2500612","LICE KILLING SHAMPOO 118 ML","PHARMACY",637,null,null,null,20]
[" 2500643","CL-MENTHOL/ZINC (CALMOSEPTINE) OINT","PHARMACY",637,null,null,null,20]
[" 2507067","CL-SILVER SULFADIAZINE (SSD) 1% CREAM","PHARMACY",637,null,null,null,20.23]
[" 2500192","ERYTHROMYCIN 0.5% OPHTH OINT 1GM","PHARMACY",637,"J3490",null,null,20.440000000000001]
[" 2500583","AZITHROMYCIN 500 MG TABLET","PHARMACY",637,null,null,null,20.61]
[" 2500207","FLEET ENEMA 133 ML BOTTLE","PHARMACY",637,null,null,null,20.95]
[" 2500641","LIDOCAINE 2% JELLY TOP ANES 120MG/6ML","PHARMACY",637,null,null,null,21.42]
[" 6000178","ENEMA (FLEETS)","PHARMACY",637,"A9270GY","GY",null,22]
[" 2500584","POTASSIUM ACETATE 2MEQ/ML 20ML VIAL","PHARMACY",637,"J3480",null,null,22.1]
[" 2500585","PHENYTOIN SODIUM 250MG/5ML INJ","PHARMACY",637,"J1165",null,null,22.39]
[" 2500314","LIDOCAINE/PRILOCAINE 30 GM CREAM","PHARMACY",637,null,null,null,24.12]
[" 2500305","LIDOCAINE 2% JELLY 5 ML TUBE","PHARMACY",637,null,null,null,25.2]
[" 2500431","PHENYTOIN 100 MG/4 ML UD CUP","PHARMACY",637,"J8499",null,null,25.92]
[" 2500629","NF-Terbinafine 250mg Oral Tablet","PHARMACY",637,null,null,null,26.76]
[" 2500208","FLUCONAZOLE 100 MG TABLET","PHARMACY",637,null,null,null,29.13]
[" 2500627","LIDOCAINE/PRILOCAINE CREAM 5 GM TUBE","PHARMACY",637,null,null,null,29.75]
[" 2500661","DABIGATRAN 75 MG CAPSULE","PHARMACY",637,null,null,null,29.76]
[" 2500606","BENZOCAINE ORAL ANESTHETIC SPRAY 20%","PHARMACY",637,null,null,null,30.39]
[" 2500311","LIDOCAINE 5% PATCH","PHARMACY",637,null,null,null,30.83]
[" 2500249","HYDROCORTISONE 2.5% CREAM 28GM","PHARMACY",637,null,null,null,32.4]
[" 2500066","BUDESONIDE 0.5 MG/2 ML AMP","PHARMACY",637,"J7626",null,null,33.5]
[" 2500422","PANTOPRAZOLE IV 40MG VIAL","PHARMACY",637,"C9113",null,null,33.5]
[" 2500129","CYCLOPENTOLATE 1% OPHTH SOLN","PHARMACY",637,"J3490",null,null,33.6]
[" 2500223","GENTAMICIN 0.3% 5ML OPHTH SOLN","PHARMACY",637,null,null,null,38.36]
[" 2507027","CL-NITROGLYCERIN 0.4MG SL TAB #25/BOTTLE","PHARMACY",637,"J8499",null,null,38.51]
[" 2500405","OLANZAPINE 5 MG TABLET","PHARMACY",637,null,null,null,39.659999999999997]
[" 2500411","OSELTAMIVIR PHOSPHATE 30MG CAP","PHARMACY",637,"J8499",null,null,42.54]
[" 2500289","LEVOFLOXACIN 250 MG TABLET","PHARMACY",637,null,null,null,44.19]
[" 2500412","OSELTAMIVIR PHOSPHATE 75MG CAP","PHARMACY",637,null,null,null,46.38]
[" 2500575","ZITHROMAX 40MG/ML 15ML SUSPENSION","PHARMACY",637,"J8499",null,null,49.4]
[" 2500382","NEOMYCIN/POLYMYXIN B/HC OTIC SUSP","PHARMACY",637,"J8499",null,null,50.05]
[" 2507028","CL-ONDANSETRON ODT 4 MG TABLET","PHARMACY",637,"Q0162",null,null,50.16]
[" 2500457","PROMETHAZINE 25 MG SUPPOSITORY","PHARMACY",637,null,null,null,53.12]
[" 2500489","SCOPOLAMINE TRANSDERMAL 1MG/72HR PATCH","PHARMACY",637,null,null,null,60.6]
[" 2500118","CLOTRIMAZOLE/BETAMETHASONE CREAM 15GM","PHARMACY",637,null,null,null,60.69]
[" 2500200","fentaNYL 12 MCG/HR PATCH","PHARMACY",637,null,null,null,60.91]
[" 2500485","RIVAROXABAN 15MG TABLET","PHARMACY",637,null,null,null,62]
[" 2500484","RIVAROXABAN 10MG TABLET","PHARMACY",637,null,null,null,62.01]
[" 2500201","fentaNYL 25 MCG/HR PATCH","PHARMACY",637,null,null,null,63.81]
[" 2500408","ONDANSETRON ODT 4 MG TABLET","PHARMACY",637,"Q0162",null,null,66.88]
[" 2500368","MORPHINE ORAL 100MG/5ML SOLUTION","PHARMACY",637,"J8499",null,null,67.290000000000006]
[" 2500036","ANUSOL HC 25MG SUPPOSITORY","PHARMACY",637,null,null,null,68]
[" 2500098","CEPHALEXIN 125 MG/5 ML SUSP 100ML","PHARMACY",637,"J8499",null,null,70.349999999999994]
[" 2500623","RASAGILINE 1MG TABLET","PHARMACY",637,null,null,null,74.760000000000005]
[" 2500292","LEVONORGESTREL 1.5MG TAB","PHARMACY",637,null,null,null,75]
[" 2500375","MUPIROCIN 2% OINT TUBE 22 GRAM","PHARMACY",637,null,null,null,75]
[" 2500518","SODIUM POLYSTYRENE SULF 15GM/60ML SUSP","PHARMACY",637,null,null,null,75.39]
[" 2500392","NITROGLYCERIN 0.4MG SL TABLET #25/BOTTLE","PHARMACY",637,null,null,null,77.02]
[" 2500055","BACITRACIN/POLYMYXIN B OPHTH OINT 3.5GM","PHARMACY",637,null,null,null,77.099999999999994]
[" 2500398","Nystatin 100,000 UNITS/GM CREAM 30GM","PHARMACY",637,null,null,null,78.75]
[" 2500429","PHENYLEPHRINE 2.5% OPHTH SOLN","PHARMACY",637,"J3490",null,null,81.260000000000005]
[" 2500399","NYSTATIN 15GM POWDER","PHARMACY",637,null,null,null,82.38]
[" 2500212","FLUTICASONE 120 SPRAYS/16 GM NASAL SPRAY","PHARMACY",637,null,null,null,84.32]
[" 2500211","FLURBIPROFEN SOD 0.03% 2.5ML OPHTH SOLN","PHARMACY",637,"J3490",null,null,86.4]
[" 2500276","NF-KETOCONAZOLE 2% CREAM 15GM TUBE","PHARMACY",637,null,null,null,92.7]
[" 2500077","CARBACHOL 0.01% OPHTH SOLN 1.5ML","PHARMACY",637,null,null,null,94.54]
[" 2500039","ARIPIPRAZOLE 5MG TABLET","PHARMACY",637,null,null,null,96.33]
[" 2500049","AZITHROMYCIN 100MG/5ML SUSPENSION 15ML","PHARMACY",637,"J8499",null,null,104.64]
[" 2500448","PREDNISOLONE ACET 1% OPHTH SUSP 5ML","PHARMACY",637,null,null,null,105.6]
[" 2500719","CL-VITAMIN K INJECTION 10MG/1ML  *ADULT*","PHARMACY",637,"J3430",null,null,115.47]
[" 2500202","fentaNYL 50 MCG/HR PATCH","PHARMACY",637,null,null,null,116.65]
[" 2500046","ATROPINE 1% OPHTH SOLN 5ML","PHARMACY",637,"J3490",null,null,116.76]
[" 2500310","LIDOCAINE 4% TOPICAL SOLUTION","PHARMACY",637,null,null,null,144]
[" 2500099","CEPHALEXIN 250 MG/5 ML SUSP 200ML","PHARMACY",637,null,null,null,153.75]
[" 2500717","CL-SUMAtriptan (IMITREX) 6MG/0.5ML VIAL","PHARMACY",637,"J3030",null,null,191.25]
[" 2500030","AMOXICILLIN/CLAV 250MG/62.5MG/5 ML SUSP","PHARMACY",637,"J8499",null,null,194.19]
[" 2500541","TOBRAMYCIN/DEXAMETH OPHTH 2.5ML SOLN","PHARMACY",637,null,null,null,195.93]
[" 2500622","BACITRACIN OPHTH OINTMENT 3.5GM","PHARMACY",637,null,null,null,236.88]
[" 2500316","NF-Linezolid Oral Tablet 600MG","PHARMACY",637,null,null,null,307.26]
[" 2500409","OSELTAMIVIR 6MG/ML ORAL SUSPENSION","PHARMACY",637,"J8499",null,null,327.48]
[" 2500149","DIASTAT 2.5MG/0.5ML APPLICATOR","PHARMACY",637,null,null,null,354.82]
[" 2500213","FLUTICASONE/SALMETEROL 250/50MCG DISKUS","PHARMACY",637,null,null,null,364.16]
[" 2500635","VANCOMYCIN 50MG/ML ORAL SOLUTION","PHARMACY",637,null,null,null,543.67999999999995]
[" 2500186","EPINEPHRINE 0.3MG/0.3ML SYRINGE","PHARMACY",637,null,null,null,555.76]
[" 2500188","EPINEPHRINE JR 0.15MG/0.3ML SYRINGE","PHARMACY",637,null,null,null,555.76]
[" 2507014","CL-EPINEPHRINE 0.3MG/0.3ML SYRINGE","PHARMACY",637,"96372",null,null,741.02]
[" 2507016","CL-EPINEPHrine JR 0.15 MG/0.3 ML","PHARMACY",637,"96372",null,null,741.02]
[" 2500683","ACYCLOVIR (ZOVIRAX) 5% OINTMENT","PHARMACY",637,null,null,null,767.88]
[" 1500013","TRAUMA RESPONSE TEAM","TRAUMA",684,"G0390",null,null,1800]
[" 1000030","PHASE II RECOVERY","RECOVERY",710,null,null,null,0]
[" 1001665","ENDOSCOPY-RECOVERY","RECOVERY",710,null,null,null,3]
[" 1701001","OPS LEVEL 1","RECOVERY",710,null,null,null,144]
[" 1000001","PACU LEVEL 1","RECOVERY",710,null,null,null,214]
[" 1701002","OPS LEVEL 2","RECOVERY",710,null,null,null,336]
[" 1701003","OPS LEVEL 3","RECOVERY",710,null,null,null,504]
[" 1000002","PACU LEVEL 2","RECOVERY",710,null,null,null,615]
[" 1000010","PHASE I RECOV MINOR 0-60","RECOVERY",710,null,null,null,725]
[" 1000080","RECOVERY ENDO - GI","RECOVERY",710,null,null,null,725]
[" 1000004","PHASE I RECOV MAJ 0-30","RECOVERY",710,null,null,null,850]
[" 1000011","PHAS I RECOV MINR 61-120","RECOVERY",710,null,null,null,875]
[" 1000005","PHASE I RECOV MAJ 31-60","RECOVERY",710,null,null,null,950]
[" 1000006","PHASE I RECOV MAJ 61-90","RECOVERY",710,null,null,null,1050]
[" 1000012","PHAS I RECOV MINR 121-180","RECOVERY",710,null,null,null,1100]
[" 1000007","PHASE I RECOV MAJ 91-120","RECOVERY",710,null,null,null,1150]
[" 1000008","PHASE I RECOV MAJ 121-150","RECOVERY",710,null,null,null,1250]
[" 1000013","PHAS I RECOV MINR 181-240","RECOVERY",710,null,null,null,1250]
["  502813","EXTENDED STAY RECOVERY","RECOVERY",710,null,null,null,1310]
[" 1000009","PHASE I RECOV MAJ 151-180","RECOVERY",710,null,null,null,1350]
[" 1000003","PACU LEVEL 3","RECOVERY",710,null,null,null,1445]
[" 1505128","LABOR-LOW RISK/HOURLY","LABOR",721,null,null,null,46]
[" 1505132","LABOR-HIGH RISK/HOURLY","LABOR",721,null,null,null,107]
[" 1500425","FETAL MONITORING","LABOR",721,null,null,null,192]
[" 1505126","LABOR-LOW RISK/1-5 HOURS","LABOR",721,null,null,null,461]
[" 1505131","LABOR-HIGH RISK/1-5 HR","LABOR",721,null,null,null,1070]
[" 1502000","VAGINAL DELIVERY","DELIVERY ROOM",722,"59612",null,null,3210]
[" 1501900","CIRCUMCISION","CIRCUMCISION",723,null,null,null,268]
[" 4400046","CL ELECTROCRADIOGRAM, TRACING","EKG",730,"93005",null,null,300]
[" 4100111","EKG","EKG",730,"93005",null,null,310]
[" 4100113","EKG NURSING","EKG",730,"93005",null,null,310]
[" 4106600","CARDIAC EVENT MONITOR (30 DAY)","EKG",730,"93270",null,null,323]
[" 4106601","CARDIAC EVENT MONITOR PATCH (30 DAY)","EKG",730,"0296T",null,null,323]
[" 4100110","HOLTER REC/ANALYSIS/INTER","HOLTER MONITOR",731,"93224",null,null,379]
[" 4100120","HOLTER MONITOR-OUTSIDE","HOLTER MONITOR",731,"93226",null,null,535]
[" 4100115","HOLTER MONITOR (48 HR)","HOLTER MONITOR",731,"93225",null,null,607]
[" 1701008","UNLISTED EVAL & MANAGEMENT","TREATMENT ROOM",761,"99499",null,null,0]
[" 1701004","TREATMENT ROOM LEVEL 1","TREATMENT ROOM",761,"99211",null,null,96]
[" 1200204","INTERP ONLY FETAL MONITOR","TREATMENT ROOM",761,"59051",null,null,104]
[" 1701005","TREATMENT ROOM LEVEL 2","TREATMENT ROOM",761,"99212",null,null,118]
[" 1701545","INJECTION (IM OR SUB Q)","TREATMENT ROOM",761,"96372",null,null,139]
[" 1700501","INJECTIONS  SC/IM","TREATMENT ROOM",761,"96372",null,null,140]
[" 1701006","TREATMENT ROOM LEVEL 3","TREATMENT ROOM",761,"99213",null,null,144]
[" 1703002","OPS TREATMENT ROOM LEVEL1","TREATMENT ROOM",761,"99202",null,null,144]
[" 5600062","NON-SELECTIVE DEBRIDEMENT","TREATMENT ROOM",761,"97602",null,null,148]
[" 1701990","MISC PROCEDURE LEVEL I","TREATMENT ROOM",761,null,null,null,150]
[" 1700012","IVP REPEAT SAME MED","TREATMENT ROOM",761,"96376",null,null,161]
[" 1700150","ARTHROCENTESIS INTERM JOI","TREATMENT ROOM",761,"20605",null,null,161]
[" 1700210","AVULSION NAIL EACH ADDITI","TREATMENT ROOM",761,"11732",null,null,161]
[" 1700011","INJECTION IV PUSH SINGLE","TREATMENT ROOM",761,"96375",null,null,185]
[" 1700005","IRRIGATION ACCESS DEVICE","TREATMENT ROOM",761,"96523",null,null,187]
[" 1701991","MISC PROCEDURE LEVEL II","TREATMENT ROOM",761,null,null,null,200]
[" 1700015","WOUNDCARE NON-SELECTIVE D","TREATMENT ROOM",761,"97602",null,null,203]
[" 1700502","INJECTION IV PUSH SINGLE","TREATMENT ROOM",761,"96374",null,null,235]
[" 1700016","WOUNDCARE NEG PRESS <50CM","TREATMENT ROOM",761,"97605",null,null,258]
[" 1700209","AVULSION NAIL PLATE SING","TREATMENT ROOM",761,"11730",null,null,268]
[" 1702005","BLADDER INSTILLATION","TREATMENT ROOM",761,"51700",null,null,268]
[" 1702006","DRSING BURN SMALL < 5%","TREATMENT ROOM",761,"16020",null,null,272]
[" 5600063","PT WIND THERAPY NEG PRESS =<50","TREATMENT ROOM",761,"97605",null,null,273]
[" 1700014","WOUNDCARE SHARP DEBRID<20","TREATMENT ROOM",761,"97597",null,null,278]
[" 5600061","PT SHARP DEBRIDEMENT = < 20 CM","TREATMENT ROOM",761,"97597",null,null,278]
[" 1500041","SLCTV WND DEBRIDEM ADDL 20 CM/","TREATMENT ROOM",761,"97598",null,null,280]
[" 1700018","WOUNDCARE SHARP DEBRID>20","TREATMENT ROOM",761,"97598",null,null,280]
[" 1700110","INSERTION FOLEY CATHETER SIMPL","TREATMENT ROOM",761,"51702",null,null,289]
[" 1701009","APPLICATION SHORT LEG CAST","TREATMENT ROOM",761,"29405",null,null,294]
[" 5600065","PT SHARP DEBRIDEMENT ADDT 20 CM","TREATMENT ROOM",761,"97598",null,null,294]
[" 5600064","PT WIND THERAPY NEG PRESS > 50 SQ CM","TREATMENT ROOM",761,"97606",null,null,312]
[" 1700017","NEG PRESS WOUND TX >50 SQ CM","TREATMENT ROOM",761,"97606",null,null,321]
[" 1700050","ASPIRAT/INJ MAJ JOINT/BUR","TREATMENT ROOM",761,"20610",null,null,321]
["  500007","NON STRESS TEST","TREATMENT ROOM",761,"59025",null,null,335]
[" 1701007","NON STRESS TEST","TREATMENT ROOM",761,"59025",null,null,335]
[" 1701992","MISC PROCEDURE LEVEL III","TREATMENT ROOM",761,null,null,null,350]
[" 5600059","PT UNNABOOT APPLICATION","TREATMENT ROOM",761,"29580",null,null,377]
[" 2500634","CL-MENINGOCOCCAL CONJUGATE VACCINE","TREATMENT ROOM",761,"90734",null,null,382.26]
[" 1700013","MULTI-LAYER VENOUS WOUND","TREATMENT ROOM",761,"29581",null,null,387]
[" 5600060","PT COMPRESSION MULTI LAYER LOWER LEG","TREATMENT ROOM",761,"29581",null,null,387]
[" 1700019","UNNA BOOT APPLICATION","TREATMENT ROOM",761,"29580",null,null,482]
[" 1702011","VAS LINE REM W/O PUMP","TREATMENT ROOM",761,"36589",null,null,494]
[" 1701993","MISC PROCEDURE LEVEL IV","TREATMENT ROOM",761,null,null,null,500]
[" 2500616","CL-PNEUMOCOCCAL 13 VACCINE 0.5ML","TREATMENT ROOM",761,"90670",null,null,543.14]
[" 1700677","BLADDER INFUSION","TREATMENT ROOM",761,"51720",null,null,759]
[" 1702008","VAS US GUIDANCE","TREATMENT ROOM",761,"76937",null,null,875]
[" 3207002","US REPLACE PICC SAME ACCESS","TREATMENT ROOM",761,"36584",null,null,1473]
[" 3200156","US THORACENTESIS","TREATMENT ROOM",761,"32555",null,null,1478]
[" 3207001","US PICC INSERT MIN 5 YRS","TREATMENT ROOM",761,"36569",null,null,1615]
[" 1702009","VAS LINE REPLACEMENT","TREATMENT ROOM",761,"36584",null,null,1873]
[" 1700300","EXC MALIG LESION 3.1-4.0","TREATMENT ROOM",761,"11624",null,null,1878]
[" 3207000","US PICC INSERT MAX 5 YRS","TREATMENT ROOM",761,"36568",null,null,2456]
[" 1702010","VAS LINE REMOVAL WITH PUMP","TREATMENT ROOM",761,"36590",null,null,2675]
[" 1702007","INSERT PICC","TREATMENT ROOM",761,"36569",null,null,2750]
["  500004","OBSERVATION PER HOUR","OBSERVATION",762,"99220",null,null,0]
["  500212","OBSERVATION HOURS 12-24","OBSERVATION",762,"99220",null,null,0]
["  502823","OBSERVATION DIRECT ADMIT","OBSERVATION",762,"99212",null,null,0]
["  500242","OBSERVATION HOURS 42-45","OBSERVATION",762,"99220",null,null,22]
["  500246","OBSERVATION HOUR 46","OBSERVATION",762,"99220",null,null,22]
["  500247","OBSERVATION HOURS 47 TO DSCH","OBSERVATION",762,"99220",null,null,22]
["  500240","OBSERVATION HOURS 41","OBSERVATION",762,"99220",null,null,24]
["  500237","OBSERVATION HOUR 37","OBSERVATION",762,"99220",null,null,32]
["  500238","OBSERVATION HOURS 38-40","OBSERVATION",762,"99220",null,null,32]
["  500232","OBSERVATION HOUR 32","OBSERVATION",762,"99220",null,null,33]
["  500233","OBSERVATION HOURS 33-36","OBSERVATION",762,"99220",null,null,33]
["  500229","OBSERVATION HOURS 28-31","OBSERVATION",762,"99220",null,null,46]
["  500211","OBSERVATION HOURS 9-10","OBSERVATION",762,"99220",null,null,55]
["  500227","OBSERVATION HOUR 27","OBSERVATION",762,"99220",null,null,73]
["  500225","OBSERVATION HOURS 25-26","OBSERVATION",762,"99220",null,null,81]
["  500201","OBSERVATION HOURS 2 - 8","OBSERVATION",762,"99220",null,null,174]
["  500200","OBSERVATION HOUR 1","OBSERVATION",762,"99220",null,null,625]
[" 4400315","CL VFC FLU MIST","VACCINE ADMINISTRATION",771,"90660SL","SL",null,12]
[" 4400022","CL FLU ADMINISTRATION","VACCINE ADMINISTRATION",771,"G0008",null,null,13]
[" 4400021","CL SD INTRANASAL IMM ADMIN","VACCINE ADMINISTRATION",771,"90473",null,null,15]
[" 2500946","VFC FLULAVAL 0.5ML SYRINGE","VACCINE ADMINISTRATION",771,"90686",null,null,15.18]
[" 2500930","VFC BEXSERO 0.5ML SYRINGE","VACCINE ADMINISTRATION",771,"90620",null,null,19.82]
[" 2507033","VFC HEP A PED","VACCINE ADMINISTRATION",771,"90633",null,null,19.82]
[" 2507034","VFC HIB","VACCINE ADMINISTRATION",771,"90648",null,null,19.82]
[" 2507035","VFC GARDASIL","VACCINE ADMINISTRATION",771,"90649",null,null,19.82]
[" 2507036","VFC PREVNAR 13","VACCINE ADMINISTRATION",771,"90670",null,null,19.82]
[" 2507037","VFC ROTATEQ","VACCINE ADMINISTRATION",771,"90680",null,null,19.82]
[" 2507038","VFC FLUZONE QUAD PED","VACCINE ADMINISTRATION",771,"90685",null,null,19.82]
[" 2507039","VFC FLUZONE QUADRIVALENT","VACCINE ADMINISTRATION",771,"90662",null,null,19.82]
[" 2507040","VFC KINRIX","VACCINE ADMINISTRATION",771,"90696",null,null,19.82]
[" 2507041","VFC PENTACEL","VACCINE ADMINISTRATION",771,"90698",null,null,19.82]
[" 2507042","VFC DTAP","VACCINE ADMINISTRATION",771,"90700",null,null,19.82]
[" 2507043","VFC MMR","VACCINE ADMINISTRATION",771,"90707",null,null,19.82]
[" 2507044","VFC PROQUAD","VACCINE ADMINISTRATION",771,"90710",null,null,19.82]
[" 2507045","VFC IPV","VACCINE ADMINISTRATION",771,"90713",null,null,19.82]
[" 2507046","VFC TDAP","VACCINE ADMINISTRATION",771,"90715",null,null,19.82]
[" 2507047","VFC VARICELLA","VACCINE ADMINISTRATION",771,"90716",null,null,19.82]
[" 2507048","VFC PEDIARIX","VACCINE ADMINISTRATION",771,"90723",null,null,19.82]
[" 2507049","VFC MENACTRA","VACCINE ADMINISTRATION",771,"90734",null,null,19.82]
[" 2507050","VFC HEP B PED","VACCINE ADMINISTRATION",771,"90744",null,null,19.82]
[" 2507051","VFC MENINGOCOCCAL B","VACCINE ADMINISTRATION",771,"90620",null,null,19.82]
[" 4400012","CL IMMUNIZATION ADMIN SINGLE","VACCINE ADMINISTRATION",771,"90471",null,null,19.82]
[" 4400015","CL SD VFC ADMINISTRATION","VACCINE ADMINISTRATION",771,"90471",null,null,19.82]
[" 4400016","CL IMMUNIZATION ADMIN TWO OR","VACCINE ADMINISTRATION",771,"90472",null,null,19.82]
[" 4400018","CL SD VFC ADMIN EA ADDL","VACCINE ADMINISTRATION",771,"90472",null,null,19.82]
[" 4400309","CL VFC HEP A ADULT","VACCINE ADMINISTRATION",771,"90632SL","SL",null,19.82]
[" 4400310","CL VFC HEP A PED","VACCINE ADMINISTRATION",771,"90633SL","SL",null,19.82]
[" 4400311","CL VFC HIB","VACCINE ADMINISTRATION",771,"90648SL","SL",null,19.82]
[" 4400312","CL VFC GARDASIL","VACCINE ADMINISTRATION",771,"90649SL","SL",null,19.82]
[" 4400313","CL VFC INFLUENZA <3","VACCINE ADMINISTRATION",771,"90655SL","SL",null,19.82]
[" 4400314","CL VFC INFLUENZA >3","VACCINE ADMINISTRATION",771,"90656SL","SL",null,19.82]
[" 4400316","CL PREVNAR 13","VACCINE ADMINISTRATION",771,"90670SL","SL",null,19.82]
[" 4400317","CL VFC ROTATEQ","VACCINE ADMINISTRATION",771,"90680SL","SL",null,19.82]
[" 4400318","CL VFC FLUZONE QUAD PED <3YRS","VACCINE ADMINISTRATION",771,"90685SL","SL",null,19.82]
[" 4400319","CL VFC FLUZONE QUADRIVALENT >3 YRS","VACCINE ADMINISTRATION",771,"90686SL","SL",null,19.82]
[" 4400320","CL VFC KINRIX","VACCINE ADMINISTRATION",771,"90696SL","SL",null,19.82]
[" 4400321","CL VFC PENTACEL","VACCINE ADMINISTRATION",771,"90698SL","SL",null,19.82]
[" 4400322","CL VFC DTAP","VACCINE ADMINISTRATION",771,"90700SL","SL",null,19.82]
[" 4400323","CL VFC MMR","VACCINE ADMINISTRATION",771,"90707SL","SL",null,19.82]
[" 4400324","CL VFC PROQUAD","VACCINE ADMINISTRATION",771,"90710SL","SL",null,19.82]
[" 4400325","CL VFC IPV","VACCINE ADMINISTRATION",771,"90713SL","SL",null,19.82]
[" 4400326","CL VFC TDAP","VACCINE ADMINISTRATION",771,"90715SL","SL",null,19.82]
[" 4400327","CL VFC VARICELLA","VACCINE ADMINISTRATION",771,"90716SL","SL",null,19.82]
[" 4400329","CL VFC PEDIARIX","VACCINE ADMINISTRATION",771,"90723SL","SL",null,19.82]
[" 4400330","CL VFC PNEUMONIA","VACCINE ADMINISTRATION",771,"90732SL","SL",null,19.82]
[" 4400331","CL VFC MENACTRA","VACCINE ADMINISTRATION",771,"90734SL","SL",null,19.82]
[" 4400332","CL VFC HEP B PED","VACCINE ADMINISTRATION",771,"90744SL","SL",null,19.82]
[" 4400333","CL VFC HEP B ADULT","VACCINE ADMINISTRATION",771,"90746SL","SL",null,19.82]
[" 4400334","CL VFC COMVAX","VACCINE ADMINISTRATION",771,"90748SL","SL",null,19.82]
[" 4400685","CL FLUZONE QUAD PED <3YRS","VACCINE ADMINISTRATION",771,"90685SL","SL",null,19.82]
["  500100","FLU MIST ADMINISTRATION","VACCINE ADMINISTRATION",771,"90473",null,null,22]
[" 4400007","CL IMMUN ADMIN 8 YRS< FIRST","VACCINE ADMINISTRATION",771,"90465",null,null,22]
[" 4400308","CL VFC PPD","VACCINE ADMINISTRATION",771,"86580SL","SL",null,22]
[" 4400328","CL VFC TD","VACCINE ADMINISTRATION",771,"90718SL","SL",null,22]
[" 4400019","CL IMMUNIZATION BY INTRANASAL","VACCINE ADMINISTRATION",771,"90473",null,null,32]
["  500103","IMMUN ADMIN 1 VACCINE","VACCINE ADMINISTRATION",771,"90471",null,null,34]
["  500102","HEP B ADMINISTRATION","VACCINE ADMINISTRATION",771,"90471",null,null,39]
[" 4400020","CL IMMUNIZATION BY ORAL/NASAL","VACCINE ADMINISTRATION",771,"90473",null,null,40]
["  500101","PNEUMONIA ADMINISTRATION","VACCINE ADMINISTRATION",771,"90471",null,null,47]
[" 4400014","CL INFLUENZA ADMINISTRATION","VACCINE ADMINISTRATION",771,"90471",null,null,50]
[" 4400023","CL PNEUMONIA ADMINISTRATION","VACCINE ADMINISTRATION",771,"G0009",null,null,68]
[" 4400024","CL HEP B ADMINISTRATION","VACCINE ADMINISTRATION",771,"G0010",null,null,71]
[" 2500619","CL-DTAP (INFANRIX)","VACCINE ADMINISTRATION",771,"90700",null,null,71.98]
[" 1500507","IMMUNIZATION ADMIN 1 VACCINE","VACCINE ADMINISTRATION",771,"90471",null,null,76]
[" 2500626","CL-INFLUENZA VACCINE (FLUAD) 0.5ML SYR","VACCINE ADMINISTRATION",771,"90694",null,null,80.180000000000007]
[" 1700504","IMMUNIZATION ADMINISTRATI","VACCINE ADMINISTRATION",771,"90471",null,null,91]
[" 2500618","CL-PENTACEL 0.5ML VIAL","VACCINE ADMINISTRATION",771,"90698",null,null,267.86]
[" 2500614","CL-TYPHOID VI POLYSACCHARIDE VACCINE","VACCINE ADMINISTRATION",771,"90691",null,null,314.19]
[" 2500620","CL-VARICELLA VACCINE","VACCINE ADMINISTRATION",771,"90716",null,null,407.3]
[" 2500713","CL-ProQUAD (MMR + CHICKEN POX) VACCINE","VACCINE ADMINISTRATION",771,"90710",null,null,598.84]
[" 1505125","FETAL NON-STRESS","OTHER",920,"59025",null,null,375]
[" 3206770","US DUPLEX SCAN AORTA LIMITED","OTHER",920,"93979",null,null,655]
[" 4100121","MULTIPLE SLEEP LATENCY TEST","OTHER",920,"95805",null,null,1945]
[" 4100122","DIAGNOSTIC SLEEP STUDY","OTHER",920,"95810",null,null,3282]
[" 4100123","SLEEP STUDY THERA TITRATI","OTHER",920,"95811",null,null,4337]
[" 3203969","US ART DOPPLER LOW EXT RT","RADIOLOGY",921,"93926RT","RT",null,826]
[" 3203972","US ART DOPPLER LOW EXT LT","RADIOLOGY",921,"93926LT","LT",null,826]
[" 3203961","US RENAL ART/VEN DUPLEX LMT","RADIOLOGY",921,"93976",null,null,910]
[" 3209976","US DUPLEX DOPPLER PELVIC IMT","RADIOLOGY",921,"93976",null,null,910]
[" 3206818","US VENOUS US RT","RADIOLOGY",921,"93971RT","RT",null,1010]
[" 3206819","US VENOUS US LT","RADIOLOGY",921,"93971LT","LT",null,1010]
[" 3010001","US VENOUS REFLUX STUDY BILAT","RADIOLOGY",921,"93970",null,null,1278]
[" 3206925","US CAROTID DOPPLER","RADIOLOGY",921,"93880",null,null,1367]
[" 3206817","US VENOUS D SCAN BILAT EXT","RADIOLOGY",921,"93970",null,null,1450]
[" 3310022","CT ABD VENOGRAM W","RADIOLOGY",921,"74177",null,null,4435]
[" 2208128","CYTOPATH THIN LAYER PAP S","PAP SMEAR",923,"88142",null,null,88]
[" 3200441","US ABI","RADIOLOGY",929,"93922",null,null,485]
[" 3200432","US ARTER BILAT SEGMENTAL","RADIOLOGY",929,"93923",null,null,912]
[" 3200442","US D SCAN BILAT LOW EXT ARTERIAL","RADIOLOGY",929,"93925",null,null,1044]
[" 3200435","US D SCAN AORTA COMP","RADIOLOGY",929,"93978",null,null,1050]
[" 3200433","US D SCAN BILAT UP EXT ARTERY C","RADIOLOGY",929,"93930",null,null,1065]
[" 3200434","US D SCAN UNI UP EXT ARTERY LIM","RADIOLOGY",929,"93931",null,null,1145]
[" 3200443","US RENAL W DOPPLER","RADIOLOGY",929,"93975",null,null,1545]
[" 2309230","THERAPEUTIC PHLEBOTOMY","OTHER",940,"99195",null,null,168]
[" 1702004","MNT GROUP 30-MIN","EDUCATION",942,"97804",null,null,30]
[" 1200046","MNT GROUP ADDT'L HR 30-MI","EDUCATION",942,"G0271",null,null,42]
[" 1200044","DSMTGROUP 30-MIN","EDUCATION",942,"G0109",null,null,47]
[" 5500008","SMOKING CESSATION COUNSEL I","EDUCATION",942,"99406",null,null,48]
[" 1200045","MNT ADDT'L HR 2ND REF 15-","EDUCATION",942,"G0270",null,null,68]
[" 1702003","MNT REASSESS 15-MINS","EDUCATION",942,"97803",null,null,75]
[" 5500009","SMOKING CESSATION COUNSEL II","EDUCATION",942,"99407",null,null,86]
[" 1702002","MNT INITIAL 15-MINS","EDUCATION",942,"97802",null,null,91]
[" 1200043","DSMT INDIVIDUAL 30-MIN","EDUCATION",942,"G0108",null,null,120]
[" 4001139","CARDIAC REHAB SESSION","CARDIAC REHAB",943,"93798",null,null,251]
[" 4001138","CARDIAC EVAL COMPREHENSIVE","CARDIAC REHAB",943,"93798",null,null,357]
[" 5500012","PULMONARY REHAB W EXER","CARDIAC REHAB",948,"G0424",null,null,251]
[" 1209187","MC PT MANIPULATIVE THERAPY","PRO FEE",960,"97124",null,null,65]
[" 1209656","MC NASOGASTRIC TUBE PLACEMENT","PRO FEE",960,"43754",null,null,83]
[" 1209100","MC EXAM-MINIMAL/BRIEF","PRO FEE",960,"99281",null,null,87]
[" 1209013","MC PF EACH ADDTL NAIL PLATE","PRO FEE",960,"11732",null,null,94]
[" 1209290","MC STRAP ANKLE","PRO FEE",960,"29540",null,null,102]
[" 1209291","MC STRAP TOES","PRO FEE",960,"29550",null,null,102]
[" 1209219","MC EAR  IMPACTED CERUMEN","PRO FEE",960,"69210",null,null,106]
[" 1209222","MC EVAC-SUBUNGUAL HEMATOMA","PRO FEE",960,"11740",null,null,111]
[" 1209118","MC F/B EYE-CONJUNCT/SUPERFIC","PRO FEE",960,"65205",null,null,113]
[" 1209216","MC PF REM FB CONJUNCTIVA; EMBEDDE","PRO FEE",960,"65210",null,null,127]
[" 1209145","MC SPLINT FINGER","PRO FEE",960,"29130",null,null,132]
[" 1209293","MC PF PROCTOSIGMOIDOSCOPY","PRO FEE",960,"45300",null,null,138]
[" 1209186","MC STRAP ELBOW/WRIST","PRO FEE",960,"29260",null,null,139]
[" 1209130","MC BRRN  FIRST DEGREE","PRO FEE",960,"16000",null,null,140]
[" 1209217","MC CORNEAL W/O SLIT LAMP","PRO FEE",960,"65220",null,null,144]
[" 4409123","MC PC OBSV FINAL DAY/DISCH","PRO FEE",960,"99217",null,null,144]
[" 4400138","CL CARE PLAN OVERSIGHT 15-29 MINU","PRO FEE",960,"99339",null,null,146]
[" 4409138","MC CARE PLAN OVERSIGHT 15-29 MINU","PRO FEE",960,"99339",null,null,146]
[" 1209225","MC PF ASPIRATION/INJ INTERMED JOI","PRO FEE",960,"20605",null,null,151]
[" 1209652","MC PF CHG CYSTOSTOMY TUBE SIMPLE","PRO FEE",960,"51705",null,null,162]
["  506213","6 OPHTHALMIC BIOMETRY","PRO FEE",960,"92136",null,null,170]
[" 1209226","MC MAJOR JOINT-SHOU/HIP/KNEE","PRO FEE",960,"20610",null,null,179]
[" 1209004","MC PF REPAIR FULL ARM CAST","PRO FEE",960,"29705",null,null,182]
[" 1209140","MC SPLINT SHORT LEG","PRO FEE",960,"29515",null,null,182]
[" 1209221","MC AVULSION  SIMPLE","PRO FEE",960,"11730",null,null,188]
[" 4409124","MC PC INITIAL OBSV LOW","PRO FEE",960,"99218",null,null,188]
[" 1209138","MC SPLINT SHORT ARM","PRO FEE",960,"29125",null,null,197]
[" 1209129","MC INSERTION FOLEY CATH","PRO FEE",960,"51702",null,null,207]
[" 1209135","MC NASAL HEMORAGE-POSTERIOR","PRO FEE",960,"30905",null,null,209]
[" 1209139","MC SPLINT LONG LEG","PRO FEE",960,"29505",null,null,209]
[" 4409130","MC PC OBS DAILY CARE LOW","PRO FEE",960,"99224",null,null,211]
[" 4409132","MC PC OBS DAILY VISIT COMPRE","PRO FEE",960,"99226",null,null,213]
[" 1209101","MC EXAM-LIMITED","PRO FEE",960,"99282",null,null,214]
[" 1209108","MC EXAM-LIMITED 2","PRO FEE",960,"9928225","25",null,214]
[" 1209137","MC SPLINT LONG ARM","PRO FEE",960,"29105",null,null,230]
[" 4400139","CL CARE PLAN OVERSIGHT 30 MINUTES","PRO FEE",960,"99340",null,null,234]
[" 4409139","MC CARE PLAN OVERSIGHT 30 MINUTES","PRO FEE",960,"99340",null,null,234]
[" 1209134","MC NASAL HEMORAGE-ANTERIOR","PRO FEE",960,"30901",null,null,235]
[" 1209554","MC CHANGE GASTROSTOMY TUBE","PRO FEE",960,"43760",null,null,254]
[" 1209555","MC CHANGE GASTROSTOMY TUBE","PRO FEE",960,"43762",null,null,254]
[" 4409125","MC PC INITIAL OBSV INTERMEDI","PRO FEE",960,"99219",null,null,256]
[" 1209120","MC F/B EAR  AUDITORY CANAL","PRO FEE",960,"69200",null,null,260]
[" 1209124","MC I&D ASPIRATION OF ABSCESS","PRO FEE",960,"10160",null,null,264]
[" 1209297","MC PF APPLICATION SHORT LEG CAST","PRO FEE",960,"29405",null,null,269]
[" 1209131","MC BURN DRESSING SMALL","PRO FEE",960,"16020",null,null,272]
[" 1209039","MC PF ELBOW/FINGER SHRTARM C","PRO FEE",960,"29075",null,null,279]
[" 1209105","MC UP TO 2.5 CM-W&L","PRO FEE",960,"12001",null,null,285]
[" 4409131","MC PC DAILY OBS CARE MODERATE","PRO FEE",960,"99225",null,null,285]
[" 1209654","MC PF ENDOMETRIAL BIOPSY","PRO FEE",960,"58100",null,null,289]
[" 1209123","MC I&D ABSCESS  SIMPLE","PRO FEE",960,"10060",null,null,290]
[" 1209154","MC ENDOTRACHEAL INTUBATION","PRO FEE",960,"31500",null,null,290]
[" 1209265","MC TRANSCUTANEOUS PACING","PRO FEE",960,"92953",null,null,290]
[" 1209158","MC ANOSCOPY","PRO FEE",960,"46600",null,null,299]
[" 1209133","MC COMPLEX  EACH ADD 5 CM","PRO FEE",960,"13122",null,null,302]
[" 1209132","MC BURN DRESSING MEDIUM","PRO FEE",960,"16025",null,null,305]
[" 1209102","MC EXAM-ROUTINE","PRO FEE",960,"99283",null,null,321]
[" 1209109","MC EXAM-ROUTINE 2","PRO FEE",960,"9928325","25",null,321]
[" 1209203","MC CRITICAL CARE EA AD'L 1/2","PRO FEE",960,"99292",null,null,321]
[" 4409126","MC PC INITIAL OBSV CARE COMP","PRO FEE",960,"99220",null,null,324]
[" 1209231","MC ELBOW-NURSEMAID W/MANIP","PRO FEE",960,"24640",null,null,326]
[" 1209012","MC PF INCISION/DRAINAGE HEMA","PRO FEE",960,"10140",null,null,341]
[" 1209033","MC PC TX NASAL BONE FX W/","PRO FEE",960,"21310",null,null,342]
[" 1209062","MC PF SMPLE REP FACE =<2.5CM","PRO FEE",960,"12011",null,null,343]
[" 1209106","MC W/L 2.6CM TO 7.5CM","PRO FEE",960,"12002",null,null,343]
[" 1209164","MC REPAIR-UP TO 2.5 CM","PRO FEE",960,"12011",null,null,343]
[" 1209061","MC PF APPLICATION LONG CAST","PRO FEE",960,"29345",null,null,347]
[" 1209243","MC CLSD PHALANX(S)NO GRT TOE","PRO FEE",960,"28510",null,null,354]
[" 1209041","MC PF APP LONG ARM CAST","PRO FEE",960,"29065",null,null,361]
[" 1209037","MC PC CLSD TRT FX GREAT TOE","PRO FEE",960,"28490",null,null,367]
[" 1209055","MC PFDRAIN EXT EAR SIMP ABSC","PRO FEE",960,"69000",null,null,371]
[" 1209220","MC COMPLEX  ANTERIOR","PRO FEE",960,"30903",null,null,399]
[" 1209159","MC LUMBAR PUNCTURE","PRO FEE",960,"62270",null,null,402]
[" 1209165","MC 2.6 - 5.0 CM-REPAIR","PRO FEE",960,"12013",null,null,402]
[" 1209107","MC W/L 7.6CM TO 12.5CM","PRO FEE",960,"12004",null,null,426]
[" 1209166","MC 5.1 - 7.5 CM-REPAIR","PRO FEE",960,"12014",null,null,426]
[" 1209065","MC PF REM FOREIGN BODY MOUTH","PRO FEE",960,"40804",null,null,428]
[" 1209066","MC PF REM FOREIGN BODY MOUTH","PRO FEE",960,"40804",null,null,428]
[" 1209001","MC PF ADD 5CM OR LESS FACE","PRO FEE",960,"13133",null,null,441]
[" 1209068","MC PF I&D ABSCESS COMPLICATE","PRO FEE",960,"10061",null,null,448]
[" 1209040","MC PF REP SIMP 12.6 TO 20 CM","PRO FEE",960,"12005",null,null,449]
[" 1209080","MC PF CLSD TRT FX W/O MANIP","PRO FEE",960,"28515",null,null,449]
[" 1209119","MC F/B INTRANASAL","PRO FEE",960,"30300",null,null,462]
[" 1209239","MC CLOSED PHALANGEAL SHAFT","PRO FEE",960,"26720",null,null,467]
[" 1209240","MC CLOSED DISTAL PHALANGEAL","PRO FEE",960,"26750",null,null,467]
[" 1209175","MC ED EXCISION NAIL MATRIX","PRO FEE",960,"11750",null,null,468]
[" 1209242","MC PF CL TX FX GT PHALANX(S); WO","PRO FEE",960,"28490",null,null,470]
[" 1209826","MC PF CL TX ULNAR SHFT FX W MANIP","PRO FEE",960,"25535",null,null,470]
[" 1209057","MC PF REP COMPLX TRUNK 1.1-2","PRO FEE",960,"13100",null,null,472]
[" 1209238","MC CLOSED CLAVICULAR","PRO FEE",960,"23500",null,null,477]
[" 1209633","MC PF CL TX RADIAL&ULNA FX W MANP","PRO FEE",960,"25565",null,null,479]
[" 1209271","MC PF INJ ANES AGENT TRIGEMINA NERVE","PRO FEE",960,"64400",null,null,482]
[" 1000322","PF EPIDURAL LUMBAR/SACRAL W/O","PRO FEE",960,"62322",null,null,484]
[" 1209171","MC UP TO 2.5 CM-REPAIR","PRO FEE",960,"12031",null,null,486]
[" 1209552","MC PF INJ TRIGGER POINT 1/2 MUSCL","PRO FEE",960,"20552",null,null,489]
[" 1209152","MC PF REM TUNN CVC W/O PORT/PUMP","PRO FEE",960,"36589",null,null,494]
[" 1209121","MC SUBCUTANEOUS-SIMPLE","PRO FEE",960,"10120",null,null,499]
[" 1209268","MC FINGER ABSCESS-SIMPLE","PRO FEE",960,"26010",null,null,505]
[" 1209553","MC PF INJECT TRIGGER POINTS 3/>","PRO FEE",960,"20553",null,null,505]
[" 1209177","MC UP TO 2.5 CM-REPAIR","PRO FEE",960,"12041",null,null,508]
[" 1209167","MC 7.6 - 12.5 CM-REPAIR","PRO FEE",960,"12015",null,null,520]
[" 1209103","MC EXAM-INTERMEDIATE","PRO FEE",960,"99284",null,null,535]
[" 1209110","MC EXAM-INTERMEDIATE 2","PRO FEE",960,"9928425","25",null,535]
[" 1209230","MC AC SEPARATION W/O MANIP","PRO FEE",960,"23540",null,null,546]
[" 1209072","MC PF CONT NASAL HEMRAGE POS","PRO FEE",960,"30905",null,null,553]
[" 1209274","MC CLOSED VERTEBRAL PROCESS","PRO FEE",960,"22305",null,null,556]
[" 1209275","MC PF CLSD TRT SCAPULAR FX W/O MA","PRO FEE",960,"23570",null,null,569]
[" 1209183","MC UP TO 2.5 REPAIR","PRO FEE",960,"12051",null,null,575]
[" 1209178","MC 2.6 - 7.5 CM-REPAIR","PRO FEE",960,"12042",null,null,582]
[" 1209161","MC PF CLSD TRT PROX FIBULA/S","PRO FEE",960,"27780",null,null,583]
[" 1209611","MC PF CLSD TRT RADIAL HEAD NECK F","PRO FEE",960,"24650",null,null,598]
[" 1209173","MC 7.6 - 12.5 CM-REPAIR","PRO FEE",960,"12034",null,null,609]
[" 1209172","MC 2.6 - 7.5 CM-REPAIR","PRO FEE",960,"12032",null,null,613]
[" 1209116","MC DISLOC FINGER","PRO FEE",960,"26770",null,null,622]
[" 1209208","MC PF CL TX CRPL FX WO MAN E","PRO FEE",960,"26600",null,null,622]
[" 1209064","MC PF CLSD TRT FX PHALANG W/","PRO FEE",960,"26755",null,null,625]
[" 1209090","MC PR UNLIST PROC VASC SURG","PRO FEE",960,"37799",null,null,625]
[" 1209286","MC F/B SUBCUTANEOUS","PRO FEE",960,"28190",null,null,625]
[" 1209259","MC PF TUBE THORACOSTOMY","PRO FEE",960,"32551",null,null,627]
[" 1209232","MC METACARPOPHALANGEAL/FING","PRO FEE",960,"26700",null,null,630]
[" 1209048","MC PFCLSD TRT HUMERAL CONDYL","PRO FEE",960,"24576",null,null,631]
[" 1209042","MC PF CLSD TRT GRT HUMERAL T","PRO FEE",960,"23620",null,null,637]
[" 1209114","MC SHOULDER W/MANIPULATION","PRO FEE",960,"23650",null,null,637]
[" 1209015","MC INJ GREATER OCCIPITAL NER","PRO FEE",960,"64405",null,null,642]
[" 1209252","MC W & L-1.1CM TO 2.5CM","PRO FEE",960,"13120",null,null,652]
[" 1209278","MC CLOSED METATARSAL  EACH","PRO FEE",960,"28470",null,null,652]
[" 1209184","MC 2.5 - 5.0 CM REPAIR","PRO FEE",960,"12052",null,null,653]
["12009006","MC PF CL TX DIST FIB FX W/O","PRO FEE",960,"27786",null,null,678]
[" 1209047","MC PF ESOPHAGOGASTRIC W/BALL","PRO FEE",960,"43460",null,null,679]
[" 1209049","MC PF ESOPHAGASTRIC TAMPONAD","PRO FEE",960,"43460",null,null,679]
[" 1209059","MC PF CLSD CARPOMETACARPAL","PRO FEE",960,"26670",null,null,684]
[" 1209179","MC 7.6 - 12.5 CM-REPAIR","PRO FEE",960,"12044",null,null,688]
[" 1209160","MC PF CLSD TRT ARTICULAR FX","PRO FEE",960,"26740",null,null,715]
[" 1209280","MC W&L 1.0CM OR LESS","PRO FEE",960,"12051",null,null,716]
[" 1209254","MC W & L - 1.1CM TO 2.5 CM","PRO FEE",960,"13131",null,null,720]
[" 1209007","MC PF CL TX TRIM ANKLE FX W/","PRO FEE",960,"27816",null,null,721]
[" 1209063","MC PF TRT CLSD ELBOW W/O ANE","PRO FEE",960,"24600",null,null,723]
[" 1209162","MC PF CLSD TRT PROX HUMERAL","PRO FEE",960,"23600",null,null,728]
[" 1209016","MC INJ LUMBAR SACRAL SINGLE","PRO FEE",960,"64483",null,null,729]
[" 1209234","MC PATELLA","PRO FEE",960,"27560",null,null,729]
[" 1209017","MC PF CL TX PATELLAR FX W/O","PRO FEE",960,"27520",null,null,751]
[" 1209010","MC PF CL TX RADIAL SHAFT FX","PRO FEE",960,"25500",null,null,758]
[" 1209018","MC PF CL TX ULNAR SHAFT FX W","PRO FEE",960,"25530",null,null,758]
[" 1209185","MC 5.1 - 7.5 CM REPAIR","PRO FEE",960,"12053",null,null,758]
[" 1209005","MC PF CL TX BIMAL ANK FX WO","PRO FEE",960,"27808",null,null,763]
[" 1209008","MC PF CLTX MALLEOLUS FX W/O","PRO FEE",960,"27760",null,null,763]
[" 1209206","MC PF CL TX FX W8 BAR WO ANT","PRO FEE",960,"27824",null,null,763]
[" 1209292","MC PF CL TX HUMERAL SFT FX W","PRO FEE",960,"24500",null,null,784]
[" 1209111","MC W/L 2.6CM TO 7.5CM","PRO FEE",960,"1310159","59",null,797]
[" 1209020","MC PF ED/CLOSED TIB SHAFT FR","PRO FEE",960,"27750",null,null,805]
[" 1209002","MC PF W/WO SKIN OR SKEL TRAC","PRO FEE",960,"26725",null,null,807]
[" 1209073","MC PF CLSD TRT METACARPL FX W","PRO FEE",960,"26605",null,null,807]
[" 1209256","MC W & L - 1.1 CM TO 2.5","PRO FEE",960,"13151",null,null,815]
[" 1209153","MC RESUSCITATION","PRO FEE",960,"92950",null,null,821]
[" 1209003","MC PF CL TX RADIALULNAR SHAF","PRO FEE",960,"25560",null,null,827]
[" 1209244","MC PF CLSD TRT CARPAL FX W/O","PRO FEE",960,"25630",null,null,827]
[" 1209104","MC EXAM-COMPREHENSIVE","PRO FEE",960,"99285",null,null,829]
[" 1209112","MC EXAM-COMPREHENSIVE 2","PRO FEE",960,"9928525","25",null,829]
[" 1209270","MC THUMB-CARPOMET - W/MAN","PRO FEE",960,"26641",null,null,839]
[" 1209174","MC SUTURE INTEMD 12.60-20.0 CM","PRO FEE",960,"12035",null,null,852]
[" 1209050","MC PF CLSD TRT CALCANEAL FX","PRO FEE",960,"28400",null,null,869]
[" 1209009","MC PF CL TX DISTAL RAID FX W","PRO FEE",960,"25600",null,null,872]
[" 1209156","MC THORACENTESIS","PRO FEE",960,"32555",null,null,883]
[" 1209253","MC W & L - 2.6CM TO 7.5 CM","PRO FEE",960,"13121",null,null,889]
[" 1209653","MC PF CLSD TRT METATARSAL FX W/MA","PRO FEE",960,"28475",null,null,897]
[" 1209207","MC PF TX SCAPOID FX W/O PER","PRO FEE",960,"25622",null,null,918]
[" 1209036","MC CLTX MTCARPHLNGL W/ANES","PRO FEE",960,"26705",null,null,932]
[" 1209058","MC PF CLSD TRT IP JOINT ANES","PRO FEE",960,"26775",null,null,932]
[" 1209011","MC PF CL TX KNEE DISLOC WO A","PRO FEE",960,"27550",null,null,963]
[" 1209022","MC PF CLSD TX S/P HIP ARTHRO","PRO FEE",960,"27265",null,null,967]
[" 1209091","MC PF CLSD TRT TIB FX W/O MA","PRO FEE",960,"27530",null,null,973]
[" 1209214","MC MUSCLE DEEP/COMPLICATED","PRO FEE",960,"20525",null,null,975]
[" 1209272","MC PF CLSD TRT FEMORAL FX W/O MA","PRO FEE",960,"27238",null,null,988]
[" 1209245","MC PF CLSD TRT FX ORBIT WO M","PRO FEE",960,"21400",null,null,989]
[" 1209438","MC PF ABD PARACENTESIS/WGUID","PRO FEE",960,"49083",null,null,997]
[" 1209202","MC CRITICAL CARE 1ST HOUR","PRO FEE",960,"99291",null,null,1070]
[" 1000320","PF EPIDURAL CERVICAL/THORACIC","PRO FEE",960,"62320",null,null,1107]
[" 1209051","MC PF CLSD TRT DISTAL FIBULA","PRO FEE",960,"27788",null,null,1187]
[" 1209821","MC PF INJ ANESTH;","PRO FEE",960,"64450BZ","BZ",null,1187]
[" 1209823","MC PF INJ ANESTH; OTHR PERIPHERAL","PRO FEE",960,"64450",null,null,1187]
[" 1209255","MC W & L - 2.6CM TO 7.5CM","PRO FEE",960,"13132",null,null,1213]
[" 1209279","MC THROMBOLYSIS BY IV CORONARY I","PRO FEE",960,"92977",null,null,1268]
[" 1209146","MC PF CLSD TRT FEMORAL FX W/","PRO FEE",960,"27508",null,null,1270]
[" 1209637","MC PF ED/CLOSED BIMAL ANK FRACT","PRO FEE",960,"27810",null,null,1283]
[" 1209257","MC W & L -2.6CM TO 7.5 CM","PRO FEE",960,"13152",null,null,1402]
[" 1209071","MC PF CLSD TRT FEMORAL SHAFT","PRO FEE",960,"27500",null,null,1481]
[" 1209269","MC FINGER ABSCESS - COMP","PRO FEE",960,"26011",null,null,1531]
[" 1209302","MC PFEXPLORE TRAUM WOUND EXT","PRO FEE",960,"20103",null,null,1573]
[" 1209294","MC CLSD TRT DISTAL RADIAL FX W/MA","PRO FEE",960,"25605",null,null,1607]
[" 1209151","MC PF LIGATION MAJ ARTERY EX","PRO FEE",960,"37617",null,null,1953]
[" 1209212","MC SUBCUTANEOUS-COMPLICATED","PRO FEE",960,"10121",null,null,2078]
[" 1209115","MC DISLO SLD W/AN","PRO FEE",960,"23655",null,null,2092]
[" 1209069","MC PF AMP FINGER THUMB DIREC","PRO FEE",960,"26951",null,null,2266]
[" 1209236","MC PF PARTIAL EXCISION DISTAL PHA","PRO FEE",960,"26236",null,null,2653]
[" 1209060","MC PF HEMORRHOIDECTOMY  INT/","PRO FEE",960,"46255",null,null,3459]
[" 1209054","MC PF LIGATION ARTERY INT MA","PRO FEE",960,"30920",null,null,3877]
[" 1209053","MC PF REP TENDON/MUSCLE EXTE","PRO FEE",960,"25270",null,null,4667]
[" 1100100","CRNA PROF SERVCS PER UNIT","PRO FEE",964,null,null,null,134]
[" 1207197","CLSD TRT POSTERIOR PELVIC RING","PRO FEE",969,"27197",null,null,437]
[" 1207198","CLSD TRT POSTERIOR PELVIC RING","PRO FEE",969,"27198",null,null,437]
[" 1200187","PT MANIPULATIVE THERAPY","PRO FEE",981,"97124",null,null,65]
[" 1200656","NASOGASTRIC TUBE PLACEMENT","PRO FEE",981,"43754",null,null,83]
[" 1200100","EXAM-MINIMAL/BRIEF","PRO FEE",981,"99281",null,null,87]
[" 1200013","PF EACH ADDTL NAIL PLATE","PRO FEE",981,"11732",null,null,94]
[" 1200290","STRAP ANKLE","PRO FEE",981,"29540",null,null,102]
[" 1200291","STRAP TOES","PRO FEE",981,"29550",null,null,102]
[" 1200219","EAR  IMPACTED CERUMEN","PRO FEE",981,"69210",null,null,106]
[" 1200222","EVAC-SUBUNGUAL HEMATOMA","PRO FEE",981,"11740",null,null,111]
[" 1200118","F/B EYE-CONJUNCT/SUPERFIC","PRO FEE",981,"65205",null,null,113]
[" 1200216","PF REM FB CONJUNCTIVA; EMBEDDE","PRO FEE",981,"65210",null,null,127]
[" 1200145","SPLINT FINGER","PRO FEE",981,"29130",null,null,132]
[" 1202469","PF EYE EXAM W/ANESTH LIMITED","PRO FEE",981,"92019",null,null,134]
[" 1200293","PF PROCTOSIGMOIDOSCOPY","PRO FEE",981,"45300",null,null,138]
[" 1200186","STRAP ELBOW/WRIST","PRO FEE",981,"29260",null,null,139]
[" 1200130","BRRN  FIRST DEGREE","PRO FEE",981,"16000",null,null,140]
[" 1200217","CORNEAL W/O SLIT LAMP","PRO FEE",981,"65220",null,null,144]
[" 1200225","PF ASPIRATION/INJ INTERMED JOI","PRO FEE",981,"20605",null,null,151]
[" 1201203","PF STURE INTERMD 12. 0-20.0 CM","PRO FEE",981,"12055",null,null,151]
[" 1202468","PF INSERT BLADDER CATHETER","PRO FEE",981,"51701",null,null,157]
[" 1200652","PF CHG CYSTOSTOMY TUBE SIMPLE","PRO FEE",981,"51705",null,null,162]
[" 1200226","MAJOR JOINT-SHOU/HIP/KNEE","PRO FEE",981,"20610",null,null,179]
[" 1200004","PF REPAIR FULL ARM CAST","PRO FEE",981,"29705",null,null,182]
[" 1200140","SPLINT SHORT LEG","PRO FEE",981,"29515",null,null,182]
[" 1200221","AVULSION  SIMPLE","PRO FEE",981,"11730",null,null,188]
[" 1200074","PF REMOVAL IUD","PRO FEE",981,"58301",null,null,192]
[" 1200157","CORNEAL W/ SLIT LAMP FB REMOVAL","PRO FEE",981,"65222",null,null,193]
[" 1200138","SPLINT SHORT ARM","PRO FEE",981,"29125",null,null,197]
[" 1200129","INSERTION FOLEY CATH","PRO FEE",981,"51702",null,null,207]
[" 1200135","NASAL HEMORAGE-POSTERIOR","PRO FEE",981,"30905",null,null,209]
[" 1200139","SPLINT LONG LEG","PRO FEE",981,"29505",null,null,209]
[" 1200101","EXAM-LIMITED","PRO FEE",981,"99282",null,null,214]
[" 1200108","EXAM-LIMITED 2","PRO FEE",981,"9928225","25",null,214]
[" 1202871","DR ABSC CYST HEMAOM DENTOALVEO","PRO FEE",981,"41800",null,null,218]
[" 1200137","SPLINT LONG ARM","PRO FEE",981,"29105",null,null,230]
[" 1201310","PF C REP TRUNK; EA ADDTL 5 CM/","PRO FEE",981,"13102",null,null,233]
[" 1200134","NASAL HEMORAGE-ANTERIOR","PRO FEE",981,"30901",null,null,235]
[" 1201002","BLADDER INSTILLATION IRRIGATION","PRO FEE",981,"51700",null,null,246]
[" 1200554","CHANGE GASTROSTOMY TUBE","PRO FEE",981,"43760",null,null,254]
[" 1200555","CHANGE GASTROSTOMY TUBE","PRO FEE",981,"43762",null,null,254]
[" 1202006","PFSREPS/N/A/G/TR/E;20.1-30.0CM","PRO FEE",981,"12006",null,null,258]
[" 1200120","F/B EAR  AUDITORY CANAL","PRO FEE",981,"69200",null,null,260]
[" 1206084","INJECTION ANESTHETIC AGENT FAC","PRO FEE",981,"64402",null,null,261]
[" 1200124","I&D ASPIRATION OF ABSCESS","PRO FEE",981,"10160",null,null,264]
[" 1200297","PF APPLICATION SHORT LEG CAST","PRO FEE",981,"29405",null,null,269]
[" 1200131","BURN DRESSING SMALL","PRO FEE",981,"16020",null,null,272]
[" 1200039","PF ELBOW/FINGER SHRTARM C","PRO FEE",981,"29075",null,null,279]
[" 1200105","UP TO 2.5 CM-W&L","PRO FEE",981,"12001",null,null,285]
[" 1200654","PF ENDOMETRIAL BIOPSY","PRO FEE",981,"58100",null,null,289]
[" 1200123","I&D ABSCESS  SIMPLE","PRO FEE",981,"10060",null,null,290]
[" 1200154","ENDOTRACHEAL INTUBATION","PRO FEE",981,"31500",null,null,290]
[" 1200265","TRANSCUTANEOUS PACING","PRO FEE",981,"92953",null,null,290]
[" 1200158","ANOSCOPY","PRO FEE",981,"46600",null,null,299]
[" 1200133","COMPLEX  EACH ADD 5 CM","PRO FEE",981,"13122",null,null,302]
[" 1200132","BURN DRESSING MEDIUM","PRO FEE",981,"16025",null,null,305]
[" 1200102","EXAM-ROUTINE","PRO FEE",981,"99283",null,null,321]
[" 1200109","EXAM-ROUTINE 2","PRO FEE",981,"9928325","25",null,321]
[" 1200203","CRITICAL CARE EA AD'L 1/2","PRO FEE",981,"99292",null,null,321]
[" 1107385","ABG","PRO FEE",981,"36600",null,null,326]
[" 1200231","ELBOW-NURSEMAID W/MANIP","PRO FEE",981,"24640",null,null,326]
[" 1206083","INCISE THROMBOSED HEMORRHOID E","PRO FEE",981,"46083",null,null,339]
[" 1200012","PF INCISION/DRAINAGE HEMA","PRO FEE",981,"10140",null,null,341]
[" 1200033","PC TX NASAL BONE FX W/","PRO FEE",981,"21310",null,null,342]
[" 1200062","PF SMPLE REP FACE =<2.5CM","PRO FEE",981,"12011",null,null,343]
[" 1200106","W/L 2.6CM TO 7.5CM","PRO FEE",981,"12002",null,null,343]
[" 1200164","REPAIR-UP TO 2.5 CM","PRO FEE",981,"12011",null,null,343]
[" 1200061","PF APPLICATION LONG CAST","PRO FEE",981,"29345",null,null,347]
[" 1201008","PF I&D PILONIDAL CYST SIM","PRO FEE",981,"10080",null,null,349]
[" 1208006","DILATION ESOPHAGUS","PRO FEE",981,"43450",null,null,350]
[" 1200243","CLSD PHALANX(S)NO GRT TOE","PRO FEE",981,"28510",null,null,354]
[" 1201850","PF DESTROY LESION (NOT EXCISIO","PRO FEE",981,"41850",null,null,354]
[" 1501899","UNLISTED PROCEDURE DENTOALVEOL","PRO FEE",981,"41899",null,null,357]
[" 1200041","PF APP LONG ARM CAST","PRO FEE",981,"29065",null,null,361]
[" 1200037","PC CLSD TRT FX GREAT TOE","PRO FEE",981,"28490",null,null,367]
[" 1201001","PF SLCTV WND DEBRIDEM 20 CM OR","PRO FEE",981,"97597",null,null,369]
[" 1208001","REMOVE OTHER DEVICE VAGINA UNDER ANES","PRO FEE",981,"57415",null,null,369]
[" 1200055","PFDRAIN EXT EAR SIMP ABSC","PRO FEE",981,"69000",null,null,371]
[" 1202467","PF UNLISTED PROCEDURE ANT SEG","PRO FEE",981,"66999",null,null,393]
[" 1200220","COMPLEX  ANTERIOR","PRO FEE",981,"30903",null,null,399]
[" 1200159","LUMBAR PUNCTURE","PRO FEE",981,"62270",null,null,402]
[" 1200165","2.6 - 5.0 CM-REPAIR","PRO FEE",981,"12013",null,null,402]
[" 1200107","W/L 7.6CM TO 12.5CM","PRO FEE",981,"12004",null,null,426]
[" 1200166","5.1 - 7.5 CM-REPAIR","PRO FEE",981,"12014",null,null,426]
[" 1200065","PF REM FOREIGN BODY MOUTH","PRO FEE",981,"40804",null,null,428]
[" 1200066","PF REM FOREIGN BODY MOUTH","PRO FEE",981,"40804",null,null,428]
[" 1200001","PF ADD 5CM OR LESS FACE","PRO FEE",981,"13133",null,null,441]
[" 1200068","PF I&D ABSCESS COMPLICATE","PRO FEE",981,"10061",null,null,448]
[" 1200040","PF REP SIMP 12.6 TO 20 CM","PRO FEE",981,"12005",null,null,449]
[" 1200080","PF CLSD TRT FX W/O MANIP","PRO FEE",981,"28515",null,null,449]
[" 1200119","F/B INTRANASAL","PRO FEE",981,"30300",null,null,462]
[" 1200239","CLOSED PHALANGEAL SHAFT","PRO FEE",981,"26720",null,null,467]
[" 1200240","CLOSED DISTAL PHALANGEAL","PRO FEE",981,"26750",null,null,467]
[" 1200175","ED EXCISION NAIL MATRIX","PRO FEE",981,"11750",null,null,468]
[" 1200242","PF CL TX FX GT PHALANX(S); WO","PRO FEE",981,"28490",null,null,470]
[" 1200826","PF CL TX ULNAR SHFT FX W MANIP","PRO FEE",981,"25535",null,null,470]
[" 1200057","PF REP COMPLX TRUNK 1.1-2","PRO FEE",981,"13100",null,null,472]
[" 1202866","PF INTPHALAN DISLOCTE W/ANES","PRO FEE",981,"28665",null,null,476]
[" 1200238","CLOSED CLAVICULAR","PRO FEE",981,"23500",null,null,477]
[" 1200633","PF CL TX RADIAL&ULNA FX W MANP","PRO FEE",981,"25565",null,null,479]
[" 1200271","PF INJ ANES AGENT TRIGEMINA NERVE","PRO FEE",981,"64400",null,null,482]
[" 1200171","UP TO 2.5 CM-REPAIR","PRO FEE",981,"12031",null,null,486]
[" 1200552","PF INJ TRIGGER POINT 1/2 MUSCL","PRO FEE",981,"20552",null,null,489]
[" 1202870","UNLISTED PROCEDURE","PRO FEE",981,"45399",null,null,491]
[" 1200152","PF REM TUNN CVC W/O PORT/PUMP","PRO FEE",981,"36589",null,null,494]
[" 1200121","SUBCUTANEOUS-SIMPLE","PRO FEE",981,"10120",null,null,499]
[" 1200268","FINGER ABSCESS-SIMPLE","PRO FEE",981,"26010",null,null,505]
[" 1200553","PF INJECT TRIGGER POINTS 3/>","PRO FEE",981,"20553",null,null,505]
[" 1200177","UP TO 2.5 CM-REPAIR","PRO FEE",981,"12041",null,null,508]
[" 1200167","7.6 - 12.5 CM-REPAIR","PRO FEE",981,"12015",null,null,520]
[" 1200103","EXAM-INTERMEDIATE","PRO FEE",981,"99284",null,null,535]
[" 1200110","EXAM-INTERMEDIATE 2","PRO FEE",981,"9928425","25",null,535]
[" 1200230","AC SEPARATION W/O MANIP","PRO FEE",981,"23540",null,null,546]
[" 1200072","PF CONT NASAL HEMRAGE POS","PRO FEE",981,"30905",null,null,553]
[" 1200274","CLOSED VERTEBRAL PROCESS","PRO FEE",981,"22305",null,null,556]
[" 1200275","PF CLSD TRT SCAPULAR FX W/O MA","PRO FEE",981,"23570",null,null,569]
[" 1200183","UP TO 2.5 REPAIR","PRO FEE",981,"12051",null,null,575]
[" 1200178","2.6 - 7.5 CM-REPAIR","PRO FEE",981,"12042",null,null,582]
[" 1200161","PF CLSD TRT PROX FIBULA/S","PRO FEE",981,"27780",null,null,583]
[" 1200611","PF CLSD TRT RADIAL HEAD NECK F","PRO FEE",981,"24650",null,null,598]
[" 1200173","7.6 - 12.5 CM-REPAIR","PRO FEE",981,"12034",null,null,609]
[" 1200172","2.6 - 7.5 CM-REPAIR","PRO FEE",981,"12032",null,null,613]
[" 1200116","DISLOC FINGER","PRO FEE",981,"26770",null,null,622]
[" 1200208","PF CL TX CRPL FX WO MAN E","PRO FEE",981,"26600",null,null,622]
[" 1200064","PF CLSD TRT FX PHALANG W/","PRO FEE",981,"26755",null,null,625]
[" 1200090","PR UNLIST PROC VASC SURG","PRO FEE",981,"37799",null,null,625]
[" 1200286","F/B SUBCUTANEOUS","PRO FEE",981,"28190",null,null,625]
[" 1200259","PF TUBE THORACOSTOMY","PRO FEE",981,"32551",null,null,627]
[" 1200232","METACARPOPHALANGEAL/FING","PRO FEE",981,"26700",null,null,630]
[" 1200048","PFCLSD TRT HUMERAL CONDYL","PRO FEE",981,"24576",null,null,631]
[" 1200042","PF CLSD TRT GRT HUMERAL T","PRO FEE",981,"23620",null,null,637]
[" 1200114","SHOULDER W/MANIPULATION","PRO FEE",981,"23650",null,null,637]
[" 1200015","INJ GREATER OCCIPITAL NER","PRO FEE",981,"64405",null,null,642]
[" 1200252","W & L-1.1CM TO 2.5CM","PRO FEE",981,"13120",null,null,652]
[" 1200278","CLOSED METATARSAL  EACH","PRO FEE",981,"28470",null,null,652]
[" 1200184","2.5 - 5.0 CM REPAIR","PRO FEE",981,"12052",null,null,653]
[" 1200006","PF CL TX DIST FIB FX W/O","PRO FEE",981,"27786",null,null,678]
[" 1200047","PF ESOPHAGOGASTRIC W/BALL","PRO FEE",981,"43460",null,null,679]
[" 1200049","PF ESOPHAGASTRIC TAMPONAD","PRO FEE",981,"43460",null,null,679]
[" 1200059","PF CLSD CARPOMETACARPAL","PRO FEE",981,"26670",null,null,684]
[" 1200179","7.6 - 12.5 CM-REPAIR","PRO FEE",981,"12044",null,null,688]
[" 1202960","CARDIOVERSION EXT PF","PRO FEE",981,"92960",null,null,691]
[" 4400162","CL DIVISION OF FEMALE PERIEUM EX","PRO FEE",981,"0W8NX",null,null,709]
[" 1200160","PF CLSD TRT ARTICULAR FX","PRO FEE",981,"26740",null,null,715]
[" 1200280","W&L 1.0CM OR LESS","PRO FEE",981,"12051",null,null,716]
[" 1200254","W & L - 1.1CM TO 2.5 CM","PRO FEE",981,"13131",null,null,720]
[" 1200007","PF CL TX TRIM ANKLE FX W/","PRO FEE",981,"27816",null,null,721]
[" 1200063","PF TRT CLSD ELBOW W/O ANE","PRO FEE",981,"24600",null,null,723]
[" 1200162","PF CLSD TRT PROX HUMERAL","PRO FEE",981,"23600",null,null,728]
[" 1200016","INJ LUMBAR SACRAL SINGLE","PRO FEE",981,"64483",null,null,729]
[" 1200234","PATELLA","PRO FEE",981,"27560",null,null,729]
[" 1200017","PF CL TX PATELLAR FX W/O","PRO FEE",981,"27520",null,null,751]
[" 1200010","PF CL TX RADIAL SHAFT FX","PRO FEE",981,"25500",null,null,758]
[" 1200018","PF CL TX ULNAR SHAFT FX W","PRO FEE",981,"25530",null,null,758]
[" 1200185","5.1 - 7.5 CM REPAIR","PRO FEE",981,"12053",null,null,758]
[" 4400163","CL DELIVERY OF PRODUCTS OF CEONCEPTION","PRO FEE",981,"10E0X",null,null,760]
[" 1200005","PF CL TX BIMAL ANK FX WO","PRO FEE",981,"27808",null,null,763]
[" 1200008","PF CLTX MALLEOLUS FX W/O","PRO FEE",981,"27760",null,null,763]
[" 1200206","PF CL TX FX W8 BAR WO ANT","PRO FEE",981,"27824",null,null,763]
[" 1200292","PF CL TX HUMERAL SFT FX W","PRO FEE",981,"24500",null,null,784]
[" 1200111","W/L 2.6CM TO 7.5CM","PRO FEE",981,"1310159","59",null,797]
[" 1200020","PF ED/CLOSED TIB SHAFT FR","PRO FEE",981,"27750",null,null,805]
[" 1200002","PF W/WO SKIN OR SKEL TRAC","PRO FEE",981,"26725",null,null,807]
[" 1200073","PFCLSD TRT METACARPL FX W","PRO FEE",981,"26605",null,null,807]
[" 1200256","W & L - 1.1 CM TO 2.5","PRO FEE",981,"13151",null,null,815]
[" 1200153","RESUSCITATION","PRO FEE",981,"92950",null,null,821]
[" 1200003","PF CL TX RADIALULNAR SHAF","PRO FEE",981,"25560",null,null,827]
[" 1200244","PF CLSD TRT CARPAL FX W/O","PRO FEE",981,"25630",null,null,827]
[" 1200104","EXAM-COMPREHENSIVE","PRO FEE",981,"99285",null,null,829]
[" 1200112","EXAM-COMPREHENSIVE 2","PRO FEE",981,"9928525","25",null,829]
[" 1200270","THUMB-CARPOMET - W/MAN","PRO FEE",981,"26641",null,null,839]
[" 1200174","SUTURE INTEMD 12.60-20.0 CM","PRO FEE",981,"12035",null,null,852]
[" 1200050","PF CLSD TRT CALCANEAL FX","PRO FEE",981,"28400",null,null,869]
[" 1200009","PF CL TX DISTAL RAID FX W","PRO FEE",981,"25600",null,null,872]
["12046320","EXCISION THROMBOSED HEMORRHOIDS","PRO FEE",981,"46320",null,null,879]
[" 1200156","THORACENTESIS","PRO FEE",981,"32555",null,null,883]
[" 1200253","W & L - 2.6CM TO 7.5 CM","PRO FEE",981,"13121",null,null,889]
[" 1200653","PF CLSD TRT METATARSAL FX W/MA","PRO FEE",981,"28475",null,null,897]
[" 1200207","PF TX SCAPOID FX W/O PER","PRO FEE",981,"25622",null,null,918]
[" 1200036","CLTX MTCARPHLNGL W/ANES","PRO FEE",981,"26705",null,null,932]
[" 1200058","PF CLSD TRT IP JOINT ANES","PRO FEE",981,"26775",null,null,932]
[" 1202868","PF REPAIR 7.6 TO 12.5CM WOUND","PRO FEE",981,"12054",null,null,941]
[" 1205505","PF CL TX RADIAL SHFT FX W MANI","PRO FEE",981,"25505",null,null,962]
[" 1200011","PF CL TX KNEE DISLOC WO A","PRO FEE",981,"27550",null,null,963]
[" 1209082","ABDOMINAL PARACENTESIS","PRO FEE",981,"49082",null,null,964]
[" 1200022","PF CLSD TX S/P HIP ARTHRO","PRO FEE",981,"27265",null,null,967]
[" 1200188","PF REPAIR WOUND 12.6cm to 20.0cm","PRO FEE",981,"12045",null,null,968]
[" 1209188","MC PF REPAIR WOUND 12.6cm to 20.0cm","PRO FEE",981,"12045",null,null,968]
[" 1208000","EGD","PRO FEE",981,"43235",null,null,970]
[" 1200091","PF CLSD TRT TIB FX W/O MA","PRO FEE",981,"27530",null,null,973]
[" 1200214","MUSCLE  DEEP/COMPLICATED","PRO FEE",981,"20525",null,null,975]
[" 1200272","PF CLSD TRT FEMORAL FX W/O MA","PRO FEE",981,"27238",null,null,988]
[" 1200245","PF CLSD TRT FX ORBIT WO M","PRO FEE",981,"21400",null,null,989]
[" 1200438","PF ABD PARACENTESIS/WGUID","PRO FEE",981,"49083",null,null,997]
[" 1202867","REPAIR INT WND 12.6 TO 20.0CM","PRO FEE",981,"12054",null,null,1006]
[" 1202466","PF CLSD TRT REMORAL FX PROX EN","PRO FEE",981,"27230",null,null,1035]
[" 1202869","CLSD TRT ARTICULAR FX W/MANIP","PRO FEE",981,"26742",null,null,1056]
[" 1200202","CRITICAL CARE 1ST HOUR","PRO FEE",981,"99291",null,null,1070]
[" 1200051","PF CLSD TRT DISTAL FIBULA","PRO FEE",981,"27788",null,null,1187]
[" 1200821","PF INJ ANESTH SINGLE INJ","PRO FEE",981,"64450BZ","BZ",null,1187]
[" 1200823","PF INJ ANESTH; OTHR PERIPHERAL","PRO FEE",981,"64450",null,null,1187]
[" 1208002","SCREENING COLONOSCOPY","PRO FEE",981,"G0121",null,null,1212]
[" 1208003","COLONOSCOPY SCREEN HIGH RISK","PRO FEE",981,"G0105",null,null,1212]
[" 1208005","COLONSCOPY SCREENING","PRO FEE",981,"45378",null,null,1212]
[" 1200255","W & L - 2.6CM TO 7.5CM","PRO FEE",981,"13132",null,null,1213]
[" 1200279","THROMBOLYSIS BY IV CORONARY I","PRO FEE",981,"92977",null,null,1268]
[" 1200146","PF CLSD TRT FEMORAL FX W/","PRO FEE",981,"27508",null,null,1270]
[" 1200637","PF ED/CLOSED BIMAL ANK FRACT","PRO FEE",981,"27810",null,null,1283]
[" 1208009","CARPAL TUNNEL AND GUYON DECOMPRESSION","PRO FEE",981,"64721",null,null,1298]
[" 1208004","COLONOSCOPY WITH BIOPSY","PRO FEE",981,"45380",null,null,1333]
[" 1200257","W & L -2.6CM TO 7.5 CM","PRO FEE",981,"13152",null,null,1402]
[" 1200056","PF VAGINAL DELIVERY ONLY","PRO FEE",981,"59409",null,null,1476]
[" 1200071","PF CLSD TRT FEMORAL SHAFT","PRO FEE",981,"27500",null,null,1481]
[" 1200269","FINGER ABSCESS - COMP","PRO FEE",981,"26011",null,null,1531]
[" 1202470","PF CL TX TIB SHFT FX W MANIP","PRO FEE",981,"27752",null,null,1568]
[" 1209470","PF MC TX TIB SHFT FX W MANIP","PRO FEE",981,"27752",null,null,1568]
[" 1200302","PFEXPLORE TRAUM WOUND EXT","PRO FEE",981,"20103",null,null,1573]
[" 1200294","CLSD TRT DISTAL RADIAL FX W/MA","PRO FEE",981,"25605",null,null,1607]
[" 1200151","PF LIGATION MAJ ARTERY EX","PRO FEE",981,"37617",null,null,1953]
[" 1200212","SUBCUTANEOUS-COMPLICATED","PRO FEE",981,"10121",null,null,2078]
[" 1200115","DISLO SLD W/AN","PRO FEE",981,"23655",null,null,2092]
[" 1208007","TRIGGER FINGER DECOMPRESSION","PRO FEE",981,"26055",null,null,2110]
[" 1200069","PF AMP FINGER THUMB DIREC","PRO FEE",981,"26951",null,null,2266]
[" 1208008","REPAIR INCARCERATED VENTRAL HERNIA","PRO FEE",981,"49561",null,null,2335]
[" 1200227","PF INSERT PLEURA DRAINAGE W/O IMAGING","PRO FEE",981,"32556",null,null,2597]
[" 1209227","MC PF INSERT PLEURA GRAINAGE W/O IMAGING","PRO FEE",981,"32556",null,null,2597]
[" 1200236","PF PARTIAL EXCISION DISTAL PHA","PRO FEE",981,"26236",null,null,2653]
[" 1201000","PF CL TX TRIMALL ANKLE FX; W M","PRO FEE",981,"27818",null,null,2947]
[" 1200060","PF HEMORRHOIDECTOMY  INT/","PRO FEE",981,"46255",null,null,3459]
[" 1200054","PF LIGATION ARTERY INT MA","PRO FEE",981,"30920",null,null,3877]
[" 1200053","PF REP TENDON/MUSCLE EXTE","PRO FEE",981,"25270",null,null,4667]
[" 1200822","PF DELIVERY OF PLACENTA","PRO FEE",981,"59414",null,null,4961]
[" 4400122","CL TREADMILL, INTERPRETATION","PRO FEE",982,"93018",null,null,78]
[" 4400144","CL PHYFEE AVULSION NAIL EACH ADD","PRO FEE",982,"11732",null,null,101]
[" 4400123","CL PC OBSV FINAL DAY/DISCH","PRO FEE",982,"99217",null,null,144]
[" 4400145","CL PHYFEE ARTHROCENTESIS ITERM","PRO FEE",982,"20605",null,null,162]
[" 4400124","CL PC INITIAL OBSV LOW","PRO FEE",982,"99218",null,null,188]
[" 4400143","CL PHYFEE AVULSION NAIL PLATE SI","PRO FEE",982,"11730",null,null,201]
[" 4400130","CL PC OBS DAILY CARE LOW","PRO FEE",982,"99224",null,null,211]
[" 4400132","CL PC OBS DAILY VISIT COMPRE","PRO FEE",982,"99226",null,null,213]
[" 4400125","CL PC INITIAL OBSV INTERMEDI","PRO FEE",982,"99219",null,null,256]
[" 4400148","CL PC OBS SAME DAY CARE LOW","PRO FEE",982,"99234",null,null,282]
[" 4409148","MC PC OBS SAME DAY CARE LOW","PRO FEE",982,"99234",null,null,282]
[" 4400131","CL PC DAILY OBS CARE MODERATE","PRO FEE",982,"99225",null,null,285]
[" 4400126","CL PC INITIAL OBSV CARE COMP","PRO FEE",982,"99220",null,null,324]
[" 4400150","CL PC OBS SAME DAY INTERMED","PRO FEE",982,"99235",null,null,375]
[" 4409150","MC PC OBS SAME DAY INTERMED","PRO FEE",982,"99235",null,null,375]
[" 4400152","CL PC OBS SAME DAY COMPLEX","PRO FEE",982,"99236",null,null,472]
[" 4409152","MC PC OBS SAME DAY COMPLEX","PRO FEE",982,"99236",null,null,472]
[" 4400119","CL PHYFEE REPLACE PICC SAME ACCE","PRO FEE",982,"36584",null,null,564]
[" 4400116","CL CONTROL NASAL HEMORRHAGE","PRO FEE",982,"30905",null,null,670]
[" 4400142","CL PHYFEE EXC MALIG LESION 3.1-4","PRO FEE",982,"11624",null,null,738]
[" 4400118","CL PHYFEE PICC INSERT >5YRS","PRO FEE",982,"36569",null,null,901]
[" 4400114","CL PC MANIP/ANEST SLDR JOINT","PRO FEE",982,"23700",null,null,913]
[" 4400115","CL PC CLSD TX TRIMALLEOLAR F","PRO FEE",982,"27818",null,null,1587]
[" 4109112","MC EKG INTERPRETATION AND REPORT","PRO FEE",985,"93010",null,null,59]
[" 4100112","EKG INTERPRETATION AND REPORT","PRO FEE",985,"93010",null,null,60]
[" 4400146","CL PHYFEE DEBRIDE WOUND 20 CM/LE","PRO FEE",987,"97597",null,null,94]
[" 4400133","CL DAILY HOSP CARE, PHYFEE/PHYFEE/LC","PRO FEE",987,"99231",null,null,107]
[" 4409133","MC DAILY HOSP CARE, PHYFEE/PHYFEE/LC","PRO FEE",987,"99231",null,null,107]
[" 4400141","CL DAILY NEWBORN CARE","PRO FEE",987,"99462",null,null,117]
[" 4400136","CL FINAL HOSP CARE/DISCH","PRO FEE",987,"99238",null,null,150]
[" 4409136","MC FINAL HOSP CARE/DISCH","PRO FEE",987,"99238",null,null,150]
[" 4400134","CL DAILY CARE, EPHYFEE/EPHYFEE/MC","PRO FEE",987,"99232",null,null,151]
[" 4409134","MC DAILY CARE, EPHYFEE/EPHYFEE/MC","PRO FEE",987,"99232",null,null,151]
[" 4400160","CL SNF DISCH < 30 MIN","PRO FEE",987,"99315",null,null,162]
[" 4400127","CL INIT HOSP CARE, C/C/LC","PRO FEE",987,"99221",null,null,166]
[" 4409127","MC INIT HOSP CARE, C/C/LC","PRO FEE",987,"99221",null,null,166]
[" 4400137","CL HOSP DISCH>30 MIN","PRO FEE",987,"99239",null,null,188]
[" 4409137","MC HOSP DISCH>30 MIN","PRO FEE",987,"99239",null,null,188]
[" 4400161","CL SNF DISCH > 30 MIN","PRO FEE",987,"99316",null,null,202]
[" 4400135","CL DAILY HOSP CARE, D/D/HC","PRO FEE",987,"99233",null,null,205]
[" 4409135","MC DAILY HOSP CARE, D/D/HC","PRO FEE",987,"99233",null,null,205]
[" 4400128","CL INIT HOSP CARE, C/C/MC","PRO FEE",987,"99222",null,null,225]
[" 4409128","MC INIT HOSP CARE, C/C/MC","PRO FEE",987,"99222",null,null,225]
[" 4400154","CL INIT SNF C/C/MC","PRO FEE",987,"99305",null,null,230]
[" 4400140","CL PHYFEE INITIAL E/M NEWBORN","PRO FEE",987,"99460",null,null,249]
[" 4400147","CL INPT SERV INC ADM/DIS-LOW","PRO FEE",987,"99234",null,null,277]
[" 4409147","MC INPT SERV INC ADM/DIS-LOW","PRO FEE",987,"99234",null,null,277]
[" 4400155","CL INIT SNF C/C/HC","PRO FEE",987,"99306",null,null,294]
[" 4400129","CL INIT HOSP CARE, C/C/HC","PRO FEE",987,"99223",null,null,334]
[" 4409129","MC INIT HOSP CARE, C/C/HC","PRO FEE",987,"99223",null,null,334]
[" 4400149","CL INPT SERV INC ADM/DIS-MOD","PRO FEE",987,"99235",null,null,375]
[" 4409149","MC INPT SERV INC ADM/DIS-MOD","PRO FEE",987,"99235",null,null,375]
[" 4400151","CL INPT SERV INC ADM/DIS-COMP","PRO FEE",987,"99236",null,null,472]
[" 4409151","MC INPT SERV INC ADM/DIS-COMP","PRO FEE",987,"99236",null,null,472]
[" 4400117","CL PHYFEE PICC INSERT <5YRS","PRO FEE",987,"36568",null,null,1081]
[" 4400121","CL VAGINAL DELIVERY ONLY","PRO FEE",987,"59409",null,null,2226]
[" 4001145","PHASE III","OTHER",990,"93798",null,null,5]
[" 5500050","PHASE 3 RESP THERAPY","OTHER",990,null,null,null,6]
[" 2500666","NF-Abilify Tablet 20MG","PHARMACY",null,null,null,null,1]
[" 2500847","NF-Amoxicillin Chewable Tab 200MG","PHARMACY",null,null,null,null,1]
[" 2500907","NF-Tetrahydrozoline HCl Opth Solution 0.","PHARMACY",null,null,null,null,1]
[" 2500935","NF-Tinactin Cream 1%","PHARMACY",null,null,null,null,1]
[" 2500990","NF-Diclofenac Sodium Topical Gel 1%","PHARMACY",null,null,null,null,1]
[" 2501107","NF-Tetrahydrozoline HCl Opth Solution 0.","PHARMACY",null,null,null,null,1]
[" 2501193","NF-Doxylamine-Phenylephrine  Tab 7.5MG-1","PHARMACY",null,null,null,null,1]
[" 2501229","NF-Tetrahydrozoline HCl Opth Solution 0.","PHARMACY",null,null,null,null,1]
[" 2501302","NF-HYDROmorphone HCl-NaCl IV 1MG/ML-0.9%","PHARMACY",null,null,null,null,1]
[" 2501349","NF-Terbinafine HCl Topical Cream 1%","PHARMACY",null,null,null,null,1]
[" 2500691","NF-Xalatan Ophthalmic Solution 0.005%","PHARMACY",null,null,null,null,2]
[" 2500988","NF-Nasacort Allergy 24HR Nasal Spray 55M","PHARMACY",null,null,null,null,3]
[" 2501117","NF-Felodipine Tablet ER 2.5MG","PHARMACY",null,null,null,null,4]
[" 2501371","NF-Rosuvastatin Calcium Oral Tablet 20MG","PHARMACY",null,null,null,null,4]
[" 2501401","NF-Rosuvastatin Calcium Oral Tablet 20MG","PHARMACY",null,null,null,null,4]
[" 2501553","NF-Flonase Nasal Spray 0.05MG/1ACTUATION","PHARMACY",null,null,null,null,4]
[" 2500740","NF-Betamethasone Valerate Cream 0.1%","PHARMACY",null,null,null,null,5]
[" 2501158","NF-Famotidine Tablet 20MG","PHARMACY",null,null,null,null,5]
[" 2501004","NF-Topiramate Oral Capsule 15MG","PHARMACY",null,null,null,null,7]
[" 2501404","NF-Aspirin/Butalbital/Caffeine/Code Caps","PHARMACY",null,null,null,null,7]
[" 2500833","NF-Clotrimazole Troche MM Lozenge 10MG","PHARMACY",null,null,null,null,8]
[" 2501465","NF-Fluocinonide Cream 0.05%","PHARMACY",null,null,null,null,9]
[" 2501295","NF-Irbesartan Oral Tablet 300MG","PHARMACY",null,null,null,null,11]
[" 2501328","NF-Cromolyn Sodium Ophth Solution 4%","PHARMACY",null,null,null,null,11]
[" 2501036","NF-Meloxicam Oral Tablet 15MG","PHARMACY",null,null,null,null,14]
[" 2500774","NF-Methotrexate Injection Solution 25MG/","PHARMACY",null,null,null,null,18]
[" 2500838","NF-Colchicine Oral Capsule 0.6MG","PHARMACY",null,null,null,null,19]
[" 2501130","NF-Aquacel Hydrofiber Dressing Device","PHARMACY",null,null,null,null,19]
[" 2501138","NF-Colchicine Oral Tablet 0.6MG","PHARMACY",null,null,null,null,20]
[" 2500987","NF-Rosuvastatin Calcium Oral Tablet 40MG","PHARMACY",null,null,null,null,26]
[" 2501369","NF-Mirapex Oral Tablet 0.25MG","PHARMACY",null,null,null,null,26]
[" 2501384","NF-Rosuvastatin Oral Tablet 10MG","PHARMACY",null,null,null,null,26]
[" 2501109","NF-Lyrica Oral Capsule 25MG","PHARMACY",null,null,null,null,29]
[" 2501555","NF-Midazolam Hydrochloride Inj Soln 5MG/","PHARMACY",null,null,null,null,30]
[" 2501496","NF-Crestor Tablet 40MG","PHARMACY",null,null,null,null,33]
[" 2501242","NF-terbinafine Oral Tablet 250MG","PHARMACY",null,null,null,null,38]
[" 2501326","NF-Cialis Tablet 5MG","PHARMACY",null,null,null,null,42]
[" 2501377","NF-Solifenacin Succinate Oral Tablet 10M","PHARMACY",null,null,null,null,43]
[" 2501324","NF-Lunesta Tablet 1MG","PHARMACY",null,null,null,null,56]
[" 2501366","NF-Jardiance Oral Tablet 25MG","PHARMACY",null,null,null,null,65]
[" 2501367","NF-Jardiance Oral Tablet 25MG","PHARMACY",null,null,null,null,65]
[" 2501467","NF-SUMAtriptan Succinate Oral Tablet 50M","PHARMACY",null,null,null,null,75]
[" 2500904","NF-Glutamine Powder","PHARMACY",null,null,null,null,79]
[" 2500871","NF-Glutathione Powder","PHARMACY",null,null,null,null,87]
[" 2500909","NF-Calcitonin-Salmon Nasal Spray 200IU/1","PHARMACY",null,null,null,null,96]
[" 2501426","NF-Pataday Ophthalmic Solution 0.2%","PHARMACY",null,null,null,null,161]
[" 2501023","NF-Sildenafil Tablet 25MG","PHARMACY",null,null,null,null,199]
[" 2501182","NF-Spiriva Respimat Inh Spray 1.25MCG/1A","PHARMACY",null,null,null,null,409]
[" 2501288","NF-Butrans Transdermal Patch ER 10MCG/1H","PHARMACY",null,null,null,null,437]
[" 2501045","NF-Cyclosporin A Powder","PHARMACY",null,null,null,null,448]
[" 2501294","NF-Boniva Oral Tablet 150MG","PHARMACY",null,null,null,null,687]
[" 2501150","NF-Pro Comfort Tens Unit Device","PHARMACY",null,null,null,null,1931]
[" 2501278","NF-Pro Comfort Tens Unit Device","PHARMACY",null,null,null,null,1931]

{"sheet":"Sheet2","index":1,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"Sheet3","index":2,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}